It’s that time of the year when the curtains come down to a humbling yet demanding career of being medical student. Medical students all around the world are by now either preparing to graduate or are in the process of planning for their clinical rotations. And for those who are lucky or unlucky, depending on where you stand, are still in school trying to demystify what we are taught in classes, study from textbooks or learn during our bedside training in the last years of medical school.
With the next two months being my last days in medical school, I believe I should write up a few tips on how to survive the last years of clinical rotations and hopefully pass on the wisdom. I promise I will make the posts shorter so that I don’t take your time much.
Write everything down, I can’t stress enough the importance of this. You will learn more, ask the important questions and will be ahead of your peers 2-3 years by the time you start working as medical doctor.
Set aside a book for your rotations where you write everything of note. You need to develope your notetaking skills and a system to keep track of everything. For example, this is how I write things down.
Case 1417-4( Patient’s room number and bed)
Male, 52 (Sex,Age)
Hx: Abd. pain @ 10 yrs, worsen 3 days ago, refers to shoulders, cholic stones seen in OPD, no sys. symptoms. No smoking, drinking, cariovascular problems, diabetes or allergies.
Px: Vital signs normal, abd. tenderness on palpation, varicosity and jaundice on inspection, No murphy sign, Liver and spleen unpalpable.
IMx: Ultrasound: Gallbladder stone and inflammation.
Dx: Cholic stone and Chronic Cholecystitis. Reason: Chronic pain, US and tenderness.
Labx: ↓ Albumin.
Mgx: Surgery. Procedure: Open Cholecystomy
Pre-Op: All lab test normal, informed consent and cleared for operation. No food; give glucose, antibiotics for prophylaxis, and Enema for GI decompression.
Op: Small gallbladder 60mm*30mm with clear border below the right lobe of liver, Ligation of cystic artery and duct, removal of gallblader, combination of pigmented and yellow stones noted.
Post-op: No food for one day, give fluids 40ml/kg and glucose 20Kcal/Kg, PPIs and antibiotics.
Post-op care: No complications, suture removal on day 8.
That is how a typical notesheet should look like, you can write more details or less detail as you see fit. Only write down what the patient or professor tells you, Don’t prob for more details as you will look more intrusive or worse, the professor has more patients to attend to. Solicit more details from senior students or residents or better, finish your notes from the case folders or the computer. If in Chinese, ask for permission if you can take it in your flash drive and later translate it using Google Translate. Keep the privacy of the patients and don’t write or distribute identifying details.
For now, that’s all I could come up. Tomorrow, I will talk about medical abbreviations as they will help you write less for more and save you time in the process.