Student Corner Stories and Lessons

I was entering my third year of medical school when my brother’s friend called me, saying “I think your brother has schizophrenia.” I packed my suitcase and headed home. The plan was to get him a psychiatry referral and start him on medications. Easy, right?

A medical student with type 1 diabetes has to develop workarounds for her surgical rotation, choose her specialty carefully…and decide whether, when, and how to disclose her condition to her educators and to patients.

Despite having conducted numerous speculum exams, the medical student had yet to submit to her own first pelvic exam. In college, she had been sexually assaulted in her dorm room, and the idea of the exam brought up ferocious anxiety, metallic bile, fear, and refusal.

William was smoking on the shelter’s porch the day we met, looking like hell. When I introduced myself, he exhaled a brick of smoke into my face. I would need to earn his trust. But over time, William would lay the foundation for my education in patient care.

There was an improbable air of intrigue about the black 1997 Camry I’d inherited from my mother. As I packed it for my trip to Baltimore to begin medical school, I began rediscovering its quirks

Despite the tricks in our practice exam questions, I would always nail ones about depression — if you looked hard enough, it was always hidden somewhere. But despite my finely honed detective skills, I missed the diagnosis in a real patient with obvious symptoms.

Being observed changes us and can reinforce or reverse a power dynamic. A dentist-turned-medical-student, finding herself jittery as she examines a standardized patient, more fully understands the experiences of her incarcerated dental patients.

A medical student receives a call from his physician father, whose voice is heavy and calm. There is news, unfortunately. A mass. He speaks with the same quiet reserve and scientific openness to fact that have made him a good physician. 

Last August, a fourth-year medical student ended her life by jumping out of a window. In the aftermath, other students expressed rage over not feeling adequately supported, indicating that they were also struggling with depressionanxiety, and suicidal ideation.

Standardized patients prepare like actors learning a role, but they are also educators, and no one else in medical school is positioned to give students a patient's-eye view of the doctor–patient relationship.

Since social problems affect health and treatment effectiveness, considering them in assessments and treatment plans should improve outcomes, reduce costs, and improve patient satisfaction. How should clinicians learn to explore and address social determinants of health?

When a patient at a U.S. teaching hospital says she wants no trainees involved in her care, do we tell her to go elsewhere? Transfer her to the nonteaching service? Or somehow convince her that she will receive better care on the teaching service?

Nostalgic for the bad old days of her own training, a physician wonders how, lacking the satisfactions and pleasures of taking responsibility for patients during absurdly long shifts, today’s trainees will learn key lessons about what it means to be a doctor.

When we become obsessed with finding the right answer, at the risk of oversimplifying the richly iterative and evolutionary nature of clinical reasoning, the result is the very antithesis of humanistic, individualized patient-centered care.