Trainees II

This is a continuation of yesterday's post (below).

There might be a socioeconomic disparity among patients seen by medical students. For example, homeless clinics are common in many medical schools. They are positive and wonderful entities, providing free care to those who do not have access, giving back to a community, and advancing the education of first and second year medical students. However, I think it is a little disconcerting that we are "learning" on those with low socioeconomic status. The care we deliver is good care so I don't think we're learning at the expense of these patients, but it is interesting that in our health care system, those who fall through the cracks get picked up by trainees.

Similarly, rotations at county hospitals often offer medical students more opportunities to do "hands-on" procedures, and this is sometimes attributed to the patient population. Those with less education may not understand the difference between student, resident, fellow, and attending and have a higher likelihood of having procedures done by a medical student. In my experience, patients who decline having a medical student care for them are better educated and understand the system.

In the vast majority of clinical situations, having a medical student does not lead to suboptimal care; in fact, academic teaching hospitals deliver better care to their patients. But there is a health care disparity that those who have a lower socioeconomic status are more likely to have greater medical student involvement. I'm not sure if this is a problem, but it is something to think about.

My own experience as a student has greatly influenced my attitude as a patient. The more I realize how much I have learned and gained from patients, the stronger I feel that when I am a patient, I want to encourage medical students taking care of me to do more. I have taken care of patients who are physicians or retired physicians, and they often are the ones that teach me the most. Medical students often feel "entitled" to care without trainees, but I would like to encourage my peers to let that nursing student place the IV or the pharmacy student give the vaccine because we understand best how educational and necessary such experiences are.