Learning in Coda

The difficulty with structuring a curriculum designed for graduating medical students is that our experiences have not been uniform. Since fourth year is comprised mostly of electives, we have all built different strengths and skills. Our last block of medical school is designed to smooth out any deficiencies but as a result, some lectures and small groups are basic for some people and new to others. I attended a small group on working with the difficult patient which was very enlightening because such experiences are common but we often forget to debrief about them. How do you deal with a patient who is demanding, demeaning, uncooperative, clingy, borderline, or unreasonable? Unfortunately, we all get these patients in the hospital, but we aren't trained well to handle them, and subsequently, they may get less-than-ideal care. One of the great psychiatry attendings came to facilitate the discussion because psychiatrists have the best formal training on personality disorders. I also chose small groups dealing with topics like inpatient diabetes management (converting outpatient regiments for inpatient ones, how to manage insulin when someone is not eating, etc), how to survive the first night of call, and ICU basics.

Outside of these small group sessions, I participated on a panel for the upcoming fourth year medical students about applying to preliminary residency programs. The anesthesia department also held a celebratory toast in honor of those who matched this year, inviting third and fourth years to come ask us questions.