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FCM, Pharmacology, and First Day in the Clinic

Posted Oct 23 2008 2:04pm
We had another Foundations of Clinical Medicine (FCM) session today. It was on paying for health care, and we had to go over to Case. I thought the point of it was going to be for us to work with the UP students. But instead, we all just sat together in a huge lecture hall and listened to a couple of physicians talk about the problems with health care in America, and then a patient with sickle-cell anemia spoke about the problems she had with getting health insurance as a chronically ill person. The patient's part of the talk was the most useful as far as giving me things to think about. Afterward, we broke up into our usual small groups, so that the CCLCM students were with the CCLCM students and the UP students were with the UP students. Not only was that disappointing, but it was also kind of awkward for us to be there all dressed up like we were, considering that the UP students wear jeans, t-shirts and sweat shirts. We definitely stuck out like a sore thumb. Those of us with clinics today (about a quarter of the CCLCM class, including me) were particularly dressed up, like shirt-and-tie kind of dressed up. We weren't wearing our white coats, but still. Speaking of dressing up, I have to admit that I was kind of surprised that the UP students were not dressed up, actually. If that same patient had come over to CCF to speak to just the CCLCM students, we would all have had to not only be dressed up, but also wearing our white coats. It's interesting how different the conventions are at CCF versus just a mile down the road at Case.

At the end of the small group session, we went back to the LRI, and then half of the class did an electrophysiology lab while the other half had a pharmacology seminar. I had pharm today. We'll switch on Friday, so that's when I'll be doing the electrophysiology lab. I normally really like pharm, but somehow I just felt distracted today and it was hard to pay attention. I think maybe my mind was on it being my first day in the clinic.

I have an hour in between finishing my classes at noon and starting clinic at 1 PM. There was a lawyer who came over from Case and to give a brief talk (sponsored by the American Medical Student Association, I think) about racially based medicine. It was interesting, but not nearly as controversial as I had expected it to be. I had to leave early so that I'd have time to get to the clinic. I already knew where to go because I had gone over there once before to make sure I could find it. People have clinics all over town, pretty much. Some people are way far out, like an hour drive away, and others were lucky enough to have clinic on campus. Thankfully, I am in the second group.

My preceptor is an internist, and today was mostly a shadowing day. Next week we are going to be learning how to do things like take blood pressure during our clinical skills class, and I think we will be practicing interviewing standardized patients too. Then in two weeks when I go back to the clinic, I'll be doing those same things for real with patients. I am supposed to see four patients each session, two with my preceptor and two by myself, and I have to keep a log of each patient that I see. My preceptor was encouraging me today to ask patients the difficult questions, meaning subjects that are normally awkward to talk about with perfect strangers like sexual history, or if it was a woman, about any physical abuse. I was kind of amazed at how directly my preceptor asked the couple of women we saw today about whether they were being abused. Apparently sometimes a woman really will just start confiding about abuse when she is asked about it bluntly like that. Apparently sometimes also patients will tell students things that they don't tell their doctors. I hope I won't be finding out more than I can handle hearing! At any rate, I think I am going to be learning an awful lot over the next two years, and I also think that I got a really good preceptor. Like I said before, this is the reason why I am in medical school.
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