The “Practice” of Medicine

Anyone becoming a doctor will at some point be told by a reluctant patient, “You're not practicing on me,” or “I'm not having a medical student or a resident learning on me.” Usually, what ensues is a cowardly exodus of the trainee from the patient's room, a quick plea to the attending physician, and either 1 of 2 scenarios: The trainee is demoted to observer status, with a visceral feeling of humiliation, or the attending physician makes the compelling argument to the patient that training in medicine is necessary and the patient concedes, leaving the poor trainee even more apprehensive and anxious than he or she was before. Occasionally, hospital administrators declare patients VIPs and exempt them from a teaching service. Countless times I have been looked at by patients who saw themselves as “volunteers” about to endure various trial-and-error experiments to further my education. These experiences caused me to question whether my role as a student was contributing in any way to the patient's overall care.

The reactions of these patients remind me of my own experience as a patient on a teaching service. While attempting to master the urea cycle for my upcoming MCAT, I managed to drink enough caffeine to develop atrial fibrillation. At a nearby teaching hospital, I was asked my medical history several times by multiple people. While in the emergency room, I was subjected to 2 rectal exams by 2 different students. At the time, I did not …