Experienced physicians know there’s a lot about practicing medicine that doctors-to-be don’t learn in med school. The only way for students to truly learn the ins and outs is to engage in some on-site training… and somebody’s got to give it to them.
Many docs are hesitant to bring students on board, feeling that working them into their usual routines is an inconvenience. But doing some teaching is kind of your karmic duty.
You learned from established physicians during your school days – now it’s your turn to return the favor. And if you go about it properly, incorporating students into your practice isn’t that painful at all.
Ace the Selection
One of the benefits of running your own practice is choosing which students do and don’t obtain the privilege of learning in your office. You may feel pressure from your patients or colleagues to bring their student kin in as learners, but you’re under no obligation to do so.
In this situation, you’re allowed to (and should) be as choosy as you like; a student who’s around a lot will come to represent your practice as an employee would. But bringing a student into your practice is an all-around goodwill gesture, so do be open to suggestions from people you know and trust.
It’s wise to formally interview all student-learner candidates before agreeing to enter into a mentor/mentee relationship. Ask students about their previous clinical experiences and short-term and long-term goals. Suss out whether you think they’d be a good fit for your practice’s culture, as you would any hire.
Once you’ve chosen a student to bring in, decide on a fixed schedule and term length for their learning stint or formal rotation with you. That way you’re not tied down past a certain timeframe should your professional relationship with a med student turn sour.
Orient the Student
Before allowing the student to take part in your clinical process, put him or her through the same orientation you’d engage in with any new employee. Have your office manager show the student around, explain your office policies and get the appropriate privacy and liability paperwork signed.
After that, expose the student to all of your office processes. Consider having the student go through your office as a patient would and receive a mini-orientation from the appropriate staffer in each area. You can even schedule it into the day’s calendar.
At registration, your front desk attendant walks the student through your PM system or check-in kiosk. Then your nurse shows off the basics of the exam room; you go through your charting process or EHR; your lab technician details the tests you perform on site, and your billing department discuss charges and superbills.
Once the student has gone through it all, sit down with him or her to decide on learning objectives, discuss the student’s comfort level in patient care and establish what tasks you’re comfortable having him or her handle for you (such as performing some basic consultations or taking patient vitals).
Orient Your Patients
Don’t let the presence of a med student at your office be a surprise for your patients – their comfort level matters, too.
Hanging a notice in your waiting room, perhaps even with the student’s picture on it, is a good way to introduce the student to your patients before actually introducing the student to your patients. It’s also prudent to have a flyer handed to patients at reception directly informing them your practice is a ‘teaching facility.’
Let them know in the document that you may have a student accompanying you into the exam room, and list any and all duties you may relegate to the student during the appointment. Also, let patients know to inform your front desk attendant if they’d rather opt out from having the student involved in their care.
This way, a patient doesn’t feel rude for shooing the student out of the exam room or pressured when you ask in person if he or she is comfortable having the student present (though you still should ask at the start of the visit).
Let It Be About Learning
After the patient encounters that you and the student engage in together, take a few moments to reflect on the patient’s condition and the events of the visit. Even just a quick recap and explanation of why you prescribed a certain medication are informative for a student.
Don’t feel the need to go into full-on ‘teacher mode’ to impart knowledge. Go about your business as usual and encourage the student to learn from your example. Additionally, open up avenues for the student to help you and expand his or her knowledge in the process. Consider this scenario:
“A patient who recently started on an antipsychotic medication comes in with palpitations,” writes Dr. Dawn E. DeWitt, MD, MSc. “Have the student review the medication’s side effects and bring the information back to you. Both you and the student will learn something and the student will have the satisfaction of being truly helpful.”
As time goes on, increase the amount of autonomy you give the student. Let him perform follow-up calls with patients he’s already seen – or even follow-up visits. Have him perform a ‘pre-consultation for a complicated case, then report his assessments to you (in front of the patient) before you make an official diagnosis.
Considering the ensuing doctor shortage, physicians should do all they can to foster growth and excellence in the up-and-coming doc population. It may be difficult to work a student into your practice at first, but soon enough it will feel as normal as ever.
And not only will mentoring improve your karma, but it may also help you recruit that student-turned-doctor to your practice down the road.
Do you have student learners in your practice? How do they affect your workflow?
