Third-year medical students spent their first two years of study building a foundation of medical knowledge. Now they are ready to put some of those skills into practice and have marked the special occasion with a ceremony in the University of Cincinnati (UC) College of Medicine last week to celebrate the start of their hospital rotations.
"You now will be entrusted to care for patients,” said Andrew Filak, MD, senior associate dean for academic affairs in the College of Medicine. "Your actions and your attitudes will have an effect on the lives of the patients who present to you.
"One of the strengths of the UC College of Medicine is the hands-on clinical education that you receive,” Filak added. "You have the opportunity to be an active member of the health care team. I encourage you to take full advantage of this opportunity by participating and being actively involved. Get to know your patients. Spend time with them. Listen to their stories. Read about their illnesses and diagnosis and treatment options and actively participate on rounds.”
Filak was among the speakers at the college’s annual Student Clinician Ceremony held Thursday, June 28, 2018, in Kresge Auditorium. The Student Clinician Ceremony, founded by the Arnold P. Gold Foundation, is designed to recognize the important transition to third-year clinical rotations. The ceremony celebrated this milestone while addressing some of the inherent challenges and placed an emphasis on the importance of practicing humanism in medicine and professionalism.
New clinical rotations can be very stressful for students, but they aren’t alone and are part of a team of caregivers and medical professionals at hospitals across the region including UC Medical Center, West Chester Hospital, Cincinnati Children’s, the Cincinnati Department of Veterans Affairs (VA) Medical Center and other health systems.
"I vividly remember the very first patients that I began to follow as a third-year student on my pediatrics rotation—a little girl with brain cancer,” said Filak. "I remember the gentleman who was an expert on Russian porcelains that I followed as a third-year student on the Internal Medicine rotation. I still have a copy of his book. These patients and many others taught me so much.
"I am forever indebted to every patient that I have ever encountered,” added Filak. "Our patients offer so much to us in their time of need and they always deserve our respect and commitment to them. Our patients are our best teachers.”
Filak offered students a bit of advice:
- Wear their white coats proudly, but keep them clean.
- A key to success is to be on time and if you can’t be then come early.
- Tell the truth. If you don’t know the lab results don’t make them up. If you don’t know the answer on rounds admit it and follow with a commitment to look it up and find an answer. Then look it up.
- Smile because that simple act goes a long way with patients. Medical knowledge and skill is necessary, but caring is essential in the healing process.
Richard Lofgren, MD, president and CEO of UC Health, also offered a welcome to the Class of 2020 as members of the UC/UC Health community of medical professionals.
"You are going to be part of a team and you are playing an important role in that team,” said Lofgren. "I realize when you start out it will be awkward and uncomfortable, but you need to be a very active participant. You are part of a team and we welcome you. One of the things as an academic health system that we recognize is that we have a very clear purpose that we are here to advance healing and reduce suffering. Along the way you are going to participate in fulfilling that purpose and fulfilling that obligation to our community.”
Lofgren said even the patient-doctor simulations that College of Medicine students participate in aren’t enough to capture the experience of actually taking care of a real patient. Lofgren echoed Filak’s advice to listen to patients, but also to everyone on the team: mentors, nurses, therapists and other physicians, and to not be afraid to ask questions.
Chief Resident Richard Hoehn, MD, Department of Surgery, reminded students to remember the importance of humanism in all that they do.
"As medical students you are in a great position. You do not have the burden of a pager, putting in orders, billing, or all the things that keep residents and attending physicians busy. That is your future; it is coming, and you’ll get there. For now, you get to spend as much time as you want with your patients.
"Some of my favorite moments in third year were just stopping and talking to people about their life, medical or otherwise,” said Hoehn. "I remember a women I met on my family medicine rotation. I listened to her life story about growing up and growing old in Glendale and I even got her recipe for banana pudding. I was in there so long my family medicine attending physician walked in to see what was going on, which is kind of funny given I went into a profession that likes to do history and physical exams in five minutes or less.”
Hoehn said he also sought out every opportunity to be present for end-of-life discussions.
"This is an area where most physicians are uncomfortable and under-trained. As a medical student you can do nothing more than observe, but that will provide you a world of knowledge,” said Hoehn. "Watch the patient as they come to terms with their cancer diagnosis. Listen to the family when they realize that mom or dad is never coming home again. Learn from the residents and attending physicians who guide these discussions.
"Some will inspire you and others will not,” said Hoehn. "This year I spent four months as the trauma senior resident and I had to deliver horrible, devastating news to families regularly. The way I approached those situations and spoke to those families was the result of years of learning from others, and for you, it starts now.”
Hoehn reminded the students that when they put on the white coat, people offer them trust.
"They tell you everything,” he said. "They want to be heard. They want to be understood. Sometimes they just need more Lisinopril and sometimes they really just need to chat. You are here to learn, so get the most out of the experience. Get to know your patients. Learn from your patients and learn to be a doctor.”
Salima Sewani and Heather Peterson, two fourth-year medical students, read letters filled with advice to third-year medical students from the Class of 2013.
Students recited the class Oath of Professionalism. The Class of 2020 also presented the Optime Magistrum Awards for outstanding teaching in medical courses to Heather Christensen, PhD, Keith Luckett, MD, Laura Wexler, MD, Lisa Kelly, MD, William Naber, MD, Kathryn Wikenheiser-Brokamp, MD, PhD and Margaret Powers-Fletcher, PhD.
Christensen also was presented with a Gold Apple Award while Silver Apple Awards went to Matthew Kelleher, MD, and Dana Sall, MD.