Case 1
Resident role:
You are the PGY 3 this month on service and on your team is a 3rd year medical student
doing his/her first clinical rotation. The student routinely comes late to rounds, has
missed a few days of the rotation and the intern has complained that the student has not
been consistently completing patient care related tasks (i.e. checking on labs, calling in
consults, calling private attendings).
The student often comes to rounds with helpful articles and makes thorough and
organized case presentations. The student asks very astute academic questions but often
doesn’t have the latest clinical information on the patient.
You asked the student to meet with you for a few minutes after rounds to discuss how
things are going on the service this month.
Case 1
Student role:
This is your first clinical clerkship. You have found being in the hospital every day
stressful for a variety of reasons. You’ve never been around people who are very ill and
it makes you uneasy. You are not really sure what is expected of you and the housestaff
seem very busy and inpatient with your lack of experience and practical knowledge.
They have not been that helpful in answering your questions or in teaching you
procedures.
You have always been a very good student and feel much more comfortable with book
learning. A fourth year student you know told you that the residents really like the med
student to bring in relevant articles and that studying for the shelf exam is really
important. So you have focused your energies into doing literature searches on the
patients’ problems, reading a lot and writing good patient write-ups.
You realize that you have a problem with lateness. It’s never affected your schoolwork,
however, because you never found lectures all that useful anyway.
Case 2 – Resident Role
You are a PGY 3 on a ward team. There is a 3rd year medical student assigned to your
team that you have been working with for two weeks. The student is a hard worker, very
intelligent with good analytical skills and actively involved in the care of all of his/her
patients. The student participates actively in clinical discussions but sometimes quotes
studies and medical facts that later turn out to be inaccurate. The student is a bit of a
“know it all” and the intern has been getting a little irritated with the way in which the
student questions her medical knowledge. In addition, the nursing supervisor called you
last week after the medical student raised his/her voice to a nurse at the nursing station,
questioning the nurse’s competence.
Case 2 - Student role:
You are doing a clerkship in a specialty that you are very interested in. You are really
enjoying the month but there is so much to know and so much information to keep track
of about each patient. Everyone seems to know more than you do. But you’ll never
admit that to anyone. You are often embarrassed to ask for help or admit that you don’t
know something for fear that your colleagues will think less of you. You work very hard
to help take care of the patients that you are following and you think that your intern
really appreciates it.
You can get very impatient with others when things don’t go as planned or if you are
unsure about what to do. More than once you have snapped at the nurses when they
haven’t provided you felt was the best care for the patient.
Case 3 - Resident role:
You are the resident for the ward team and one of your interns has been assigned a 3rd
year medical student. The student has been working with your team for a little over a
week. You need to give this student feedback about some of the problems that you have
observed during his/her rotation. The student is very intelligent, his/her case
presentations and notes in the chart are thorough and he/she participates actively in
rounds yet often makes derogatory comments about patients who are minorities, or who
have alternative lifestyles. You are meeting with the student following today’s noon
conference. You realize that you really don’t like this student and are not looking
forward to speaking with him/her.
Case 3 - Student Role:
You are a 3rd year medical student and the resident supervising your team has asked to
speak with you after the noon conference. You get the feeling that the resident doesn’t
like you very much and you are nervous.
You have always wanted to be a doctor and genuinely want to help people. Even though
you grew up in New York City, you have been very sheltered by your family and have
always lived at home. You recognize that your parents and extended family are very
politically and socially conservative and that many others in the medical setting do not
share their views. You are feeling a bit conflicted about this but haven’t dealt with the
issue head on. You do feel confident in your fund of knowledge and your ability to take
care of patients.