MEDICAL STUDENT
TRANSITION COURSE
Professionalism in the
Clinical Environment
ANTHONY A. MEYER, MD, PHD
CHAIRMAN, DEPARTMENT OF SURGERY
UNIVERSITY OF NORTH CAROLINA
Beginning Clinical Clerkships
Remarkable Opportunity
New Challenge
Unprecedented Responsibility
Start of Your Clinical Career
Change In Focus
Up to now – Focus has been on the
student
Clinical Care – Focus is on the
patient
You are part of a team to help the
patient – the patient is not here for
you to learn
Clinical Clerkship Service Rotations
Each service is different
Patient mix and diseases
Number and level of residents
Number of faculty and clinical activity
Workload
Time schedule
Service structure developed to meet
patient needs and other requirements
General Learning Goals
for Clerkship
Acquisition of knowledge and skills
Integration of knowledge and skills
Application of knowledge and skills
Additional Learning Goals
 Patient Interaction (active participation in care
and responsibility)
 Staff Interaction (roles & respect)
 Colleague, Resident and Faculty Interaction
(collaboration & respect)
Patient Interaction
Early on, you may be uncomfortable
Your patients will have varying comfort with
students
A few patients may not want student
involvement
Many patients are frightened, have pain, are in a
new experience
Don’t personalize negative experiences
Try to put yourself in the patient’s situation
Ask yourself, what if it was my ________
Resident Interaction
Closest to you in age, background and
experience
You will learn much from them
More advanced than you, but still in
training
Residents’ primary responsibilities are
their education and patient care
If you have concerns, speak with the
clerkship director
Hospital Staff Interaction
Respect all people who participate directly
and indirectly in the care of patients
You can learn a great deal from the
hospital staff
Remember that competence, intelligence
and contribution to patient care are not
determined by academic degree
Realize that you have a common goal –
providing the best possible patient care
Faculty Interaction
All are interested in teaching but have
different roles and styles
Varying other responsibilities
Different schedules of patient care
Different stages in their careers
Don’t hesitate to approach them
If you have concerns, speak to the
clerkship director or department chair
3rd Year Medical Students
Responsibilities & Roles
Different teams have different responsibilities for
students
You start as the least experienced person on the
team
Find out your responsibilities (some explained,
some assumed)
Learn and perform your role before you start
another
If it’s your responsibility, make sure it is
accomplished
Accepting responsibility for patient care is one of the
first steps to being a physician
Feedback to Medical Students
Variable in amount and form
Comes from Faculty, residents, peers, and staff
It is not always announced
It’s not always verbal
It is not always positive
Use it to improve, not just to feel good
Don’t hesitate to ask for feedback
Traditions in Medicine
Traditions are present in all societies and
professions
Contribute to professionalism and ethics
Often hard to understand
Respect traditions, but remember the patient is
always most important
It is your activity and commitment over a career
that will create new traditions
Professionalism
Dedication to others
Commitment to excellence
Performance standards
Behavior standards
Respect for all
Confidentiality
How should I Act?
What should I do?
Treat patients like you want your family
members treated
Show respect, courtesy and civility toward
everyone
Observe and learn from others
Look and act like a physician
If you’re not sure, ask
Seek out opportunities to help
Enjoy what you are doing
Important Things To Consider
Patient care and learning are not
“like on the TV medical shows”
Medicine is a humbling profession
Be part of a patient care team
Allow yourself to feel
Act professionally
Learn from everything and everyone,
even when not being taught
Transition to Clerkship
- SUMMARY Exciting
Challenging
Demanding
Period of incredible growth
Opportunity to be part of one
the greatest professions