Big Man on Campus

Now that I am one week into my senior year of medical school, I can say with some confidence that feels quite different from my experiences as a (lowly) third year medical student. It is a great pleasure to work with third year students: not only is it enjoyable to teach and feel like one is helping someone else, but it is also gratifying to see how far we have come in developing clinical skills and a nascent ability to survive Medicine. The emphasis changes from surviving the wards (and the requisite clerkship exams for each specialty) to thriving as a young doctor. I am currently spending four weeks on a sub-internship, a trial where the fourth year medical student takes on the role of a first year resident with matching responsibilities, in my field of choice: Neurology. Clinical instructors often use the acronym “RIME” to represent the four stages of a medical student’s evolution: reporter, interpreter, manager, and educator. Most of a third year medical student’s responsibilities and expectations involve accurate reporting of history, physical examination findings, and laboratory and imaging findings as well as the development of clinical diagnosis skills (interpretation). Now, as a fourth year and a sub-I, I’m taking on more responsibilities as a manager (making treatment decisions and requesting studies) and an educator (teaching students, and occasionally residents, with less experience in a particular area).

On a personal note, I’m enjoying revisiting my field of interest after a one year absence and solidifying my fund of knowledge. I’m more confident now in my examination skills, assessments, and gut feeling. I’m also developing confidence and comfort in the notion that sometimes I know more than an intern and sometimes second-year residents: they’re not necessarily far from my present state of knowledge. Maybe next time I’ll even be confident enough when I hear someone with more experience than me ask “Which side?” when discussing an anterior communicating artery aneurysm to respond, “What do you mean? There’s only one.”

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