Dr Suzanne Donnelly, Director of Clinical Education
You will find that it is usual for patients to be very obliging, most are delighted to help you learn, and much of clinical training can be very enjoyable. If you find yourself in any situation or encounter which is beyond your capabilities, you must always “ask up” for advice to a qualified team member or member of the ward staff. Recognising the limits of your competence is a key skill of the doctor at every level of practice, it does not represent weakness and will gain you respect as a student. Some situations which may arise include:
- Where you know a patient under the care of your team, you should let the consultant or registrar know immediately and follow their advice.
- Where a patient reveals something which you think may be relevant to their care which is not documented in the clinical notes. Inform a member of the medical team and allow them to judge its importance.
- Do not share “confidences” with patients.
- Never present yourself as a doctor or expert adviser to a patient or their family and correct their perception that you are a doctor if necessary. Patients may presume that you can advise on, for example, whether or not they should take a medication. You must always point out that medical advice must come from their doctor(s) and that you are not yet one.
To make the most of short rotations, get a team member to watch you as you practise your developing skills and to give you feedback on what you can do to improve. UCD clinical tutors have been trained in giving feedback, know the standard to which you should aspire and will advise you on how to reach it. Additionally, take every opportunity to present cases and demonstrate your skills to doctors and your peers and be ready to learn from their comments. Every comment on your skills should help you improve your performance. Make the most of those opportunities.
Recognise When You Need Support
Be aware that you will likely find some aspects of clinical training to be challenging. Sad and upsetting things will happen to people you have come to know, you will realise that medical care cannot always cure and that sometimes doctors and healthcare workers make mistakes. The clinical environment can be stressful for everyone – including students. If at any time you find you are overwhelmingly affected by events or people, or if you just need to talk remember that the Belfield-based student support services are available to you, and that your tutors and clinical supervisors are likely to be able to help put perspective on your experience of difficult or even extreme cases.
A supportive network is vital for all who work in medicine and developing that amongst your classmates, friends or the UCD medicine community is very worthwhile. Just remember to keep all discussions confidential.
Above all, remember that every patient encounter is an opportunity to develop your communication, empathy and caring skills - even if they are not explicitly listed in every module descriptor, they are key themes of the medical programme and vital for your future success as a doctor. Clinical medicine can be exciting, challenging, frustrating, stressful, upsetting and fulfilling in a single day. We are privileged - make the most of your experiences in our clinical training sites and enjoy as you do.