Doctor Skills

Blood pressure, respirations, heart rate, height and weight measurements, eye exam, ear exam, palpation for swollen glands, and an inspection for obvious signs of distress- these are things your doctor can do in their sleep.  Most of the time your doctor probably doesn't even do them- a nurse will in order to save time.  Pretty much everything I just listed any one of you could do with minimal training (except maybe the eye exam).  However, learning these basic clinical skills in the context of what they mean is overwhelming.

At a different school we would have probably started learning basic clinical skills on day one.  Here we take a more traditional approach and focus on learning the underlying physiologic and biochemical processes first.  We were asked to pick partners for this semester’s Doctor-Patient Relationship.  We spend a couple of hours in lecture hearing about the skills we’re going to learn and all of the underlying malfunctions they could show us.  We then get to spend a couple of hours practicing on each other. 

It’s probably obvious to all of you that hearing about a physical skill and actually being semi-decent at that physical skill are totally different.  You can watch kung-fu movies all day long, but you’re going to get your ass handed to you if you try to fight Bruce Lee.  I imagine that watching us struggle in the physical skills lab to do even the most basic things has to be comical to our professors.  We’re supposed to know the anatomy, the biochemistry, and the physiology of the human body by this point so I’m pretty sure the profs like to watch us squirm and try to fake it for a while before they step in and show us how idiotic we’re acting.

Malcolm Gladwell wrote a book about experts and how it takes 10,000 hours to be considered an expert at anything.  His basic premise is that if you want to be good at something, you've got to be willing to put in the work.  According to my estimates, we got in approximately 3000 hours last year. 

~10 hours of studying on a weekday (8 hours of class and 2 hours of review) * 5 days a week
 + ~12 hours of studying for a weekend
 * 47 weeks in a year

Now this is most likely a considerable underestimation of how much we actually study, but I don’t want to be accused of being hyperbolic.  Now think, that was just one year.  We've got 3 more years to go (1 for basic sciences and 2 for clinicals).  As we progress in our studies we’re only going to spend MORE time learning.   So according to my conservative estimate, by the time we’re finished with medical school, we’ll have ~12,000 hours of training/learning.  This doesn't even include the further training we will receive in our intern year or residencies or fellowships.

I want to be that physician who can do this stuff in her sleep.  I want to know this stuff cold, both the physical skills and the underlying knowledge.  Right now I struggle and spend most of my time confused, but I could totally take your blood pressure or do an ear exam.

I’m willing to put in the hours.


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