Lessons From My First Patients

Through the International-Inner City-Rural Preceptorship (I2CRP) Honors Program at my school, I have had the unique opportunity to help provide interdisciplinary health care in a year-long longitudinal clinical experience at Crossover Enhanced Teaching Practice Clinic. In this experience, I have worked collaboratively with attending physicians, pharmacy attendings, pharmacy students, and Spanish language interpreters. On a biweekly basis, I have addressed patient concerns and learned about the practice of medicine simultaneously. Initially, as a second semester first year student, I was overwhelmed by the amount of responsibility that I was charged with in the scope of the patient’s care. Nevertheless, I grew to love the people I worked with and enjoyed the challenge of actually applying the clinical skills that I learned in my Foundations of Clinical Medicine course to real patients with complex social histories, multiple chief complaints, and often various chronic diseases.

During each evening clinic, my pharmacy partner and I worked together to review the patient’s chart and take the patient’s vital signs before entering the exam room. We would then ask questions to ascertain why the patient came to the clinic and subsequently work to effectively address the patient’s health problems. Afterwards, we would perform the relevant physical exams and on-site lab tests then finally present our joint assessment and plan for the patient to the attending physician and pharmacist. I valued finding real-life connections between the diseases I learned in my preclinical courses and the presentations I saw in my patients. Nevertheless, I wanted to go beyond the disease presentations of my patients and have enjoyed getting a glimpse into my patients’ lives.

Since the second semester of my first year, I have met patients from diverse cultural backgrounds and different life circumstances. Some of my patients have been relatively healthy and only needed refill prescriptions and follow-up appointments to maintain their current health status. Others were chronic disease patients who needed adjustments in their management of hypertension and diabetes because their families have hit a rough spot financially or the patients did not have the means to change their lifestyles. Moreover, I have interacted with patients who were distrustful of health care in general and just wanted each visit to be as short as possible. People may have come to the clinic with similar complaints, but how they experienced their disease or health issue significantly impacted how I approached treatment options and health education counseling for that individual patient.

With my last preclinical course exam in May and the biggest test of them all in June, I am looking forward to my third year rotations. From my year-long clinical experience at Crossover, I know that my rotations will have even more to offer me in terms of interactive, hands-on learning. It will most likely be a whirlwind, learning how to use an electronic medical record, navigating the various hospitals, and adapting to different team structures and practice models, but it will be a 12-month adventure of patient encounters that really are the heart of medicine.