Has anyone else been frustrated by medical student presentations? Why can’t they distill the history down to the helpful parts, rather than repeating every word the family told them? Why can’t they interpret the exam a little, instead of reciting a checklist of normal findings? Why can’t they make an attempt to localize the lesion and then develop a differential diagnosis instead of jumping to the MRI findings?
It struck me the other day that the reason is obvious–no one has ever really taught them what to do. Yes, we give them a background in neuroscience, and Dr. Jensen’s new Integrated Neuroscience course gives them a very good introduction to clinical neurology. However, nowhere do they learn the nuts and bolts of “here’s how you present a case”, until they hit the wards and face our boredom and impatience at their novice efforts.
So, I sat down the other day to write up a page or two on how I’d like cases to be presented on the stroke service. Once I got started, however, mission creep set in and it morphed into a broader editorial on the clinical method stretching to
13 14 pages.
If anyone’s interested, take a look here and give me some feedback on how to make it better. If Drs. Chacon and Jensen like it, I’ll have Mary Beth distribute it to the stroke service students at the beginning of each rotation. Otherwise, I’ll just change the title to “Dr. Sattin’s idiosyncratic expectations for students who happen to be on the stroke service with him”.
Update 10/23/12 0100: I’ve updated the file to reflect the many good suggestions of Dr. Jensen. I continue to welcome additional feedback.