I have two new medical students on my team, their first medicine rotation. It's hard-- although, sadly, not impossible-- to remember when I knew so little. After rounds, I asked them to go back to one of the patients and get a more detailed history.
"So should we pretend we're starting from scratch?"
"What do you mean?"
"Should we pretend we don't know anything he's already said?"
"No... why would you do that?"
"We just thought if you want us to pretend we're starting at the beginning..."
"No, I don't need you to be crazy. The patient knows what he's told us. I just want you to confirm everything and dig a little deeper, get a real sense of his medical history. It's partly for his benefit, and partly for yours. I want you to start seeing the kinds of issues the patients deal with, and start building up some experience in asking the right questions and getting the important information."
"So we shouldn't pretend we've never met him..."
"No, you were just in there ten minutes ago. He met you. You met him. There's no reason to pretend you didn't. Just tell him you want to get a little more history from him."
"And you want us to record it on a phone or something?"
"No... I want you to take some notes, and then write up a summary. You can look at the notes in the computer to see what a note looks like, and try to model your notes after the ones we've been doing. I don't expect your first notes to be perfect, but you'll start to get the hang of it."
"We're allowed to use the computers?"
"Sure. You'll be using them to type up your notes."
"So we're going to be doing this a lot?"
"Yep. I'm going to assign you each a couple of patients, and those will be your personal patients. You'll check on them every morning before rounds, and give the team a report about how they're doing, before we all go in and visit them."
"Like, we don't get to work together? We'll be going in alone?"
"Yep. You won't be making decisions alone, but you'll be going in and gathering information to bring to the team, so we can all talk about what's going on and figure out the treatment plan."
"We don't have to touch them, do we?"
"Uh, sure, you'll be doing physical exams, and hopefully before the end of your rotation, you'll be drawing blood, things like that."
"I don't want to draw blood."
"I don't want to draw blood either. It's part of the job."
"I'm not good at it."
"And that's why you have rotations. So you can learn and get better. I wasn't good at it either. Now I'm slightly less terrible at it. You learn."
"I think I'm going to do radiology or something like that. I don't need to draw blood."
"You're going to have to draw blood."
"I don't want to draw blood from the sick patients."
"You're in a hospital. They're all sick."
"No, you know what I mean."
"Why don't we start with the patient history and we'll go from there."