During my first OBGYN call, I was interviewing a pregnant lady who we were worried had placental abruption. She was also stressed and worried, understandably. I was asking about her partner (who wasn’t there), and intentionally wanted to screen for any intimate partner violence, but I unintentionally asked “how long have you been together for?”, to which she looked me dead-in-the-eye and snapped, “what the hell does that have to do with anything?”. Silence. I apologized, finished up my history, presented to the resident, told her about this bit, she said ‘don’t worry about it’, and we went back to the patient’s room so my resident could assess her. The patient didn’t want any ‘students’ in there. Oh man. That was in my second week of clerkship. The resident was really nice about it though and ended up giving me some very useful pointers on how to conduct a sensitive history around intimate partner violence after I asked her for tips. I guess sometimes you’ll say things you didn’t intend to during histories and interactions with patients, but learning what to say and what not to say is a process, and part of it is making mistakes, asking for help, and learning from them!

– CC4

 

I asked my preceptor for feedback mid-rotation once and he called me a below average clerk. I then asked him where I would rank in the clerks that he’s worked with and he said I was tied for last. There was a lot of things he said but here are some other things that happened during the interaction: he said that I didn’t walk fast enough so it shows I wasn’t enthusiastic; he imitated what my face looked like when he was giving me feedback and made it seem like I looked like a doofus; said I was such a chill guy that it seemed like I didn’t care. Anyways, moral of the story: you’ll meet some preceptors that will be such a positive influence, and others that just bring you down. Don’t let the negative experiences bring you down like I did, because in the grand scheme of things, their opinion means very little.

– CC4

I was in my IM CTU rotation and I was having a pretty rough time. For context, a full team would consist of one staff, one PGY-2 in IM, two PGY-1’s, potentially an elective student and two CC3’s. I think residents often take their vacation time during the CTU rotation. This resulted in our team actually having no residents—there were a few days where there was just one staff and two CC3’s. I’ll fast forward the details, but this resulted in me making TONS of mistakes. On some days I stayed until 10:00PM (and I wasn’t on call). It even once led to my staff getting short with me in front of many of my colleagues. It was super embarrassing! (Shout out to the resident that I saw me having a rough day and pulled me aside to talk to me). I was feeling down the entire day but decided to capitalize on the situation by asking my staff for feedback so that I could improve. I was sitting with him in a nursing station as he was telling me all the things I could improve on. But as he was telling me, I could feel tears collecting in my eyes. I think he noticed but tried to ignore it. But once the first tear fell, I couldn’t stop crying. I was pretty rattled at the moment and my staff froze because he didn’t know what to do. I wasn’t sure what to do either, so I just picked up all my things as he was talking to me and walked out of the room. He ended up apologizing for being so tough, but his entire demeanour changed throughout the rotation—he ended up being a lot more calm and supportive, spent more time teaching and gave really solid feedback when I asked. I think in the end, he was as embarrassed as I was that he made me cry and things changed when he realized that. Also, there may be tough experiences but you’re definitely not alone in experiencing them.

– CC4

Here is my fail strong story.

This was during my neurosurgery rotation at one of the busy neurosurgery teams in Toronto. It was one of my first nights on call and was with the staff and the senior residents on the neurosurgery team. I was eager to make a positive impression and also wanted to do stuff in the OR.
Of course the staff on for that night asked me what specialty I wanted to go into to which I responded “”neurosurgery or Uber””. He liked this response.
Later on in the night while an A case was being wheeled in for medically refractory increased intracranial pressure the staff asked me if I had ever drilled a burr hole and whether I would like to try.
A burr hole is a key step in opening the skull during a neurosurgical operation. It is done using a hand held drill after the layers of skin and periosteum have been dissected.
I was very flattered to be given this opportunity so early in my rotation and was of course eager to try.
When the time came he gave me a brief explanation of how the most important part of holding the drill is protecting the patient from having the drill go right into the brain (this would be devastating on many levels). Although the drill has an inbuilt mechanism of stopping as soon as it gets through the skull, one still wants to be cautious. To protect the patient you need to apply counter pressure while stabilizing the drill with the other hand (yes the one not holding the drill).

I then took the drill in my right hand and used my left hand to apply counter pressure and stabilize the drill. I then pressed the foot peddle to get the drill going and started to apply pressure. I was listening for the pitch to change to high pitch which would mean I have gone through the skull and would need to stop.
At this moment time slowed down as I was listening for the pitch to change. The staff was right there beside me and all the residents were looking on. And then suddenly the double gloves on my left hand got caught in the drill.
This was not a complication that I had been hoping for and right away took my foot of the peddle and removed the drill.
I was mortified with embarrassment.
The staff was kind – he did not yell at me. He said not to worry and his finished the burr hole using a smaller drill piece and the operation was completed without complication.
This episode was embarrassing for me but at the end of the day the staff’s kind, sensitive and professional response was a key learning experience for how one should respond to mistakes.

– CC4

During clerkship, I went through a breakup with a partner who I’ve been with for close to a decade. It was the hardest thing I’ve encountered yet. I had breakdowns in clinic where I had to step out, and I had to email my staff that I was not able to come in the next day due to a personal crisis. I felt embarrassed that I could not get a hold of myself in the professional setting. And it came as no surprise when I got an email saying that I didn’t pass an exam during this time and had to do extra work as a result. Clerkship is tough and unforgiving of personal life issues. But there are ways to make clerkship better, some of which I wish I knew beforehand such as taking time away from clerkship, or spreading the year over longer periods of time. During difficult times like this, it is extremely important to reach out to your support network, I was lucky that I had amazing friends both in and outside of medicine to fall on.

It is also okay to let your preceptors know about these personal life issues as well. When one of my staff asked me about how I’m doing, I opened up to them, and to my surprise, they were extremely understanding and caring of me as an individual, not just a medical student who works with them. In fact, when I opened up to a staff about this, they in turn opened up about something that had happened in their personal life recently, and in that moment, all the medical hierarchy disappeared and we were just two people caring for one another.

Don’t be afraid to reach out if you need help and are going through something tough. Things within our lives outside of medicine will continue to happen even with clerkship going on. It’s okay if something doesn’t go according to plan, you are not alone – reach out, get help, talk to someone.

– CC4

After morning rounds, I was approached by my staff who I’ve only worked with for one or two shifts prior to this. They brought me aside and said that they were uncomfortable with my attire (I was wearing a loose knit sweater, black tights, and boots) and then asked me to go home to change. So I had to go home after rounds, change, and then return to work. This experience made me doubt myself as a clerk, and it felt like the biggest deal. In hindsight, I realized I can’t control what other people’s perceptions and expectations are – and they will be extraordinarily different with each staff (literally had one staff who always wore jeans). But the only thing I can control is myself, which is to make the best of the situation and slay my outfits in every setting thereafter, as well as trying my best to bring a good attitude to work as well. Because no matter how well you dress, if you have a bad attitude, it still won’t look good.

– CC4

During an OSCE, I had a standardized patient who was Fitzpatrick 0.2 (very pale, light hair, very light eyelashes, lips, etc.) He acted very sick for the station. During the physical exam portion, I started with “Patient looks stated age, looks quite unwell and seems to be in distress, very pale…” Then I wondered whether that was offensive since he’s naturally pale and not because he was sick. Lesson: Know what’s part of the OSCE case.

– CC4

Once, on Gensurg, I was supposed to be on call on a Sunday which I totally forgot about. So I slept in, hit up my fave cafe, sent a snap to my buddy of the cafe, and then got a message from him at noon saying “I’m postcall today, i think you’re supposed to be on today based on the schedule…”. Turns out my name was cut off at the bottom of the schedule and I didn’t check the next page. So I showed up at 14:00 for call, the senior resident laughed, and gave me the option of either just going home (no questions asked) vs. staying for the rest of the night and still taking a full post-call day on Monday. He was very chill about it. I chose the latter. TLDR: Everyone makes mistakes, most services are not built around medical students in order to function, schedule your calls into your i/gcal ahead of time.

– PGY1

At the start of clerkship, I was on pediatric CTU. I was assigned to see a patient in a room of 3 to do a HEADSS history to clarify a few things. in the same room, there was another patient with a very similar name. I ended up taking the history from a 10 year old developmentally delayed child with a metabolic syndrome in for a monthly infusion. When I realized my mistake, I told the family of the child with metabolic syndrome who were quite understanding and I went and did the history for the correct patient. That point really drove home to me the importance of checking patient names before delivering health information or doing an assessment. It also reassured me that we all do make mistakes and that it is important to be honest about our mistakes and remain accountable. I told my preceptor of my mistake as well and instead of admonishing me ,like I had worried, she laughed and shared some initial mistakes she had made when she first started clerkship.

– PGY3

Early on in my CC3 core rotation in Obstectrics and Gynaecology, I received some harshly worded and discouraging feedback from preceptors on my clinical skills in the office setting and on the wards. These situations resulted in a couple of meltdowns in the car after clinic. I didn’t realize how much those words affected me until the mid-rotation feedback session with the site director, who, based on data gathered from her colleagues, expressed concern about my oral presentation skills and my ability to participate on the wards. In fact, they were very concerned that I might not pass the oral exam. I was nearly 80% finished clerkship at this point and this was the first rotation in which I failed to meet expectations. Thankfully, the site director worked with her colleagues to make sure I got extra support for the second half of the rotation. At the time, I felt twofold about the situation: I felt embarrased; it was as though I had a giant beacon on my forehead everytime I walked on to the Labour and Delivery ward, signally to all staff and interprofessional providers that I was the defective clerk who couldn’t pull herself together and who couldn’t effectively produce anything comprehensible when presenting a patient. It was with the encouragement of peers, friends and personal counselling that I could remind myself that I was capable of taking on feedback from the site director and staff, and that although the remaining three weeks of the rotation would be uncomfortable, I needed to remind myself that the best place to push myself out of my comfort zone was in the relatively low-stakes circumstance of being a clinical clerk. I was grateful that my efforts to speak up, learn how to organize my oral presentation skills, and to build my knowledge were recognized by the end of the rotation. The experience in two words? Growing pains.

– CC4