Medical Education - Page 4
As a clerk in medicine the student will rotate
among various outpatient clinics and
become familiar with groups of diseases that are
classified as cardiovascular, allergic,
infectious, rheumatic, neurological,
gastrointestinal, and dermatological. Teaching clin-
ics in these subspecialties are conducted by
members of the medical school's faculty.
Short periods of time (several weeks each) are
usually allotted to otolaryngology
(diseases of the ear and throat) and
ophthalmology. The student learns the basic diag-
nostic techniques in these specialties and has
an opportunity to study the medical and
surgical treatments used in these
areas.
The clerkship in surgery enables the student to
apply their newly acquired diagnostical
training. The student gains insight into the
process of determining when an operation is
required as well as the need for pre- and
post-surgical care. If assigned to the emergency
room, he or she may have an opportunity to
perform, under supervision, minor surgery
such as treatment for infections of fingers,
draining of abscesses, or suturing of lacerations.
Many institutions offer as an elective a course
in operative surgery where animals are
treated as patients. Participation by the
third-year student in such a program provides him
or her with an opportunity for training as a
surgeon, first assistant, scrub nurse, and anes-
thetist.
The student develops a foundation in the
physiology of the human female in the
first year and in pathology of diseases of the
female urogenital system in the second
year; he or she is now prepared for clinical
work in gynecological diseases, and during
the third year, the student participates in
conferences, ward rounds, lectures, surgery,
and outpatient clinics. It is quite common for
the student to deliver about a half dozen
babies. These deliveries are naturally
performed under the close supervision of a resi-
dent in obstetrics. Aside from the training in
childbirth, the student learns about the
medical and emotional problems of prenatal
care. In the outpatient obstetric clinic the
student has the opportunity to examine and
counsel women in pregnancy. This provides
an especially favorable opportunity to develop
skills in doctor-patient relationships.
The clerkship in pediatrics is devoted to the
study of children and their diseases.
The life span covered is from shortly after
birth to adolescence. The student is taught to
recognize the need not only for diagnosis of
the pediatric diseases but to anticipate them
and thus better help to ensure that the child
will develop into a healthy adult. The prepa-
ration for the pediatric clerkship is
frequently initiated in the latter part of the second
year with lectures and some clinical experience
in the fundamentals, such as heart
sounds, X-rays, and EEGs of infants and
children. Work in the clinics and wards
becomes more intensive in the third year when
the student is exposed to varied medical
and surgical problems of children's diseases.
The fourth year provides additional oppor-
tunity for pediatric training along with
greater responsibility.
During the third year, the student-instructor
relationship becomes more personalized
and an exchange of views begins to take place;
the student assumes the status of a junior
colleague. The junior medical student's
responsibilities are carefully demarcated and essen-
tially restricted to taking medical history and
carrying out a physical examination. The
acute illnesses students see in the wards and
the explicit problems they handle in the clinics
are often "classical," and therefore students
are free from the necessity of coping with diag-
nostic and therapeutic uncertainties that fall
outside their limited area of knowledge.
The Fourth Year
In the fourth year, the student's activities
are frequently divided into four quarters. One
is devoted to surgery (including general,
orthopedic, and urological), another to medi-
cine, a third to pediatrics, psychiatry,
neurology, and radiology, and a fourth to elective
study. There is usually considerable latitude
in the arrangement of the order in which
the program may be carried out.
In the surgical clerkship, seniors may
frequently be assigned their own cases. They
will, under careful supervision, be responsible
for the patient workup, help arrange for
laboratory tests, and contribute to discussions
involving the diagnosis. Students will
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