Teaching hospitals

A few days ago, I overheard a conversation at work. One of the other medical students was speaking to my research mentor’s secretary, and the gist of the conversation, to which both the medical student and the secretary seemed to agree, was this: “I try to avoid going to teaching hospitals for my medical care because I don’t want medical students and residents to ‘practice’ on me.”

I’m not going to pretend that medical students, residents, and other trainees know what they’re doing, and I acknowledge that people have the right to choose who takes care of them. I concede that health is an important thing, and that it shouldn’t be entrusted to just anyone; healthcare isn’t something to be toyed with or taken lightly. Even still, this sentiment doesn’t quite sit right with me, especially coming from someone who is, herself, a medical student.

First of all, teaching hospitals (especially those at major academic medical centers) tend to be at the bleeding edge of medical technology and to offer the most advanced techniques and therapies available. These are places that worry a great deal about their reputations and have the resources to attract the most prestigious, most top-of-their-game staff members. This is why the rich and famous tend to seek out these academic teaching hospitals for the various surgeries and other procedures that they may need.

Secondly, while there will be trainees running around who will have some responsibility in your care, nothing is done without the oversight of a full-fledged attending physician. It’s true that medical students or residents may be given the opportunity to “practice” on the patients, but the attendings will do their best not to put you in any real danger. In fact, many patients volunteer for trainees to practice simple procedures on them (for example, drawing blood or taking a blood pressure), because they want to give back to society for the wonderful care they’ve received. Furthermore, with so many trainees around, there will be more people looking at and talking about your case. Attendings are human, too, and sometimes they miss things just like everyone else. At a teaching hospital, medical students and residents are around and can potentially catch their attendings’ mistakes.

Lastly, and perhaps most importantly, you’re a medical student! You’re going to be poking and prodding and practicing on hundreds of patients before you feel like you know what you’re doing! How can you expect other people to allow you to practice on them, when you’re not even willing to have it done to you?

3 thoughts on “Teaching hospitals

  1. It’s sad to see that medical students themselves could have this attitude! How do they expect to get the most out of their learning if they don’t practise.
    I understand ‘trainees’ might be scary in that field but is it really different to any other ‘apprentice’… we let apprentices on our hair, our houses and our cars so why not our bodies? We all gotta learn somehow.

  2. I understand the sentiments, so it was good news to hear that med students in our country have a doll to practise on. A pretty high tech doll that could speak back to you and generate all sorts of problems with its body, you can even sew its skin up lol. Apparently very human like.

    I believe med students will do their best, but I’ve also heard about how some are so horrible. This new graduate my sister worked with was doing all sorts of things everyday that could take lives.

    I guess what I’m trying to say is, it’s reasonable for people to doubt the ability of trainees. If you were charged with a crime, would you want a new law school graduate to defend you (they will also have supervising senior counsels), or would you like someone with more experience? Even as a law student I probably wouldn’t trust my classmates. :P

    • I think the biggest problem I had with this conversation was just that it was coming from another medical student. This was someone who is allegedly about to devote her life to serving others, and who will be practicing on a lot of other people throughout her career before she’s ready to be a “real” doctor. It’s an extremely hypocritical way of thinking.

      Let me be clear, though. As medical students, we do get a lot of practice with standardized patients (basically actors pretending to be patients), we practice basic exam skills on each other, and we also have various simulators (including something like the one you described). Medical students also have almost no role in taking care of patients, and in fact, we’re only allowed to write in one part of the patient’s chart: the social history.

      Residents get a little more responsibility, but again, not without oversight and never without having to report to an attending, so it’s a little different from relying on a new law school graduate to handle your case.

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