Imagine you are a first-year medical student and just moved across the country to start your training. It is a stressful time, adjusting to a new city, a school, and new people.
Such was the start of clerkship, lost in a sea of paperwork and bureaucracy. A mountain of bookkeeping distributed to each student: due dates, boxes to check, requirements to fulfill and all with the threat of expulsion if any part was deemed incomplete. I understand the need to track what we experience for assessment, but the framing and focus of this introduction emphasized what should be a secondary to our learning.
“What can you do here that we can’t do at home?” This question angered my resident. How dare a patient admitted to the hospital ask for justification of their plan? The progress note had already been written and orders entered; assent to the plan was assumed and having to walk the patient through the options would extend rounds considerably. What an inconvenience.