Medical Miseducation, Part 3

Initially appeared on doktorko.com on 12/3/2005.

At the beginning of Clerkship, our school chaplain - in an astounding piece of spin - related "Clinical Clerks" to "clerics," likening us to members of the clergy who were appointed with the divine task of attending to patients.  This of course bolstered our spirits, but later on we learned the truth - that "clerks" were really just clerks - that is, people who were charged with keeping records, filing, and other busy work.

One of our main responsibilities was keeping our charts in order.  We were expected to place labs in the proper place, update the medicine sheets, do drug indexes, etc.  As with our other responsibilities, this was passed off as being one of our more important "medical" tasks and therefore something we should do with gusto.  It never happened to me personally, but i had heard of horror stories when the Despot would do rounds and toss un-arranged charts out the window for the hapless clerk to go out and collect with a lesson learned.  This is unethical (and probably illegal) in more ways than one; for example - would you want to be the patient whose chart gets thrown out the window and whose positive HIV test gets exposed for the world to see?  Of course if that ever happened, i guess it would be the clerk's fault and he'd receive one million demerits and keep on arranging charts until the end of time.

All this fostered was a deepening sense of fear and anxiety and a redirection towards mindless clerical (see?) duties versus any real medical and clinical learning.  Before rounds we would scramble about making sure the charts were arranged and all the notes were filled in - regardless of the quality of the content.  This promoted an attitude geared towards quantity versus quality.  Something which i personally can blame for me not knowing enough about medicine when i entered Residency.

Other "medical" tasks we were required to do were push stretchers around ourselves and run downstairs for lab results and radiology films.  We were essentially arms and legs for the residents and consultants - who, while they had their own troubles - mostly made it a point to make it clear that we were the lowest forms of life in the hospital.

And always, always, we were told that it was for our benefit, that it was part of our education, that we would appreciate it in the end.

Well, it's been four years since i finished Clerkship, and i still don't appreciate it.