CEO: Approach the care of patients as a cooperative endeavor, integrating patients’ concerns and ensuring their health needs are addressed.
Taking History.
As I reflect on my medical education and the lesson that I have learned about patient care there is on concept that remains firm: taking a good history is first and foundational. The importance and skill of history taking is one that has been reiterated, from that first longitudinal group session all the way to my fourth year. It is a lesson that I understood during pre-clinicals but really came to appreciate during my clinical rotation. I still remember the first admission I did as a 3rd year on my Internal Medicine rotation. I had gone through my checklist of questions and came back to present to my senior. He suggested that we go back together so that I could observe him obtaining a history. It was a great lesson for me in history taking, bedside manners and being patient centered in medical care. The first thing the resident did was to sit in a chair next to the patient to ensure that he was on the patient level. The second thing he did was ask open-ended questions, allowing the patient to respond. Finally, and perhaps what I have reflected on the most is when he asked the patient what made her come in and what she was worried about. For that particular patient, we were concerned about pneumonia but she was worried that her Crohn’s disease was getting worse. I have applied that last phrase to every patient thereafter, from my ambulatory pediatric to my psychiatry inpatient rotation. I have learned to appreciate what the patient can teach me from a history more than what I could ever tell. As I transition from medical student to resident I can honestly say history-taking is my strongest skill and the one I have worked hardest on honing. It is during the history that you get to know the patient, hear their voice and listen to their concern. My goal for intern year is to never lose sight of patient-centered care, even in the busyness of notes, order and discharge summaries. I also aim to keep my focus on the patients need an how I can work as part of a system in trying to address them.
Below is my third-year feedback from my 3 week IM Gen-Med inpatient rotation. The comments reflect my improvement particularly in terms of patient care and presentation.
Making History.
I started medical school in 2017 as part of the first class of the Primary Care Track program. I was excited to begin my medical education and to be making history. I was making history as the first physician in my family (my father has a PhD) and as a black woman immigrant entering the medical field. For me this history was not just my own but the opportunity to serve the communities I represented. Reflecting on that journey now in my final year has taught me that making history is not just about what you do, but more so what you learn and the legacy you leave behind. The photo below is my at the white coat ceremony, you can tell that I was excited for the journey. However, I could not have imagined how the process of medical school would change me and stretch me. My medical education has highlighted how all the tools I have acquired before—during my undergrad study in public policy and graduate study in public health—would be relevant and applicable even as a enter the specialty of Family Medicine.
