Richard Zhang
It’s not a secret that medical students face a lot of difficult scenarios. Some are slow and insidious, like the slow creep towards the next board exam. Others are devastating, like having to break bad news to a patient for the very first time. One particular difficulty in med school that many people overlook though is the ‘awkward scenario.’ Here are some of the most common awkward scenarios med students face, as well as some ways to lessen, or at least work around, some of that awkwardness.
- Crowding around the same patient
I once had a teaching session where one intern was filling in for three attendings, and so throughout the session, there were six medical students all keen to see some livedo reticularis or listen to some crackles crowding around one single patient. I hung around at the back for the most part, because I didn’t want to make the patients feel like an attraction at a zoo, but at the same time, I did have to take a look and perform the examination for the sake of my own learning. In these awkward situations, try to do everything you can to ensure the patient’s comfort. Also be mindful of privacy – patients may not want to take their top off for your physical examination if there are five of you gathered around their bed. Come back later alone and ask again to do the exam then.
- Being the 20th medical student to see that one patient with interesting clinical signs
I’m sure everyone has experienced this at one point. If you find a patient with any interesting signs at all, chances are that that particular patient has had many many medical students already examine them beforehand. Whenever I find a patient with interesting signs on the ward, I almost always feel apologetic when I walk up to them and ask to examine them. For these patients, understand that constantly being examined and poked and prodded at can be very tiring and frustrating. Be respectful, and if they do allow you to examine them, make sure to genuinely thank them. Also, if they are gracious enough to allow you to examine them, try to avoid simply listening to the murmur you wanted to listen to and then taking off – spend some time with them if they seem like they could use some company.
- When you follow your resident *literally* everywhere
I follow my resident literally everywhere, like a little duckling following the big mama duck, because I usually feel just as helpless as a little duckling in the hospital. Problem is, sometimes if they walk really fast and speak through a mask, I can’t quite hear them so I just follow them by default. Don’t be like me. Make sure you don’t follow them into the bathroom.
- Seeing a patient outside of the hospital
This might be quite a rare experience for a fair number of readers because most medical students are far too busy studying to go outside, but on the rare occasion you do, you may run into a patient whose care you were involved in. The good news is, most patients you see outside of the hospital context are just as reluctant as you to start conversation so you can just awkwardly wave at each other and move on with your day, but occasionally, some will come up to you and try to strike up a conversation. In these situations, remember to stay professional. Be polite of course, but if the patient asks you for any favors or asks you about anything treatment-related, don’t be afraid to simply decline to speak any further about their care and recommend that they book another appointment if they have any questions. My go-to script is just to say “I would love to help, but I’m not confident saying anything concrete without a doctor to supervise me, so if you come in again to the hospital, I’d be more than happy to run your concerns by my supervisors.”
- Sexual health histories
I’m sure this is a pretty universal awkward experience every medical student has fairly early in their careers. It’s never easy getting anyone to open up about private matters, and it’s even harder if the patient is of the opposite sex, so it’s crucial to establish a good rapport early in the consult before you begin the sexual health history. When it is time to ask about their sexual history, begin by explaining that you will be asking personal questions, and remind them that they may choose not to answer a particular question if they don’t want to. Typically, introducing yourself like this will help make them feel more comfortable, which may then in turn make them more willing to share information with you. From then on, just make sure you are respectful, and avoid asking loaded questions that may make them less likely to reveal important information to you.
- Being clearly out of your depth
This is probably one of the less common embarrassing/awkward scenarios on this list, but it can certainly be one of the most difficult to navigate. Occasionally, you may be asked by your resident or attending to perform a procedure that you simply aren’t prepared for, and it almost always feels like there is an overwhelming pressure to say yes and perform the procedure flawlessly, for fear of losing face in front of the resident/attending. In these situations, calmly explain that you don’t feel comfortable carrying out that particular task alone, and that you would like to have some guidance or supervision. Try not to turn down learning opportunities – being out of your comfort zone is a great way to improve as a practitioner in medicine. Simply explain to your resident that you’d appreciate some guidance, and 9 times out of 10 they’ll come and supervise, which will make the task significantly easier and less anxiety-inducing for you.
- When patients are a little too eager to characterize their bodily fluids
A fair few of the more awkward situations I’ve been in occurred during my family medicine rotation. A number of patients would come in presenting with simple upper respiratory tract infections and as part of the history, it was my responsibility to ascertain whether they noticed any phlegm and characterize these changes. This wasn’t an issue for the most part, but a few patients would bring in tissues with their phlegm, and try to hand it to me. I would always politely decline, but it could sometimes get very uncomfortable if they really pressed me to take a closer look at them. From what I can gather from conversations with my peers and residents, this isn’t an uncommon experience, so it’s important to be able to handle these awkward situations. As always, remember to be polite, but also remember that there is no absolute need for you to handle these samples. Do not be afraid to say that you have a very good assessment of the sample already from their excellent explanations, and that it won’t be necessary for them to bring their samples with them in future.
- Being around kids
I love hanging out with kids outside of medical contexts, because all you have to do is lie to them and tell them funny stories and they’ll think you’re the coolest person ever, but remove my ability to tell lies and put a stethoscope around my neck and all of a sudden no child wants anything to do with me anymore. I can’t say I blame them, because I also used to associate doctors with painful shots, but it does make your job difficult when they do everything they can to thwart your efforts to awkwardly examine them. In these situations, remember to establish rapport with the child as well as the parent. Depending on the age, engaging in play can help establish this rapport with the child, and can also help you perform a quick general assessment of the child’s health.
I’m sure there are an endless list of awkward situations that you may encounter throughout medical school, but these were just 8 of the more common ones I have experienced so far. Hopefully, you’ve taken away a few little pointers that can help lessen some of the embarrassment or cringe that you may feel if you encounter any similar experiences in the future!