January 9, 2015
Article by Global Pre-Meds
Hospital doctor shadowing & global health experience programs.
If you plan on attending medical school, you will have a combination of classroom lectures, laboratory work and clinical rotations. Although all aspects of school can be challenging, clinical rotations may be the most intimidating.
During clinical rotations, you will apply the knowledge you have gained in class and care for real people. That may be both exciting and a bit scary. The good news is, you are not completely on your own. You will have a preceptor. In most cases, a resident will be assigned as your supervisor for each rotation. In some instances, you may have more than one supervising resident.
Although your resident will care for many patients, you may only be assigned to follow a certain number of those patients. Following a patient requires you to know their medical history, what their chief complaint is and what care they have received and still need.
At some point during clinical rotations, you will attend rounds on the patients your supervising resident is caring for. Rounds involve a clinician presenting information about the patient to other medical professionals who are also involved in the care. Rounds are usually held in the patient’s room and are often attended by the resident, the attending physician, nurse and possibly a respiratory or physical therapist.
As a med student, you will have the chance to present some of the cases on the patients you are following. But before you attend patient rounds, you need to pre-round on your patients. Pre-rounding involves the following:
Check the results of diagnostic tests. Before you present a case in rounds, you need to know the latest test results. Rounds are often early in the morning. But lab draws and tests are often done even earlier.
Read progress notes. The attending physician or other members of the team may have documented information in the patient’s chart under progress notes. Read the notes from the last few days, so you will know what has been happening with the patient and how their care is progressing.
Perform an exam: When you do your pre-rounds, you should see each patient you are following and do a quick exam. The exam may vary depending on what the patient is being treated for. For example, if it is a surgical patient, you may check an incision or drainage tubes.
Clarify any questions you have. If there is something you do not understand, get clarification from either doing more research or speaking with the patient. For instance, if blood tests were not done as scheduled, find out why. The patient may have refused, or the lab may be behind schedule.
Talk to the nurse on duty. When you are doing pre-rounds, talk to the nurse who is caring for your patients. Ask how the patient’s night was. The nurse who is taking care of the patient can provide you with the most up to date information on the patient, such as new symptoms or problems that have developed.