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The medical student and the patient: experiences of patients admitted at an academic hospital

16 April 2024

Ikaneng Yingwane reflects on the unique dynamics between medical students and their patients as he continues his fourth-year studies at Sefako Makgatho Health Sciences University, South Africa.

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Academic hospitals stand at the pinnacle of medical care, renowned for their cutting-edge research, advanced technology, and multidisciplinary expertise. However, behind the towering walls of innovation, academic hospitals also serve as crucibles of medical education- where aspiring physicians embark on a journey to cultivate their knowledge, skills, and bedside manner. Thus, the experiences of patients admitted at academic hospitals unfold against the backdrop of medical education.

 

These patients perceive students in different ways. For some, the presence of students offers an opportunity for more personalised medical attention, which they expressed otherwise missing out on from the teams of specialists, registrars, nurses, and technicians who while in the pursuit of intricate and comprehensive treatment plans for these patients’ equally intricate medical conditions, negate on the humanistic aspects the patient to health-care provider relationship. Yet for others, the prospect of being examined by novice practitioners evokes feelings of vulnerability and apprehension.

 

The relationship between medical students and patients is characterized by a mutual exchange of knowledge, empathy, and trust. It hinges upon rapport building and open and clear communication. However, patients find it hard to achieve this kind of relationship when they have to establish with one student, and then the one after that, and then the next one after that…and with all of them asking virtually the same questions. This becomes frustrating for these patients who also must concurrently do the same with the different teams of healthcare professionals also attending to them. It is, therefore, not uncommon that patients often show complete disinterest in engaging with students.

 

The approaches that medical schools have towards regulating student and patient interactions are pivotal in mitigating poor student-patient interactions. The lecturers (who are sometimes still practising) or doctors affiliated with the medical school usually facilitate these interactions. However, in their eagerness to show students clinical signs or how to elicit them in real patients renege on some basic ethical principles prioritising the academic benefits of the patients’ condition over their comfort. In other instances, though, students are allowed to see patients completely unsupervised. Some of them, having caught wind that patients may be reluctant to interact with them if they know they are students, introduce themselves as doctors obtaining access to patients that they otherwise might not have received.

 

Patients admitted to academic hospitals benefit from the dynamic interaction between medical students and patients. Students can make a significant contribution to patient-centred care through teamwork, communication, and compassion, while patients become active participants in the educational process. Medical students must embrace their role as torchbearers of the healing profession with humility, integrity, and unwavering dedication to the well-being of the people they serve.