FUD re: transition from school science to applied medicine

Hi, guys–happy Friday!

Ok–confession time.

So, I’m a good student. I’ve proven that across all my years of academia. I’m at home in the classroom, and when it comes to science–I’m truly interested in what I’m learning. Fascinated, actually.

But I have limited clinical exposure–to date, I’ve only shadowed. I will be picking up volunteer hours in a maternity ward at the semester break, and I will get another 50-75 hours of shadowing done before I apply in the spring. So between shadowing and volunteering, I will have a whopping 200-250 hours (approximately) of clinical exposure.

Having said that, I’m constantly wondering about my ability to make the transition from the classroom to the exam room. I’m good with people,so that’s not what I’m worried about. It’s the technical aspect. Feel this muscle, see that vein, look at that x-ray, listen to this lung… the “doing” part of it all.

Right now, when a doctor shows me a film and asks me if I see something on the lung (as he’s pointing it out), it looks like a cloudy blob and I wouldn’t have noticed it had he not been pointing at it. But I nod and smile and say, “oh, wow…yeah…” When I am clueless. Honestly.

I’m throwing this brutal honesty out there to hopefully hear that I’m not the only one who worries about this. If I hear crickets chirping, I will then go into panic mode. I just wish there was a way to fit some more hours in the day, and a way to have more hands-on exposure. I’m super envious of my peers on this forum who have nursing, PA, EMS, etc. exposure already. I can’t imagine anything worse than getting through pre-reqs, getting into med school, doing well in the classroom, and then finding out that you royally stink as a clinician.

Please…someone…tell me something reassuring. LOL

I’m laughing, but then again I’m not…you know?

Your post makes me think back to beginning to learn clinical skills in nursing school. Taking a blood pressure now is second nature, but it took a while to get there. First I couldn’t even hear the sound they were talking about, then I had to concentrate so hard to hear it that I’d forget the systolic # (top #) by the time I finished listening for the diastolic value (bottom #).

The only way to get good at the technical stuff is to do it…and there are a LOT things MDs do routinely that I don’t already do as a nurse, so I’ll still be doing a good share of fumbling. I think we’re all in the same boat, basically, no matter what our backgrounds (except one surgeon I know who was a vet first…)

It’s reasonable to wonder about it, but I don’t think you have cause to actually worry.

If you already have the “people” part and the study skills/aptitude, then the skills part will come. One of the docs at work that I love working with is an old pre-med, whose background was in teaching (and NOT in science). She’s a good doctor: thorough, approachable, caring. All characteristics you do not seem to be lacking in.


(BTW, I have heard practicing physicians talk about how little they can tell from an X-Ray…they just wait for the radiologist’s report. The fact that you can’t make heads nor tails of them yet should NOT be surprising.)

My mom likes to tell me that “worrying is paying interest on debt you don’t have.” Usually when I say/do something like this post. Clinical experience is about knowing that you want to deal with that experience every day, not learning how to suture.

When I first took a CPR class my simulation of responding to an accident started with the announcement of “Excuse me, I know PCR” and wondering why everyone kept giggling. I have no real clinical skills beyond that, although I can apply a band-aid with precision.

You go to medical school, and go on rotations, to learn those things. Lots of schools, particularly DO, include some form of patient interaction or exposure in the 1st two years. The worst that can happen is you act the part and say the wrong thing, or say the right thing but do something else stupid. Everyone will laugh,then you’ll learn what you need to.

Oh, Pixie–that cracked me up. Love it… PCR… my first thought was, “How is polymerase chain reaction going to help someone breathe?”

Annette–thanks for the vote of confidence! You’re absolutely right, of course. It will come with time…

I like to worry about things I have no control over yet. Drives my husband nuts.

I do have some skill–I’m a mom, of course, so I have the bandaid thing down stat. Also, as crazy as this may sound, I grew up on a farm. Well, farm makes it sound small. It was an industrial sized production…and during the summer, my dad made us work in order to “build character.” My job was to work with animals in the nursery–so I got to give the mothers all their shots during and after labor, and the babies all their vaccinations, vitamins, etc. I even got to help some of the vets from the LSU research labs when they’d come out and do minor procedures, since they knew I liked that stuff… As strange as this is about to sound, I actually got really good with syringes, microscopes, and scalpels by the time I was 13! LOL Maybe that counts for something?

This topic doesn’t keep me up at night…yet… I guess it’s just nice to know I’m not the only one who thinks about this stuff.

I feel like I could’ve written the OP. Carrie, Annette, Pixie, thanks for sharing! Makes me feel better!

The only clinical experience I have was when I was 12 and volunteered at a vet’s office. All I did was hold the animals during exams/surgeries, prep syringes for exams, count pills out for prescriptions, and help remove ticks. That’s 13 years ago, haha.

Carrie, You’ll be fine! The technical skills will only become better with practice. It took me a couple of years to feel like I was a good EMT after EMT school, then I went to paramedic school and it’s taken several years after that to feel like I’ve got it down. And for what it’s worth, I’m still constantly trying to be a better paramedic!

It’s all about practice and diligence. Being a musician, you know about those!

Learning science is outstanding, but it’s so much better when it’s applied! To me, that’s the best thing about medicine: An application of science and compassion where it matters most!

The doing…that’s when it gets fun! Keep your chin up, you’ll see!


p.s. Maybe if you have time and are motivated to do so, in your glide year you can take a course and become a tech at a hospital somewhere. Some places are funny about letting you start I.V.'s depending on your scope of practice, etc, but you could take vitals, hook them up to 12 leads, etc. Nothing like doing to make you feel a bit more comfortable. Anyway…just a thought.

I agree completely with Dan. It is all about practice and repetition. Even with something as simple as doing reflex testing has turned out to be a challenge. You listen to the instructor and go “well that’s easy” and then you go to try it and discover that your lab partner apparently doesn’t have any reflexes at all. But after a while, with a little hands on guidance for the teaching assistance, you discover that your partner is going to live after all. Then you need to practice, because if you think “ok so I’ve got that now” the next time you have to do a reflex, its not going to go well.

So I would say it is great you are aware of the issue, but medical school is where you learn and practice. As my pathology professor likes to say, if you knew how to do everything already, you wouldn’t be in 1st year medical school. Every professor knows that we (most of us) are clueless and they are extremely patient showing things over and over and over again.

Anyway, that’s my perspective. If you still feel that way about the clinical basics once you are a resident, then you might need to worry.


Well, luckily, the knowledge and skill is what you are supposed to come OUT knowing, not what you are supposed to GO IN knowing.

Despite my years of nursing and nurse practitioner experience, I still saw just a fuzzy blob (if that) on the xray). But we’ve been having 4-6 hours of “imaging” lecture/seminar with each system, and after the radiologist points it out on about 15 x-rays, you start to see it. If it’s a little subtle he says you have to “squint and hallucinate” (a favorite phrase of our histology teacher), but seriously, I’ve been surprised to find that this is something I can learn.

It’s experience that causes radiologists to be able to glean so much from x-rays, but hopefully they will share that with you when you are in school!


Carrie - I repeated it 3 or 4 times before someone finally said “Um… it’s CPR.” I AM SO AWESOME.

This is my favorite thread this week. Love the perspectives from Kate, Dan and Lynda.

Well, you just told us the keyword, you are “fascinated” and this will make all the difference in the world for you. You won’t have any problems in finding the right passe. I just got my master in public health and I know exactly what your worries are. Just be confident in your ability to absorb information.