{"id":48975,"date":"2020-11-06T12:55:11","date_gmt":"2020-11-06T11:55:11","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=48975"},"modified":"2020-11-06T16:16:13","modified_gmt":"2020-11-06T15:16:13","slug":"lily-copping-medical-students-as-patients","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2020\/11\/06\/lily-copping-medical-students-as-patients\/","title":{"rendered":"Lily Copping: Medical students are also sometimes patients\u2014we should incorporate this into our education"},"content":{"rendered":"

\"\"<\/a>The Sharp Scratch team and I recently got together with Anne Stephenson, a South London GP, to chat about being both medical students and patients in our own right. In a pretty short space of time, we covered the oft held assumption that medical students are all “healthy,” whether having an illness makes us better at empathising with patients on our placements, and the dynamics between us and our doctors in our own appointments.\u00a0<\/span><\/p>\n

Before discussing these further, I want to acknowledge my significant privilege in the area of chronic illness, a necessary task when discussing the historically (and presently) exclusionary field of medicine. Although I <\/span>do <\/span><\/i>have a health condition requiring professional input, I am very able-bodied and have never had to ask for unique arrangements to be made simply to engage with my course\u2019s content. To put it clumsily, the way in which my body moves through the world has never interfered with my sense of belonging on this degree course.<\/span><\/p>\n

For this reason, while I can offer insight into my own personal experiences of navigating being both a medical student and a patient, I accept my scope is limited and therefore not encompassing many other medical students\u2019 experiences.\u00a0\u00a0<\/span><\/p>\n

\u201cThe patient left the room and the staff member just looked at me and said \u2018Urgh, imagine how horrible it must be to have to take so many medications just to stop yourself feeling miserable\u2019. And I\u2019m sitting there thinking \u2018Well I had a phone call with my psychiatrist the day before. We\u2019ve just upped all my medications, added another one, and yeah\u2014I know how it feels\u2019.\u201d<\/span><\/i><\/p>\n

Isobel Walker (Issy), one of the panellists on the podcast, shared an encounter she\u2019d had recently where a staff member made this comment about the patient to her after the consultation. Although not intending to be malicious, they clearly made the comment without considering the potential for Issy to relate to the patient or be offended by the words; raising the complex issue of medical students being assumed to be “well.” In that moment, the idea that Issy could be anything but perfectly healthy did not cross their mind. Instead, a line was drawn between the patient and the professionals; the medicated and the unburdened; the unwell and the well.<\/span><\/p>\n

Similarly, in my third year, a respiratory doctor was teaching my group about bronchiectasis, a condition I have, and kept referring to how unappealing the patients and their symptoms were. While bronchiectasis <\/span>is<\/span><\/i> pretty debilitating for many people, what made my friend and I exchange a series of cringing side-eyes was the assumption that no one in that room could possibly have a personal stake in the conversation. A \u201cpatient\u201d was an abstract, distant, <\/span>other <\/span><\/i>existence. It wasn\u2019t <\/span>us.<\/span><\/i><\/p>\n

Continuing this conversation, we listened to a clip in which a fellow medical student, Gavin, recounted his experience as a patient on a cardiology ward. His story well represented the choice medical students have when navigating their own healthcare. Gavin\u2019s decision to be upfront about what he was studying, whether that felt like a significant choice or not, led to his medical team changing the way they spoke to him about his care. They shifted their approach to reflect an educational, peer-to-peer encounter, as opposed to a more typical patient-doctor dynamic. Gavin spoke about this experience positively as it allowed him to learn and more deeply understand his condition, and he expressed being grateful to those doctors for taking the time to teach him.<\/span><\/p>\n

\u201cI want to be treated like a traditional patient.\u201d<\/span><\/i><\/p>\n

Clearly, a “traditional patient” is a pretty loaded term, and raises questions that would require an entirely separate article to unpick, but in the flurry of reacting to Gavin\u2019s story this is what my brain blurted out. Presented with his favoured patient-doctor dynamic, my (potentially over-dramatic) reaction was that I had completely different expectations of my caregivers.<\/span><\/p>\n

That is, I want to be looked after. I want to walk into my appointment and breathe a sigh of relief. I want to drop the burden of symptoms, medications and prognoses at the door and rest in the knowledge that for the next 10 minutes or so, someone else is taking responsibility.<\/span><\/p>\n

I could (and do) rant until the cows come home about the paternalistic and alienating tendencies of some doctors. When discussing consultation styles, I am an avid supporter of holistic, patient-led, non-hierarchical therapeutic decision making. However, I also have a glimpse into the exhaustion of simply being unwell. There are appointments where myself and my doctor have collaborated to form a management plan, but there are also appointments where I have stared into the distance as I\u2019m prescribed antibiotics and told I can\u2019t sit my exam.\u00a0\u00a0<\/span><\/p>\n

Sometimes patients just want, and need, to feel held.\u00a0<\/span><\/p>\n

What the team articulated well in the episode is, as with <\/span>all<\/span><\/i> patients, different medical students will require different things from their caregivers. Some medical students want their doctors to treat them like peers, and enjoy the changed language and consultation style that comes with it. Others, like myself, often choose to avoid admitting they study medicine, and instead opt to be treated in a more \u2018traditional\u2019 style. In reality, I think we all end up fluctuating between the two.<\/span><\/p>\n

It is not at all ground-breaking to conclude by stressing the point that medical students are sometimes also patients. But I\u2019m going to say it anyway. The false dichotomy created between healthcare professionals and the \u2018sick\u2019 is harmful and cultivates shame around illness.\u00a0 I wonder how much we could learn by deconstructing the walls we\u2019ve built between ourselves and our patients, therefore expanding our understanding of illness and wellness. The fact that medical students are (surprise, surprise!) \u2018normal\u2019 people is something to celebrate and incorporate into our education, not something to fear.\u00a0<\/span><\/p>\n

Lily Copping<\/strong>, Fourth year medical student at Bart’s and The London School of Medicine and Dentistry<\/span><\/i><\/p>\n

Competing interests: None declared.<\/span><\/i><\/p>\n

—<\/span><\/p>\n

The <\/span>Sharp Scratch<\/span><\/a> Panel:<\/span><\/p>\n

Nikki Nabavi<\/strong>, <\/span><\/i>The BMJ<\/span>, University of Manchester<\/span><\/i><\/p>\n

Isobel Walker<\/strong>, University of Nottingham<\/span><\/i><\/p>\n

Lily Copping<\/strong>, Bart’s and The London School of Medicine and Dentistry<\/span><\/i><\/p>\n

Being a patient as a medical student episode guests:<\/span><\/p>\n

Anne Stephenson, GP<\/span><\/i><\/p>\n

Gavin Ball, University of Manchester<\/span><\/i><\/p>\n

Listen to the episode on <\/span>Spotify<\/span><\/a> and <\/span>Apple pods<\/span><\/a>.\u00a0<\/span><\/p>\n

Follow us on Twitter:<\/span><\/p>\n

Panel: @nikkixnabavi<\/a> @lilycopping<\/a> @issywalker<\/a><\/span><\/p>\n

Brought to you by: @bmj_latest<\/a>, @BMJStudent<\/a><\/span><\/p>\n

Sponsored by: @MPS_Medical<\/a><\/span><\/p>\n

 <\/p>\n

 <\/p>\n

 <\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

The Sharp Scratch team and I recently got together with Anne Stephenson, a South London GP, to chat about being both medical students and patients in our own right. In […]<\/p>\n

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