Pre-TTE Reflection (Day #0)

I applied to attend TTE prior to starting my clinical rotations as an MS3 with the intention of better understanding the healthcare system – in ways that are not necessarily taught or addressed in the first two preclinical years of medical school. Now having completed MS3 rotations, my intention is not any different but rather it is more apparent just how broad and deep of a goal it is to fully understand our healthcare system.

Clinical rotations vary heavily from residents and attendings to specialities and institutions. My experience was no different. And yet, each rotation was essentially the same: we, as students, were the extra body in the room – eager to learn and help without always a one-hundred percent understanding of how to do so. The pre-reading for TTE reminded me, now a few weeks removed from clinical rotations, just how important it is to maintain that enthusiasm to help – to share knowledge – to collaborate with our team as we progress in our careers. More importantly, it reminded me that as I transition from the extra body in the room as a student to a more hands-on team player as a resident and eventual attending, my understanding of how to help (in the context of not only my patient and their loved ones but also up to the systematic practices of my institution) should grow proportionally.

Although there was a theoretical understanding that medicine is rooted in hierarchy, the reality of that system in practice was a definite force. If my patient is uncomfortable, by speaking up, am I advocating for them or am I not realizing that it is expected and thus, just annoying my team with knowledge they already know? I certainly walked this line more often than not. But as the pre-reading for TTE emphasizes, there is truly no such thing as over-communication.

Of course, the challenge – I think- is when my responsibility grows towards the patient from MS3 to MS4 (and hopefully, resident). The pre-reading discussed the often disproportionate amount of work put on residents, nurses, etc. in regards to their level of training, supervision, etc. One memorable quote referenced how sleep deprivation can decrease utilization of empathy. I am hoping through TTE to learn skills and gain knowledge that will prepare to deliver high quality health care as I start to actually deliver more healthcare. Personally, I am also hoping to gain a better understanding of quality improvement research. I want to better define “patient-centered care”, “quality healthcare”, and “patient advocacy” so that I may implement those principles in my career.