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...FAIL! I'm referring to my very first patient encounter in The Eye Center, about four months ago. I can still remember that morning very clearly. Three of my classmates and I were gathered around a computer, nervously waiting for our four morning patients to arrive. When the screen indicated that a patient was ready to go, my stomach dropped. I knew that I was going to take the first patient of the day and I got major butterflies in my stomach. It's not that I felt unprepared. SCO does an AMAZING job preparing students to succeed in clinic. It starts during your first year with countless hours in the lab learning and practicing the skills. It continues with RAM trips, SVOSH trips, exams for the homeless in your community, school screenings, and even more hours during second year practicing and refining your skills. I knew that I could perform well in the clinic, but because it was my first official patient of my 3rd year clinic experience, I was petrified.
I jumped into my case history and chair skills, before returning to report to my staff doctor. As I prepared to give my report and plan before beginning refraction and the ocular health exam I noted the time. I had been in there for a VERY long time! Looking back now, I had spent too much time talking with the patient and had lost control of the exam. After getting back on track, I began to proceed through the exam. My patient had significant health challenges which I had never seen before (most of my patient encounters in screenings/labs had been on healthy eyes). Although I knew, on paper, what I should be seeing or looking for, I was amazed at how different some of the findings looked. Besides being very slow, I was very confused by what I was seeing. Only after my staff doctor confirmed the findings did I realize that conditions and diseases can present in many different ways. In other words, there is NO TEXTBOOK PICTURE that can accurately represent what I will see in every patient. The only way I will get comfortable with diagnosing and treating my patients will be for me to see LOTS of eyes. That is why I am SO grateful I came to SCO. We have the largest eye clinic in the country and see hundreds of patients every day!
While I didn't really "fail" in that first patient encounter, I made tons of mistakes in my charting and my time efficiency was atrocious. Now, four months later, I have gotten faster and more confident in my charting ability. Thanks to the dozens of patient encounters I have had this semester (in The Eye Center and nursing homes around Memphis), I have gotten better at identifying abnormalities in the eye. I have gotten better at striking a balance in getting to know my patients and proceeding through the exam at a good pace. While I have improved, I still have many weaknesses which I will improve in the coming months. My clinic experience has been enjoyable, challenging, humbling, and encouraging. The staff doctors at SCO are wonderful! They are there because they want to help us become great doctors. Their advice and counsel has been the secret to making strides in the clinic. I can't wait to see what the next few months have in store!