June 26, 2006

What Pre-Med Experiences Should Be. (Part II)

In a previous post, I talked about the first half of my improvised plan of "what do I do now?" when I didn't get into medical school. Shadowing doctors is easy to fit into a school schedule as a once a week sort of activity. People who have more time on their hands because they just graduated as an undergrad and didn't get into any grad programs face a new set of challenges.

The Real World. How do you apply your skills learned in a job? What job should you apply for? What are you really qualified to do after you've gone through a pre-med program?

These are great questions to be asking yourself. I certainly questioned myself as I pored through the requirements for various health-related professions. If you listen to your college counselor, they claim that "there are plenty of things you can do with a biology degree!" Of course, most of those things require more than a bachelors degree. I had no knowledge on how to draw blood, no clinical hours booked in any certification program, no experience in anything clinical, to be perfectly honest. I knew that I didn't want to take any extra classes to become a EKG tech, lab tech, nurse aide, physicians assistant, etc... I wanted to go to medical school! What would be the sense in spending money on a program for a job that I would expect to be short term?

All I had was my meager medical knowledge and my willingness to learn more if I was given the chance. Lucky for me, I found a job that had only these requirements.

Ward Clerk. Here's the requirements from my employer's website:
Minimum: Must be able to communicate with visitors, patients and staff, both orally and in writing. Previous experience dealing with the public.

Preferred: Knowledge of medical terminology. Prior Hospital experience.
Whoa. You don't even need to go to college to become a ward clerk! Then again, secretaries learn a lot of their skills on the job. Playing secretary to the nurses in a hospital ward is not as easy as you might think. It requires a significant amount of knowledge about the inner-workings of the hospital, because nurses, nurse aides, doctors, lab techs, patients and their families... pretty much everyone... expects you to have a handle on what is going on.

The job is very paradoxical. I was at the bottom of the experiential totem pole. Out of all the people working in the hospital (nurses, nurse aides, doctors, lab techs and so forth,) I probably hold the least qualifications. Yet I was in charge of the majority of what goes on in the ward. I made appointments for EKGs, X-rays, CT scans, MRI scans, nuclear medicine scans. I scheduled lab draws. I made sure that the nursing station is well-stocked. I transcribed (and often translated) doctor's orders. I relayed messages between pharmacy and the nurses, doctors and nurses, patients and family... it can all be very overwhelming and stressful, especially with angry doctors, whining patients and aggravated nurses breathing down my neck.

I've found myself in the situation where I don't know what the heck I'm supposed to do. I might not comprehend a doctor's order, so I have to ask a nurse. Then once I get that sorted through, I might not know what to do with this information. Does it need to be documented? Do I have to request something from another department? Do I have any forms that I need to fill out? So, I might have to call another ward clerk to get the answers I need (or make a quick consult in a manual of standard operations.) I've come to terms with my own incompetence and inadequacy... which is a good thing. You shouldn't fake like you know what to do.

Ward clerking has been an excellent learning experience for me. I've learned a lot about the different duties involved in the care of a patient and I got to see them day to day. I get to see what labs are drawn for patients, what meds are prescribed and how nurses work their butts off to follow doctor's orders. My only regret is that I am stuck with all the paperwork and I don't get to ever see patients.

Funny how doctors complain of the same thing... but I've gained a greater respect for the paperwork. Good documentation can make things run a lot smoother for everyone and this is a lesson I intend on remembering.

Aside from my growth of experience, my handwriting has improved tremendously. This stereotype is definitely true of doctors. After shadowing a doc through hospital rounds, I've seen how busy they are and how they need to rush through orders and progress notes to get things done. The handwriting that results is quite atrocious. I can recall one incident where I wrote an order for 500 mg of Warfarin (an anticoagulant drug) instead of 500 mg of Levaquin (an antibiotic.) The nurse kindly pointed the glaring error out to me and said "oh, I can see how you got this." The doctor's handwriting was so wiggly, that these two words would have looked identical. I thought it suspicious that the patient was already receiving 5 mg of Coumadin... but I just write 'em as I read 'em. I'm not supposed to correct doc spelling errors or write verbal orders from docs. I'm glad that the nurses double-check the ward clerk work.

Hopefully my penmanship will remain comprehensible in the years to come so future ward clerks won't face the same problems that I did!


  1. I ward clerked for awhile, too and I very much agree with you that it helps you pay attention to detail and documentation. Now, as a med student, it seems like I'm more careful than some of my fellow students about writing clear orders, with clear handwriting, and making sure things are labeled properly.

    And thankfully, unlike a LOT of doctors I've seen, I won't have to act completely helpless when it comes to making copies or sending faxes - and I won't act like it's beneath me to do it either.

    Good post.

  2. Yeah, there's no shame in being clueless, just shame in remaining so. :-)

  3. wait until you're an intern and you are still the least knowledgeable of all those hospital people you mentioned and you're the one who makes the most decisions in your patient's care!