The Medical Apprentice

“Hi, my name is Pat Clements, and I’m a medical student.  I know we just met, but I’m going to take a seat and ask you thirty questions or so about your bowel habits.”

This month I am doing an “away” elective.  Fourth-year med students can apply for electives at other medical schools, adding to their clinical experiences and allowing them to visit residency programs in their field of interest.  I’m up at Mott Children’s Hospital at the University of Michigan.  I am rotating in Pediatric Gastroenterology, the specialty that deals with the digestive system.  Disorders of these organs impair the ability to eat, digest food, absorb nutrients, and excrete waste.

U of M has a pretty big pediatric referral base, so plenty of interesting cases come their way.  I’ve already seen a couple of “mythical” diseases (ones that I thought existed only in textbooks).  At the same time, the majority of my days in clinic I see the “bread and butter” of Pediatric Gastroenterology.  These are patients referred for evaluation of constipation/diarrhea, vomiting, and failure to adequately grow.

When interviewing a patient and their family, particular questions are asked during the review of systems.  For GI, the questions are focused heavily on diet and bowel habits.  As you can imagine, these areas are sometimes a bit strange to talk about.  There’s even a standardized scale to help move the conversation along.  The little guys look back with wide eyes to their parents.  Does he really want me to talk about my poop?  On the other end of the spectrum are the young adults, often mortified to have to talk about their sometimes embarrassing problems.  Issues with the GI system can cause a lot of frustration and discomfort for children and parents alike.  Hopefully in the end the solution makes the child healthier and gives them a better quality of life, making the awkward “GI interrogation” well worth it.

This month will hopefully give me a good exposure to patients with the spectrum of gastrointestinal illnesses, plus increase my experience in evaluating growth and nutrition.  I’ll try not to mention bowel movements in every blog, but no guarantees!

Tags: gastroenterology, michigan, Mott, pediatric GI

This entry was posted on Wednesday, October 7th, 2009 at 11:09 pm and is filed under Uncategorized.
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