The question: I have a new family doctor and he works at a clinic where I was told I may see a resident doctor or medical students from time to time. I'm not sure what this means and I'm wondering what to do if I don't want to see students? I'm worried about sharing this as I really like my doctor but don't want to offend him. Any suggestions?
The answer: If you have ever been a patient, whether it's in a family practice clinic or in a hospital, you have likely been cared for by a resident doctor or medical student as part of your health-care team. Given the ubiquitous nature of students, as a patient it's important to understand what the different types of learners are, who is ultimately responsible for your care and what your rights are if you are not comfortable having a student care for you.
First, let's understand what the difference is between a medical student and resident doctor: Medical students are still going through their undergraduate medical training and are generally in the final years of their program (third or fourth year) when they are seeing patients. At this stage, they are responsible for taking your complete history and then reporting back to their supervising physician, who reviews the information. Together, they come up with a plan for the patient. Medical students are not licensed and they cannot prescribe medication unless cosigned by a staff physician.
Resident doctors have completed medical school and have received their medical degrees, but are not yet licensed to practice independently. A family-medicine residency in Canada is two years, while specialty-training residency programs are generally five years in length. Residents work more independently than medical students, but still work under the guidance and supervision of a fully licensed physician who is ultimately responsible for the care they provide to patients. Resident doctors can write prescriptions and order tests.
It is understandable why you may feel some trepidation seeing a student if this is new to you, but there are several advantages to being seen by a student that may help ease this concern:
- 1. You get more time: Because they are in training, medical students and residents have more time to spend with patients than staff physicians. As a result, most patients feel less rushed and more able to express their concerns without the regular time constraints felt in a doctor’s office.
- 2. You’re getting the most up-to-date care: Residents doctors are preparing for qualifying exams and medical students are preparing for the completion of their degree and applying for residency programs. They are regularly attending seminars and have the latest medical information, not to mention savvy with the newest medical innovations that benefit patient care.
- 3. You get two sets of eyes: Because they are working under the guidance of a staff physician, not only do you get the opinion of the resident or medical student, but also their supervisor. While it’s a safeguard to ensure that your care is complete and as safe as possible, it can also enhance your care to have more than one physician review your concerns.
- 4. You may get seen earlier: Staff physicians can be fully booked. But when we have medical students or residents working with us, it opens up appointment spots which may help you get an earlier appointment.
- 5. You can help shape a new doctor’s career: My best learning didn’t come from books but from my patients. I have learned so much as a physician from my patients and am forever grateful to those who allowed me to participate in their care. By allowing students to participate in your care, you are helping them develop their interpersonal skills and medical acumen to carry through to the remainder of their career.
The potential downside to seeing a resident or medical student is that they are rotating through and you may not be able to see them beyond their two-year training program. It's not uncommon for patients to feel disappointed when their residents graduate after they have developed a close relationship.
Residents are also rotating through different specialties, which may limit their time in a family-practice clinic and make it challenging to see the same resident every visit. Another potential downside is that the extra time it can take to see a resident or student may not fit a patient's schedule.
The bottom line: Residents and medical students are common and can offer you excellent, timely and thorough care under the guidance of a staff physician.
That being said, if you feel uncomfortable seeing a medical student or resident for whatever reason, it is fully within your right as a patient to say this to your doctor. When this happens, they note it on your chart and ensure that you are only booked with your regular staff doctor. And it certainly should not change the level of care you receive or your ability to continue seeing him.
Dr. Sheila Wijayasinghe is the medical director at the Immigrant Womens' Health Centre, works as a staff physician at St. Michael's Hospital in their Family Practice Unit and at Hassle Free Clinic, and established and runs an on-site clinic at Women's Habitat Shelter in Etobicoke.
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