Tuesday, 21 October 2014

An ode to the helpful MSer

Another new blogger – as a junior doctor with an interest in MS, my time with TeamG is predominantly spent researching new treatments and teaching medical students. This post is about the latter…

How many of you are regularly accosted by medical students when in clinics or hospital? Or have had a doctor like me rush round apologetically but no doubt somewhat intrusively asking “I understand you have MS – would you mind if some students came and examined you?”  

I often feel guilty when doing this as I am sure that for many of you it is not top of your wish list, hence I’m writing this to thank those of you that help out, encourage those of you who would rather not to speak up, and give you some insight from the students perspective. Any comments on your experiences would be much appreciated and will help to try and improve the situation for everyone.

At Bart’s, students only get two weeks out of a 5 year course studying neurology and neurosurgery – no time at all! Much of this is spent in lectures, hence it is not unreasonable to think that these doctors-to-be might only meet a couple of patients with MS during their whole course. Furthermore, it is well known that neurology is generally seen as a rather obscure and complicated subject that students are often inclined to shy away from.

Besides the obvious importance of increasing awareness of the condition, people with MS are often able to teach students much more than many other patients that they come across – as a group, my experience of MSers is that they are often younger and better informed about their condition than your average patient, and hence better able to impart this knowledge onto the students.

In addition to this, however, any chronic condition such as MS that involves regular clinic visits or trips to a teaching hospital can understandably lead rather quickly to “student fatigue” – the sight of yet another nervous group of 20-somethings, proudly sporting their new stethoscopes and eager to attack you with a tendon hammer may no doubt be a rather unpleasant prospect… (An under-reported risk factor of tysabri – when hooked up to a drip once a month you have a limited ability to escape the gaggle...) 

When you next find yourself in such a position, please therefore remember the following:


  1. Number 1 for a reason – please tell us to go away if you don’t want to see students! No excuse needed, and it certainly will not affect your treatment.
  2. In addition to the above, please also say if you would rather not be put through a full examination – I’m sure this can be tiresome (especially if it’s not for the first time that day…). A lot of the time if you are just happy to let the students ask you a few questions about your condition they will learn more than they would have done with a tendon hammer.
  3. Please do tell the student (and the teaching doctor) afterwards where they could improve – you will often be much more experienced than the students! This is especially important if you found anything uncomfortable.
  4. If you are kindly letting students talk to or examine you, try not to tell them that you have MS – it is really useful to make them try and work it out for themselves based upon what you tell them (and as a bonus you get to watch them squirm when they can’t work it out)
  5. Agreeing to be examined only on the condition that the students/doctor go and make you a cup of tea immediately afterwards is entirely acceptable – by that stage you probably deserve it.


It is just over 4 years since I first met an person with MS as a student. I can still remember it very clearly, and I’m sure their willingness to be interrupted by the likes of me had a significant contribution as to why I am pursuing a career in neurology now. 

A simple conclusion is therefore that we are very grateful to those of you who are able to help contribute to teaching medical students, and that this really does have a big impact upon them. 

At no point, however, should you be made to do anything that you don’t want to – whenever you don’t feel like it, please do tell us to go away!

11 comments:

  1. Hi Thomas, welcome to the world of MS blogging! It's a good idea to show appreciation for the people who give up their secrets to help educate new doctors and show how that can help engender an interest in neurology. so well done for that. I would hope that most people already know they don't have to cooperate with being a 'guinea pig', but understand the benefits to all concerned.
    I notice that in the later part of your post you refer to 'people' rather than 'patients' and this is certainly what I prefer - I think you might find that most 'MSers' agree. Also, I feel I should tell you that I for one would hate it if someone came up to me and said 'I understand you have MS', as I try to squish that fact into a little box and ignore it! - even if I am in a hospital being seen by a neurologist etc. Somehow it dehumanises and adds a label, which I personally don't want. I am not trying to be negative, but you might find that people react (even) more positively to your request, if you take these things into account. Remember we are people first...
    Good luck with posting on here, and in the rest of your work to support the MS community - it is very much appreciated. I fear you may have to develop a thick skin as a blogger and I wish you luck with that, too!
    Best wishes
    Bouncy

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  2. Hello Thomas, yes I've had my fair share of medical students. The three Barts students are probably consultants by now, their diagnoses were Thyroid, Diabetes and blindness. They were so lovely how could anyone refuse them. At another large teaching hospital, six students were surrounding my bed and one girl asked how the MS had affected my life. My answer was that it had ruined it. Their lecturer said oh no. I was cheered to think that she had thought beyond the diagnosis. Your students are the future. I don't think they are given enough opportunity in clinic to speak to us(not just MS). I never refuse regardless of the illness.

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  3. Bouncy and anon.,

    Thank you for your comments! Very helpful and I will certainly take them on board - labels to be avoided in the future.

    Tom

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    1. Reading my post back, I'm sorry if I sounded harsh! You're doing a good job and I have to agree with other posters that doctors in training seem to be a lovely bunch, still bright eyed and bushy tailed!

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  4. "Number 1 for a reason – please tell us to go away if you don’t want to see students! No excuse needed, and it certainly will not affect your treatment." One reason I choose a teaching hospital in the U.S. is for the opportunity to aid in medical education. I feel it is important for students to see MS not just read case histories.

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  5. I love student doctors and I think they love me. They're genuinely interested in learning everything they can, so I'll happily talk through it and answer any questions. It's been a while since my last relapse as I'm on Tysabri, but I've showed off pale discs, huge reflexes and loss of proprioception, talked about things like paraesthesia, weakness, balance, fatigue... you get the picture.

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  6. Thanks for your thoughtful empathetic post. Please keep writing.

    Thus far I have always agreed to see the med student. That may or may not have been the right choice as I am an extremely private person and strongly dislike the feeling of being exhibit A, ms patient.

    The reason I've done it is that my diagnosis process was long, complex and painful. I was told that tingling sensations were depression. I had a surgical resident entirely miss an ms flare before I was diagnosed, despite frequent conversations for two weeks post operation and fairly dramatic symptoms. I want medical students to know from experience that we exist.

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    1. Thank you all for your comments - I think between you, you have summed the situation up very well. When we ask if you would mind being examined or talking to us, for some this is a minor request and I am really glad to hear that many of you have had positive experiences. For others, however, this is a request for you to share some of your most personal thoughts and feelings with complete strangers only to benefit their education. This is why it is entirely acceptable for you to decline. The times when you are prepared to do so, however, are when I myself and the medical students I teach most strongly feel what a privilege it is to be the recipients of such trust. It really does make a difference.

      Many thanks again of behalf of all of us!

      Tom

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  7. Hello Tom,

    As the others have written, welcome to our little world and thank you for your enthusiasm!

    I'm under the care of Ben Turner and Grace Anjorin at RLH, so have had a couple of students sit in on consultations, which is always absolutely fine with me, as in my opinion, we have a moral obligation to assist with research and education.

    Thinking about your comment regarding the students having very limited time to study neurology and meet MSers, I would be more than happy to attend the hospital to speak with / be examined by students on an ad hoc basis. We need young neurologists and researchers to be enthusiastic about MS, as this is the best chance we have for a cure, so I am very much in favour of MSer / medic collaboration.

    I am more than happy for you to contact me about this, using the details held in my medical records, if it is something that you would like to organise.

    All best,
    Rosalind Clements

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    1. Rosalind,

      Sorry for the delay in getting back to you - I somehow managed to miss your post. Thank you very much for volunteering! I am not sure if there are any systems in place for ad hoc teaching, but I will take this forward and speak to the education department about it. If there is any potential for this, if you still want me to, I could put your name forward.

      Many thanks once again! I was with a fantastic patient earlier today who taught the small group of students I was with an incredible amount. Just goes to show once again how invaluable enthusiastic and knowledgeable patients can be to medical education.

      Tom

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    2. To anon who wants a list of good neuros. Sorry we did not post as you are asking about specificpeople

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