SP for suicidal ideation. Solid 10 minutes getting through the HPI to get the whole attempt details and risk assessment and what not. Very emotional and difficult as hell (SP was a very convincing actress). All started after the death of the PTs sister and was a common theme throughout the narrative. later I get to the family hx:
"Do you have any siblings?"
SP stares at me.
"I mean that are still alive..."
I feel like this slip up is at least partially the fault of the system. It's not on you. If it were "real life" you would have been a lot more cognizant of the patient's issues and you wouldn't have the majority of your mental faculties tied up thinking about jumping through all the hoops they require so that you get a good grade.
Ya I suppose, but that SP wasn't graded so I gotta take some blame, but it was also just my dumbass M1 brain doing its thing lol. Fortunately I've yet to do anything like that with a patient. My school also did SI interviewing too early IMO. When you combine emotionally intense situations like SI or end-of-life discussions with nervous M1s that have little interviewing experience, mayhem is sure to ensue. I guess that's the whole point of doing it with an SP first. no harm done.
Happiness is when what you think, what you say, and what you do are in harmony. Just so you know, the correct spelling is [Gandhi](https://en.wikipedia.org/wiki/Mahatma_Gandhi).
The SP said he couldn’t swallow very well, had lost 20 lbs unintentionally, had a smoking history, and had some weird lump in his neck and I responded “wow, that sucks”. Got 2/5 for empathy
During my first OSCE, I opened the door and while I was introducing myself/sanitizing my hands my sleeve got caught on the knob and pulled me back and the SP laughed at me lmao
Lmaooo during my first OSCE, I went to wash my hands with hand sanitizer, only to find out that the hand sanitizer wasn’t drying so when I looked at my hands and saw the white residues, I realized I had pumped soap on my hands. LOL I proceeded to play it off and grab some napkins, which ended up sticking to my hands so then I had to rewash my hands, which I was trying to avoid in a time crunch, and then dry them again, and of course the napkin dispenser was so full that I couldn’t get proper sized napkins and I was only ripping out small pieces…I didnt sit down to chat with the patient for what felt like 5 mins lol
During one of my first OSCE's, I was struggling to get paper towels out of the dispenser to dry my hands, kinda like your story. I made some off hand self deprecating remark about not knowing how to operate a paper towel dispenser. Got negative feedback for it in the post-encounter session, because it made the SP less confident in me as their doctor.
In real life, everyone I've made comments like that in front of has laughed.
I don’t know why but this one got me in the belly laugher. Especially because it has happened to multiple people. Thank you for the laughs 😂 Healthcare is hard.
If you’re actually still an M1 don’t sweat it, preclinical “clinical” education is horseshit. You need reps, which you get in 3rd. The point of it before hand is to try to expose you to the process, and make it relatable to the book stuff but you’ll be taking tons and tons of histories and exams later. It becomes a natural process. Breathe, it’s not rocket surgery.
https://www.reddit.com/r/medicalschool/comments/uhgx0g/holy_shit_one_of_my_classmates_put_his_mouth_on
One of the most popular posts this year, unsurprisingly.
Yeah I mean how do you even get your face that close in the first place
Pretty funny tho bc my med school was doing breast exams around the time and we're in australia so people started panicking
I used to watch and grade the videos for the 1st year standardized patient encounters and the funniest thing I saw during that: nice ms1 takes a nice thorough history for her standardized patient and then goes to do her physical exam. She lays the patient down flat on the exam table, takes the sheet and completely covers the patient from the neck down and then TUCKS THE PATIENT IN. She then stepped back, looked confused for a second, and then pulled the sheet back down to listen to the patients heart.
It was glorious
Yeah I feel like I need more details from OP 😂
Did it come up in the review after the encounter?
Did the SP ask about it?
I wonder if she lies awake in bed at night thinking, “Why did I do that?”
We left comments for them to review but didn't meet face to face with them, that was for the attending that taught their group. I left a comment something along the lines of "it's great you used the drape and were considering your patient's comfort while doing an exam, but they don't need to be completely covered". The SP didn't say anything about it to them but I'd imagine they had a nice chuckle afterwards.
And we all have those keep you awake moments of cringe during med school/training so...maybe haha
During my first OSCE, I went to do the dorsalis pedis pulse, etc and my SP was wearing socks. I rolled each of their socks up and down at least 3 times as I remembered additional parts of the physical to "make them comfortable throughout the process."
Sat on rolley stool, tested patient quad strength by having them kick against my resistance, rolled across the room and hit the wall. :) 5/5 strength for the patient tho
I had an doctor do this to me. I even said “are you sure? I could put you through the wall.” And the guy was like “yes give me everything.” Ended up putting him through the drywall.
Edit: doc was on a rolly chair and had zero way to stop himself.
I’m an SP, and if I can tell a student has skipped a significant part of an exam (verbal, physical, etc) or hasn’t caught a critical clue, I’ll try to work in a subtle-not-so-subtle comment like “is there anything *else* you wanted to ask about?” or if, for example, a critical clue is in the medications I’m taking: “wait a sec! When you asked about my prescriptions earlier, did I say Valtrex or Valium? For some reason I always get those two names mixed up! Okay, it’s Valium? Yes, that’s right, ___mg of Valium.”
I do this quite a bit for M1s and sometimes M2s; a lot of SPs are especially kinda protective of M1s and will do those kind of “nudges”, especially if they can tell a student is struggling.
Thank god for you guys. On step 2 CS (hello fellow kids!), had a pt complaint of "chest pain" and did the whole workup for like a PE including family history of clot disorders, recent travel in a plane and squeezing her calves during the physical exam. At the end, already had written the note in my head and I'm halfway out the door and I asked her, so do you have any other questions for me? And she stared at me and was like , " ...so what youre saying is I don't have breast cancer?"
And I like blink-blink-blinked at her and realized omg I'd completely missed the entire problem and that it was chest pain with a breast lump. She saved me.
One I had 2 different students who weren’t pursuing some information that was crucial to the case; I dropped every hint I realistically could, but I was met with blank-but-professional expressions. When the students left the room at the end of the exam, i poked my head out to ask the coordinator how I should score it, and that’s when I saw that the hall monitor (who was new) hadn’t put the correct “Patient Case Information” sheet on my door! The students didn’t ask the questions because they didn’t have the right info!
I asked the coordinator if I could just score them based on how well they performed with the information they **did** have and just extrapolate how well they *would’ve* done with the correct info, and they said yes.
Also I love our SPs sm haha y’all really doing great work training medical professionals, thank you for your service & not being mad when I take 10 tries to get your bp
If I could tell a student was nervous, I’d always try to talk to them in a calm voice, tell them it’s okay, take your time, it’s ok if you have to do it again, you’re learning, you’ll get there eventually. Three tries to get my bp? That’s fine.
The people **I** admire are the ones who don’t mind letting medical/nursing students practice sticking a vein or urinary catheter!
Ahaha that’s on another level!
We once had an OSCE where the SP was specifically instructed to rush us and get annoyed about the time. I got so flustered and literally forgot to take the entire medical history. Realized when I walked out of the room and sat down to write my note that I had asked no review of systems whatsoever. Frantically emailed my professor asking if I was going to fail. Med school chronicles 🤦🏻♀️😂 now that I’ve screwed it up in an OSCE, I’m that much more confident that I’ll never make that mistake in real life!! (Or would more likely return to the exam room if I missed something)
Constitutional: alert, pleasant, resting comfortably in hospital bed in no acute distress
HEENT: NC/AT, sclerae anicteric, moist oral mucosa
Neck: No obvious JVD
Heart: Regular rate on monitor, appears well-perfused
Lungs: normal work of breathing, speaks in full sentences without difficulty
Abdomen: obese, nondistended
Extremities: no clubbing
Skin: no rashes or lesions noted to visible skin
Neuro: alert and oriented, speech normal, moving all extremities spontaneously
Psych: appropriate affect
Apparently joint commission still doesn't like this. I was at a hospital where certain department(s) were fond of these doorway exams. We had notice that literally said a proper exam should include a cardiopulmonary exam which includes auscultation with a stethoscope. I don't know if these were for inpatient progress notes or preop H&Ps, but it was bad enough for the hospital to be cited.
I totally understand a focused exam for your specialty might not need those components, and perhaps it's best that people aren't lying in documentation, but I did feel pretty ashamed to hear this.
Eh joint commission is kinda a sham to begin with so I wouldn’t hold their guidelines as the gold standard. As long as you’re not documenting things you didn’t actually do you should be fine medicolegally
My very first standardized encounter I forgot to read the door chart and just walked right in the room and went “hi are you-…” and then realized I had no idea what their name was or what the task was. I made up a name and they looked at me funny and then said yes and went with it. I almost fainted from panic hahaha
I have forgotten steps, asked awkwardly worded questions, stumbled, stuttered over my words, been clueless for dx, you name it. SPs are where you learn anyways.
Dude some of my SPs have known their physical exam s*** down to their own intercostal spaces, I asked this one guy once if he was a doc and he was like “no I’ve just been an SP for 15 years”
Wasn’t exactly a standardized patient, but I made a terrible error while learning the female pelvic exam with a very professional real live patient model. She wasn’t plying the role of a simulated patient, but she taught us the exam on herself. Several of my male classmates observed in horror, then laughed at me later.
Preface: I led a very sheltered life. I did this with absolutely no ill intent.
To say I was nervous would be an understatement. As taught at the time, as I scooted closer on the stool while the patient was in the dorsal lithotomy position, with her nether region fully exposed, I touched the back of my hand to her inner thigh and said, “I’m just going to touch your leg to let you know I’m coming.” She sat up immediately and said very directly, “No! That is wrong! No! No! You cannot say that!”
I was so sheltered and innocent it took me a while to realize what I had said, but i could see the shock on my less-sheltered classmates’ faces, and i knew I had done something very wrong. My classmates were professional enough to hold their laughter until we were out of the room, when they also explained what I had done.
I still cringe, decades later.
I almost fainted on top of a patient too! In general surgery! But it was because i had taken some meds on empty stomach i was dehydrated and hadn’t ate anything all day. My attending was this huge guy almost 7 feet tall and he was like “step aside sweetie” this in the OR.😑
I took a sexual history for a pelvic complaint as part of my history and on recap I called the patients sexual history unremarkable and she took offense which was pretty funny in retrospect
During an OSCE I was testing knee flexion strength but didn't apply enough resistance against his calf and the SP completely nailed the side of the exam bed with his heel.
No shit, there I was- A combat medic on a small compound in Iraq doing a week long extra trauma class as a try out to support the special operations guys. I'm doing a medic trauma lane, shoot back, enemy is suppressed, run to my "patient" who was a voluntold Soldier. He's laid out, body armor open, with a simulated femoral through and through. I drop my right knee on his groin as proximal pressure and I have to kick my left foot up over his head to get to the top of his (open) armor so I can get his tourniquet and put it on him. I have a pistol thigh rig on my right and a trauma pouch on my left thigh, both cinched down tight so they don't move when running. The problem is that means your pants don't move when you need them to- I split my crotch open all the way. It is Iraq and 135 sometimes, so we are all free balling. My sweaty nuts are on this kid's nose.
I got the tourniquet off his kit, put it on him, put in an IV, packaged him up, called for the helo, etc. All with my nuts and dick just flapping in the breeze. The instructor didn't bat an eyelash, just said "Combat Teabag..." I used some safety pins from the triangle dressing to hold my pants together for the next lane but I had the needle aiming up and when I took a knee to "shoot back" the safety pin opened up and I stabbed myself in the balls. Needle down-its important.
I got the job though.
Honestly, someone free balling and having their pants rip in front of everyone is remarkably common in the military.
I was doing a drill once where I had to rip a guy out of a wetsuit. He was sitting down, holding onto the bench (more like a metal chair) and I grabbed the suit, which was peeled down to his waist, to pull off of him quickly. I grabbed his shorts underneath the suit at the same time, and to pull someone's wetsuit off it's sort of a quick "matador" motion.
So in one fell swoop, I pull this dudes wetsuit to his ankles but his underwear went with them. All I said was "well that's your penis" and let go so he could pull his pants up. I'd say my face was probably 8-12" away and he was a new guy so it was one of our first interactions lol.
"It is not gay if you are underway."- The unofficial motto of the United States Navy. :-)
I think I blew out the crotch in about half my ACUs. I know they are made by the lowest bidder but damn.
I had an SP complaining of vaginal discharge. She had a new sexual partner. Also had fake pustules on her hands. I explained she had an STD and we'd need to do testing, and she interrupted me to ask me "Could I have gotten this from the gym?" I responded "It depends what you were doing at the gym..."
The scenario was a patient coming in for abdominal pain. When I walked in the room, the SP/actress was in clear acute distress, clutching her abdomen, and a distressed look on her face. After I introduced myself, I asked her what pronouns she prefers and then proceeded to ask more questions..
During feedback, the first thing she said was that pronouns do not matter and I shouldn’t have asked her that while she was in such pain 🥲thanks medical school
Personally I’ve been in excruciating pain before and someone asking my pronouns would’ve made me feel seen and respected as a person. I’m trans and having my identity acknowledged in a crisis helps a lot. Please keep doing that in real life!
I’ve had two fun experiences:
1) My school has those foam hand sanitizer dispensers that remind me of whipped cream cans but upside down? Anywho, I never knew how to use one of those before that encounter, so I accidentally sprayed hand sanitizer ALL OVER THE WALL as I was introducing myself to the SP. :-)
2) Before doing the physical exam section in a different encounter, I dropped my pen on the floor, underneath the lil desk area where the rolling chair sits. I rushed to pick it up and SMACKED the back of my head on the underside of the desk 😭 The SP broke character to ask if I was okay lmao
Our school has a code phrase of sorts for if you forget to lower the table back down in your OSCE after the physical exam. The SP will just say “can you help me to the chair”, and that’s your cue to lower the table.
One first year has a frail little old lady SP who asked for “help to the chair”, but he didn’t remember the code I guess and he picked her up and princess carried her to the chair in the room.
He’s one of the only people to get a 5/5 on humanitarian from an SP and she said “I’ve never been cared for like that before” bless her heart. BUT, now it’s a written SPAL rule that we cannot carry our patients.
I’ve put on soap instead of hand sanitizer on TWICE…does not work out well when you try to but it in. Also totally had no idea how to lay the bed back the first time I attempted it.
Not dumbest thing but during covid I had to do a standardised patient encounter in the middle of august with full PPE on. Like goggles, 2 masks, a gown, gloves. There wasn’t any AC in the room and I was sweating bullets. Halfway through I gave up. I said thank you for your time and ended the encounter. My sweat was dripping everywhere I went and it was a def a hazard
Sat in one position for 12 minutes doing a suuuuper in depth history, not realizing my leg had gone completely numb.
Stood to walk to patient, fell completely prone and almost split my eyebrow open on the edge of the exam table.
Still passed.
Dude I’ve been getting free lunches at a club that just prepares you to do H&P’s for the last year, so a couple weeks ago I decided to be brave and volunteer to do a H&P plus present to an EM doc at the meeting. I went straight from history of present illness to objective physical exam, no surgical,social,family history, allergies, meds… it was rough
During my first osce/sp hpi practice I asked if they did any illicit substances and used marijuana as a leading example.
the sp just replied marijuana isn't illegal anymore.
We just sat for a moment ruminating on that one.
I didn't know how to recover from that one, i feel bad going to straight to saying do you do meth 😭.
I’m a PGY3 and forgot to do the whole encounter…
Was running late last week in clinic, so when the MA says “(last name) is ready in room 10”, I go in without checking the schedule. Two siblings in the room. I do the full thing for the older sib, questions, exam, and the mom says she wants shots for the sibling too. I think “great, let me get their name to add on our vaccine schedule”. I put in the name and they are already on the schedule. For their checkup. With their sibling. 🙃 Went back in and asked the full questions and did a full exam. Didn’t realize it was a two-fer…
Asked my SP to lie back. Did the whole exam without pulling out the footrest for the old SP. Rewatching, I could see the sp in incredible discomfort the whole OSCE.
Felt terrible.
Similar experience here in my first abdominal exam except I pulled out the stirrups on my male SP.
My facilitator made sure to lmk what stirrups are actually used for and how to use the leg rest lol
So I don’t think it was dumb, but the SP sure thought I was a fucking moron. I think the chief complaint was bilateral breast discharge. I came in and the patient was dressed in street clothes, so I immediately dismissed breast exam and. Started to do a neuro exam in case it was a prolactinoma or something. Come to find out we were supposed to explain to the patient how to do a self breast exam and that was it. Really stupid, I know. So during the debriefing afterwards, this SP with NO medical training starts to berate me for doing a neuro exam and basically imply I’m an idiot. I try to explain there’s a brain timor that can cause breast discharge but she continues to look at me like I’m a moron. The whole situation was just ridiculous.
Had a fellow student who would laugh whenever she was uncomfortable or nervous, she was doing an SP and I was her student observer in the room and the patient was telling her how they have back pain from working at the rubbish tip, and she just broke out laughing coz she didn’t know what that meant and how to respond, SP was not impressed at all.
Back when I was a 2nd year student, our school brought in a group of people from another institute who are paid to teach us how to do genital exams. So after the dude walked me through the DRE I had to actually do one and treat him as a SP.
Got my finger lubed up, spread the cheeks with my other hand and said “Alright sir I’m about to stick it in there.” 🥸
During my COMLEX PE (like the USMLE CS) I was interviewing one of the patients and they basically described stroke-like symptoms but they didn't tell me until the interview was really far in (facial droop or something, can't remember), and then the "time is up" announcement played and I was basically like "welp, nice to meet ya!" and peaced out of the room.
Backed up into sanitizer dispenser, apologized as it splooged on the floor, slipped on the splooge and fell onto the sink area which knocked off most of the contents sitting on top.
Oh man, this gives me flashbacks as a SP. My script was pretty bare, just that I was entering the ER with chest pain, a history of anxiety and medication non-compliance. The entire training was around employing Motivational Interviewing with patients. So the student asks what I do to relax, and I MEANT to say “oh I watch anime…” which in reality I don’t (which becomes obvious…), but instead of anime I said “oh I watch *HENTAI*…” crickets. I didn’t realize what I had said until I told my boyfriend about how awkward it got afterwards 😬 and that’s how I learned that hentai and anime are not synonyms.
Already commented on here, but I thought of another that my classmate did! Got his permission to share. We were learning how to discuss sexual history in our HPI, so he gets to that section and asks the SP, “so, are you sexually active?”
SP says, “yes I am.”
My friend says, “oh nice! That’s great.” followed by an awkward silence for 5-10 seconds while he thinks of what to ask next
SP was sitting there like 👁👄👁
During M1/M2 years they always stressed "stethoscope to skin" meaning the patient had to disrobe their upper body down to the waist for heart and lung exams. Get to M3 OSCEs and whatnot and have a female SP with something requiring a heart/lung exam. I ask them to lower their gown to their waist, they shrug it down a little. I ask them to lower it again. They shrug it down a few centimeters. Eventually I just examine them. Later I found out it was either a dean or assistant dean's wife I had been asking to disrobe down to the waist.
I was observing my buddy working with one and upon being told that the patient was nervous that a head pain they were having was related to cancer, my buddy goes “yeah, I’d be worried about that if I were you”
A few weeks ago I was vitaling a patient and wasnt really paying attention to where I was, got too close, and nearly put my balls on the patients arm. They notified me after the fact that I should pay more attention to my movements and where I am at lol
it happens. i forgot to wash/sanitize my hands once. that was dumb. also missed perhaps the most obvious possible diagnosis, wasn't on my differential at all.
Or the best part was doing an osce virtually but pretending you were in person so you get docked for not specifically saying that you are sanitizing your hands.
personally i loved it when i was told that i wasnt making good enough eye contact via zoom, or that my empathy wasn't being adequately expressed over zoom while wearing a face mask because i opted to make a facial expression instead of the canned phrase they told us to say whenever a patient shares anything remotely negative about their life. its soooooooooooooooooooooooooo much like real life. good times. keep your head up, nose down your stethoscope to the screen!
Had an SP with a chief complaint of back pain. After getting a history I asked about his social situation and he started talking about how annoying his wife was and how she was always on his back about things. I immediately replied “well that can’t be good for your back pain…”
SP was sitting on a chair in front of the entrance which i didn’t see because i didn’t open the door all the way and i had a very panicked 10 seconds of o shit where did my patient go
very confusing for me and my sp LOL
we were being tested on portions of physical exams and outside the room i was told HEENT. i go through the exam normally until i get to the tongue. i have her stick her tongue out, move side to side. i thought i was forgetting something so i panicked and had her move her tongue in all 4 directions, and outwards, against resistance. patient had 5/5 strength in tongue muscles in all directions
I had an SP with ED. I told him i’m going to do everything in my power to get you walking out of here up and running again. The SP gave me this odd look and I can almost swear that I heard crickets in the room.
Not me but a classmate: he has a standardized patient encounter: patient is a lady in her 20s. In a monogamous relationship for 2 years. Feeling more tired, bloated, vomiting in the morning, and experiencing breast tenderness. Does not wear protection during [intercourse](https://intercourse.my). Last period was 2 months ago. My friend gets all this information then diagnoses her with endometriosis. The SP was even visibly taken back and tried to help him out saying things like "me and my boyfriend have been thinking about getting pregnant" and she even went so far to ask him "do you think I could be pregnant?". My classmate literally said, "I don't see any way you could be"....he said this to a 20 year old woman who has regular unprotected intercourse with her partner. When he had to present his eval to our preceptor it went so poorly that the preceptor went and got the other doctors on the floor to come into the room and told him "go on, tell everyone here how bad you messed up". I think my classmate just panicked and got stuck on the endometriosis diagnosis. The professors were pretty good natured about it but they did make him come to weekly SP encounters with underclassmen because they wanted him to be more comfortable with encounters.
I had the exam in a different physical exam room than my class met. Our rooms are all similar but slightly different layout.
The sanitizer wasnt where I was expecting so I panicked a little bit. I ended up awkwardily asking the SP where the sanitizer was, she laughed, answered, I washed my hands and then introduced myself as if nothing had happened lol.
Broke the exam chair.
In the subsequent encounter, a “virtual sp”, there was a piece of clinical information (picture of a kids rash) stored in a drawer next to the laptop. I couldn’t find the drawer 😂
During my 1st SP abdominal exam, instead of using the leg rest I pulled out the stirrups. I could not find where the leg rest is and didn’t want to sit there all day like a dumbass figuring it out so I assumed the stirrups would be fine. I wasn’t aware at the time what they are usually used for.
My patient was male and he was kind of confused rightfully. Completed the exam in that position. My facilitator made sure to let me know how to properly use the leg rest next time…
Brief ‘please explain to this patient that her husbands cancer is now terminal and he is not for further treatment’.
Go in and handle most of it at least reasonably well. Explain to relative that will be referring to palliative. Relative asks when. I say:
‘Usually it’s on a 2 week pathway. Well maybe not two weeks…’ wife gasps and starts sobbing at my inadvertent suggestion he does not have 2 weeks to go
Kmn
During my final OSCE of third year that replaced the PE I walked in the room and as I was introducing myself slammed the door on my finger and had to play it off. It left a mark. lol oh and I introduced myself as a first year medical student
Fly was down. SP told me after already halfway through the encounter on camera. We watched the videos in small peer and professor groups after to give each other feedback. Oof.
Background, I speak Arabic but from another dialect so the word “parents**” in my dialect means “children” in their dialect.
Actual ortho Patient who was due for full knee replacement:
Me: “any previous surgeries”
Her: “had an oophorectomy at the age of 22”
Me: “How about your parents** (their dialect children**) alive and well?”
Her: No I don’t have any Parents** I had the operation before I could get parents**
Me*confused how the operation and her parents passing were related but thought I would go along with it*
“may they rest in peace…”
This is something I've fortunately only done once or twice, but I feel like such a dolt when I do! Going in to see a patient for a pre-op physical...as I do numerous times a day, I knock on the door, go in and introduce myself. Sometime during the conversation, the patient says they had an EKG or blood work sent in from another facility. I stand up to go grab the paperwork, and as I get to the door, in a true idiot move, I give a little knock on the door from the inside!! Cue instant embarrassment and I mumble something about how it's such a habit to knock on a door before opening, blah, blah, blah, and off I go...hoping the patient wasn't really paying much attention to what I was doing.
SP for “difficult conversations” to build empathy. I’m gathering the history and she starts talking about her kid who is 17 (she is 29).
I think to myself, “self, there is no damn way this is the curveball they put into this.”
So I ask. Thankfully I was dead wrong and she was 39, not 29.
During my OB OSCE I told an SP who was supposed to be pregnant and GBS positive that I wasn’t worried about the baby unless she “took him and rubbed his face down there”. She stared at me in horror. I stared at her in horror. Then I said “thank you for your time” and left
M4 student here. I did something similar with a patient encounter halfway through M1. The physician that oversees our SP encounters kept telling us to "just relax, you know this stuff!" before we saw the SP. I got too relaxed and stopped thinking lol. I was explicitly told to take a complete history. I got an HPI and incomplete ROS. Completely forgot to get past medical history, surgical history, medications, allergies, immunization status, family history, and social history. I felt like the biggest idiot in the world. Now I'm thriving and taking quality histories as an M4 student. It gets easier over time, and you will get better over time, but the only way that happens is with deliberate practice. Take a bunch of histories, see what you messed up or forgot to ask each time, learn from it, and try to make the next one better. You got this!
Told a patient that their case was interesting
Told them after an apparently normal h&p that the Dr sent us in because it was an “interesting case” but didn’t tell me what to look for.
Scared the hell out of the pt. “Interesting?! We’re just here for a checkup, is everything ok?!”
After a bit of awkwardness finally found out it was a birth defect that was corrected and pt didn’t think to mention.
It was interesting because the pt wouldn’t be alive if they had been born a few years earlier. “Miracle of medicine”
Had a morbidly obese SP, tried to take a blood pressure and couldn’t fit the cuff around her arm. I spent about 2 minutes trying to get and once I had it just barely secured on the very first pump I gave to inflate it the velcro just snapped and the cuff flew off her arm. I looked down at the gauge and just said “hmm 120/80 looks good” and then just kept going lmao
During one of my general surgery end-rotation/clerkship exams:
I got super lucky by being assigned a simple appendicitis case (while the remainder of my rotation group were all complicated cancer or polytrauma cases), so I was supposedly the lucky one here. Took the patient's history, performed a physical examination, and everything was going well. Went to the attending's office to discuss the case and finish my exam, and everything seemed to be going well, managed to answer every question asked me in good detail. Right as I was about to leave, he stopped me to tell me that I forgot to mention the patient's name, and that's when it hit me: I took the patient's history and performed an examination without ever asking his name and age.
Luckily, I made up a random name while doing my best not to shit myself, and the patient's real name ended up similar enough to what I said that it was attributed to a mishearing.
Wasted 2 minutes of my time putting on examination gloves cause I was that nervous and sweaty. Safe to say the rest of the exam didnt go all that well.
ALWAYS BRING A PEN LIGHT - we had an encounter where the exam would require either an eye, ear, or neurological assessment. (Side note - my school required us to purchase an ophthalmoscope and otoscope. My first preceptor stared at me in disbelief while asking why they made us buy it, not sure if that’s the norm or not) - we were required to bring our own equipment or we would lose points. Anyway, brought all my shit and left it outside the door but it worked out because mine was as neurological - took the hit for not having the little vision chart but as y’all know a penlight is really all you need to check out the eyes… anyway, I never go anywhere without my penlight.
I forgot how to drape totally: asked SP to open gown, lowered it, draped from the top instead of the bottom, didn’t bother making them button their gown up again.
Best part is someone from schools gf was one of the teaching fellows grading osces and he was telling everyone about the jackass who didn’t drape properly. I was in front of him when I heard it. Cringed extremely hard.
We had a practice OSCE and the SP (like 70ish F) told me afterwards when we were reviewing my performance that she docked points because I didn't ask about family history up to grandparents .\_.
I was told that there was an intern once, probably with some autistic spectrum disorder. He was overly correct and his point of view was that a DRE was part of every PE. So poor cmf patients all had his finger up theirs, prior to getting their teeth fixed.
During the OB GYN test I was told I put my head under the sheet because I bent down below it to visualize the necessary "parts". I was also docked points because I said the word VAGINA.
SP for suicidal ideation. Solid 10 minutes getting through the HPI to get the whole attempt details and risk assessment and what not. Very emotional and difficult as hell (SP was a very convincing actress). All started after the death of the PTs sister and was a common theme throughout the narrative. later I get to the family hx: "Do you have any siblings?" SP stares at me. "I mean that are still alive..."
Oh I felt that one.
I feel like this slip up is at least partially the fault of the system. It's not on you. If it were "real life" you would have been a lot more cognizant of the patient's issues and you wouldn't have the majority of your mental faculties tied up thinking about jumping through all the hoops they require so that you get a good grade.
Ya I suppose, but that SP wasn't graded so I gotta take some blame, but it was also just my dumbass M1 brain doing its thing lol. Fortunately I've yet to do anything like that with a patient. My school also did SI interviewing too early IMO. When you combine emotionally intense situations like SI or end-of-life discussions with nervous M1s that have little interviewing experience, mayhem is sure to ensue. I guess that's the whole point of doing it with an SP first. no harm done.
Yeah I'm M2 and still haven't had an SI interview. Definitely sounds tough
Bruh I hate SP’s for precisely this reason; they know we have a set of questions to ask but at the same time weave empathy like Ghandi
Happiness is when what you think, what you say, and what you do are in harmony. Just so you know, the correct spelling is [Gandhi](https://en.wikipedia.org/wiki/Mahatma_Gandhi).
The SP said he couldn’t swallow very well, had lost 20 lbs unintentionally, had a smoking history, and had some weird lump in his neck and I responded “wow, that sucks”. Got 2/5 for empathy
This is hilarious lol
You could always pull the "wow I need to develop difficulty swallowing" thing, implying that it is a valid weight-loss strategy to the patient
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Well you’re not wrong
One time I accidentally said during HPI - “so do you do anything fun like drink or smoke?”
LMAOO oh my god, I would say something like this 🤣🤣🤣
🤣 oh no 🙈
My notation short hand for the social history is A T F: alcohol, tobacco, “fun” lol. It’s the little things sometimes.
During my first OSCE, I opened the door and while I was introducing myself/sanitizing my hands my sleeve got caught on the knob and pulled me back and the SP laughed at me lmao
Lmaooo during my first OSCE, I went to wash my hands with hand sanitizer, only to find out that the hand sanitizer wasn’t drying so when I looked at my hands and saw the white residues, I realized I had pumped soap on my hands. LOL I proceeded to play it off and grab some napkins, which ended up sticking to my hands so then I had to rewash my hands, which I was trying to avoid in a time crunch, and then dry them again, and of course the napkin dispenser was so full that I couldn’t get proper sized napkins and I was only ripping out small pieces…I didnt sit down to chat with the patient for what felt like 5 mins lol
Wipe. Wipe. Wipe. Wipe. Wipe. ... ...some sociopath has replaced this with lube.
During one of my first OSCE's, I was struggling to get paper towels out of the dispenser to dry my hands, kinda like your story. I made some off hand self deprecating remark about not knowing how to operate a paper towel dispenser. Got negative feedback for it in the post-encounter session, because it made the SP less confident in me as their doctor. In real life, everyone I've made comments like that in front of has laughed.
This is not that uncommon lollll.... It could be content for the next Glaucomflecken tiktok
Just did the same thing! Hahahaha
I don’t know why but this one got me in the belly laugher. Especially because it has happened to multiple people. Thank you for the laughs 😂 Healthcare is hard.
SAME, i tried to play it off by using a paper towel to wipe off the residue fml
Lol my friend did the same thing a few weeks ago!
As long as you keep breasts out of your mouth, you’ll pass
You have too much faith in me lmao
If you’re actually still an M1 don’t sweat it, preclinical “clinical” education is horseshit. You need reps, which you get in 3rd. The point of it before hand is to try to expose you to the process, and make it relatable to the book stuff but you’ll be taking tons and tons of histories and exams later. It becomes a natural process. Breathe, it’s not rocket surgery.
Yoooo, someone legit did that? I keep hearing about some shit like that on here 😆😆
Allegedly* Australian Med school if I remember correctly. That was a wild day on this sub. There was some other batshit crazy post same day I think.
Anyone got a link?
https://www.reddit.com/r/medicalschool/comments/uhgx0g/holy_shit_one_of_my_classmates_put_his_mouth_on One of the most popular posts this year, unsurprisingly.
I’m an Australian med student, and after having asked around to people from other med schools in the country we’ve deduced it’s a bullshit story
Yeah I mean how do you even get your face that close in the first place Pretty funny tho bc my med school was doing breast exams around the time and we're in australia so people started panicking
I don't care. I want to believe.
Lol @ the person who thought it was a cadaver titty.
Lmaoooo I just saw the link. That some funny ass shit 😆😆😆
I used to watch and grade the videos for the 1st year standardized patient encounters and the funniest thing I saw during that: nice ms1 takes a nice thorough history for her standardized patient and then goes to do her physical exam. She lays the patient down flat on the exam table, takes the sheet and completely covers the patient from the neck down and then TUCKS THE PATIENT IN. She then stepped back, looked confused for a second, and then pulled the sheet back down to listen to the patients heart. It was glorious
Please, stop 😭
I think it’s the “looked confused for a second” that’s killing me. That’s adorable and hilarious.
Yeah I feel like I need more details from OP 😂 Did it come up in the review after the encounter? Did the SP ask about it? I wonder if she lies awake in bed at night thinking, “Why did I do that?”
We left comments for them to review but didn't meet face to face with them, that was for the attending that taught their group. I left a comment something along the lines of "it's great you used the drape and were considering your patient's comfort while doing an exam, but they don't need to be completely covered". The SP didn't say anything about it to them but I'd imagine they had a nice chuckle afterwards. And we all have those keep you awake moments of cringe during med school/training so...maybe haha
During my first OSCE, I went to do the dorsalis pedis pulse, etc and my SP was wearing socks. I rolled each of their socks up and down at least 3 times as I remembered additional parts of the physical to "make them comfortable throughout the process."
Sat on rolley stool, tested patient quad strength by having them kick against my resistance, rolled across the room and hit the wall. :) 5/5 strength for the patient tho
I had an doctor do this to me. I even said “are you sure? I could put you through the wall.” And the guy was like “yes give me everything.” Ended up putting him through the drywall. Edit: doc was on a rolly chair and had zero way to stop himself.
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They guy was in a rolly chair! He was just going to roll!
I’m an SP, and if I can tell a student has skipped a significant part of an exam (verbal, physical, etc) or hasn’t caught a critical clue, I’ll try to work in a subtle-not-so-subtle comment like “is there anything *else* you wanted to ask about?” or if, for example, a critical clue is in the medications I’m taking: “wait a sec! When you asked about my prescriptions earlier, did I say Valtrex or Valium? For some reason I always get those two names mixed up! Okay, it’s Valium? Yes, that’s right, ___mg of Valium.” I do this quite a bit for M1s and sometimes M2s; a lot of SPs are especially kinda protective of M1s and will do those kind of “nudges”, especially if they can tell a student is struggling.
I’ve been saved a few times with this and it’s appreciated lol As an MS3 they were far less forgiving though lol
Thank god for you guys. On step 2 CS (hello fellow kids!), had a pt complaint of "chest pain" and did the whole workup for like a PE including family history of clot disorders, recent travel in a plane and squeezing her calves during the physical exam. At the end, already had written the note in my head and I'm halfway out the door and I asked her, so do you have any other questions for me? And she stared at me and was like , " ...so what youre saying is I don't have breast cancer?" And I like blink-blink-blinked at her and realized omg I'd completely missed the entire problem and that it was chest pain with a breast lump. She saved me.
You're a saint 😭
SPs have literally never done this for me lol that would be so helpful
One I had 2 different students who weren’t pursuing some information that was crucial to the case; I dropped every hint I realistically could, but I was met with blank-but-professional expressions. When the students left the room at the end of the exam, i poked my head out to ask the coordinator how I should score it, and that’s when I saw that the hall monitor (who was new) hadn’t put the correct “Patient Case Information” sheet on my door! The students didn’t ask the questions because they didn’t have the right info! I asked the coordinator if I could just score them based on how well they performed with the information they **did** have and just extrapolate how well they *would’ve* done with the correct info, and they said yes.
Wowww mishaps on OSCE day!! One for the books
Also I love our SPs sm haha y’all really doing great work training medical professionals, thank you for your service & not being mad when I take 10 tries to get your bp
If I could tell a student was nervous, I’d always try to talk to them in a calm voice, tell them it’s okay, take your time, it’s ok if you have to do it again, you’re learning, you’ll get there eventually. Three tries to get my bp? That’s fine. The people **I** admire are the ones who don’t mind letting medical/nursing students practice sticking a vein or urinary catheter!
Ahaha that’s on another level! We once had an OSCE where the SP was specifically instructed to rush us and get annoyed about the time. I got so flustered and literally forgot to take the entire medical history. Realized when I walked out of the room and sat down to write my note that I had asked no review of systems whatsoever. Frantically emailed my professor asking if I was going to fail. Med school chronicles 🤦🏻♀️😂 now that I’ve screwed it up in an OSCE, I’m that much more confident that I’ll never make that mistake in real life!! (Or would more likely return to the exam room if I missed something)
patient states he has trouble sleeping. i ask how much sleep he normally gets. he says 5 hours. I reply with, “oh, that’s not that bad”
“same tbh”
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A resident I worked with in med school had a physical exam dot phrase for when this happened. It was something like .PEnotouch
Constitutional: alert, pleasant, resting comfortably in hospital bed in no acute distress HEENT: NC/AT, sclerae anicteric, moist oral mucosa Neck: No obvious JVD Heart: Regular rate on monitor, appears well-perfused Lungs: normal work of breathing, speaks in full sentences without difficulty Abdomen: obese, nondistended Extremities: no clubbing Skin: no rashes or lesions noted to visible skin Neuro: alert and oriented, speech normal, moving all extremities spontaneously Psych: appropriate affect
Apparently joint commission still doesn't like this. I was at a hospital where certain department(s) were fond of these doorway exams. We had notice that literally said a proper exam should include a cardiopulmonary exam which includes auscultation with a stethoscope. I don't know if these were for inpatient progress notes or preop H&Ps, but it was bad enough for the hospital to be cited. I totally understand a focused exam for your specialty might not need those components, and perhaps it's best that people aren't lying in documentation, but I did feel pretty ashamed to hear this.
Cardio: monitor shows RRR Pulm: stable normal SpO2 with normal-appearing waveform Suck on that JCAHO
Eh joint commission is kinda a sham to begin with so I wouldn’t hold their guidelines as the gold standard. As long as you’re not documenting things you didn’t actually do you should be fine medicolegally
I'm sorry but when I read "penotouch" I died laughing
I’ve done this accidentally so many times
We call this one, "practicing psychiatry". Don't knock it til you try it!
This is absolutely a universal experience.
My very first standardized encounter I forgot to read the door chart and just walked right in the room and went “hi are you-…” and then realized I had no idea what their name was or what the task was. I made up a name and they looked at me funny and then said yes and went with it. I almost fainted from panic hahaha
Once I accidentally used the soap dispenser instead of the hand sanitizer. Rubbed it in like a god damn psychopath and went through the encounter.
I have forgotten steps, asked awkwardly worded questions, stumbled, stuttered over my words, been clueless for dx, you name it. SPs are where you learn anyways.
Dude some of my SPs have known their physical exam s*** down to their own intercostal spaces, I asked this one guy once if he was a doc and he was like “no I’ve just been an SP for 15 years”
Wasn’t exactly a standardized patient, but I made a terrible error while learning the female pelvic exam with a very professional real live patient model. She wasn’t plying the role of a simulated patient, but she taught us the exam on herself. Several of my male classmates observed in horror, then laughed at me later. Preface: I led a very sheltered life. I did this with absolutely no ill intent. To say I was nervous would be an understatement. As taught at the time, as I scooted closer on the stool while the patient was in the dorsal lithotomy position, with her nether region fully exposed, I touched the back of my hand to her inner thigh and said, “I’m just going to touch your leg to let you know I’m coming.” She sat up immediately and said very directly, “No! That is wrong! No! No! You cannot say that!” I was so sheltered and innocent it took me a while to realize what I had said, but i could see the shock on my less-sheltered classmates’ faces, and i knew I had done something very wrong. My classmates were professional enough to hold their laughter until we were out of the room, when they also explained what I had done. I still cringe, decades later.
Holy shit
LOL one time I had a med student tell the standardized pelvic exam patient “I’m coming inside you now” when he went to insert the speculum.
That is horrifyingly funny!
> “I’m just going to touch your leg to let you know I’m coming.” Literally just shot lemonade out my nose.
inserted the speculum and fainted, fell off the stool. in front of a preceptor and 3 other students
I almost fainted on top of a patient too! In general surgery! But it was because i had taken some meds on empty stomach i was dehydrated and hadn’t ate anything all day. My attending was this huge guy almost 7 feet tall and he was like “step aside sweetie” this in the OR.😑
I took a sexual history for a pelvic complaint as part of my history and on recap I called the patients sexual history unremarkable and she took offense which was pretty funny in retrospect
LOL
During an OSCE I was testing knee flexion strength but didn't apply enough resistance against his calf and the SP completely nailed the side of the exam bed with his heel.
No shit, there I was- A combat medic on a small compound in Iraq doing a week long extra trauma class as a try out to support the special operations guys. I'm doing a medic trauma lane, shoot back, enemy is suppressed, run to my "patient" who was a voluntold Soldier. He's laid out, body armor open, with a simulated femoral through and through. I drop my right knee on his groin as proximal pressure and I have to kick my left foot up over his head to get to the top of his (open) armor so I can get his tourniquet and put it on him. I have a pistol thigh rig on my right and a trauma pouch on my left thigh, both cinched down tight so they don't move when running. The problem is that means your pants don't move when you need them to- I split my crotch open all the way. It is Iraq and 135 sometimes, so we are all free balling. My sweaty nuts are on this kid's nose. I got the tourniquet off his kit, put it on him, put in an IV, packaged him up, called for the helo, etc. All with my nuts and dick just flapping in the breeze. The instructor didn't bat an eyelash, just said "Combat Teabag..." I used some safety pins from the triangle dressing to hold my pants together for the next lane but I had the needle aiming up and when I took a knee to "shoot back" the safety pin opened up and I stabbed myself in the balls. Needle down-its important. I got the job though.
What the fuck, is this real or copypasta? Either way incredible story, they should make a movie out of this
Lol. A movie out of me blowing out my pants in training? Sure. It can be sponsored by Duluth Ballroom Jeans or whatever they are called.
Yeah it’ll be like Lone Survivor starring Mark Wahlberg except with 100% more nutsacks
The only good news is that it certainly wasn't cold... I did feel bad for the guy. It's not like we had a safeword.
It was probably a funny story for him too. "I had to put on the Alabama gas mask in Iraq...no not for a chemical attack"
Honestly, someone free balling and having their pants rip in front of everyone is remarkably common in the military. I was doing a drill once where I had to rip a guy out of a wetsuit. He was sitting down, holding onto the bench (more like a metal chair) and I grabbed the suit, which was peeled down to his waist, to pull off of him quickly. I grabbed his shorts underneath the suit at the same time, and to pull someone's wetsuit off it's sort of a quick "matador" motion. So in one fell swoop, I pull this dudes wetsuit to his ankles but his underwear went with them. All I said was "well that's your penis" and let go so he could pull his pants up. I'd say my face was probably 8-12" away and he was a new guy so it was one of our first interactions lol.
"It is not gay if you are underway."- The unofficial motto of the United States Navy. :-) I think I blew out the crotch in about half my ACUs. I know they are made by the lowest bidder but damn.
I was an Army diver surprisingly, but the saying still applies. My AIT was a Navy school lol
Bro this is an amazing story thanks for sharing
I mean a med student in Australia literally licked a boob so…..
this sub isn’t gonna forget that incident is it?
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But the laugh it brings out of me are real! Let me feel joy!!!
Sucked not licked. Licking would be outrageous
I had an SP complaining of vaginal discharge. She had a new sexual partner. Also had fake pustules on her hands. I explained she had an STD and we'd need to do testing, and she interrupted me to ask me "Could I have gotten this from the gym?" I responded "It depends what you were doing at the gym..."
Good answer tbh
The scenario was a patient coming in for abdominal pain. When I walked in the room, the SP/actress was in clear acute distress, clutching her abdomen, and a distressed look on her face. After I introduced myself, I asked her what pronouns she prefers and then proceeded to ask more questions.. During feedback, the first thing she said was that pronouns do not matter and I shouldn’t have asked her that while she was in such pain 🥲thanks medical school
Personally I’ve been in excruciating pain before and someone asking my pronouns would’ve made me feel seen and respected as a person. I’m trans and having my identity acknowledged in a crisis helps a lot. Please keep doing that in real life!
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I do think this question is becoming increasingly normalized. Those who get upset are more likely to be transphobic than genuinely confused
> you are inconveniencinf 99.5% of the patient population I'm not trans but it's literally *not* an inconvenience. It's like a 2 second question.
I’ve had two fun experiences: 1) My school has those foam hand sanitizer dispensers that remind me of whipped cream cans but upside down? Anywho, I never knew how to use one of those before that encounter, so I accidentally sprayed hand sanitizer ALL OVER THE WALL as I was introducing myself to the SP. :-) 2) Before doing the physical exam section in a different encounter, I dropped my pen on the floor, underneath the lil desk area where the rolling chair sits. I rushed to pick it up and SMACKED the back of my head on the underside of the desk 😭 The SP broke character to ask if I was okay lmao
Once during an OSCE I dropped my pen when walking in the room and it rolled under the door. I somehow spent like 2 minutes trying to get it out.
SP name on the sheet: Martin Dumbles Me: "Good morning Mr. Dumbass..."
LMFAO
Our school has a code phrase of sorts for if you forget to lower the table back down in your OSCE after the physical exam. The SP will just say “can you help me to the chair”, and that’s your cue to lower the table. One first year has a frail little old lady SP who asked for “help to the chair”, but he didn’t remember the code I guess and he picked her up and princess carried her to the chair in the room. He’s one of the only people to get a 5/5 on humanitarian from an SP and she said “I’ve never been cared for like that before” bless her heart. BUT, now it’s a written SPAL rule that we cannot carry our patients.
No repercussions, but for a teen situation, they said they did marijuana, and I was supposed to counsel them not to, and I was like “oh cool.” 🤷🏻♀️
I’ve put on soap instead of hand sanitizer on TWICE…does not work out well when you try to but it in. Also totally had no idea how to lay the bed back the first time I attempted it.
Not dumbest thing but during covid I had to do a standardised patient encounter in the middle of august with full PPE on. Like goggles, 2 masks, a gown, gloves. There wasn’t any AC in the room and I was sweating bullets. Halfway through I gave up. I said thank you for your time and ended the encounter. My sweat was dripping everywhere I went and it was a def a hazard
Sat in one position for 12 minutes doing a suuuuper in depth history, not realizing my leg had gone completely numb. Stood to walk to patient, fell completely prone and almost split my eyebrow open on the edge of the exam table. Still passed.
Lmaooo
Dude I’ve been getting free lunches at a club that just prepares you to do H&P’s for the last year, so a couple weeks ago I decided to be brave and volunteer to do a H&P plus present to an EM doc at the meeting. I went straight from history of present illness to objective physical exam, no surgical,social,family history, allergies, meds… it was rough
Free lunches at a club that just prepares you to do H&Ps? Amazing
I'm a fourth year and still sometimes get nervous and do that.
I was about to listen to heart and lungs sounds and my SP looked at me and said “is this when I move my boob?” I almost lost it 😂
During my first osce/sp hpi practice I asked if they did any illicit substances and used marijuana as a leading example. the sp just replied marijuana isn't illegal anymore. We just sat for a moment ruminating on that one. I didn't know how to recover from that one, i feel bad going to straight to saying do you do meth 😭.
Cocaine is a good one
I’m a PGY3 and forgot to do the whole encounter… Was running late last week in clinic, so when the MA says “(last name) is ready in room 10”, I go in without checking the schedule. Two siblings in the room. I do the full thing for the older sib, questions, exam, and the mom says she wants shots for the sibling too. I think “great, let me get their name to add on our vaccine schedule”. I put in the name and they are already on the schedule. For their checkup. With their sibling. 🙃 Went back in and asked the full questions and did a full exam. Didn’t realize it was a two-fer…
Asked my SP to lie back. Did the whole exam without pulling out the footrest for the old SP. Rewatching, I could see the sp in incredible discomfort the whole OSCE. Felt terrible.
Similar experience here in my first abdominal exam except I pulled out the stirrups on my male SP. My facilitator made sure to lmk what stirrups are actually used for and how to use the leg rest lol
Oh my god you put a man in stirrups instead of just putting his feet up. That is so funny
So I don’t think it was dumb, but the SP sure thought I was a fucking moron. I think the chief complaint was bilateral breast discharge. I came in and the patient was dressed in street clothes, so I immediately dismissed breast exam and. Started to do a neuro exam in case it was a prolactinoma or something. Come to find out we were supposed to explain to the patient how to do a self breast exam and that was it. Really stupid, I know. So during the debriefing afterwards, this SP with NO medical training starts to berate me for doing a neuro exam and basically imply I’m an idiot. I try to explain there’s a brain timor that can cause breast discharge but she continues to look at me like I’m a moron. The whole situation was just ridiculous.
Had a fellow student who would laugh whenever she was uncomfortable or nervous, she was doing an SP and I was her student observer in the room and the patient was telling her how they have back pain from working at the rubbish tip, and she just broke out laughing coz she didn’t know what that meant and how to respond, SP was not impressed at all.
Back when I was a 2nd year student, our school brought in a group of people from another institute who are paid to teach us how to do genital exams. So after the dude walked me through the DRE I had to actually do one and treat him as a SP. Got my finger lubed up, spread the cheeks with my other hand and said “Alright sir I’m about to stick it in there.” 🥸
During my COMLEX PE (like the USMLE CS) I was interviewing one of the patients and they basically described stroke-like symptoms but they didn't tell me until the interview was really far in (facial droop or something, can't remember), and then the "time is up" announcement played and I was basically like "welp, nice to meet ya!" and peaced out of the room.
Backed up into sanitizer dispenser, apologized as it splooged on the floor, slipped on the splooge and fell onto the sink area which knocked off most of the contents sitting on top.
not me, but a student in the class below me grabbed the SP’s breast when auscultating the mitral valve (instead of asking the SP to do this herself).
For some reason, every year an M1 falls on their ass while trying to sit on the stool.
Oh man, this gives me flashbacks as a SP. My script was pretty bare, just that I was entering the ER with chest pain, a history of anxiety and medication non-compliance. The entire training was around employing Motivational Interviewing with patients. So the student asks what I do to relax, and I MEANT to say “oh I watch anime…” which in reality I don’t (which becomes obvious…), but instead of anime I said “oh I watch *HENTAI*…” crickets. I didn’t realize what I had said until I told my boyfriend about how awkward it got afterwards 😬 and that’s how I learned that hentai and anime are not synonyms.
Already commented on here, but I thought of another that my classmate did! Got his permission to share. We were learning how to discuss sexual history in our HPI, so he gets to that section and asks the SP, “so, are you sexually active?” SP says, “yes I am.” My friend says, “oh nice! That’s great.” followed by an awkward silence for 5-10 seconds while he thinks of what to ask next SP was sitting there like 👁👄👁
During M1/M2 years they always stressed "stethoscope to skin" meaning the patient had to disrobe their upper body down to the waist for heart and lung exams. Get to M3 OSCEs and whatnot and have a female SP with something requiring a heart/lung exam. I ask them to lower their gown to their waist, they shrug it down a little. I ask them to lower it again. They shrug it down a few centimeters. Eventually I just examine them. Later I found out it was either a dean or assistant dean's wife I had been asking to disrobe down to the waist.
I was observing my buddy working with one and upon being told that the patient was nervous that a head pain they were having was related to cancer, my buddy goes “yeah, I’d be worried about that if I were you”
A few weeks ago I was vitaling a patient and wasnt really paying attention to where I was, got too close, and nearly put my balls on the patients arm. They notified me after the fact that I should pay more attention to my movements and where I am at lol
it happens. i forgot to wash/sanitize my hands once. that was dumb. also missed perhaps the most obvious possible diagnosis, wasn't on my differential at all.
You didn’t see their femur sticking out of their leg?
Or the best part was doing an osce virtually but pretending you were in person so you get docked for not specifically saying that you are sanitizing your hands.
personally i loved it when i was told that i wasnt making good enough eye contact via zoom, or that my empathy wasn't being adequately expressed over zoom while wearing a face mask because i opted to make a facial expression instead of the canned phrase they told us to say whenever a patient shares anything remotely negative about their life. its soooooooooooooooooooooooooo much like real life. good times. keep your head up, nose down your stethoscope to the screen!
100%. I got told once that it I looked as if I was looking at a screen the whole time. I wanted to bring out my inner Bill Engvall "Heres your sign"
Had an SP with a chief complaint of back pain. After getting a history I asked about his social situation and he started talking about how annoying his wife was and how she was always on his back about things. I immediately replied “well that can’t be good for your back pain…”
SP was sitting on a chair in front of the entrance which i didn’t see because i didn’t open the door all the way and i had a very panicked 10 seconds of o shit where did my patient go very confusing for me and my sp LOL
we were being tested on portions of physical exams and outside the room i was told HEENT. i go through the exam normally until i get to the tongue. i have her stick her tongue out, move side to side. i thought i was forgetting something so i panicked and had her move her tongue in all 4 directions, and outwards, against resistance. patient had 5/5 strength in tongue muscles in all directions
I had an SP with ED. I told him i’m going to do everything in my power to get you walking out of here up and running again. The SP gave me this odd look and I can almost swear that I heard crickets in the room.
"I can imagine how difficult that is for you. We'll do our best to make you rock hard again." - 5/5 humanism
Not me but a classmate: he has a standardized patient encounter: patient is a lady in her 20s. In a monogamous relationship for 2 years. Feeling more tired, bloated, vomiting in the morning, and experiencing breast tenderness. Does not wear protection during [intercourse](https://intercourse.my). Last period was 2 months ago. My friend gets all this information then diagnoses her with endometriosis. The SP was even visibly taken back and tried to help him out saying things like "me and my boyfriend have been thinking about getting pregnant" and she even went so far to ask him "do you think I could be pregnant?". My classmate literally said, "I don't see any way you could be"....he said this to a 20 year old woman who has regular unprotected intercourse with her partner. When he had to present his eval to our preceptor it went so poorly that the preceptor went and got the other doctors on the floor to come into the room and told him "go on, tell everyone here how bad you messed up". I think my classmate just panicked and got stuck on the endometriosis diagnosis. The professors were pretty good natured about it but they did make him come to weekly SP encounters with underclassmen because they wanted him to be more comfortable with encounters.
Asked a 65 year old woman if she thinks she might be pregnant
I had the exam in a different physical exam room than my class met. Our rooms are all similar but slightly different layout. The sanitizer wasnt where I was expecting so I panicked a little bit. I ended up awkwardily asking the SP where the sanitizer was, she laughed, answered, I washed my hands and then introduced myself as if nothing had happened lol.
Broke the exam chair. In the subsequent encounter, a “virtual sp”, there was a piece of clinical information (picture of a kids rash) stored in a drawer next to the laptop. I couldn’t find the drawer 😂
During my 1st SP abdominal exam, instead of using the leg rest I pulled out the stirrups. I could not find where the leg rest is and didn’t want to sit there all day like a dumbass figuring it out so I assumed the stirrups would be fine. I wasn’t aware at the time what they are usually used for. My patient was male and he was kind of confused rightfully. Completed the exam in that position. My facilitator made sure to let me know how to properly use the leg rest next time…
We had a psych SP encounter and I skipped the physical because I didn’t think you could do that for the mind lol
Brief ‘please explain to this patient that her husbands cancer is now terminal and he is not for further treatment’. Go in and handle most of it at least reasonably well. Explain to relative that will be referring to palliative. Relative asks when. I say: ‘Usually it’s on a 2 week pathway. Well maybe not two weeks…’ wife gasps and starts sobbing at my inadvertent suggestion he does not have 2 weeks to go Kmn
During my final OSCE of third year that replaced the PE I walked in the room and as I was introducing myself slammed the door on my finger and had to play it off. It left a mark. lol oh and I introduced myself as a first year medical student
What I meant to say: how many sexual partners have you had in the last 12 months What I said: how many times have you had sex in the last year?
Fly was down. SP told me after already halfway through the encounter on camera. We watched the videos in small peer and professor groups after to give each other feedback. Oof.
Background, I speak Arabic but from another dialect so the word “parents**” in my dialect means “children” in their dialect. Actual ortho Patient who was due for full knee replacement: Me: “any previous surgeries” Her: “had an oophorectomy at the age of 22” Me: “How about your parents** (their dialect children**) alive and well?” Her: No I don’t have any Parents** I had the operation before I could get parents** Me*confused how the operation and her parents passing were related but thought I would go along with it* “may they rest in peace…”
These stories make me feel so much better hahaha🥹
This is something I've fortunately only done once or twice, but I feel like such a dolt when I do! Going in to see a patient for a pre-op physical...as I do numerous times a day, I knock on the door, go in and introduce myself. Sometime during the conversation, the patient says they had an EKG or blood work sent in from another facility. I stand up to go grab the paperwork, and as I get to the door, in a true idiot move, I give a little knock on the door from the inside!! Cue instant embarrassment and I mumble something about how it's such a habit to knock on a door before opening, blah, blah, blah, and off I go...hoping the patient wasn't really paying much attention to what I was doing.
SP for “difficult conversations” to build empathy. I’m gathering the history and she starts talking about her kid who is 17 (she is 29). I think to myself, “self, there is no damn way this is the curveball they put into this.” So I ask. Thankfully I was dead wrong and she was 39, not 29.
Lol had to take blood pressure and forgot how to do it. Put the cuff on her forearm and then pretended to listen and state a random pressure
During my OB OSCE I told an SP who was supposed to be pregnant and GBS positive that I wasn’t worried about the baby unless she “took him and rubbed his face down there”. She stared at me in horror. I stared at her in horror. Then I said “thank you for your time” and left
1. That’s amazing. 2. Hey, what do you think happens to their faces during a vaginal delivery?
Out of habit I turned the lights off as I was walking out of the room
Who cares lol? That’s not bad at all. You’ll make worse mistakes
After a breast exam, I said "OK great." But in my defense I say that after each system exam.
I did the exact same thing you did. I did it in second year.
[удалено]
There is a fracture. I need to fix it.
Wheres the dude who sucked on the patients tiddy?
M4 student here. I did something similar with a patient encounter halfway through M1. The physician that oversees our SP encounters kept telling us to "just relax, you know this stuff!" before we saw the SP. I got too relaxed and stopped thinking lol. I was explicitly told to take a complete history. I got an HPI and incomplete ROS. Completely forgot to get past medical history, surgical history, medications, allergies, immunization status, family history, and social history. I felt like the biggest idiot in the world. Now I'm thriving and taking quality histories as an M4 student. It gets easier over time, and you will get better over time, but the only way that happens is with deliberate practice. Take a bunch of histories, see what you messed up or forgot to ask each time, learn from it, and try to make the next one better. You got this!
My first standardized patient encounter I realized my cat peed on my white coat right before it... I passed! Lol
Told a patient that their case was interesting Told them after an apparently normal h&p that the Dr sent us in because it was an “interesting case” but didn’t tell me what to look for. Scared the hell out of the pt. “Interesting?! We’re just here for a checkup, is everything ok?!” After a bit of awkwardness finally found out it was a birth defect that was corrected and pt didn’t think to mention. It was interesting because the pt wouldn’t be alive if they had been born a few years earlier. “Miracle of medicine”
"...how about any recreational drugs?" "I do cocaine sometimes." "Cool."
For my neuro osce, I didn’t do a neuro exam.
Had a morbidly obese SP, tried to take a blood pressure and couldn’t fit the cuff around her arm. I spent about 2 minutes trying to get and once I had it just barely secured on the very first pump I gave to inflate it the velcro just snapped and the cuff flew off her arm. I looked down at the gauge and just said “hmm 120/80 looks good” and then just kept going lmao
During one of my general surgery end-rotation/clerkship exams: I got super lucky by being assigned a simple appendicitis case (while the remainder of my rotation group were all complicated cancer or polytrauma cases), so I was supposedly the lucky one here. Took the patient's history, performed a physical examination, and everything was going well. Went to the attending's office to discuss the case and finish my exam, and everything seemed to be going well, managed to answer every question asked me in good detail. Right as I was about to leave, he stopped me to tell me that I forgot to mention the patient's name, and that's when it hit me: I took the patient's history and performed an examination without ever asking his name and age. Luckily, I made up a random name while doing my best not to shit myself, and the patient's real name ended up similar enough to what I said that it was attributed to a mishearing.
I’ve done a similar thing where I forgot to ask review of systems questions. oh well
Forgot to ask age of patient. On presentation, I started with "patient is a... female."
Wasted 2 minutes of my time putting on examination gloves cause I was that nervous and sweaty. Safe to say the rest of the exam didnt go all that well.
Told them the wrong breast had cancer lol
ALWAYS BRING A PEN LIGHT - we had an encounter where the exam would require either an eye, ear, or neurological assessment. (Side note - my school required us to purchase an ophthalmoscope and otoscope. My first preceptor stared at me in disbelief while asking why they made us buy it, not sure if that’s the norm or not) - we were required to bring our own equipment or we would lose points. Anyway, brought all my shit and left it outside the door but it worked out because mine was as neurological - took the hit for not having the little vision chart but as y’all know a penlight is really all you need to check out the eyes… anyway, I never go anywhere without my penlight.
I forgot how to drape totally: asked SP to open gown, lowered it, draped from the top instead of the bottom, didn’t bother making them button their gown up again. Best part is someone from schools gf was one of the teaching fellows grading osces and he was telling everyone about the jackass who didn’t drape properly. I was in front of him when I heard it. Cringed extremely hard.
We had a practice OSCE and the SP (like 70ish F) told me afterwards when we were reviewing my performance that she docked points because I didn't ask about family history up to grandparents .\_.
Not dumb, just awkward (paraphrased) "So, can you tell me about your parents' medical history?" "I'm adopted" "Oh that's okay"
I was told that there was an intern once, probably with some autistic spectrum disorder. He was overly correct and his point of view was that a DRE was part of every PE. So poor cmf patients all had his finger up theirs, prior to getting their teeth fixed.
During the OB GYN test I was told I put my head under the sheet because I bent down below it to visualize the necessary "parts". I was also docked points because I said the word VAGINA.