Third-year Harvard Medical School students attend an orientation day at BWH before beginning their clinical rotations.

Third-year Harvard Medical School students attend an orientation day at BWH before beginning their clinical rotations.

It’s a busy morning in the BWH Emergency Department (ED). A 23-year-old woman walks in with abdominal pain. A third-year Harvard Medical School (HMS) student on her Surgery rotation is asked by her resident to perform an initial evaluation of the patient.

“What should you do? Do you follow the instructions and meet the patient, or do you need a resident or intern to accompany you?” asked Erik Alexander, MD, an endocrinologist and director of Medical Student Education at BWH, during a mock case discussion with 59 third-year HMS Principal Clinical Experience (PCE) students.

These questions and many others were presented to students during a day-long orientation this month that was designed to prepare students for their first year of clinical rotations at BWH.

“The goal of this case discussion and others is to walk students through scenarios that they’ll most likely encounter as early as tomorrow,” Alexander said.

Implemented by HMS in 2008, the PCE is a 12-month integrated program comprised of one- to three-month clinical rotations through the departments of Medicine, Surgery, Obstetrics and Gynecology, Neurology, Psychiatry, Radiology and Newborn Medicine, as well as Pediatrics through a partnership with Boston Children’s Hospital. In addition to directly observing and learning in an inpatient care environment during what is known to be medical students’ most demanding year, students also receive yearlong mentoring, consistent feedback and experience in ambulatory care settings.

Students are assigned to a faculty mentor at HMS for the year and paired with a BWH resident physician. They work alongside other residents and attendings as part of the patient care team. The experience enables students to immerse themselves in the specialties they are rotating through and gain a better understanding of different disciplines and the multidisciplinary nature of medicine.

During the mock case discussion, students also learned what to do if a patient does not speak English and how they should answer questions from a patient’s family member, for example.

Obstetrics/Gynecology Clerkship Director Nicki Johnson, MD, and Kathleen Wittels, MD, director of Student Programs for the Department of Emergency Medicine, participated in the mock case discussion and guided students through answers to several questions, including what to do when a patient calls a medical student “doctor.”

“You want to clearly and calmly explain to the patient that you are a third-year medical student, who is part of his or her care team,” said Johnson. “If the patient continues to call you doctor, it’s important not to overcorrect them.”

During the orientation, students also participated in a hospital scavenger hunt and attended a meet-and-greet dinner where they met their resident “big siblings.”

HMS student Anji Tang, who will begin her rotation in the Department of Surgery later this year, has spent the past year working in a research lab at BWH. Tang said she’s looking forward to transitioning to a clinical role and learning as much as she can during the next year.

Third-year student Eugene Vaios, whose first rotation is in the Department of Medicine, says he appreciated the opportunity to ask questions and learn more about the different types of situations he may soon encounter.

“Today was a fantastic learning experience,” Vaios said. “I feel a lot more prepared and confident going into my rotation. It was wonderful hearing from expert physicians throughout the day and taking in everything they had to teach us. I can’t wait to get started.”


Third-year HMS students