I Wish I Were an OSCE Meyer Wiener...

Tomorrow is our first OSCE test. OSCE stands for "Objective Structured Clinical Examination" and is the first time that we get to officially play doctor. We will be given a simulated patient (an actor or actress) with simulated vital signs and a simulated medical problem. We have 18 minutes to properly greet the patient, establish some semblance of rapport, clarify the chief complaint, get a pertinent history, conduct a physical examination, and provide a differential diagnosis ("I think you may have..... THIS, this or THIS"). The entire time a proctor will be hovering over us and grading our every decision. Most of the young people, my esteemed colleagues, are quite nervous about tomorrow, as very few of them have ever done anything like this. For myself, I did this in the Army for about 18 years. I'm not nervous at all!

Sort of...

In the Army, I had the opportunity to see hundreds and hundreds (and hundreds) of patients with pathologies of nearly every kind. In those experiences, though, I was the medic. I would greet, screen, stabilize, sometimes diagnose (with a doctor around), and treat. Tomorrow, I'm going into that room as a student DOCTOR. In other words, there is no one higher up the chain to blame if I mess up! Though I am only in the first semester of medical school and have a very, VERY long way to go, I am being given a taste, however small, of my future for my patient tomorrow will be looking to me, and me alone, for help to heal their ailment. They will expect me to know what I'm doing and to do it in a manner that is smooth, compassionate, and competent. They will be looking for a man both educated and sympathetic, a balance of Einstein meets Mother Teresa. I'm suddenly feeling very small. Doubts begin to ping around in my head like so many billiard balls: what if I don't measure up? What if I forget something important? What if (and this is my biggest fear, God forbid), what if I hurt the patient? Primum non nocere never weighed so heavy. 

In the end I know that tomorrow is simply a test of skills thus far developed, that the person in front of me will be a paid actor, and that it will all be over in a few minutes. What tomorrow means to me, though, is that I am growing up to become a physician, one who is being trained to care for hurting humanity. I'm beginning to sense a passion for people and a love of learning I've heretofore never known. And I am reminded that there are few greater joys than to help the hurting. 

Bring it on!

                                                   Image Credit: Ronald Harden (r.m.harden@dundee.ac.uk)