By Aaron Cantor, MS1 Pennsylvania State College of Medicine

In just the first day, I feel refreshed to listen to, and take part in, the unique conversations that develop spontaneously after activities and during breaks.  I hope we can discuss results of increased patient safety as a group with regard to medical student training at free-of-charge clinics.  These venues often provide care to vulnerable populations, who medical students may “help” by performing common procedures or assisting an overworked volunteer physician.  Many procedures have an inherent learning curve in which mistakes are common during the learning stages, and these mistakes may cause undue harm to the patient.  There is certainly a fine line between a medical student providing helpful care and learning versus harmful mistakes and discouraging patients from visiting again.  Medical students may also overestimate their skills and find themselves in uncomfortable situations without readily available assistance.  For example, I am aware of situation at a clinic where MSIs and MSIIs were allowed to insert a speculum for a Pap smear.  The students were never formally trained in this procedure but some staff in senior positions thought it would be a good learning opportunity.  Similarly, I have been offered to practice venipuncture for the first time at a health clinic even though I had no prior experience.  Yes, it seemed to be good chance to learn and a relatively innocuous procedure, but I still felt uncomfortable with trying this procedure for the first time on vulnerable patients who may already lack trust in the medical community.  Advances in patient safety should help avoid these situations but the counterargument focuses on what better methods can be employed to provide experiential training on real people.  I think practicing on each other would be a good start, but certain procedures obviously negate this possibility.

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