Musculoskeletal clerkship: Feedback for change

The musculoskeletal clerkship is a two-week pass/fail course that exposes medical students to orthopedics, rheumatology, physiatry, and orthopedic radiology. It is entirely clinic-based and observational, which I find puzzling given that orthopedists spend a considerable amount of time in the operating room doing hands-on work.

I haven't written much over these past two weeks because I haven't had anything nice to say, and I don't enjoy writing about negative experiences, no matter how germane they are to my medical school experience. Normally, I would just wait until the end of the clerkship then speak my mind through anonymous evaluations.

But a strange thing happened earlier this week. One of my orthopedics preceptors happened to be a block co-director. Dr. S asked me how MSK was going. My reply: "It's going well. I really enjoyed rheumatology clinic." The first part was polite and perhaps politic; the second part was true.

Apparently I wasn't convincing enough because he asked me, "Can I speak with you in private?" Oh boy, what did I get myself into? I would've felt like I was being called to the principal's office except for the fact that Dr. S has a very kind and non-intimidating demeanor. He sat down, crossed his legs, looked at me thoughtfully, then said, "Tell me how the clerkship is really going."

"Are you looking for frank feedback?" Yes, frank feedback. Dr. S reassured me that my comments wouldn't have any impact on my grade; he also convinced me that my feedback was valuable to him and would likely be used to shape the future MSK curriculum. Then I told him what I really think about this clerkship. I won't get into the details of my criticisms here in this forum.

The conversation lasted much longer than I expected, even eating into clinic time. I was impressed by the importance Dr. S seemed to place on this feedback by virtue of the fact that he was making his resident and patients wait. I walked away feeling that my voice and frustrations had actually been heard by someone who will use that information to make substantive changes to improve the MSK block.

It's obvious that Dr. S has been listening to many students before me; I admire him for that. In fact, Dr. S says that major changes to the MSK block may be implemented as soon as next semester.

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As a consolation prize for the unfortunate reality that I will not benefit directly from those changes, Dr. S invited me into the operating room to watch some surgeries. I saw a carpal tunnel release surgery, a couple surgeries to correct trigger finger, and removal of a cyst that was impinging on the radial nerve causing pain. Dr. S had me hold retractors, the age-old role of the medical student, but more importantly he took time to teach me.

I loved it. Great to end the clerkship on a high note. Plus, this was great practice for my upcoming Surgical Care clerkship.