4th year: So! Let’s try our hands at a patient case. There is an unconscious patient with multiple lines and a foley cath lying in a hospital bed. I’ll tell you what happens, but first, you tell me what you want to do.
1st year: … Take a history?
4th year: Er, well, no, because the patient is unconscious. But what would you normally do after taking a history?
1st years: *crickets*
4th year: … What do doctors do?
1st year: Physical exam?
4th year: Great! Vitals. Yes. So her temperature is 102. Now what?
1st year: … Take a history?
4th year: I – no, okay, no. So what do we normally do after a physical exam?
1st year: Um…. can we take her blood?
4th year: Great. Labs! What do you want to do with the blood?
1st year: Take it.
4th year: … okay, so we’re going to culture the blood sample, and – yeah… we might not have time for this one.
Action Potential 
I would have guessed “check if she’s alive” as an answer to the first question….does that count as legitimate? Haha.
Haha, didn’t even think about that.
I think so, because the 4th year also gave us a respiratory rate, but we were like “Oh.. a number. Is that… high?”
Someone who was in another group told me that we were supposed to figure out she had an infection from her catheter. Live and learn.
Do a rectal!
Excellent.
WordPress is telling me that “Do a rectal!” was my 500th comment. I AM SO PROUD.
Do a barrel roll!
(Sorry, couldn’t resist.)
Yet another example of how distanced clinical medicine is from medical education.
Hahaha.
Yeah, pretty much. We start our clinical medicine & physical diagnosis classes next month – can’t come a minute too soon.
How about read the patient’s chart? There’s gotta be some baseline data there, like presenting complaint and what diagnostics have already been done, for starters. Otherwise, might you not just be repeating blood work that’s already been done?
(Plus, I vote that a sympathetic 4th year who knows you guys haven’t done this yet would give you history=acquire more information, i.e. find and read the patient records.)
Haha, yeah. This girl was actually pretty cool – I should’ve mentioned she also told us that we had no chart, and we had no support staff.
I don’t know when we’d ever be in that situation. I sort of filled in the blanks myself and assumed she was referring to a post-zombie-apocalypse world.
Left 4 Dead 3: Med student edition!