Who needs medical students?: Doctoring is as much about teaching as it is about treating

One of our challenges as we make our way onto the wards is to determine our role. Our agenda is to learn. However, students face many different styles of teaching, and at 1 point or another, we must endure the experience of standing idly against the wall of a room 1 seat short, looking on during a session of rounds with a mixture of genuine interest and self-conscious alienation. We find ourselves wondering, “Do they know we are here?” This first question leads naturally to a second: “What difference does it make to anyone that we are here?” We are keenly aware that the 2 years of medical course work under our belts are virtually obsolete when it comes to patient care. Of course, we can write notes, assist in procedures, chase down important lab reports, and perform other such functions, but in the abrasive “admit-discharge” world of the hospital, these contributions hardly seem to justify the time and attention that medical students incessantly require. As a result, we often feel that the duties assigned to us are merely token—obligations that may qualify us to be “team members” but are not enough to make us “key players.” Discouraged by our lack of importance, at some point, often late in the evening while determining whether to go home or stay on, we come to question whether anyone would ever notice if we were suddenly to disappear. What would medicine be like without medical students? Things would probably run a bit smoother without students to slow them down. Most likely, fewer questions would be asked, explanations would be briefer, and fewer repetitions would be required. And maybe at the end of the day, everybody would make their way home a little bit earlier. But without medical students, something would be lost—something that is indispensable to the teaching hospital. In the ever-moving world of medicine, nobody can keep up with every advance, and there are good reasons to slow things down. Dwarfed by the onslaught of huge patient loads and constantly changing protocols, the sharpest of residents may get things wrong. And with their focus on “cutting edge” therapies, the wisest attending physicians may forget the mechanism of an antibiotic. The gift of having medical students in hospitals is not that they do minor procedures or write notes. It is that as long as they are present, no question is too elementary to be discussed. In this sense, medical students are the backbone of the team. They are the reminder that every patient and every finding represent an opportunity for the advancement of personal medical knowledge. In a field as rapidly evolving and expansive as medicine, where questioning the percepts on which standards and protocols are based ensures that patients continue to receive the most appropriate medical therapy, this is an invaluable contribution. Medical students, as the bottom dwellers of the academic food chain, theoretically have the entire construct of a teaching hospital riding on their shoulders. In their short white coats, they ligitimize the simplest of queries. Their mere presence stands as a constant reminder that in its highest form, doctoring is as much about teaching as it is about treating.