So yesterday the awesome attending I work with started a new “game” at the conclusion of the day, oral board style cases, and I love it! He pitches us a one liner representing a commonly seen patient and says “so what do you want to do?” and lets us have at it. We have to ask about everything and nothing gets done unless we tell someone to do it (exactly like oral boards at the conclusion of residency). And man, I wish every service did this! We as students naturally have so much information at our finger tips without realizing what it actually took to get.

Example, Sodium levels: want to see what it is, well you need to order it, but you can’t just ask for “sodium”, you need to order a set of labs, but which? Basic metabolic panel (BMP) or complete (CMP), but what’s the different? Ok, so you’ve picked one, that’s cool, but who’s taking the sample and from where? arm, leg, right, left, nurse, phlebotomist? Now they have the sample, but how long until you can SEE it? It has to go to the lab, be analyzed and then posted. And that’s to obtain ONE LAB VALUE. When I look at a patient’s medical record I typically have ~50 numbers to look through, compare & contrast, along with imaging, notes, etc. It’s overwhelming if you really think about it.

That’s what makes this game so fun! You get NOTHING if you say NOTHING. You get overwhelmed if you ask for too much. Realize you need something later, well shoot, it’s going to be ordered late and you’re going to have to sit back and wait. The patient’s crashing because you can’t think of the correct diagnosis? Well it’s going to get a lot worse rather quickly until you can remember it (good luck under pressure at the conference table with your attending sitting across from you let alone in a packed emergency room bay with everyone staring at you and a patient that’s literally dying before your eyes. I started to write up the case from today but quickly realized how much time it’s going to take to draft up something that’s not going to suck, so over the coming days/weeks I’ll post the cases along with helpful hints/tips so everyone can learn something regardless of your position/interest 😉

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