written by Emily Hayward

EAB UABEqual Access Birmingham (EAB), UAB's medical student-run free clinic for the underserved.

When I first stepped foot into Equal Access Birmingham (EAB), UAB’s medical student-run free clinic for the underserved, I was nervous. I had only been a medical student for a month. If I were to hand you a list of everything I knew about treating patients… you’d probably be holding the world’s tiniest piece of paper. But that day, I had the unique opportunity to volunteer as a clinic leader, which meant that I would be responsible for patient care.

Before the shift started, the other first year student and I received a crash-course on patient care at EAB. We learned about where we would take our patients and how the clinic runs each day. We learned how to operate the clinic’s sphygmomanometer and blood glucose meter, and even practiced the finger prick on each other.

Additionally, our MS-1 clinical course trained us in taking a patient history and conducting a brief review of systems. Still, using these skills with a real-life patient seemed completely different. I was nervous, but I felt ready to take on the challenge, and was often comforted to see the names of other MSTP students as I began reviewing patient charts.

Once I felt like I properly understood the patient’s medical history and any pressing issues, I went over to the waiting room and called for him or her. In a silly way, this was perhaps one of the hardest parts of the day. Do I announce the patient’s first name?

Last name? Both? And how do I introduce myself and my role? I found that none of these details really mattered, and with even a couple more months of experience, I’m already laughing at my naïve self!

Next, I brought each patient into the clinic area.

I recorded vital signs and led patients into an examination room. I inquired about the patient’s reason for visiting EAB, making sure to take detailed notes about his or her chief complaint and associated issues. Before leaving, I summarized the information to the patient just to make sure I had the details right.

Of everything I did that day, piecing together the patient’s story was my favorite. I felt somewhat like a detective. In many ways, I think that is what drew me to medicine in the first place. The patient had an experience (or multiple seemingly unrelated experiences) to share, and I could brainstorm the right questions to ask that would illuminate ways in which we could help.

After leaving the examination room, I took a few minutes to jot down some notes and collect my thoughts into a coherent story to present to the physician who was volunteering his time that day.

I explained that I was a first year medical student, so these were my first patients. Still, I asked him if it would be okay for me to try my hand not just at presenting the cases, but also at analyzing the situations and drawing up treatment plans.

Fortunately, the attending was extremely kind and patient with me. Even better – he encouraged me to practice fully managing each patient’s care. As a mere first-year, I had the opportunity to tell him about Patient X, who came in to the clinic with complaints of dizziness and disorientation. After viewing vitals and lab reports, I suggested my first (correct!) diagnosis and proposed an adjustment to her current medications. Later, I would enter the complete analysis that the doctor and I conducted into the patient’s electronic medical record.

At times, the shift was definitely a learning experience. There were moments where I left the room only to quickly return because I forgot to ask a question, or when I failed to write the appointment time on the door. Yet when I speak with friends at other institutions, many do not believe the independence EAB granted me. I was honored to play a critical role in diagnosing, treating, and documenting records for real patients. To hold this privilege was such a gift, and I have no doubt it will help me be a better physician in the coming years.