First-year medical student Sarah Smith was pretty excited after first donning her white coat.
She was honored to wear the symbol of compassion and patient care as a new medical professional presented during the conclusion of orientation week at the University of Cincinnati (UC) College of Medicine. But it was also a moment for the Lexington, Kentucky native to muse with her classmates about their lack of medical knowledge.
"Someone made the joke, ‘You see all these students in white coats and you would think we know something about medicine,’” says Smith. "If there had been a bad accident outside the Aronoff Center, we would all be standing around looking at each other asking, ‘Is there a doctor?’”
It’s true the Class of 2021 still has a long way to go before treating patients, but Smith says a month into medical school she feels much better about helping an injured party if she witnesses an accident or a traumatic injury. That’s largely due to her training as a first responder. All first-year medical students have completed the two week course designed to offer lifesaving, skill-based techniques and procedures to aid in an emergency.
"Before the first skills test, I was really nervous and I was thinking we are four days into medical school and we are already expected to assess a patient experiencing a medical emergency, determine if there are any life-threatening concerns, take their vitals, understand what that means and come up with a field assessment and treatment plan while we wait for advanced medical support,” says Smith, a 23-year-old psychology graduate from the University of Kentucky.
"I remember sitting in my skills test and the process came to me very naturally,” says Smith. "I was able to stay calm and remember the training we had received. This course helped me gain confidence in my ability to handle a medical emergency.”
Dustin Calhoun, MD, medical director of emergency management at UC Medical Center and assistant professor in the Department of Emergency Medicine, says the first responder program is an amalgam of short 40-hour emergency medical responder course and a 150-hour EMT course.
The class of medical students is split into groups of 20 and they learn CPR, how to deal with anaphylaxis, how to manage airways and basic trauma along with making initial assessments of trauma and medical patients, says Calhoun. The students learn how to interact with patients in crisis and how to ask basic questions and do a basic physical exam.
"The first responder program came from the concept that medical students were now getting into the clinical arena, meaning being in clinics earlier and earlier,” says Calhoun. "Twenty years ago in medical school you didn’t even touch a patient until your third or fourth year of medical school. These days, students are in clinics as early as the first half of the first year.
"When you are out wearing a white coat it makes you look like a health care professional and part of the health care professional team,” says Calhoun. "If you don’t have the ability to identify and deal with some of the basic medical emergencies that can occur, that can be dangerous. It also isn’t the most confidence-building endeavor for a medical student either.”
"If they are in a clinic and a patient collapses they are not that classic second week medical student who has no idea what to do with this, but understands the biochemistry of what just happened,” says Calhoun. "They know how to access the patient’s airway, how to help manage that patient’s airway and how to do CPR.”
Medical students know what to do if a patient has fallen off a ladder; they have the ability to control the patient’s cervical spine and assist with basic needs, explains Calhoun. First-year students can also identify a patient who is sick and in immediate need of medical care. They will know to go and find a medical professional to assist.
Most first-year medical students haven’t had any medical training as a professional rescuer, but a few do have training as a paramedic or EMT professional. These students are appointed as leaders of their team during the first responder course.
Jeff Talarek, a first-year medical student, was among those team leaders. He is a former critical care transport paramedic and firefighter, from Waterford, Michigan. Talarek, 36, has an undergraduate degree in mechanical engineering from the University of Michigan.
He says the first responder course exceeded his expectations and that he picked up some new material.
"These were more nuances than entire concepts, but I have used the opportunity to build on my prior knowledge and dive a little deeper for my own benefit later,” says Talarek. "I am thoroughly impressed with the other students, some of whom have synthesized a volume of new information very quickly.”