When medical students observe doctor appointments

This columnist believes it's a chance to help others down the road

Erin Fortin avatar

by Erin Fortin |

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You’ve been busy preparing for a doctor appointment that’s today. You have your notes from tracking symptoms, along with questions you want to ask. Maybe you’re a little anxious. You check in, wait, and then are brought into the examination room, where you discuss your medications and have your vitals taken. Finally, a doctor enters, accompanied by someone you’ve never met before.

A medical student is shadowing the doctor during the appointment. How do you feel about that? Does having a student present to observe and learn bother you?

This scenario has never bothered me, even before my diagnosis of paroxysmal nocturnal hemoglobinuria (PNH) in 2019. I thought that everyone else felt the same way, too, until the topic was brought up among my family, and some of them felt differently. They thought it infringed on their privacy and preferred not to be viewed as subjects for a student to learn from. But I think students need to start somewhere, so why not with me?

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Sharing knowledge to benefit others

Since my diagnosis, my desire to improve the future of PNH treatment has always motivated me in every aspect of my advocacy. If a student observes my rare case, it will benefit a healthcare provider in the future. As I discussed in a previous column, not every doctor knows what PNH is, so if I can be an example a student will draw from in future cases, it can be powerful.

A survey of PNH patients discussed in the Journal of Managed Care and Specialty Pharmacy found that, on average, it can take up to two years to be properly diagnosed. For some, it takes even longer. My hope is that the students who observe me will keep PNH in mind when learning about a patient’s symptoms. How amazing would it be to reduce that statistic to one year or less by spreading awareness and educating future providers?

Many students have observed my appointments, mostly with my hematologist. When I was pregnant with my daughter, I was seen by students from a local university, who began the appointment by asking questions, such as how I was feeling. Then the doctor finished the appointment.

I was happy to work with the students because most of them had never heard of PNH. Pregnancy with PNH is even rarer than PNH alone, so my doctors had limited research to guide my care. I was proud to be the first patient they’d seen with the disease.

I can see how some patients might be uncomfortable with this arrangement. Relationships are formed with doctors, who create an environment of trust and comfort. Having someone there you just met could affect how you speak with your doctor, the type of questions you ask, and how many details you want to share.

Another concern might be that your doctor, while teaching a student, might not be giving you their full attention. This hasn’t been my experience, though. I’ve never left an appointment feeling dissatisfied because we ran out of time. If at some point I did feel that way, I think I would say something to the doctor.

What are your thoughts about students observing appointments? Please share in the comments below. 


Note: PNH News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of PNH News or its parent company, Bionews, and are intended to spark discussion about issues pertaining to paroxysmal nocturnal hemoglobinuria.

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