What It's Like to See a Patient for the First Time

New section

A medical student answers questions about what it was like to see a patient for the first time during medical school.

New section

New section

Richard Wu

Undergraduate: Northeastern University 
Major: Bioengineering with a concentration in Cell and Tissue Engineering
Medical School: Boston University School of Medicine
Anticipated Graduation Year: 2025

Bio: Richard Wu is a second-year medical student at Boston University School of Medicine and the first in his family to go into medicine. While an undergraduate student at Northeastern University majoring in bioengineering, he found his passion in mentorship and education mainly through working with underserved children during his two years with AmeriCorps. Growing up as a first-generation American provided unique insights into the immigrant experience in our healthcare system, and Richard hopes to eventually be at the forefront of shaping public policy and working to make those interactions more compassionate and equitable.

When did you first see a patient?

Only a few weeks into my first year of medical school! As part of our Doctoring course, we had the opportunity to interview in-patients on the Med-Surg floor while under the supervision of an M4 (4th year medical student) preceptor so we could practice our interviewing and communication skills. The sounds and smells of the hospital, the mounting anticipation of meeting my first patient, and the knowledge that the whole interaction was being carefully observed made it quite nerve-wracking!

What was the hospital like?

My medical school’s main teaching hospital, Boston Medical Center, is the largest safety net hospital in New England. It has the busiest emergency department in the region and has a charter-mandated public health mission. We’re also located at the crossroads of the state’s opioid epidemic and serve a disproportionate population of Medicaid patients. The hospital’s mission and patients have jointly pushed it to be intimately involved in addressing the social determinants of health, and our patients often have complex challenges that extend beyond their chief medical concerns.

What were your responsibilities?

My responsibility was purely to further my own education in practicing interviewing skills. And yet, that did not help alleviate any of my nervousness. The patient in the room was quite sick and though he had agreed to be interviewed by an M1, imposter syndrome weighed heavily on me. Would I mess up and say something I shouldn’t? What would he think of me? My white coat felt like it was too large for my body. It took every ounce of concentration not to fidget with the pen in my hand, and I felt my voice shake as I blurted out the questions far too quickly and quietly.

Upon entering the room, I made a frantic sweep of the area and I didn’t see any chairs to pull up, so I stood in front of the patient, forcing him to crane his neck upwards from his perch on the bed. I slowly went down the list of questions I had prepared: O…onset. P…palliation… The mnemonic, OPQRST (each letter representing a part of the History of Present Illness (HPI) that we were to ask), got a bit blurry in my mind as I went, but slowly, I found myself smiling and joking with him. We soon dove deeper into his life story, and as he told me about the projects he grew up in I gradually began finding my stride. When it came time to present the case to my M4 preceptor, I realized that I’d managed to get quite a good amount of useful information pertinent to his chief concern! I left that hallway with a newfound excitement for the next time I’d return to the hospital.

Were you nervous?

So incredibly nervous! While you can prep all you want and memorize all the mnemonics you can, nothing quite prepares you for the feeling of standing in front of a patient. Being a first-year student, I was all too aware of the fact that I was there as a learner and that the patient was volunteering to help me despite their own challenges. A lot of medical knowledge can be learned from textbooks, but many important aspects of our education can only be achieved through real, hands-on experience and through making mistakes. Over time, I’ve gotten better at building rapport, keeping patients on topic, and covering all the questions I need to get through. There are still times when I get nervous approaching a patient, but with more time and experience, I get more comfortable.

What did you learn?

I’ve learned so much about communicating with patients through these encounters. It seems a bit silly to say – shouldn’t a medical student already know how to talk to people? But somehow, it all feels different when the person you’re with is in a hospital gown. With that first patient, I also learned all about his life: where he grew up, what he liked doing as a kid, his career, and how he ended up here. I learned about his wife who was coming to visit in a few minutes, and about his cozy apartment in the city. I learned about his vices and successes and gained a much deeper understanding of someone who had been a complete a stranger only a few minutes prior. Through this encounter, I learned the trust that patients place in those who take care of them, and that despite being a student, I am also one of the members on the care team that patients place their trust in.

What do you wish you’d known before the first experience?

How much I would love the experience and that I should speak up and be louder! Also, the value of a listening ear. I felt very powerless going into that room – that I was a learner with not much to offer. But I left that room with a much different perspective. The fact that we are students gives us a distinct advantage over those more senior than us: we can spend more time with patients. For many patients, being in the hospital can be a very lonely experience. Being able to give that patient the space and time to talk about himself and his life journey was a very meaningful experience for both of us, and one that I cherish and remember each time I go into a new room.

New section

Engage with Your Peers
Aspiring Docs Diaries

Translating Pre-Medical Experiences into Clinical Skills

Michael Foster | May 3, 2023

Your time before medical school is golden. It is a unique time to explore where your passions lie (both within and beyond medicine) and lay a strong foundation of the inter- and intrapersonal skills needed for you to be the best physician you can be. The best advice is simple: challenge yourself, be honest, and have fun! […]

Read More
Getting Into Medical School Brochure

The AAMC offers trusted resources and services to help you navigate the journey from premed to residency and beyond.