Acute

“Do you realize that the first time most of our graduates manage an emergency admission is when they become medical officers?” JW asked me last week.

I felt that was a scary idea. But after thinking for a few seconds, I had to agree.

“And therefore I shall resume on-call teaching round next year,” JW concluded happily.

When we were medical students, attending on-call rounds was bread and butter. We had to see every case emergently admitted to the hospital that day. When the professor came, we presented the cases and discussed the acute management. We never talked about hypothetical treatments such as “we would prescribe broad-spectrum antibiotics”. Instead, we were facing real patients. We said exactly the antibiotics we should choose because of the type of infection, the background medical history, and perhaps even drug allergy. This was a learning opportunity that could hardly be provided elsewhere. For example, if you just wait one more day and see the patient after he is stabilized, the situation is already totally different. And I certainly do not mind what you prescribe to manikins.

Like many good things, the on-call teaching round disappeared out of the blue. The change probably occurred during my junior training years and I could not recall what happened. JW also did not appear to know the details but just said physicians were becoming lazy.

No, it can’t be. Think about the superstars. They are anything but lazy.