It’s one thing to do a doctor’s work but it’s another thing when you diagnose something right without the doctor looking over your shoulders. Yesterday, the doctor sent me to do a full check up of a new admission on a female patient with a past medical history of hypertension and asthma. When I did a full check up I heard something abnormal while listening to her heart. I thought I was wrong but then I figured that I may not get the diagnosis right but I was confident her heart sound wasn’t normal. I went to my attending doctor and I suggested that she had a systolic murmur based on what I heard and also based on her past medical history of having hypertension. The attending doctor came in and listened to her as well and he confirmed that it was a systolic murmur also. He ordered an echocardiogram to see the intensity of the murmur.
Reading about it and answering these clinical questions correctly seems like a burden to pass the board exams; however, when diagnosing a patient with a real illness it feels exciting. Now don’t get me wrong, I don’t feel good about the patient having the illness but it’s a satisfying feeling figuring out the specific murmur out of the so many murmurs.
For those who are still studying for the USMLE Step 1, this is just the beginning of what you are studying for. Make sure you study well and know the clinical scenario for each diseases because you may run into such when you start your clinical rotations.