Kansas City University of Medicine and Biosciences - Stethoscope Yearbook (Kansas City, MO)

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bstetrlcs VERY senior student at the Kansas City College of Osteopathy and Surgery looks with great antici- patlon toward the tour of duty at the on-campus Maternity Hospital. The Obstetrical phase of medicine incorporates an immense array of diagnostic problems and, thus, provides an enormous gamut of learning experience. The young physician who desires to pursue the field of general practice soon realizes the importance of acquiring the very best Obstetrical and Gynecologi- cal training possible . . . to that goal our staff physicians and field specialists are dedicated. Over fifteen hundred infants are born annually at Conley Hospital. Each student has the privilege of scrubbing or assisting on approximately 100 deliv- eries. Personal contact with the delivery room pro- cedures is, therefore, engrained many times over to facilitate confidence and proficiency. At the time of admission, the expectant mother is thoroughly evaluated both Obstetrically and medically by the Student Doctor on duty. It becomes his respon- sibility to attend her through the tense and anxious hours of labor and to lend support and compassion during this time of need. He will follow this case to the delivery room and assist or manage this miraculous event of bringing life into the world. Next to the medical phases of the post-partum recovery . . . the student will stay by the patient's side until her condi- tion is within satisfactory limits. It is then his respon- sibility to perform a complete physical examination on the brand new babe. After satisfying himself that all is well he proceeds to the next case with unaltered anticipation and vigor. This ritual may be repeated many times during the day or night, but somehow never loses its thrill . . . each case is unique and con- tinually offers a challenge to the ambitous young fetal doctor. As in all phases of medicine, the pathological problems embrace special interest to the knowledge- able mind. The student learns early through didactic material and practical experience, to recognize these abnormal clinical situations and to furnish a method of management intent upon the safety of both the mother and fetus. This employs a vast amount of responsibility and provides a learning situation unsur- passed by other forms of training. Not to be forgotten are the seminars presented three times a week under the direction of a certified Ob-Gyn specialist. A new and different topic is discus- sed at each meeting as are general diagnostic problems which extern has had an opportunity to witness or experience som-etime during the nine week service . . . such as, breech presentation, abruption placenta, pro- lapsed cord, etc. to mention only a few. Prior to graduation the student is limited only by his interest in the field of Obstetrics: however, he is required to deliver a minimum of three babies in order to meet the qualifications for graduation. This entails strict prenatal care of the patient up to the time of delivery, complete responsibility, under supervision, for the delivery room procedure, circumcision of the male infants and management of the post-partum course for both mother and infant. The routine day never occurs at a Maternity Hospital. Each 12 hour shift may provide for times of relaxation, reading and an occasional game of cards but the spirit and atmosphere of imminent maternal emergency is forever present in the minds of these physicians.

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011 Hospital Duty THE day begins at 7:00 ILM. and ends a long twelve hours later for the medical extern. Breakfast from 7:30 to 8:00 then to the respective floor for the daily on- slaught of history and physicals. As part of the educa- tional training program, the student, while doing his- tories and physicals records his findings, makes his diagnosis, suggests his treatment and the patients pro- nosis and later compares his ideas with a member of the department of medicine. Every morning, the extern makes rounds with the staff doctors and various members of the department of internal medicine. Here again, there is much for the embryonic physician to learn under the guidance of a qualified and experienced D.O. In addition to H. and P.'s, there are multiple and varied duties which again are designed to make the senior student better prepared for his entrance into general practice as an Osteopathic Physician. 'l'he duties include such procedures as I.V. medications, dressing changes, O.M.T., assisting field doctors with examinations and personalized patient care. The latter is one of the most important features of hospital duty: that is, the intimate contact between student doctor and the patient. Here is where patient-doctor rapport begins. Seminars are held daily for all extems from 3:00 to 4:00 P.M. The student must prepare a paper dealing with the topic of that day. In addition, student doctors are invited to witness imusual cases or procedures. Pediatric Seminars are held Tuesdays and Thursdays by members of the Department of Pediatrics. Wednes- day afternoon is devoted to the Cancer Detection Clinic under the auspices of Dr. L. R. Hall. To make the extem training program more resili- ent, students are encouraged to follow specific cases of their choosing, from their inception until a final diagnosis and treatment have been completed. Often times this will involve such procedures as radiology, cystoscopy, and orthopedics. The highlights of the senior's thirteen week tour of hospital duty as a medical extern begins when he learns the procedure of the Emergency Room. Here extems observe and assist the interns in emergency treatment of those acutely ill. It is here he begins to apply his years of medical training in practical appli- cation, whether it means suturing a minor laceration or giving extemal cardiac massage. Another fascinating tour in the world of medicine comes with night duty. As an extern progresses in ability and confidence, he begins to assume more responsibility. It is his job as night man to make periodic rounds of the entire hospital. He must be in frequent contact with the charge nurse of every floor and any undue complications are reported to the surgical or medical resident on call. This has been but a bird's eye picture of the fascinating and exciting world we live in as medical extems. Medical Externship ,wg 1 , .335 f - Li -5 , .- f ? -f 1 4, ,ag

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Psychiatry mf -as Students and Psychiatric Staff at State Hospital No. 3, Nevada. Missouri l 1 t I . . f'lS'lf ffl r ' ' N ! . . l L 'vw---1 mi' The Clinic Patient Also ls Offered Psychiatric Therapy CHIZOPHRENIC reactions: catatonic, simple, para- noid types: obsessive compulsion: chronic brain syndromes: anti-social reactions-sterile phrases, objectively digested in an aseptic classroom environ- ment for three years suddenly become living realities to the senior student during his tenure of psychiatric service. During a brief four or five weeks, he loses himself in the problems of others and blends with a small dedicated staff, preoccupied with alleviating the anguish of some 2000 mentally ill. He becomes oblivi- ous to the outside world as he soon realizes that these hospitals and their grounds located at either Nevada or St. Ioseph are actually communities within them- selves, containing their own bakeries, laundries, thea- tres, clothing stores, and chapels. Becoming a member of this community, he is soon aware of the utter im- partiality of mental illness as it forcefully reveals itself causing distress to the very young and old, the very poor and wealthy. An average day of the student's psychiatric duty is full, varied, and extremely challenging. He is given the privilege of making rounds with a staff physician every morning, these rounds including geriatrics, male and female wards, and the admitting clinics. Here he gains a knowledge of correct communication between physician and patient, learning what to ask, and how to listen, each word having the potentiality of being a clue to the correct diagnosis of a particular patient. The student doctor is shown every possible considera- tion by the staff and made to feel free to question the physicians about various patients. He is also allowed the courtesy to interview any patient he so desires, and may have access to their mental, physical and social histories to complete his studies. Each day there are seminars presented by various members of the staff covering a multitude of subjects dealing with psychiatric problems and their therapies. Here again, he realizes the magnitude of just this one field of medicine. The most demanding and also the greatest challenge involves the individual patients assigned directly to the senior student for complete evaluation. The student performs a thorough psysical, as well as an exhausting mental examination. All of his findings are correlated, dictated, and presented to the staff at their bi-weekly meetings. With these find- ings, the student also offers his complete impression of each patient coupled with a tentative diagnosis. The patient is interviewed by the staff. and the student's diagnosis is either accepted or rejected, thereby proving to be another excellent training mechanism designed to help each senior student realize his short-comings, as well as his attributes in diagnosing the mentally ill. The training received at these hospitals should aid each forthcoming physician, whether he becomes a G.P. or specialist, to recognize symptoms-, to establish diagnosis, and to outline proper therapy. 'By living in these hospitals, he is certainly made aware of the tremendous improvements that have been made, but equally conscious of the vastness of the obstacles yet to be overcome. It has given the Osteopathic student doctor one more aid, one more insight, one more hand perhaps, to assist others, which should be and is his main goal in life.