BRAVING THE M.D.

JOURNEY AMIDST A PANDEMIC

"First, do no harm", says the Hippocratic Oath.. Will face-to-face clerkship now make this principle more
possible compared to virtual clerkship as we brave our way towards becoming doctors?

The COVID-19 pandemic has posed various challenges including the alteration of our way of life. Aside
from that, our educational system has also been impacted as evident in the shift from face-to-face
classes into blended or online learning. The College of Medicine was not excused from such a sudden
shift.

In light of the pandemic, we, 4th year students of the aforesaid college began our clinical clerkship
virtually.

As we all know, clinical clerkship is one of the most challenging stages of our journey towards becoming
doctors. It was just a bit saddening that the first half of our clerkship was done online.

The first time we were tasked to write an essay regarding the said undertaking, it was pegged on the
above-mentioned modality. And halfway through our academic year, in the month of ________, when
the COVID-19 cases were dropping, we were given the chance to have our clinical clerkship face-to-face.

Cagayan Valley Medical Center (CVMC), the center of medical service in the region, became my place of
clerkship. Considering that CVMC caters to the medical needs of not just Cagayanos but also of those
from nearby provinces, I was immediately immersed in a busy and demanding environment. Time flies
so fast and so are the lives of the patients. While it was not my first time working in a medical
institution, CVMC offered me a different environment with many departments and with an
overwhelming number of patients who were admitted and discharged here.

Frankly, it took me some time to get used to walking along the hallways of the hospital and talking to
real patients. But eventually, I was able to immerse and engage myself with the environment and with
situations I was into. I had full- immersion learning experiences in practical base facilities where I
interacted first- hand with patients and where I was able to apply clinical sciences. It was the time when
I said to myself, "these are real-world educational experiences".

Further, I was in- charge in obtaining information. As we had our rotations among the different areas of
the said hospital, I came into close contact with the thin line that separates life and death. What was
noteworthy were the moments when, under the supervision of the admitting physicians, I had the
learning opportunity to put into actual practice what we had learned in our classes.

Among these gems of experiences that I was able to try were inserting foleycatheter, IV, and NGT.
During my clerkship, I had my duty at the Emergency Room where we admitted numerous dengue
patients. It was during my work at CVMC that dengue cases in the province skyrocketed. Moreover, I
also dealt with rabies encephalitis and CVD patients.
One remarkable moment within the duration of my training at CVMC was the time when I had to deal
with my fellow Piateño who was actually bound to undergo dialysis since 2021. However, his parents
and wife were reluctant to subject their patient to undergo dialysis. I became empathic towards this
case considering that I personally know the patient. I was compassionate to the point of explaining and
convincing the wife to allow her husband to undergo chemodialysis, which the wife and the parents
eventually agreed to.

On the other hand, it was on July 27 when Northen Luzon including Cagayan was hit by an earthquake. I
was at the first floor of CVMC that time assisting one of our patients when we experienced the strong
earthquake. During that time, I appreciated more the earthquake drill especially that we were put in a
spot where we needed to get out of the building safely as soon as possible while still taking
responsibility of our patients.

In a nutshell, due to the pandemic situation, we were not able to finish the ideal one year clinical
clerkship. We only had time to rotate to several departments. But the other side of the coin would state
that we were still fortunate to see real patients with various medical conditions, do OR assists,
appreciate PE findings, and learn from residents and consultants during bedside rounds.

"Doc, what other lab results do you want to get?"

"Yes, doc, I will read more on that po."

These were the lines that I always uttered during my clerkship. In spite of the sleepless nights and
draining moments that I spent, I was just lucky to be guided by doctors who unselfishly shared their
knowledge and expertise, and to be surrounded by my fellow clinical clerks who I shared genuine joy
with.

As I am nearing the end of my clinical clerkship at CVMC, years from now, I will certainly look back at the
memories that I had during my virtual and physical clerkships. One thing is for sure, soon when I already
become a full- pledged doctor, I would still bear with me the idea of how fundamental our clerkship is
because that prepared me to become an efficient and a responsible physician, even if we had our
clerkship partly virtual and physical.

Truly, the experience that I had during my clerkship at CVMC, which was conducted half-online and half-
face-to-face, was fulfilling nevertheless. It was the actual exprience during our physical clerkship that
made the difference.

It is my belief that while online clerkship was also beneficial, our face-to-face clerkship was more
efficient because it was more practical. I was hands-on in assisting and dealing with our patients because
we were able to come in contact with them physically. In addition, I was able to monitor the signs and
symptoms of the patients, thus the more accurate diagnoses that I had formulated.

Nevertheless, regardless of the inconsistent modes of our clerkship, I believe that my learning was never
compromised, as it should. Besides, one thing that I inculcated in me was that, in dealing with our
patients, I am always dealing with life and death. Hence, there are no rooms for compromises.
"First, do no harm". This is the oath that we are going to take soon as physicians. In this axiom or
principle, there is no distinction between undergoing clerkship online and face-to-face. So, regardless...
first, do no harm.