“Scut work”: an important part of medical education?

When I started clerkship, I found myself doing a lot of “scut work”, or tasks that did not seem to have any educational benefit. Each rotation seemed to have its own. In surgery, this meant retracting or suctioning during a long procedure. In internal medicine, it meant completing discharge summaries, or dictating the notes of patients you had observed. Sometimes, it meant doing things like ordering dinner for everyone on the team and getting all the lab results and charts together before rounding. I often found myself wondering: Am I truly learning? 

In retrospect, I realized that I was (although I didn’t know it). Learning in medicine is so much more than just simply information about diseases and treatment plans. In fact, a lot of clerkship meant learning how the hospital runs and what goes into making sure discharges happen smoothly, patients get to their procedures, and proper documentation is written. It also meant learning how to function well as a team-member and doing menial tasks for others often made me feel more valued as a team player.

I also learned to embrace every experience. Yes, dictations or discharge summaries may have seemed trivial at first, but I began to realize how important they were for continuity of care for the patient once they left hospital. I was also able to derive important lessons from looking through the chart from beginning to end, and often I would realize the personal mistakes I had made throughout the visit. 

In a February issue of the NEJM, two physicians make the statement that medicine is a service profession. They argue that service to patients should not be regarded in opposition to medical education. They write: “As we train future physicians, we should convey the message that service to patients is fundamental to our professional role and an invaluable mechanism for learning.” I happen to agree completely.

-Carolyn