Avera Clinical First Steps

The Avera healthcare system offers a nice 6-week summer course to the Sanford School of Medicine medical students between their first and second year called the “Clinical First Steps.” The program setup for two primary purposes.


The first is to give the early medical student a glimpse into what clinical medicine is really all about. To do this, the program tries to educate the medical students about what the supporting staff do in the hospital setting. The creators of this program had some stories as based on physicians who sometimes wondered, ‘why didn’t I learn that in medical school?’ They have also heard their fair share of, ‘how come that doctor didn’t learn that in medical school?’ types of comments. So six years ago they decided to create this program to give us the type of experience that generally isn’t taught to medical students.

Today during our orientation, the leaders of this program really wanted us to take home this first goal of the program. The example was one of a young 3rd year student. The ER physicians during this trainee’s time let the student ‘lead’ on a some-what critical case. The student started barking orders and requesting tests (an ABG to be exact). Getting carried away in the moment, the student demanded to see the results of the ABG ordered only 5 minutes prior. (NOTE: I have no idea how long it takes to get results from an ABG, this is just the story we were told.) Moral of the story was that medical students need to learn how long tests take to order, how long rooms take to clean, what a social worker, PT, OT, case manager, administrator, et cetera does all day. Knowing these things will makes us more effective and understanding physicians, and is the first goal of the Clinical First Steps program.

The second goal of the program has a little different spin. According to the opinion of one of our leaders, there are some doctors out there that were not meant to be doctors. Of course these doctors were smart and dedicated individuals, but they just don’t have the compassion (or whatever) to be good physicians and just work pay-check to pay-check not ever really caring about the patients. Luckily these people are a small minority. Our leader continues on to say he feels that unfortunately a larger portion of doctors end up in specialties where they are not truly happy. He feels that many physicians do not work in a specialty where they are truly engaged in what the specialty offers and the types of patients that doctor encounters. These doctors careers quickly become just jobs. When this happens these doctors also start to live from pay-check to pay-check looking forward to the day that they retire. This man’s opinion scares me, as I (and I’m sure my colleagues as well) want to work in a specialty where we are happy and fully engaged in it throughout our careers.

Finding this calling, is the second goal of the Clinical First Steps program. Throughout the next six weeks program leaders hope to expose us to as many different specialties as possible to help us get a feel for what we may someday want to do.

I am excited to go through this program and I have high hopes that it will help me narrow down my calling. I also can’t wait to start interacting with patients again, I really miss the hospital environment and it really brought back good memories being on the floors again.