Advice to Medical Students - your thoughts

Be an expert - a thorough expert - on any drugs that you are giving to your patients.  Don't guess.  Know what you are talking about and tell the patients the real risks.  Don't gloss over important things.  For example, don't tell the patient her hair will grow back when it might not.  Never minimise the impact of hair loss.  

Just my experience because I have to know everything!
Helpful -
info sheets on side effects, and if possible ways to deal with them.

copies of all tests done, so I can give them to my GP and refer to them myself

A patient filter on your thoughts when talking to the patient. Mentioning stage 4 cancer when discussing a CT scan for lung nodules to a patient in hospital on IV antibiotics during chemo when they have been diagnosed with stage 2B is not helpful.
*****Remember patients hang on every word you say!********

Information on what will happen with chemo therapy, procedure, a info sheet could be handed out. 

Discussion on drugs used, reasons why, possible long term side effects.
My Oncologist gave me a choice of 3 regimes, using different drugs and we decided on one based on family history of heart disease, my age and health, and desirable length of time of treatment. I felt involved, understood as much as possible the reasons for choosing the drugs and had my family health history considered.

Assessment as to whether a portacath is possible/desirable before starting treatment.
Discussion of costs of everything, don't have to be asked.

Information on support groups in the area. Check that the patient has that information, don't assume that they will get it at another specialist or treatment centre.
It can just be one question, a referral to the information wall in the rooms or a handout sheet with contact details for support groups relevant to the patient. People fall through the cracks in the information network.

Not helpful-
recommending treatments without any discussion of costs, even if there are none, don't assume the patient knows this, it can be a great cause of stress not knowing if you are going to have a big bill.
Assuming the patient knows anything!
Just because things are standard practise to someone in the field, the new patient knows nothing in a lot of cases. And even if they do, telling them the basics again doesn't hurt.

But don't tell a patient that a certain pattern will be followed by another specialist unless you know for certain that it will.
I was told that I would have a certain pattern of chemo by my surgeon, and when the Oncologist told me I would be having another pattern I stressed that it wasn't what I was told would happen.
There was so much being discussed at that Oncologist appointment that I didn't get to question that.

Telling a patient that things will happen a certain way and then they don't. Be up to speed on current procedures for everything you are recommending, scans, blood tests, chemo preceedures, hospital admission, in an unfamiliar situation, if things are not done the way that you have been told they should or will be done, it can be very stressful not knowing if the proceedures are being followed the right way.
I question now, but didn't in the first instance and some people will be too sick or too nervous to ask.

Just a few things I can think of at the moment.

Press very firmly that you're treating the person as well as the disease. They will come to a point where they will see the body the way a mechanic sees a car and forget that their machine is a person. Holistic care, so important.

Couple of small things but think it says a lot about my surgeon - his staff were very busy one morning so he was taking calls and booked me in. Yesterday at my appointment my husband was quite touched that he spoke to him by his first name. He has a light but perceptive touch and sometimes makes his point with gentle humour - he is always human and relates to us as the same. 

I think what I value in a doctor is their ability to listen to me, and show concern for me as a person, not a diagnosis. We are individuals with different opinions and the right to say yes or no to treatment. Inform patients about costs, reconstruction options and new treatments that are available.

Keep an open mind and realise that survivorship is often more difficult than active treatment psychologically and side effects continue for many people for many years often impacting on their quality of life. My favourite health care professionals have held my hand as I fell asleep under anaesthetic, a nurse who tucked my feet in during chemo and my surgeon who shares a joke with me and lets me know she’s human.

Doctors need to work as part of a team and patients are part of that team and an active part. I sometimes feel broken and I rely on them for support. Young doctors need to know that treatment is a balance of so many factors and sometimes that balance looks different from different perspectives. Don’t forget to care and make sure to read the BCNA guidelines for breast cancer treatment.

Don’t tell people about a diagnosis of malignant tumour in the middle of a corridor of a busy hospital where they have nowhere to go to process this information but a busy ward. Patients listen to every word you say and read far more into it than you are aware of. We can also hear what  you say outside our rooms. 

Always give advice on reconstruction options, that way patients can make informed decisions. Unfortunately still today it is left to the patient to be proactive as was the case with me. Not everyone may want to reconstruct, but we all deserve information so we can decide. 

Always be kind. I remember my beautiful breast surgeon talking to the anaesthetist as I was being wheeled in for my mastectomy after a recurrence very soon after treatment complete. He gave me a tiny pat on the shoulder and told the anesthetist to be kind as I'd had a very rough time. I really appreciated this small
gesture.   Good luck with your talk. 
Paula xxx

I agree with the others, manners are totally important. Also  please remember there are people attached to the boobs you want to look at!  To the male registrars, at a certain point touching to check for lumps becomes kinda awkward if it goes on too long!

For a better understanding of side effects, two that come to mind immediately are neuropathy and fatigue.  No doubt your talk will emphasise the importance and value of BCNA however I'm of the view that is where most of us get the comfort and understanding of the side effects.............I liken it to the old saying "don't mention the war"..............they are unspoken or breezed over quickly in a medical setting.  It is the forum that gives us the comfort we are not alone and the support to understand and accept.
Ony@Jane221 Jane that is a great thing you are doing!

@Zoffiel brown SUEDE  pointy shoes my son informs me is de riguer atm for med students. I’d like to add @Jane221 that some discussion be had as to post treatment likely side effects- I was fine during treatment as I knew what to expect but have gotten the jitters after when changes happen that I did not expect or understand eg nerve regeneration causing chest pains , inflamed sore breast occurring months after radiotherapy has ended. I just think ,like I think is the case in the community generally , that when treatment ends they expect all is well and the med students need to know that is not the case - they need to know about the impacts  it has on ours and our family’s lives for years to come even though they may not be able to assist us in many areas.