MbShea@PWP@English@UMCP

Working as a medical scribe is a highly sought after job among pre-med students looking to gain valuable clinical experience. Not only will a scribe become familiar with medical terminology, they provide an important service by allowing doctors to work more efficiently. However, many pre-med students have limited knowledge of medical terminology, the basics of a physical exam, or medical charting, before they begin working as a scribe. The training to become a scribe is lengthy and involves many classroom training sessions to better understand terminology, physical exam findings and some anatomy. Despite all these training sessions, when I began work as a medical scribe approximately 5 months ago, I still felt underprepared. One of the most important roles of a scribe is to document the chief complaint of the patient in the history of present illness or HPI. The format of an HPI follows a strict structure and involves chief complaint, associated symptoms, timing, pertinent positives and negatives, exacerbating factors, and relevant patient history. Although all this new information can be overwhelming at first, becoming a scribe is one of the best ways to prepare for medical school or physician’s assistant school.

Reader’s response: You probably only think that becoming a scribe is good preperation for med school because you are a scribe yourself. I mean how involved in medical charting can a college student with no clinical certification be? However, it is very difficult to gain experience in the clinical setting in the healthcare setting without holding any certifications or degrees. Also, if you are working in the emergency department, I bet you get to see a lot of really cool and interesting stuff.

C -- do you take the history alone or with a physician companion?

What section heads do you anticipate? Writing them down will help propel the document forward.

AND, can you develop a mobile friendly FAQ or TIP Sheet to have on a phone? Are there patient history aps?