ICE: End of term reflection paper

Cancer Center patients and staff play important role in educating future doctors

 ICE, or Initial Clinical Experience, is a program for new University of Michigan medical students.

Medical student writes of his experiences in the Breast Cancer Clinic and says he learned more about life and the role of healthcare providers in caring for patients than he ever thought possible.


Editor’s note: ICE, or Initial Clinical Experience, is a program for new University of Michigan medical students. Instead of spending their first term only in lecture halls, they are assigned to shadow clinical faculty and other health professionals. This gives them early connections with patients and families and an understanding of the roles and responsibilities of all healthcare team members within the system.

Where is the line between disease and life drawn? This was a question I constantly thought about during my Initial Clinical Experience during my first term as a medical student. I remember the moment I found out I would be placed in the Breast Cancer Clinic and my feeling of dread. I was worried that so early in medical school I would come face-to-face with cancer, and through it, with death.

Now the term and my time in the Breast Cancer Clinic are coming to an end. Those first feelings about my assignment are completely different from how I feel now. My time in ICE has given me some of the most impactful and meaningful experiences I’ve had at medical school. While I’ve experienced many somber and sobering situations, at the same time I’ve learned more about life and the role of healthcare providers in caring for patients than I ever thought possible.

I think my initial feelings came from my naïve view that patients with cancer are isolated in their experience, that having to live with this disease is something they must go through alone. Looking back, my initial views could not be further from the truth. Instead, the Breast Cancer Clinic is a community of patients and healthcare professionals who together strive for the same goal. The treatment of cancer does not happen in a vacuum.

Reflections on a patient

Patients constantly return to the clinic during their treatment. I remember during one ICE shadowing opportunity, the interaction between a physician’s assistant and a patient was particularly meaningful to me. The patient previously had breast cancer and was treated, but now the cancer was back. This time the cancer seemed more aggressive and resistant to treatment. The day I was in clinic marked the patient’s first office visit with the physician assistant, whom she knew well from her earlier breast cancer.

I was curious to see how the patient and the PA would interact after their time apart, given what I believed was a new and unfortunate development. Going into the exam room, I was nervous. I imagined that the situation could be very emotionally charged, and I wasn’t sure if my presence as a student in the room would be appropriate for what could be a very intense reunion.

However, when the door opened, much to my surprise the situation went in a completely different direction than I had imagined. The patient, in her gown, jumped up from the exam table and gave the PA a hug. The two embraced for a moment and then began to speak as old friends catching up. Before long they both took out their smart phones and were showing each other pictures of their families and telling stories.

Being on the fringe of this situation was very important in changing my view on medicine as is practiced in the Breast Cancer Clinic, and on cancer, which doesn’t define life or death in the ways I expected. Instead of being an upsetting and intense situation for both the patient and PA, it was quite the opposite. And while the underlying cause for these two to meet again was unfortunate, the interaction was positive and inspiring to both the patient and me.

Reflections on the team

The nature of cancer treatment requires frequent visits to the clinic for infusions, blood work, radiations and checkups, and patients become regulars in the clinic. This has a significant effect on the role of the healthcare providers that work at the Breast Cancer Clinic; what they do together is so much bigger and more meaningful than what they do individually for patients: it’s the sense of community they provide. Whether or not a patient chooses to accept it, part of the patient’s life becomes centered on their clinic experiences. Things like teamwork and communication between healthcare providers thus are paramount in creating a positive and uplifting experience for patients in such a critical moment in their lives.

The sense of community that is created by team members through cooperation and integrating experiences across departments is a significant factor in how patients feel when they are treated, and how much they will allow the team of healthcare providers to take care of them.

My experience in the Breast Cancer Clinic has been so insightful into the practice of medicine. Looking forward to next term, I am excited to see how different units in our healthcare system work on the big picture for the patient.

I feel that the amount of collaboration between different healthcare providers in the Breast Cancer Clinic was a significant factor in making patients feel comfortable. Each patient was integrated into the system in such a way that the care they were given felt part of a larger plan, one that is managed by a team of providers that are all coordinated and fully aware, not only of the patient’s medical condition, but of who they are as a person.

Cameron Strong

Cameron Strong

Cameron Strong is a first year medical student at the University of Michigan Medical School. Here is what he says about his goals:  I grew up in Ann Arbor and worked in research labs at the University of Michigan since the age of 14.  I graduated from Michigan with a concentration in Neuroscience, and chose to pursue a career in medicine as a way to continue my passion for learning and use my knowledge in a meaningful way to help others. I plan to continue research throughout my time at UMMS and during my career as a physician. I feel that physicians are in a unique position to contribute to research that will have immediate and real benefits for patients.

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