Learning to become a doctor (hopefully)...

I have a confession to make. I often find my pre-clerkship classes boring. I tell my parents it's interesting. I sit mid to near the front. I seldom sleep. Yet sometimes, sitting there listening to some phD drone on about another biochemical pathway I think to myself - how could this possibly help me help patients? Yet I continue on. I even memorize this stuff (not the concepts and their clinical significance, but rather ever minute detail). Why? Because it's on the next exam.

There are those in my class who are in denial, as if the slightest insinuation of boringness implies they faked their way in med school. They don't just lie to their parents, they lie to themselves. I imagine they will be the same people who will be in charge of the curriculum in the future, who will continue the rite of passage of having med students memorize laundry lists of facts void of clinical relevance.

I quite enjoyed That Med School Guy's soul searching post Somewhere Along the Line. He explores his apparent fixation on the test over preparing to help patients. He's pretty hard on himself. Below is my comment, where I discuss possible reasons for his test vs. patient centered mentality:

Great Post! I highly doubt you were one of those “who happen to fall through the cracks,” at least judging by the sincerity of your post (and blog in general). Can you blamed for studying for the test? That’s what ultimately got you into med school, how you’ve been hardwired over your premed years. You've been forced to develop an addiction that is hard to get rid of. What’s worse, that is also currently your main evaluatory measure of whether you’re doing well in medical school. At least from an evaluatory sense, you are being told the addition is still okay. Why is that? True, med students need to look past the multiple choice tests at the big picture, though why can’t the big picture and med students’ current reality be aligned? Sounds like it would make the Professors happier as well! [Reference to earlier comment by Med Prof. Dr. K]

I have an idea. Let’s deemphasize multiple choice tests asking us what enzyme is used in the 4th step of heme synthesis (uroporphyrinogen III synthase in case you are wondering). Let’s emphasize how we do in the scant time we get as preclerks with patients practicing clinical stuff. And let’s introduce a new evaluatory measure. Hold on to your seatbelts. Let’s ask the patients how we are doing. I know it sounds crazy – let’s ask the person we are trying to help if they have been helped. I enjoy the blog.

To the brink and beyond

Stuff happens, there's no doubt about it. However, this is taking it to the extreme:

"...Naum Ciomu, 58, was operating on the man to correct a testicular malformation when he lost his temper. Grabbing a scalpel, he sliced off the penis in front of amazed nursing staff, then cut it into three pieces before storming out of the operating theatre at the Panduri Urology Hospital in Bucharest..."
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Stress and personal problems have been forwarded as the cause. No one enters medicine thinking they would do something like this, and presumably, few people will. My worry is the negative personal changes that will occur over my med school training - the affects of busyness, stress, and dealing with the emotionally charged routinely. How could someone that was able to pass through all the hoola hoops to becoming a surgeon do such a thing? It's hard for a young, idealist, self flattering medical student to understand. Yet, I've already seen changes in myself. 4 months ago I would have told you that urology (assuming I actually knew what urology was) is disgusting. After meticulously dissecting a cadeaver, speaking to a few gleeful kidney transplant recipients, learning about emerging prostate cancer research, and general desensitization to anything anatomically private...it's suddenly become a specialty of interest. That's only 4 months.

I've witnessed a doctor uncover a sensitive area of an older woman without asking her. I've heard a pediatrician refer to a child as a FLK (funny looking kid). These things bother me...at least for now. In doctors' defence, I suspect one cannot deal with emotionally charged things all day. Could a doctor look at private parts all day comfortably if she saw them as private? Could a pediatrician sustain himself without depersonalizes the innocent suffering around him (treating children who could easily be his own)?

So what are some strategies to ward off the jadedness and remain emotionally balanced?

-hang out with people outside of medicine

-blog about stuff other than medicine; I hope someone comment slaps me if I become overly fixated on med stuff

-document my current idealistic euphoria regarding my future career in medicine

-complain about stuff that doesn't seem right

We'll see how it goes.