First two years of medical school: Tests. Standardized, cookie-cutter patients in test question vignettes. 6+ hours of lecture a day. 7-10 hours of sitting and studying at a desk. Referencing textbooks. Step 1, Step 1, Step 1. My classmates and I lived in fear and awe of and constantly offered up our sleep, social life, and mental health as sacrifices to this primitive god known as Step 1.
First clinical experience of third year of medical school: I’m standing in front of a doctor, make that multiple doctors, all of varying years of experience. And there is a patient with a suspicious, ominous bone lesion in the first room, a little one with uncontrolled blood sugar who was on the verge of diabetic ketoacidosis, two patients with intractable vomiting just down the hall, a baby with an abscess that needs to be drained, and two quizzical parents chattering at me in Spanish.
Right now I’m a junior medical student; I made it this far – phew, thankful for that. But I have never, ever felt so horrendously, well, junior. The attending physician looks at me and asks me what our healthcare team should do for this and that patient. Wait, he’s asking ME? Yeah, he’s talking to me, and I blank on words but manage to stammer and stutter out an idea. This time I’m lucky enough to come up with something that actually resembles an appropriate and proper plan of care. But yesterday I wasn’t so fortunate, and tomorrow probably won’t contain a shining House M.D. moment from me either.
There is a large part of me that feels like I’m still in high school. Maybe munching on a Power Bar after a track practice, waiting for my mom to pick me up because I can’t drive yet. Or in junior high, complaining about taking piano lessons and sneaking strawberry sour belts from the kitchen with my little sister and stuffing our face with them until the acidity turns our tongues raw and tender.
Thankfully, it is the attending physician or senior who determines the final decision in every single step of patient care, and the faithful nurses who see to many of the practical aspects. Nevertheless, in a hospital hallway after about three hours of sleep on call, it is still expected that I make a reasonable effort to contribute to the care and keeping of the patients who fall under the attending’s watch. If the knowledge base of the attending physician is rated a 10, and let’s say the residents fall somewhere between a 5 and a 9, what I know amounts to about 0.08. It possibly breaks 0.1 or 0.15 if I’ve had enough sleep the night before. But please don’t get me wrong – LLU has done a fantastic job of educating me thus far; it’s just that in heat of the moment of managing an individual patient, there are no multiple choice answers, no mark-this-question-and-save-it-for-later, no more cookie-cutter patients. My classmates and I certainly do know a decent amount of information, but now it’s time to access that information in the deep recesses of our minds and apply it as quickly as possible.
Conclusion? This is AMAZING. This is incredible. This is why I came here, and although I feel young and incompetent, understandably so because I am, I am learning and doing. No more long hours turning page after page of notes; I am now spending time in the hospital, face to face with patients and face to face with physicians who are kind and attentive enough to teach me and take what knowledge I do have and build on it. Learning and doing – there are moments for relaxing and taking it easy, but this learning and doing is incredibly fulfilling, an honor and amazing responsibility when you think about it.
So that’s a little snippet of my thoughts in the first five weeks of third year, and if this is any indication of how the rest of the academic year will go, I’m gonna put my money on the likelihood that this learning and doing business is going to make for quite an exciting year!