Musings while procrastinating
I can’t believe that I have spent three years in Graduate Medical School, 3/4 almost doctor and still none the wiser.
I remember hugging my father at the airport before I embarked on this roller coaster of a journey. Tears streaming down my face (and maybe snot as well, not a good look), he whispered in my ear “The years will fly by my love.” “Yea right, buddy.” I thought. I think a more accurate thing to say would have been “The years would have flown by in retrospect, my love.” I won’t deny how I thought the days would never end in first and second year, second year especially, where we were like frightened geese being fattened, being force fed stacks and stacks of pathology and clinical knowledge on top of all we had to digest in year one, sometimes against will. My 30 odd year old brain begged for mercy. Second year… my heart still races and palms get sweaty thinking about it. It was also the year where I had my first major meltdown after the final OSCE exam. I cried from the time I exited the exam, drove, got home, where the crying continued as I did the dishes. It was comic, in retrospect.
Now with graduation being a year away, and impending recruitment drives I can actually participate in, not just help organise, I find myself thinking a lot more about what specialty I might like to train in.
With the new residency programme in place, medical graduates now have the option of selecting what they would like to do for the rest of their lives from the time they graduate, subject of course to the elusive selection process- first choice, not guaranteed- endless days as an eventual MO waiting to enter a specialty training, most guaranteed.
It is a scary thought.
I embarked on this journey so sure I wanted to be an obstetrician, fuelled further by the excellent first year elective experience I had where I spent 2 weeks out of 4 in the O&G dept of New Delhi’s largest referral hospital. I was so certain.
Now? I am not so sure.
As graduate medical students, we have to throw another factor into the mix, age. My peers and I all have previous degrees and a couple of years of work experience under our belts. The reality is a lot more stark for the females, I mean let’s face it we are all roughly at the age where we start to worry about practical things like starting a family, settling down and the viability of our eggs. Advice from well meaning, senior doctors always advise us to consider lifestyle when we choose a speciality. There’s a common saying here in Australia; Women handle tears and (pap)smears, ie: most women end up in General Practice. A very senior, no doubt sexist doctor, who during a recruitment drive early in the year ruffled many female feathers when he made the comment, “Women, you should all just consider the family medicine track, you have the option of becoming a hospital resident physician, where your greatest contribution would have been that you’ve been there a long time”.
I started employing the process of elimination, trying to figure out what I enjoyed less of and hence started crossing things out as I went along. Then wise words from yet another senior doctor, “Don’t start eliminating what you think you don’t like. Your experience as an intern will be very different from your experience as a medical student.”
How like that?
Sweeping under carpet for now.
Back to short term immediate goals, like the exams in 3 weeks.
The mythical dark arts
X-Rays… still eludes us.
The Final Quarter
1) Tomorrow heralds the start of a 6 week stint in the Australian outback, a town west of Brisbane, population 5000. After which, the requisite end of rotation exams, before the start of summer holidays.
2) The countdown to the year end holiday begins. Hello Muntri Mews Penang, long lazy lunches, and the joy of getting lost and discovering.
GP
Ok, so today marks the day I officially administered an intramuscular injection into a patient’s deltoid muscle, for real! Not on Paul/Nicholas/thomas the dummies (yes, I named them all) or on synthetic foam. I can only imagine the trepidation the sweet ‘ol war veteran felt when the clinic nurse asked “is it ok if one of our senior medical students give you your flu shot?”. Bless him and his lovely relaxed deltoid muscle.
And! As an added bonus, my GP let me freeze a seborrheic keratosis with liquid nitrogen on the forearm of another lovely old male patient.
Med student cheap thrills.
Halfway
Post exams we indulge in our first proper drink the entire year, and it was cider.
5 glasses of cider on an empty stomach later, I remember why I stopped drinking for the sake of getting drunk. The ill effects of acetaldehyde far outweighs the (small and diminishing) joy drunken revelry brings. Still! It was good fun hopping, skipping and talking loudly before the retching in the loo and stupor set in.
Unflattering photo with eye bags of samsonite proportions, but one for posterity, eh? It is the halfway mark after all 
I see the light…
Golly! Can it really be?
The finish line is in sight, in exactly 17hours 15mins.
It is surreal, when the day that you have been fantasizing about is almost nigh.
Sleeping in. The smell of a cafe brewed flat white. Reading in bed. Going to the video store. Organizing the mess in my room. Little things I take for granted.
Two things that made my day
Thank you squirrel!
And mom booking a table at Yan Ting for a lazy public holiday Dim Sum lunch with the family next week, after my lament about missing har gaus and braised chicken feet. Nuclear family. I love thee.
Home in T-minus 6 days.
But before that, getting pissed/smashed/sloshed/wasted/drunk as a skunk in 17hours and 30mins.
Freedom. There is no other smell quite like it.
Back to basics
According to Kath, we should always employ first principles to work through a problem.
Big picture Jo, big picture.
10 What it takes…
…to produce a Singaporean medical graduate from a foreign University
1) A quarter of a million Singapore dollars for fees, living expenses, books and equipment.
2) Dollars from relatives and friends who often generously pay for meals during said student’s trips home in light of ‘poor medical student’ status.
3) Priceless parental support in the form of e-mails, calls, packages, cards, errand running on student’s behalf.
4) Ditto point 3 priceless support from boyfriend/girlfriend/friends
5) Emotional support in the form housemates/schoolmates as student contemplates carbicide/dessertcide after numerous esteem bashing days by snarky consultants/fellow course mates at the hospital
6) 10 Stabilo Boss original highlighters in luminous yellow, 10 black printer ink cartridges, 2 coloured, 4 reams of A4 paper, 10 Uni Laknock rollerball pens (fine tip), 2 A4 notepads, 2 pocket sized notebooks, annually.
7) 6 large jars of Moccona freeze dried coffee, 100 tea bags, annually.
8.) 3 shirts, 2 blouses, 2 pants, 2 skirts, 2 dresses, 1 pair pearl earrings/2 ties, 1 black shoulder bag, 1 pair proper black shoes as hospital attire. More if student desires variety.
9) Medical kit containing: multivitamins, ginseng/ginko biloba or other brain boosting what-have-yous, 5 packs medicinal patches for stiff shoulders/lower back pain from prolonged sitting, plasters for domestic accidents, zit cream, antidiarrhoeal, panadol extra
10) Cookbook of mother’s recipes
Biopsychosocial
Biophycosocial learning my behind.
I have had it with Kant, Hippocrates, Aristotle and eminent bioethicist Veatch this weekend.
Evolution of the Doctor-Patient relationship, informed consent and patient’s best interest. All extremely interesting, but like the lump said, “it would be nice to be able to learn it in your own time”, as opposed to trying to digest Kantian theory at breakneck speed as fodder for the 2000 words required in two weeks.
Will revisit said theories over the holidays, right now, enough!
Quips
Our University adopts a ‘Problem Based Learning’ (PBL) approach, which means we learn through weekly cases generated by the School of Medicine, are assigned to a group of 10 and spend 5 hours a week locked up in the room with 9 other people discussing the case and generating learning objectives, focus questions and eventually a case summary from it.
There are 4 semesters in a year, and each semester, every group is assigned a PBL tutor to facilitate the session. We have been having a particularly bad run with tutors this year, starting with the Russian Post Doc fellow who did not believe in a democracy and chose to play dictator, the retired GP who spoke about not much else apart from her ski trips and ski lodge in colorado and the ex-dentist, turned homeopath whom the boys never took seriously.
This semester we have Kath, an Emergency Department Registrar, with razor sharp wit and the clinical smarts we all so desperately need during our case discussion.
Here are some of my favourite quips from Kath thus far:
“I am an emergency medicine doctor and I have no empathy for people, please take your sob story somewhere else.”
To a particularly self righteous PBL mate
Kath: “Tim, have you ever been wrong in your life?”
Tim, after a moment’s deliberation, “No Kath, I can’t say I have been.”
Kath: : “Ah. That’s what I thought.”
To a particularly obnoxious PBL mate who signs off the attendance roll by initialing his name in caps
Kath: “Tristan, at which point in life did you develop this signature, kindergarten?”
Tristian: “Yea that would be about right”
Kath: “One hopes you have achieved normal developmental milestones in other areas of your life.”
“I work in the ED. I have a very short attention span. I hate long pointless presentations, have a timer set to 8mins and am not afraid to use it.”
