Oh, The Frustration

In the fourth and final year of medical school, consultants and registrars never tire of telling you that you are "nearly a doctor". While there are moments where this feels exciting, it is more commonly accompanied by fear as the senior clinician is telling you, "Your really need to know this; you're nearly a doctor, you know."

The most petrifying thing for me at the moment isn't even the idea that I could kill someone (although this certainly is not a comforting thought), it is more the concept that I might be really crap at my job. There is so much to know, and on a day-to-day basis so much to do, that I am mostly worried about struggling with the organisational aspect of getting through things in an efficient and professional manner, and being able to just generally do things well, such as writing up notes and presenting to senior clinicians. Very boring concerns, I'm sure you are thinking, but important none-the-less - the interns who develop less-than-desirable reputations often seem to have their standing tarnished by such seemingly-minor parts of the job.

Bearing this in mind, I am trying to utilise this year as a proper training year to get used to the job I'll be doing in the not-so-distant future, getting lots of practise doing the whole workup of patients - from history, examination and ordering of basic tests, to presenting the case to a senior clinician and developing a management plan, and communicating all of this to the patient. I thought Emergency Medicine, a two-week term which I've just started, would be the perfect place to do this. However, the doctor to which I'm attached seems reluctant to let me out of her sight. As I watch the other students seeing patients alone, and then hear them presenting the cases in the doctors' "fishbowl" area, I am stuck observing. How am I supposed to learn how to actually do all the things I'll need to be able to do if I never get any practice?

I wouldn't be so upset if this was just how all the medical students in the department in general were treated; that would be much easier to accept. It is quite hard to stomach being on such a short leash, though, when I can see all the other students operating relatively independently. It makes me wonder if there is something wrong with me - if I have perhaps somehow given off the impression that I'm not competent to do such a basic and necessary task as take the medical history. I get the impression that my supervising doctor, who trained overseas, has a very different idea of what senior medical students should be capable of. When I did finally see one patient on my own today, she seemed very surprised (and a little concerned) that I had already written it up, which I am used to as being a standard task for us. When I asked if I'd made any mistakes, though, or if she could give me any feedback on improving, she didn't have any corrections for me.

Maybe I need to be a bit more pushy and "train" her as to what are valuable learning experiences for students, and the level we should be expected to operate at? It is beginning to look like a very long couple of days ahead.