Imagine yourself spending two years of your life indoors with books. Sometimes the only person you speak to for a few days is yourself, as you memorize intricate details of bugs and drugs that you never imagined yourself knowing. And then after these two years, you’re completely isolated from the world for about two months or so, studying for the exam that they tell you determines the rest of your career: Step 1.
This is the case for many U.S. medical schools. Two pre-clinical years spent with books and very little social interaction concluded with a huge board exam.
After that exam, depending on how early or late it’s taken, there’s sometimes a one or two week period to rejuvenate and enter a whole new world: clinical rotations.
I have always been told about the nightmares of the preclinical years and Step 1, and how it really gets better after you start applying your knowledge and finding your purpose with patient interactions. However, I was never told how hard that transition would actually be. No one really mentioned how challenging it is to face the beginning and end of life in literally one day if you’re on an inpatient service for family medicine, for example. Or how hard it is to now be constantly using more than your full potential (if that’s possible) for 12 hours straight as you interact with other human beings. And in my opinion, one of the most challenging parts — how to translate that interaction into a well-organized presentation in literally seconds for a resident or attending physician, as you answer their burning questions throughout the day.
“Do you know the mechanism of action for drug X?”
“Is this disease caused by environmental factors or genetics, and what’s the ratio of these causal factors?”
“Which organism most commonly causes this pathology?”
If you told me to study for a test for a few months and apply that knowledge when the day came in a silent room alone and in front of a computer, I’d be undoubtedly nervous, yet ready. But to have hundreds of these tests throughout the day within minutes, no way to really prepare other than brush up on knowledge and readings every night, and finally come across a patient with a condition that you have to answer with, “I don’t know,” to the attending, then nervous is an understatement.
The point of my endless description is to explain that the pre-clinical to clinical transition for medical students is one of the most difficult changes to adapt to.
But this is not a pity post. Because change is inevitable and essential for our learning and, most importantly, saving the lives of others. This post is dedicated to the hard-working individuals who make this transition easy, and remind every tired, sleep-deprived, and exhausted medical student why they applied to medical school in the first place.
I know that physicians are superheroes because they save lives. That’s not a new idea to anyone. But what I have experienced during my first month of clinical rotations is an attending who goes above and beyond to ensure that I was learning the most from every single patient, while stopping in between to debrief me about treatment plans.
He’s an emergency medicine physician awake for over 24 hours, but will leave a patient’s room to call me from the hall and ask if I’d like to watch him do an interesting procedure while walking me through his steps at 4 a.m. Residents with numerous responsibilities, notes to write, patients to call and requirements to fulfill before they graduate, yet guiding me through exams and presentations that I’d have an incredibly hard time doing on my own for the first time.
I think these individuals are all true superheroes. I don’t know how they manage saving lives, going above and beyond for their patients, while simultaneously teaching a student how to do the same in the future. But I do know that I am infinitely grateful for these selfless doctors. To our teaching residents and attendings who help us fall in love with medicine and patient care more and more every single day: You deserve to be appreciated every day too. Thank you.
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