June 9, 2008

• So frustrating

  Todays Adventure may be a little bit frustrating…or more accurately, about frustrations. There are of course numerous things that can frustrate one in medical school-the long hours, the lack of nonmedical social interaction, the endless testing, the sheer number of things you need to know, the calls, the bad residents or attendings, the list goes on and on.

  But you have probably already figured most of that out, and the question burning a hole in your pockets (pardon my mixed metaphors) is what is the most frustrating aspect of medical school TO ME. The author of this blog. The ginourmous, invisible egomaniac who sits here and doodles on this her interwebs for you.

  Well, lets briefly go back to the beginning. A nod to hidden beside me, who posed the classic question, why did you want to become a doctor in the first place?

  Lets clear one thing up here: my main reason for going to medical school and wanting to be a doctor was not “to help people.” There are lots of things to do if you want to help people. Plumbers help people, Internet hookup guys help people, Mechanics help people. Every premed and their mother thinks that this is what interview boards want to hear. Not that i DONT want to help people, but for the record everyone who actually gets in has some motive above and beyond this altruistic bullshit.

  As an addendum, I didnt get into medicine for the money either. Which is good, as with my MD will come roughly 200,000 in debt. Probably closer to a quarter million once all the interest is figured in.

  So now that we have established that I am broke and hate people, why did I get into medicine? For the challenge. For the sheer joy of solving the puzzle that you people are. You come to me with several different hints, and i get to put it all together, and even when the picture is the same, it never happens exactly alike twice. Yes people, even at your worst, you present as unique as delicate little snowflakes. Or perhaps obese, smoking, alcoholic, elderly snowflakes…but i digress.

  During my interviews, this is basically what my answer came down to. Sure it was gussied up a little bit in pretty language, but the thrill of the chase, the joy of discovery and the actual titillation achieved solving a problem, particularly one as complex and invisible as sickness are what get me through the day.

  So now that you know why i got into medicine, what are the most frustrating things about it?

  Not what you might think. The studying and the long hours on call were thing i knew i was getting into. Actually, what all my pet peeves basically boil down to is: INCOMPETENCE.

  Now I dont actually mean stupidity by this, though i saw my fair shair of that in every rotation. I mean things like Attendings who micromanage, nurses who wake residents every 5 minutes to ask if the patient can have a sip of water, people who cant figure out the computer system despite having worked in the hospital for more than one week

  In the beginning of the year, the major source of incompetence and inefficiency, was, well, me. I had no clue what it was like to work in a hospital, where anything was located, how to write a note, or do basically anything. Very frustrating, especially since right about the time you learn how to do everything well, either your team changes, or you switch rotations, so you dont get a chance to look competent when it counts. Of course, as the year went on, I learned my way around so this became less of an issue

  The next major source of frustration was the enforced mandatory lectures given by my school. Now it took me a while to learn this, but I am not the type of person who learns by sitting in a lecture unless i am very interested in the topic material…and even then, the span of attention is limited. Yet for every rotation i went on, at least once a week, clinical duties were interrupted by some lecture or another that I had to attend. Now if these lectures were at least on site it would not have been so terrible, as I completely understand the rationale behind noon conferences and morning report and things like that. But too force me to drive out to the middle of nowhere at a hospital i am not even assigned to to listen to a lecture about something i could better learn by asking my residents or reading? ANd to make this lecture at a time when the commute is during rush hour with inclement weather or road construction? Now that really grinds my gears. I understand that if the school doesnt make these lectures mandatory, many people wont show up. The obvious solution then, is to make the lectures worthwhile, or provide an alternative to attending lecture…perhaps some written presentation or something to that effect. Not making me drive several hours to sign my name on a sheet of paper and then fall asleep

  Another source of frustration was how limited certain hospital sites kept the medical students. I am perfectly aware that as a third year there are some things I am not capable of performing or the hospital might be liable for. By the same token however, this is the year when I am supposed to experience a lot of hands on learning. So attendings or residents who are fans of having the student merely take a history can be quite irksome. The catchall is “see one, do one, teach one” not “see one, see another, see a third” As an active learner, give me something to do, and I will do it…then we can review what needs improvement or what went well. But please dont assume by the end of my third year that i need to be taught how to do a physical exam unless you have seen me fail at it. Sitting in a corner watching you work doesnt make me think, wow, what stunning technique, but rather, what else could i be doing to more efficiently spend my time in the hospital?

  The final major source of frustration in 3rd year is, well, 4th year. Trying to schedule electives who dont have the decency to tell you if you are in or out or on a waiting list until you have called…sites that get your paperwork, but lose something and blame you for it. My troubles with 4th year could be a post in and of themself. But in short, those were my greatest frustrations, and ones shared I think by certainly many of my classmatess, if not by many med students in general

  On an unrelated note, the next med post will be preceded by a very special cooking with almost dr j. What with the top chef season finale airing tonight, my friends and I will be doing our own cooking challenge, letting every technique we have learned all year bust out. And pics of course will be included. In the meantime, hope i am answering all your questions. I still have a lot left to go!

  • 9:16 pm
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