It has nearly been 3 full weeks since I took that board exam, and in some ways I still feel a little traumatized by the whole thing -- not so much from the actual 8 hours of answering the questions, but more-so the run up; the anticipation, the fear, the adrenalin, the realization that one specific slice of 8 hours sitting in a testing center has significant implications and influence in what the rest of my life will be. Its not the end-all-be-all by any means, but it is a number (meaning the exam score) that will follow my name for the next 20 months, until the day in early 2016 when I find out what kind of medical residency I match into. And, when I say traumatized, I think it really boils down to not getting any time to grieve the process -- and process my body's grievance stemming from the mental and physical abuse I put myself through -- studying for 15 or so hours per day for over a month. This was the finishing touch of a couple of very taxing years. In fact, for over 2 years medical students look forward (with a mix of dread and killer instinct swirled together) to this exam -- years of anticipation! For most of us, we take the exam, and within a week or less we are jumping head first into our clinical education phase, where we have patients address as doctor and we are asked real questions in earnest from patients, in hopes we have some answers to their very real problems. To go from abstract, esoteric, molecular science and pharmaceutical mechanisms of action to dealing with patients and their problems in the span of 3 days, for me, was an exercise in integrating two very important perspectives -- patient care and protocol with best medical practices, which are based in the science behind it all. Its nothing if not supremely interesting and engaging.
I am thankful now, more than ever for my years spent working in an Emergency Department. It gave me the ability to feel very comfortable with patients -- including when they are unhappy and difficult to deal with. It has given me a honed sense (for a newby) of when I'm being given a pile of bullshit for a story or history. That said, I'm not here to oust drug seekers, but still, despite their nefarious intentions, still provide that patient some kind of care. He or she may refuse to listen, and they may get angry with the decision to not dispense narcotics, but if we can still have a discussion about other aspects of health, and discuss the reasons why narcotics can't be given -- emphasizing the health risks and evaluating the other health dynamics at play, I can still walk out of the patient's room feeling like it wasn't a waste. The importance of giving a person the time of day and honestly inquiring as to their wellbeing does wonders for a power imbalanced relationship such as the doctor-patient one, and should not be forgotten, even in the most challenging clinical encounters. Sometimes ya just gotta call the sheriff though.
Family medicine hasn't been at the top of my list of medicine to pursue -- and maybe this happens at every rotation, provided you're with people you like and respect (such as is my situation now), but the versatility provided through doing FM is more impressive than I previously thought. Maybe in month or two I'll be up on the DSB proclaiming my love of all things surgical and my pending future as an orthopod. We'll see.