Saturday, May 9, 2015

Never Bored but Always Preparing for the Board

Being a medical student is such an interesting place to be. We are in interesting places literally, metaphorically, philosophically, emotionally and of course financially. There is a lot written, and a there continues to be much written about the med student experience. It is definitively a formative experience and I can't help but write about the experience.

A few spurious thoughts on the process:

Today, one of the Obstetricians I was with asked me what other rotations I had done this year -- something that I've been asked at every rotation this year. This time I, with a brief but glorious pause, told him that I had already done all of my cores -- and had also served at a free clinic and spent time with an interventional cardiologist. Of course I knew that this was going to be the last gig of 3rd year -- but that was the first time I had articulated that point and it was pleasant. We then chatted how crazy it was that this was the chunk of time that I was to know exactly what I would dedicate my life to. At the school I attend, the 4th year schedule is completely up to me to organize and arrange. This is of course incredibly time consuming, depending on what approach one takes, and of course the next 4 or 5 months we will have submitted our interview requests. In these interviews, our academic record, including grades, evaluations, board scores, crazy extracurriculars, clinical record and elective choices will be reviewed, all of which play a huge part in being able to actually match at any given program in whatever specialty. I think I know what I want to do. I would like some more time to figure it out, though.

Another large aspect of going into medicine is the constant, rigorous selection process at every stage for every opportunity. Some of them are objective metrics, others are harder to deal with -- like programs who decline an application for an elective or audition rotation, and of course those who aren't interested in interviews. This is less an issue of a program necessarily shunning a candidate and more a "real world" dynamic and habits inclined to do business with previous relationships that have proven successful. This is how most of the world works. However, making the transition from academia (purely) to a training program where we are employees with contracts is a strange one. Granted, we still may be in "academia" by name, and we will conduct research and be involved with teaching -- but make no mistake, it is a business arrangement. It is a very complicated dynamic, and one that I don't fully understand, but doctors can still help people while being in a business environment. I think that all physicians should review their personal statements that they penned to get into medical school in the first place, where some variety of "I want to be a doctor to help people" theme was on display. I also think that realizing this early -- especially for student-doctors who have not had to be in the "real world" business environment is imperative to ward off burn out -- which often stems from disillusionment of how things work, and not feeling like they are able to make a difference in the system, and of course, in people's lives.

Many doctors, even if they are not a teacher in the full time sense, will bring on students if asked. They know that their experience is important to pass on -- and as a student in the process of contacting physicians and asking them to add even more inconvenience to their already jam-packed schedules to show me the ropes is a strange process. One major theme that has impressed me is that whether you are on a core (required) rotation, or an elective -- whether you really dislike, or really love whatever given field you are spending time in, it is imperative to demonstrate interest, invest time in reading up on major elements in that field, and of course, be pleasant! The coffee shop/roaster I worked at for many years in Denver was (still is) involved with a lot of wholesale business to other coffee shops, and employees of the shops we would sell coffee to would send their employees to us for training. We would teach them to make a proper latte, cappuccino and how to pull a proper espresso shot. We would teach them about the coffee beans, and show them how we roasted them, all in the hopes they would be good, knowledgeable stewards of our coffee and of course, be successful in the relationship with our business partners. There were times that a teenager, or young person would show up for training and obviously have no interest in learning anything. We would teach these people the bare minimum, and often send them off with skills that were inadequate to make a steamed milk espresso drink for anyone -- not for lack of effort. The same principle applies to medical students. A little enthusiasm goes a long way. The rotation I'm on right now has what some of the other students have described as "strong personalities," which, being medicine, this should come as no surprise. I've found, through chatting with the MAs that there have been students who have spent time there who have, at worst, outright told the doctors that they didn't care about learning about OBGYN, or that they hated what they were doing and really didn't care about much other than passing the exam. After a couple of days on the rotation, and after getting to know the MAs, they told me that they thought I was doing a great job, and that the doctors liked me. This was very nice to hear (as it always is) especially as I really felt lost. Admittedly, I was not looking forward to this as much as other gigs, and I really have very little interest in OBGYN as a career. Furthermore, one reason I've chosen IM over FM is that I don't have to take care of children (I love children, just don't want to treat them) and IM has very little women's health training. And because of all of that, I knew that this might be the best opportunity to learn about OBGYN and I should make the most of it. Apparently having this attitude has paid off in that the doctors are actually interested in teaching me -- if I could give one piece of advice to medical students entering this stage of training, it would be this -- act like you want to be there, even if you don't at first, and you may just enjoy your time more than you thought possible.

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