Meriting Merit

Our exam results came out today. While I would have been happy merely to have passed, I was actually awarded a merit. Medical degrees aren't graded (well, would you actually want to know that your doctor only qualified with a 2:2?), but my university does offer honours to the top 15% of the year; the merit/distinction allows us to accrue points towards these honours. Although I thought that I struggle to keep up with the 'hard science' part of the course, I have been finding the more clinically based element of the course makes it much more accessible.

I've also started doing some part-time work for the local hospital as a nursing assistant. Although the benefits are largely fiscal, it's also great to be able to increase the amount of patient contact I get. It can be very difficult to talk to a patient who is stressed, or angry, depressed or in pain. Despite its noble intentions, medicine is a highly nepotistic field, where it's not so much what you know as whom. Most of my classmates haven't done much in the way of work experience; usually it's a few days shadowing a consultant who's a friend of Daddy; I find it worrying that tomorrow's doctors can prescribe cyctotoxic drugs but don't know how to hold a patient's hand.

This has become the year of placements. Currently, we are learning medicine systematically; after studying each system (renal, GI, respiratory, etc) we then do a week-long placement in hospital, learning basic clinical skills, such as history taking and examination, which are relevant to that system. Sounds great, but for me it has meant spending half my week on a bus, being dagged across the west country and vomiting repeatedly in front of everyone I know.

Next week is our gastro placement, and I have to say I'm looking forward to it significantly less that my cardiac or respiratiory placements. Partly because the shine is off the apple now, and the format of these weeks has started to become repetitive; partly because the hospital at which I'm on placement is very small, meaning that it can be difficult to find patients prepared to be manhandled for the umpteenth time, bt largely it's just because I really don't like intestines one little bit, and even my new and beautifully pink stethoscope can't cheer me up.

However annoying the placement may be, it is far less troublesome than what we're doing after it: the dreaded neurology. The nervous system is really the chink in my armour, and I struggle to grasp even fairly basic concepts. But the system is six weeks long, and I know it's going to pass as quickly as the hundred years war. But for all that the course is becoming difficult and at times, dull, I still wouldn't rather be doing anything else.

Summer Holiday!

Well, after nine months of panic, pressure and procrastination, I have finally completed my first year at medical school. It seems an age ago that I stepped into the department for the first time, years since those introductory lectures on biochemistry and protein formation. And yet, it also feels as though no time has passed at all; the year seems to have gone past in a heartbeat. I know so much more than I did this time last year; however, I am aware that in the scheme of things, I know less than nothing.

There have been times where I have questioned my motivations for doing this difficult degree (mostly during anatomy class - still my least favourite subject), but on the whole I am still excited and enthused about the challenges that lie ahead, the new and fascinating things to learn. Year two is very similar to year one - we still have anatomy classes, and spend almost all of our time in lectures, although we do have Basic Clinical Skills to look forward to, as well our Selected Study Component, in which we study our choice of projects. Unlike the first two terms, we are now looking at medicine in a systematic way - we have already looked at the cardiovascular system and the musculoskeletal system. Next year, we'll be learning about the respiratory system, the endocrine and reproductive system, the GI system, the renal system and the nervous system. After year two, we become more like apprentices, spending more of our time learning clinical skills and spending time in placement.

I have spent the last six weeks being utterly sick of medicine, stressed and tired. Now, I can't wait for the first of October, when the lectures start again.

This will be the final week of lectures for the year; I can't believe how quickly it's gone. Of course, there are exams to go, obviously (there are always more exams), but it still feels like yesterday that I was walking into the medical school for the first time. I remember it so vividly; I was listening to The Fray's 'How to Save a Life,' on my iPOD, and felt my eyes welling up with tears as I walked in, feeling like I had reached the end of a long and difficult journey... only to realise I had walked into the engineering building by mistake, prompting one swift about face and two red cheeks.

While I'm amazed at how much I've learned in one meagre academic year, this year has really served to show me how great my ignorance is. I can see now why medics and doctors are constantly being examined - it is such a vast subject which is constantly evolving and changing, and ignorance is not acceptable. It is a huge responsibility and I am only just beginning to realise the necessity of keeping it highly regulated.

As I suspected, I will have one resit in July, although thankfully it is for a subject that I didn't really study for in the holiday; there are lots of people on my year who failed exams that they worked very hard for, and I think that must be so much worse. While initially I was absolutely gutted to have failed an exam, I am also learning to give myself a break; my background in English, not science, and I hadn't done any for five years when I began the course. I managed to pass all of my science-based exams, when many of my peers didn't; for me, that is still a great achievement, and I should feel proud of what I have accomplished.

I still feel like a fraud here, and even if I pass my resit and make it back for next year I suspect I still will; however, I think I will try to enjoy the ride a little more from now on; after all, there's still four years to go...

The Waiting Game

The exams are done; I am about 99.8% sure that I failed at least one of them, but I won't find out if this is actually the case until the end of May. This is unfortunate for my sanity, as I'm finding it very difficult to stop worrying about it and focus on the task at hand. To further add to my concerns, I managed to wheedle out of the office staff that 16 people so far have failed this particular exam, so my fears are only exacerbated. For every exam failed, we are allowed one resit, and that is all; after that, we're out.

We have already begun learning the new material; it is much more clinically focussed than what we were learning before the exam, but unfortunately it is much more difficult. The cardiovascular system is a truly fascinating one, but much more complex than basic metabolism. My new lecturer is totally amazing, though, and makes all of his lectures absolutely fascinating; I am much more inclined to get up in the mornings, knowing he is going to be instructing me!

The pressure of the new work, combined with the anxiety of the imminent exams results have led me to the discovery that actually, despite being a mature student, I am not coping very well with the stress, and it is affecting me in ways which I never thought it would. I am much more abrupt that usual, and far more irritable. For example, as I write this, I am irrationally angry that my lecturers do not use full sentences in their notes, so I am forced to re-write everything. It is a terrible thing to reach the age of 24 and realise that you have no idea how to handle stress.

Race Against Time

My exams start on Monday. Unlike January's exams, these are important, and if I fail any, I have only one chance to resit. Should I fail on the resit, I will be made to withdraw from the course. I have five exams from Monday to Friday, and my list of subjects to study is:

Embryology
Membranes and Cell Structure
Physiology
Metabolism and Homeostasis
Pharmacology
Molecular Genetics and disorders
Pathology and Immunology
Cancer Biology
Society, Health and Medicine
Medical Ethics
Whole Person Care
Epidemiology
Anatomy
Histology

So, to summate: 15 subjects, 5 exams, and 1 tiny, tiny brain already filled to capacity. I feel like every time I speak, or think about something else, my brain leaks information. Don't ask me about the nightmares. See you on the other side.

What If?

This is an essay which I am entering for a competition, entitled 'What If.' Participants were asked to consider what their lives would be like if they hadn't made the choices in medicine that they have. Enjoy!

What If?

When I was 21, and in my final year of my English degree, a man in his sixties collapsed with cardiac and respiratory failure in the shopping centre where I worked. Without hesitation, I began to perform CPR until the paramedics arrived. It was a strange place to have an epiphany, but, as I tilted back the man’s head and began to breathe for him, for the first time in my life, I realised what I should be spending it doing.
After completing my degree, the thought of studying medicine never left me, but, not having the means to put myself through university a second time, I tried to forget about it and embark on another career that satisfied me. However, after a year, I still could not lay the dream of becoming a doctor to rest, and I made a daunting decision: I left my job to do work experience, and sold my flat in order to finance myself through university. Getting into medical school with an arts degree was not easy, and initially I was not successful; happily, in August, a university offered me a place, and I began the course.
While I enjoy the rigours of the course, there are moments when I wonder what my life would be like if I hadn’t applied for medicine. I see an office job in publishing, or maybe advertising. There are occasional holidays to Italy and France, and eventually, a small two-bedroom semi-detached in the suburbs. I see dinner parties with port nightcaps, and brunches in delis on Saturday mornings. I see pencil skirt suits, and cashmere jumpers, and more shoes than will easily fit in my wardrobe. There are dinners of risotto with asparagus and Parma ham, tomatoes on the vine, roasted with a little olive oil and served with cool mozzarella cheese. I see lazy afternoons spent walking in the park after a Sunday roast, and evenings spent curled up on the sofa with a glass of full-bodied, ruby red Zinfandel, perusing perhaps, the latest edition of Elle magazine.
These days, toast and breakfast cereal have encroached upon most of my meals, and delis are now the enemy, since I can’t afford even a small jar of sun-dried tomatoes. My 2’6” bed takes up the majority of my room, which is more fittingly described as ‘draughty shoebox,’ and sharing a kitchen with ten other students has provided an introduction to microbiology earlier than anticipated. My budget for shoes has decreased dramatically, with my cherished pair of Converse trainers finally succumbing to two terms’ near-constant wear and unravelling at the seams. Jumpers are infinitely more likely to have been made from the fleece of the acrylic sheep than they are to have come from any actual animals. Purchases of glossy magazines have also been severely curtailed, and evenings are usually spent staring at textbooks and writing notes in scruffy handwriting until either cramp or exhaustion set in.
In short, I am poor and overworked, with ever-decreasing employment and financial prospects. I have never been happier. I believe the life I would have led, while probably more profitable and certainly comfortable, would have been a life with little fulfilment, and even less purpose. It is true that medical students entering the profession are facing a more testing time of things than in former years; rising debt, the lack of accommodation for F1 doctors, and the shortage of training placements being just three of the recent difficulties to befall new doctors. However, I think it is easy to forget how privileged we are; we are able to spend our days getting to know new people, in a job which is challenging and constantly changing. Bu it is more than that: we go to sleep at night with the certain knowledge that we made a difference to someone’s life, whether it was a life-saving intervention, a difficult diagnosis, or simply relieving pain. I am often asked by family and friends, given the current climate for new doctors, whether I regret embarking on this career change. My answer is always no – I miss my creature comforts, but I think I’d miss my future more.