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5 Things I Wish I Knew At The Beginning of Medical School

It is not just nostalgia and excitement that grips me as I am nearing the end of medical school. A part of me is terrified at the thought of finally having to own that white coat, to be the person in charge. There is another part (though not as dominant) that is filled partly with regret. Regret over the things I didn’t do, the things I could have done differently, the moments I missed, the unnecessary anxieties…
I can’t go back in time and fix them. I don’t think it will amount to much since my mistakes taught me lessons that you can never find in textbooks. What can be done, however, is to pass on what I have learned. So for all those who are going to be starting medical school, here are a few things you may benefit from.
1. How to Stay Motivated
Once during a lecture, our surgery professor said, “ Try and quit swallowing for just a minute and see what happens. This is what patients with esophageal cancer have to go through every minute of their lives.” I did. And less than a minute passed till I had to resume swallowing to avoid drooling like a labrador. It was horrible, but at the same time, like many epiphanies life throws your way, it was enlightening.
Your patients are more than just the big scary words in your anatomy book or the complex biological entity your physiology texts make them look like. And the best way to remind yourself of that, to seek the inspiration you need to study when you are dead on your feet, is to put yourself in their place, to empathize. Believe me, I know how ridiculously hard it is. But I also don’t know anything to be more motivational. Your patients are your inspiration. That day when they will come to you, full of hope, expecting answers and expecting to get the treatment they need, that is your goal. That day when you are that person literally fighting for someone’s life, that is who you are working to become. And the best way to aspire to be that person is to remember your patients.
When you are struggling to remember the differences between adenocarcinoma and squamous cell carcinoma of the esophagus and wondering why you need to know it anyway, think of the swallowing reflex. Think of what you would be without it. When you are grappling with community medicine, remember that lack of primary care can be the main reason why cancers are not detected early and also the reason why, God forbid, you may have to tell a patient someday, “I am sorry. There is nothing we can do.”
Motivation does not always lie within your textbooks or even the looming threat of your GPA or board exams. Sometimes, it simply lies within the walls of the hospital you hope to conquer one day.
2. Take Care of Yourself
This is probably the hardest for me to write because it was the hardest lesson to learn. Burnout during medical school is real. Depression is real. Forgetting why you ever began studying medicine and wondering if there is any chance you can opt for an alternate career can be scary. But it can also be overcome and even better, prevented
So I say this to all the newbies. Stop being your own worst enemy. Stop blaming yourself for everything. You are going to witness multiple things which will simultaneously excite you, terrify you, and leave you numb. The key to survival is to only be affected to the extent that your empathic sense is not dulled and neither is your productivity. You will hear miserable stories from your patients and be made a fool of by your supervisors. Do not isolate yourself from the lessons they teach. Take what will make you a better doctor (you will know what this is) and leave the rest behind.
Medical students are supposed to be the busiest people on earth. And while that is certainly understandable, you don’t always have to be busy studying. Get busy on making yourself feel good. Shower. Exercise. Do your bit to look your best. You don’t have to keep burning the midnight oil with your textbooks. Instead, do something you like. Something that will keep you going.
Ultimately, it is these things that help us take care of ourselves.
3. Treat Your Patients the Same Way You Would Like to Be Treated
I say this as someone who has seen both sides of the picture, as a medical student and as a patient. Once, when I had to go to my GP, the medical student taking my full history sat me down in a quiet room and asked me various questions about my health. All the time, she never looked away or even stopped to answer the phone. She made sure her attention was undivided and in this way, she made me feel that I was in the right place and getting the right care.
As students, it is easy to get distracted by many things. But it is important to remember that what makes you a good doctor is not if you remember all the questions you are supposed to ask or how quickly you guess the diagnosis. Rather, it is about how you make the patient feel. Do they feel like they are your priority at the moment or you are just concerned with looking good in front of your professor? Moreover, when they feel comfortable talking to you, they are more likely to give a clearer history of their own health.
4. Listen to your seniors
Your seniors are the masters of giving good advice, sometimes even more than your professors. Be it which book is best for last-minute cramming or how to balance ward rotations and social life (ha!). And to put it simply, it is because they have been longer in this wild race than you have. Even if it is one year that separates you from them, they went through a lot to know what they know now. They are in touch with the problems you face in this day and age, even when you have knowledge at your fingertips thanks to technology. They will know all about the best apps to download to help you cram and organize your flashcards. They will reveal all the tidbits you need to pass your exams, the kind of gold you really need and won’t find in your books and definitely not from your professors.
Listen to them. You may not have to follow all they have to say but just learning from their experience is worth it. They have gone through all the uncertainties you are currently facing. And at this point in time, it is necessary and comforting to know that so many others not only felt the same way but also ‘made it’ despite what they went through. It is important to learn from them. At the end of the day, make sure you have good relations with them from Day 1. It goes a long way.
5. Practice being a safe doctor
It isn’t just about having the best surgical hand or having a photographic memory. Sometimes, or rather most of the times, it is about saying no. No to a procedure you are unsure about even if you are afraid it will incur wrath from your supervisor or make you a laughing stock amongst your peers. It is about saying no to a question regarding patient history that you forgot to ask rather than giving the wrong information. Other times, espescially if you are posted in the ER, patient safety means ruling out the worst possible diagnosis. Chest pain? Always get an ECG no matter how many times you have read in your text books that a lot of gastrointestinal conditions can present similarly.
Sir William Osler once said, “Listen to your patient, he is telling you the diagnosis.” The few minutes you spend with your patient will tell you more than any lab test or even any consult will. You may suspect many differentials but at the end of the day, it is your listening and examining skills that will ensure you not only arrive at the correct diagnosis, but also you have a satisfied and happy patient ready to trust their doctor.
This not just safety. This is what courage looks like.