On to Year Three

Friday marked the end of the formal education we have come to know since day one, when we sat in classroom and were spoon fed doses of information for the purpose of tests that evaluated how well we could study. We go from being students and passive learners to starting our doctoring apprenticeship. We take on the role of the student doctor and become responsible for the care of our patients. We now must take charge of our own education.

We have been told that we start out as students, who closely identify with our patients. By the third year, we begin to see our patients as a list of symptoms. And by the end of our fourth year, we closely identify with the doctor.

The third year has been compared to a socialization process, during which we develop our identity as a physician. As part of process, we learn to function as part of a medical team. We may oftentimes feel outside our team, standing on the periphery, watching and not really understanding or associating with others, especially when begin to navigate the complexities of the wards and the details of our patients lives and diseases.

You are also charged with advocating for your patients. The major challenge for any student stems from the dichotomy that exists between fulfilling the goals of the team and serving the patients, especially when the goals do not align.

As students, we are naïve and unaware about the social norms of the medical culture. We maybe referred to as dead weights or speed bumps on teams. We ask lots of questions, slow down the team’s progress, seek endless guidance and affirmation that we are doing things right. We have not yet been completely exposed to the realities of medicine and we are on the bottom of the todem pole, which makes us powerless.

At the same time, we do offer a different perspective because we spend the most time with our patients. In this regard, we are the closest to our patients and places us in a position to speak for our patients.

As we move forward, I know my life will change drastically. I know I will have to make sacrifices to excel in the third year. Fourth years have told me that you can pick two: sleep, exercise or a social life. Not sure which two I would pick, but I know I would focus on maintaining some sort of balance in my life (if possible). Most importantly, I hope I can draw on my sources of strength (family, friends, mentors, exercise and inner peace) to help carry me through the most difficult times ahead.

As we descend into the wards, we are about to enter an entirely new culture and we will soon be learning a new language that changes every 6 to 8 weeks. We are like nomads, traveling into strange lands without a map. We will fixate on what to wear, what to carry in our pocket, what to present and how to write a note. We are undergoing a transformation from a lay person with two years of formal medical education, to becoming fully indoctrinated into this mysterious medical culture.

From other students and physicians, I have heard that each field has a personality. As impressionable students, we will be tempted to change ourselves to excel. I know a number of students will change to please the attending of the month, like a chameleon that learns to blend in. At the same time, I know I will have to resist such dangerous temptations and remain true to myself and accept my limitations.

On day one of clerkships, we will be given a lifelong responsibility- “here is your patient, take the very best care you can.” I hope I can fulfill this responsibility and look forward to the challenges and learning ahead.

Wish me luck!