I can spend 10 minutes per consultation if people have straight-forward tonsillitis or gastroenteritis.
But what about the parents who are hesitant about vaccinating? I need more than ten minutes to make an impact.
What about the woman whose pregnancy test was unexpectedly positive, and needs to discuss options? She might not have anyone else to discuss options with.
What about the myriad people with psychiatric illness? I need more than ten minutes to figure out if it’s depression, or if there is a history of hypomanic spells. Is it substance induced? Is there another general medical condition? Who can start someone on antidepressants after a ten minute consult?
And what about the worried well? The old people with children abroad, with a bag full of chronic medication, and stories of challenges as numerous as the stars.
My dad has a favourite piece of advice for new graduates. It goes something like this:
Remember that when you come into contact with a patient, you may be the only person that touches them that day. The only person that hears their voice, that looks into their eyes. Make sure your touch is a kind one.
General Practitioners are pushed for time (and push their locums for time) because it’s the only way they can make any kind of profit, really. I understand that. But that is not the family medicine that I was taught, and I’m having trouble finding the balance.
Last night I worked my last shift for Community Service. 1 January 2018 will mark three years since I walked into my first day of work. And on that day, more than 1,000 new interns will enter our workforce.
I remember the nerves the night before: being unable to sleep. Feeling like a fraud, like I had been allowed to graduate by accident. Worried that I would be labelled Worst Intern Ever; worried that I’d have awful colleagues. But I survived the first week, and eventually the first year, too.
And so will our new interns. I have some tips for those who need ’em.
I’m linking up with Jamie’s annual end of year bookish survey again this year.
I spent 11 months of this year without internet, so I’ve hardly reviewed any books, and posted about books rarely too. I also haven’t read much this year. It’s been a tough one. Jamie has a lot of questions, and I don’t have answers to them all, so I’ve actually left some of them out.
If you’ve been reading South African news, you’ll know that at least 300 interns and community service doctors stand to be unemployed next year, due to a lack of funded posts at accredited institutions.
In final year, we thought that getting an internship post at our desired hospital was the hardest – and most coveted – thing.
Two years later, we all tried to find a community service posting that would give us a foot into the door to our future specialties.
But we didn’t know that those were the easy parts. Then, we still pretty much had guaranteed employment (most of us, at least).
Then came the end of Community Service, and reality hit us in the face: we were on our own.
* * *
That’s where I am now. The government no longer “owes” me a job, and unless I find one, I’ll be unemployed come January 2018. People used to say, “There’s no such thing as an unemployed doctor.” These days, there are plenty of them, because freezing posts is a done thing. Continue reading “The Threat of Fun-employment”→
Ever since I wrote about how going for therapy was my biggest gift to myself*, I’ve met with a few medical students to talk about the topic of mental health. Many of them were worried about their ability to make it through med school with their illness. Many were worried about the viability of a career in medicine with depression.
When I was a student, there was a rumour that students with mental illness would be excluded from the course. We were informed by our senior students, and they by theirs, and thus the rumour was propagated. Continue reading “Can I Be A Depressed Doctor?”→