Here’s a quick post-call ramble: I had a pretty bad night on call last night.*
And it was still better than medical school.
I hated med school.
In first year, I hated the loneliness. I had went in hoping for intelligent conversation with the country’s cream of the crop and at least initially, I could not find it. What I found was a narrow-minded and selfish little campus, and I hated it. Continue reading “I Hate Med School – And That’s Okay”→
Today this blog turns four years old. Technically a few minutes to midnight yesterday, but it’s much of a muchness really. Four years ago I wrote about practising speculum exams on sim-dolls in the skills lab. I was so embarrassed to do a bimanual examination on a doll in front of my male classmates. Everything was new and scary and who would have guessed that four years later we would be effortlessly sliding speculae and doing Pap smears and getting ready for the big wide world.
Mostly it has just been my own personal issues that unfortuantely do have the ability to get me down and out.
Needless to say, the Musculo test on Friday was atrocious. Not only was the work difficult and volumous, but I could not concentrate or focus for the life of me. It had never before been that bad. Turns out the test was so difficult that even those who could concentrate were guessing almost as much as I was.
As a student – any kind of student – one’s favourite academic activity is to criticise. Your syllabus, modules and lecturers are all weighed, measured and found wanting.
I am going to take a wild guess and say that of all courses offered the world over, medicine is the one that varies the most from institution to institution. What’s more, medical syllabi are constantly changing. To the best of my knowledge, my own university has undergone two major syllabus-revisions in the past fifteen to twenty years.
South African medical students are very fortunate in that we always have access to cadavers for dissection. Many western countries, as I have been told, simply don’t have these available to medical students.
My class started dissecting in September 2009. The new syllabus is all about integration, so where in the past curricula students spent about a year almost exclusively dissecting, we now have dissection at the beginning of most bodily systems. We have now dissected just about everything except the head/brain/spine and the musculoskeletal system.
Today we started with Neuro-dissection. At this point I should mention that dissection has never really been a problem for me – so much so that that bothered me. I couldn’t equate the body lying on the table with that of a human. It seemed to be only a shell, which I suppose it really is. In my culture, at least.
The inspiration for this document came during my second year while studying for an end-of-block test. At the same time, the then-first years were studying for Pathology, aided by “Le Document”. [If you are a Tygerberg Medical student and you don’t know Le Document, I really pity you.] Anyway, somewhere in this time period I looked at a fellow second year, threw my hands in the air rather dramatically and exclaimed, “I wish I had a Le Document for Second Year!”
As you read this document, you will notice that it is markedly different to the one you used during your first year.
It is not focussed on a single module – because the point of your second year is to have a more integrated view on the human body and medical practise. Your patients will not present to you as a system, but as a body (even if you are a super-super-specialist).
It is not in Question-Answer format – because that was for first years. In your second year you will often find that you are required to answer things you didn’t even know were being asked.
It is application-centred – because this year, you will be swamped by theory; you really don’t need any more 🙂
Today I studied for my Reproductive System examination. Yes, I am trying very hard to take this studying-thing seriously.
The more I study this system, the more I am scared of having children one day. Nevermind that, the more I fear my Obstetrics rotation which will happen next year. That is a bad thing, since I would really like to be an OBGYN one day.
Take episiotomies, for example. An episiotomy is an incision through the perineal muscles for delivery of the foetus. To make it clearer: you cut through the muscles between the patient’s introitus and anus… I do think that hurts. I think it hurts the doctor almost just as much.
Yesterday I studied for my Endocrine System exam. I have decided that I simply cannot have a supplementary exam in January as
I need actually to have a holiday in the short time provided
I won’t be able to take too many textbooks home with the airlines’ baggage allowances for domestic flights
Endocrinology is supposedly the easiest module we do in second year, but I am not sure that I agree. The difficulty lies in the complexity of hormones and the fact that symptoms can be so non-specific. The volume is not so much though, which makes it easier.
One of the most important things they try to drill into our heads at Med School is the ability to take a good, relevant history. If we get a question in a test or exam asking, “Patient X has these symptoms, describe the steps you would take to reach a diagnosis” and we do not start with Take a relevant clinical history, we’re pretty much screwed.
The importance of a history is not exaggerated. Apparently some UK study indicated that over 75% of diagnoses can be made on a good clinical history. I am still scouring Google for that study, so if you know it do pass it along.
As mentioned before, I am currently in the last quarter of my second year as medical student. The module my class is handling at the moment is called Introduction to Clinical Medicine. This is where, after almost two years of intense theoretical training, we get introduced to the clinical set-up of medicine. It is a time both exciting and scary.
He who studies medicine without books sails an unchartered sea,
But he who studies medicine without patients does not go to sea at all.