I am currently in the 3rd week of my medical posting...or at least i am supposed to be. I practically slept through the whole of last week; i could barely keep myself awake. This week i'm plagued by insomnia, waking up at 3am and unable to fall back asleep. I am very much interested with my studies, but just overwhelmed because there is too much to do. Its draining just thinking about it & planning my next course of action and frankly, i have little energy to do anything. Forget eating or socializing; i'm too tensed most of the time anyway.
Let me give you a tour of the expected life of a final year medical student in University Malaya.
My current posting : Internal Medicine.
We are rotated among the 8-10 sub-specialty wards each week (cardiology, neurology, geriatric, hematology, etc.) for the 8-week posting. Depending on the ward, each student will have about 7 patients to cover; meaning to fully clerk the history, full examination, trace lab results & X-rays, study the case notes, and follow-up until discharge. By exam standards, full clerking + examination + diagnosis + plan investigations should be done in <1 hour (experienced doctors can do it within 10-30mins depending on the illness...that's y the GPs shoo you away after 2 minutes). Simple math will tell you it will take minimum 8 hours in the ward including breaks & moving between patients, just to cover the patients...without even checking reference textbooks about the disease. 8 HOURS OF BASIC EXPECTED PREPARATION FOR JUST 1 HOUR OF CLASS (TEACHING WARD ROUND). We have 2-3 teaching ward rounds a week. And some of our lecturers expect us to be in the ward 7.30am-5.00pm to join with the consultant/medical officer ward rounds or help with blood taking and other things like that. Then we have on-call duties once a week so we have to stay at the ward or emergency department at least until midnight & follow the doctors.
That is just the ward work. Mind you, its not like we are getting paid...and neither are we actually treating the patient...just aggressively observing.
Then in every posting, we are expected to observe procedures like X-rays, CT scans, endoscopy, biopsies, blablabla...at our own time. Regardless if we have seen such procedures before (perhaps in different postings), failure to obtain the the attending doctor's signature to complete/fill out log books would reflect poor attitude and less marks. On top of that, we have tutorials on various topics once or twice a week, each taking about 1-2 hours. Because the lecturers themselves are specialists/consultants, they are very busy thus last-minute schedule changes are not uncommon. Then in some postings we also have to attend to the clinics, to learn about follow-up, clinic vs ward setting, learn how to decide which patients need to be admitted, so on and so forth. And because UMMC is very sub-specialized, different clinics are on different days!!! Then there are additional stints with the Departments of Pathology and Radiology every other week....sometimes requiring searching for additional patients or writing up reports. Then we also have 1-2 hours of general lectures and 2 hours of Clinical Pathology Conference (CPC) once a week. Attendance for EVERYTHING is compulsory, anyone with <80% per posting will be subjeced to inquiry by the Dean's Office and barred from our final exam. Oh, and did i mention that we have end-of-posting exams every 8 weeks?
Overwhelmed yet? Noticed that i haven't even mentioned READING or STUDYING.....let alone RELAXING. Ideally, they expect students to read up on the disease/conditions of their allocated patients in the wards as well as their treatment options, read up in tutorial topics beforehand, revise the contents of the general lectures, and prepare for the CPC which are very complicated cases like you see on House. I personally think one has to either be manic or hyperthyroid or hyperactive or addicted to coffee/red bull/crystal meth to be able to cope. That's why i am contented with my C-mark at every major exam.
Hospital staff (doctors, nurses, dentists alike) always say this about UM grads : UM grads are excellent, they are very skilled with clinical work and have a lot of knowlegde, but have bad attitudes. Well, that's because in the process of our training/grooming/education we have learnt to say FUCK YOU!!! We'll go around doing out own business, as long as the patient is safe/stable, the filing & documentation is up-to-date, we really don't give 2 shits about anything else.
Ain't we a fun bunch. Now...has anyone got some crystal meth for me?
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6 years ago
hello dima, your schedule is like crazy, and i thought i was the only one crazy here. I think all of them put high expectations on the future doctors, think of it this way, you will not regret it, you will use all your knowledge whe you start work, but even more, when you become doctors after graduating, you will still need to study, the knowledge is never ebough, we have a lot to learnt, you will not regretit, i promise you.
ReplyDeletei learnt all this in the hard way. I wish I paid more attention in class, what I learnt so far in class is being applied in my work, I even have to study more. There has been many breaking point but I learnt not to give up. all this knowledge is useful, it may seem difficult, i do feel like killing myself or my seniors sometimes, but i think it's worth all the hard work and effort. there will come a time when you feel self-satisfied. so, keep up yeah....