Welcome to the Club

This is for all of my friends and future colleagues who are embarking on the journey into medicine.

This is the start of something you've been waiting for, seemingly, forever. Whether it's a day you couldn't quite believe until you made it to your first orientation class, or a day that seemed set in stone from when you were touting a make-believe stethoscope in kindergarten, this is now your future. It comes with some heavy responsibilities - because quality of life can hang in your hands, because people's happiness can be held in your grasp, however tight you choose to make it. And because if you mess up, it isn't just your mistake to worry about. But it also comes with great privilege - a chance to spend much of your day examining and understanding humanity or lack thereof, a chance to spend time with colleagues who will completely understand each moment of the rest of your career. Right now, it's big and scary and exhilarating and amazing. 

You're all very special people. For most of your life, you've probably been top of your class. Many of you will have been very popular at school - and we know that many of you are social butterflies. Many of you would have been school captain. Your parents may have been telling all of their friends that you, their special child, are now doing medicine (much to your chagrin, I'm sure). You excelled through your first degree. Many of you also did other courses and worked hard in your respective careers. Some of you have kids - and to them, you must be the most special person ever. Some of you have careers in music and art, in research, in law. You all have passions and things that keep you going. I'm sorry to break it to you - but you're not special any more.

That's not a bad thing, though, not being special. You've finally got what you've always wanted - a group of like-minded individuals. Instead of being the smartest, the top of the class, the special one, you're now part of a cohort of people just like you. You're mostly over-achievers. You're all very intelligent. And only one of you can be top of this class. Thankfully, it doesn't really matter what grades you get in medicine. Your exams will rarely be able to cover all the details you are meant to learn. You might know all that you need, and more, but still pull 70% on the exam. You mightn't know everything and get 80%. You need to pass, but now is the time to stop worrying about what grades you get. Make sure, instead, to work with your new colleagues to understand the concepts. Challenge each other to work smarter rather than harder. Work together because there's a lot to know and only so much space in your brain. You mightn't be special in this cohort but you are still special to someone. Right now, those special people are your families, partners and friends. Soon, those people who find you special will also be  your patients.

Look around you. The people in your lecture theatres and your tutorials are the people with whom you will spend the rest of your life. These are the people who will hold you in the darkest moments and who will celebrate with you the greatest of joys. Some of them might be groomsmen at your wedding, or your life-long best friend, or the people with whom you end up doing specialist training. These people understand you. Treat them well.

Take care of each other. You will hear a number of stories in your time about doctors, great doctors, who couldn't cope with the stress of it all anymore. People who were found dead in operating theatres (alone, and not the patient) or toilet cubicles, or in motels near the hospital, or at home, because they became isolated. Because medicine is stressful. Because they did something that worked out badly for a patient and they didn't know how to cope. You'll hear those stories and think it won't be you. That you're smarter than that - that you'd seek help. But when push comes to shove, will you? Are you starting to do that now, when study gets on top of you? Are you keeping your hobbies alive? Are you spending time talking about things that have nothing to do with your textbooks? Because keeping your mind healthy starts now. You're not told these stories to scare you. You're told them because we care - everyone who has spent some time in Medicine already cares. About you. And we know that you get sick and worried and tired too. You don't have to be invincible. And you don't have to do it on your own.

Keep in touch with people outside medicine. Your high school friends, previous work colleagues and family will keep you grounded. They'll remind you that there is a life outside the walls of the hospital. They'll remind you that you really are special, even if you couldn't get a cannula into any patient today, or you couldn't remember the signs of myocardial infarction. Your friends might have real jobs now. They are out earning a living while you slave away at your studies. Let them talk about their experiences. Not everyone wants to hear about this new disease you've discovered. And it'll do you some good to remember the real world.

Don't get angry when they ask you silly questions about med school - health may seem simple to you now, but that doesn't mean it's simple to everyone else. And yes, you will get a lot of questions. You're not a doctor. But you do know more about medicine than many of your friends now. And you'll probably know far less about whichever disease your Aunt Beryl has. Respect people's experiences. And remind them that you're just getting started. You don't know everything. And you don't need to. And, I'm sorry to break it to you, you never will. there's too much to know and only so much time. Remember that your level of knowledge can be dangerous. Instead, help your friends and family to find reliable resources for their questions. And remind them to visit their GP. And visit your own GP while you're at it. You need to be healthy too. 

About study - because I know you've been waiting for the practical tips. You'll be told that you "need to know" a thousand and one things and you'll be told to read just as many textbooks. You'll be told more ways to study and learn than you ever thought possible. Your friends will ask you if you've studied this or that, or ridicule you for studying your way when theirs works better. Remember that it works better for them. And your way might work better for you. It might take a while to find the perfect way for you to learn. Work out what fascinates you and make sure you incorporate it into your medical learning. Remember that you're learning for life now, not for tests. Also remember that you need to pass the tests to make that life-learning relevant. So make sure you cover the core curriculum. Even if it seems ridiculous, it probably has some relevance. You're just starting - you don't know what you need to know just yet. Ask questions. Lots and lots of questions. Even if they seem silly. You will only be a first year medical student once. By the time you're an intern, you'll be expected to know all the things that seem like silly questions now. Save yourself the uncertainty later. Keep in mind the big picture.

People will have told you that medicine is life and death. Mostly, though, it's not. Mostly it's making people healthier or keeping them from getting sicker. You'll be faced with many more ethical and moral questions in this arena. Would you feel comfortable doing a long or complicated surgery on a very healthy but very old person? Would you feel comfortable doing the same surgery on a young but very unhealthy person? How about giving a ten year old very expensive treatments that might promise them a few more months of life? What if those months were going to be painful for the child but important for the family? Your role, down the track, will be just as much in knowing the medicine as in knowing how to guide people through engaging with it. You will have people crying over scars from surgery that saved their life and gave it back to them in all its fullness. You will have people thank you profusely for something that you hardly realised you'd done. And you might forget what it's like to be a patient. Remember that even though you know very little now, you can be a comfort. You can offer smiles and small-talk. Having someone care and having someone spend quality time talking often means the world to patients stuck in hospital for days or weeks on end.

You've worked hard to get here. You will be great doctors. Just never ever lose that fire that burns in you now. Keep it alive. And always remember the privilege you have to be so involved in people's lives.

Welcome to the club.


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