Welcome to your clinical years

Dear brand new third-years (and those of you starting your clinical years of med school),

Congratulations! You finally made it! You've made it through the two years of painful eight-hour lecture days and into the world of real medicine. You've graduated from standard student to mini-worker with full-time study responsibilities on top. You're finally getting to do what you signed up for in this course. 

I'm only a year ahead of you, and the wisdom I can offer is scarce. However, it wasn't so long ago that I sat in our massive auditorium and wondered how we'd all make it work. I remember how difficult it was trying to piece together the multitude of assessments, compulsory requirements and placements that were to come. And I remember wondering how we'd ever make it through. Sometimes it's good to know that thousands of people have been where you are right now. And most of them have made it. 

Your orientation week was probably pretty scary. I was shivering in my boots for parts of it - and not just because those auditoriums are cooled far beyond what is required. Suddenly that accidently-on-purpose entry to medicine became the reality of a career pathway. I wasn't just on some conveyor belt of tertiary education - I was heading towards real work in real hospitals where I'd be charged with real people's healthcare. I'd be expected to know things, and be able to do things, and be able to help.

But you know what? We made it. It sounded scary and impossible and totally overwhelming in that week of orientation, and we spent the first few days of our first rotation frantically trying to work out from our peers if we were on the right track. But we made it. And we were all in it together.

I was really lucky that my first rotation was with a group of doctors who constantly encouraged my learning. The interns, you must remember, are only two years ahead of you in their learning. They know what you need to know better than you might. And it's okay to ask for their help. In fact, it's probably good for their learning to ask questions. Help them out a little with paperwork and they'll have a few extra minutes to spend explaining things. You're also allowed to be friendly with your team - it makes the work week much more enjoyable for everyone. Remember, these people are your colleagues. You're going to be working with them for the rest of your life. Tag along with the senior residents when they go on consults. Find the registrars studying for their exams - they'll know everything and teaching you will help them with their studies too. That is, unless they're three weeks out from exams, in which case you might want to give them some space. And the consultants, well, they know everything or just about. Respect their years of experience. They'll have numerous esoteric facts to add to your repertoire - but they'll also value well-pondered questions. Make the most of their time when you have it.  Remember how much their time costs and how lucky you are to have even five minutes of their undivided attention.

Be interested. Whether you want to be a pathologist, a general practictioner or an upper GI surgeon, there are things you can learn from every rotation. You will be happier, and your team will respect you for making an effort. Remember that they're often volunteering their time to teach you. You are their apprentice.

Respect your patients. They might seem like two-demensional medical problems when you are on ward rounds, but these are people who have jobs, and families, and histories and futures. They have feelings, and some of them will really struggle to be stripped of their personalities in hospital. Of all the people on the team, you're the one with the most amount of time to offer them for comfort and conversation. Patients don't just teach you about medicine, they'll give you pearls of wisdom about life in general. You're unlikely to cure anyone in your third year of medical school, but you'll probably make a big difference just by letting people talk to you. Be kind and empathetic, and never underestimate the value of a conversation.

Find time for your homework. I know that sounds silly to say, because you need to be learning on the wards, but textbooks without clinic is about as useful as clinic without textbooks. You need both. Write down a list of questions for yourself and try to answer them. You'll know more the next day and maximize your placement time.

Start on your core curriculum study early. Work in groups where possible. And no, you don't need to create thousand-page study documents. But you do need to know an awful lot, and it's wise to figure out how you'll retain it best early on. There will be no cramming for your finals. And if you manage to cram effectively, please teach me your skills. Everyone learns differently, so your friends might tell you how they learnt all these great things by reading an entire textbook. Don't continue to read textbooks if all that happens is falling asleep between its pages and waking up with creases in your face. You don't need to read all the books or use all the websites or watch all the videos. There are too many of them. Read a little, watch a little, teach, discuss, question and answer. Very few are perfect but something will keep it in your head. For me, seeing a patient with a condition, researching it, doing a few quiz questions and then telling a friend cemented things pretty well. It also ends up being a huge time investment - so if you're like me, remember that it'll stick eventually and an hour with a patient will teach you more than an hour in the library, staring blankly at an incomprehensible page of notes.

Try to get enough sleep, eat well and exercise. I know you'll be told that a thousand times in your career and it'll always seem impossible. But try. You won't always get there. Remember you learn a lot better when you're well rested, and you stay awake better when you eat well. Exercise makes you feel good, too. Of the three, good quality sleep will be your best friend this year. Ward rounds early in the morning can be painful if they're post-3h sleep, pre-coffee consumption. And you'll be expected to comment on medical things in front of patients, so you'll need some level of intellect about you. 

Finally, try to keep some kernel of yourself alive. By that I mean, do the things your love. This year will be busy and there's an endless amount of time you could spend studying. You will need to make time for friends, family and hobbies amongst all of that. There won't be much spare time popping up. Sometimes you have to realise that an hour or three doing something that makes you happy will be much better for your study overall than another evening in front of the computer. Medicine has a habit of attracting creative, intelligent, lateral thinkers with exciting extracurriculars, and then stealing away all the time to be who you were before. It's way too easy for the year to disappear in front of your eyes and realise you haven't played your violin or hit up a tennis court or whatever it is you love. These things make you who you are. And YOU are the one who got accepted into medical school, and who it is hoped will one day make a good doctor. Being a well-rounded you will reduce the likelihood of burnout, keep you sane, and paradoxically, help you study.

You'll make it. You'll do just fine. And you'll probably have a blast.

Take a moment to stop and smell those proverbial roses. Look at who you are, and who you're going to be. This is an amazing time of your life. Thank your patients for giving up their time to talk to you. And remember this is a fantastic time in your medical career.

Good luck!


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