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No Patients Please, We’re Academic Doctors

Aaronsingh72x721Aaron Singh -- These past few weeks I’ve been helping give "Cambridge Access" talks at various locations in the country. These talks are an unofficial initiative to improve access and encourage applications to Cambridge from those who might not otherwise apply, believing the common image of Cambridge as a place where stuffy old dons in robes sip champagne, eat caviar, grant each other’s children admission, and slap each other on the back for being so great. So I’ve been going to some pretty far-out places to speak on what it’s like to study medicine in Cambridge, and why more students should apply.

I remember back when I was an applicant myself, when I listened to some of my seniors speaking. And to prepare for my talk, I asked myself, “What do I wish those guys told me back then?” After rejecting the initial answer that rose reflexively to my mind (“Apply to Cambridge? What are you, nuts? RUN BOY RUN!”) I had to agree that the most important thing was conveying just how different studying medicine here was compared to the rest of the world.

Anyone who’s read my posts before will know that the system of medical education here isn’t exactly my cup of tea, and many of you have left encouraging comments, ranging all the way from “Chin up, dear, it’ll get better” to “Stop whining and get on with it, moron!” Other universities in the UK and throughout the Commonwealth (though not in America, as far as I know) teach scientific medicine alongside clinical medicine, making sure students understand the relevance between the two, and giving medics enough of what they want (read: blood, gore, billowing white coats and hot nurses) to keep them hooked. But in Cambridge the first 3 years is hardcore science, with patient contact only twice a year. So after 2 years in Cambridge, I’ve realised that medicine here isn’t for everyone. Being an old, traditional university that’s big on research, it aims to inculcate a love for research in its students and a scientific curiosity that, whilst a necessary asset for doctors, is a lot more useful to academicians.

And yet a lot of students who want the usual method of learning medicine apply to Cambridge (and other research universities) anyway, for the prestige and the big fat crest on their degrees, completely unaware that for the first 3 years they are nothing more than glorified natural scientists rather than real medics. So in the end, what did I tell the eager beavers who turned up with their wide eyes and their faith in humanity as yet undamaged?

“Every university teaches medicine in its own unique way, so whichever one you apply to, for Pete’s sake, do some research on the course there.” (And here I bit down hard on the little red horned voice in my head urging me to scream “RUN PEOPLE RUN!”. These voices can get so irritating. Maybe I should tell my therapist about them sometime.)

August 7, 2007 | Permalink

Comments

I'm currently going through the application process and trying to work out which courses I'd like. It's actually easier than I thought it was going to be as it has become apparent that I am quite particular. And it's defintely made easier by visiting the Uni's and getting a feel for the departments.

I went on the Imperial openday and realised that I would hate it there, on principle because I seemed to be surrounded by people who wanted prestiege more than content. Their talk was a hard sell on the social life of London, and I seemed like the only person who actually wanted to know abuut the course. That worries me slightly. The fact that at Imperial many future doctors choose to intercalate in Management worries me further.

I spoke to the head of admissions, who was a really nice person, but I think even she realised that Imperial probably wouldn't suit me. And at Imperial medics are basically the "arts" and I can't deal with being isolated like that either. (sorry about this turning into a how much I hate Imperial rant)

I'm definitely a Cambridge person. I need to know the science in as much depth as possible, and there is so much depth, but the reason why I'm not a research scientist is that I want to see the broader picture as well, of how it can be managed or treated in the patient. This was gauged from the amount I'm enjoying my research project at Manchester Uni atm. On the drive there, I was seriously considering applying to Natural Sciences, because Imperial scared me about their medical course so much, but I just knew that it was the course for me as I started to speak to more students. I know there isn't much patient contact at all. That would suck a bit, but at the end of the day, the clinical stuff can be caught up in the last three years, where you can concentrate fully on it.

It would really irritate me to apply to a University just for the prestiege. But there are pushy parents (like my mother) where that's all they want from their kids. I am arguing with her on this point on principle, but I'm not at a point of not applying to Cambridge just to piss her off, yet. I just want to make sure that I will love all of the courses that I am applying to, and I want a university that cares about the science rather than the money, but I do want London as well, for the big hospitals and wide social cohorts.

Posted by: esme | Aug 8, 2007 3:54:21 AM

The university I trained at had a strict "See One, Do One, Teach One" principle. It was really great for experience, but we were essentially the workforce of the hospital. We were pulling 100 hour shifts at the hospital but it was still expected that we would study in our free time (what free time?!).
Looking back I sometimes wish I had gone to a university that focused more on academia (just so I would look less stupid when I attempt to teach med students here).
I think you're giving the eager ones great advice!

Posted by: Amanzi Down Under | Aug 12, 2007 6:02:48 AM

I'm a sixth-year Student of pre-grad med school in Venezuela (south america), and I can relate to the scene Aaron describes with "RUN KID... RUUN!!"..
Yet, what I would've liked people who I came to for advice to tell me is that Medicine is not all about practice and skill; there has to be a great deal of information inside our temporal lobes before we ever face a patient. AND that those 3 years of book-eating, non-sleeping study are SO VERY MUCH necesary not just so that your name as great practitioner lives on; but because when you face a patient, you're also facing the worst of the miseries a human can bear.. sickness, so you MUST be prepared to know the WHYs and the HOWs.
I remember myself wanting to learn about fever as soon as I entered first-year, so I went up to one of my teachers and asked "¿when do we talk about fever?", and his answer was "When you get the difference between fever and hypertermia.. for now, let´s talk about bones."-- Much in medicine is never talked about inside the classroom, thats when one's own initiative comes into play, SO if you're planning to study medicine, it helps if you're the kind of person who always wants to know a little more..
Though this next might doesn't apply to all countries, mine belongs to the lot denomined "third-world countries"; And its because of this that there is a great difference between public health service and private health service; just for the reader to get the picture, in private health sistems, there are tomographs-age technology to up-to-date technology, while in public health system, one can barely ask for an X-ray because it might be under repair, or patients have to go to private laboratories to do an hematology because there are no reactives, or who knows what.. something is always missing or not working; SO this influences VERY MUCH on our practice because they are all based on the public health infrastructure, so we learn semiology, we explore the patients sings and symptoms, and though sometimes painful for the patient, we search for bloomberg's sign when we highly suspect of appendicitis in a patient... Because sometimes you can't wait for a pre-op ecography when there is no ecograph!! (pre-op = pre operatory). I don't mean to critisize my country's public health system; but one piece of advice for people who want to learn medicine in MY country would be: Prepare for everything. Learn as much as possible because that will save your life and your patient's life.


Posted by: Hector | Aug 15, 2007 2:37:46 PM

Hey - I'm sorry Imperial scared you about the course... I'm studying medicine there at the moment and I definately made the right choice. I fully appreciate its not for everyone (finding out that, after all, is what the open day is for), but I just wanted to reassure you that we are not all there for it's name (Oxbridge tends to rank higher on the prestiege scale to be honest...), and also that the majority do not intercalate management (or want to). But being the only 'almost-arts' students is certainly a little tedious at times... Good luck with your choices and application.

Posted by: Ann | Aug 15, 2007 2:51:32 PM

terrific! i wonder how could we keep going in studying such theory while everything changes fast outside. i remember one of my lecture said that we must be a long life learner, but this term is actually hard to accomplish

Posted by: inda | Aug 15, 2007 9:15:03 PM


duderati - seriously, you're taking it all far far to seriously. most medical schools are big enought and varied enough for you to make of them what you want. like academics? imperial has got some world-class science going on. like the more psychosocial side? cambridge has got that in spades too, you just need to know where to look. so please, don't worry about it too much. and don't eschew prestiege - in the new medical jobs market, it'll be far more important than you realise now. email me if you want.

Posted by: James | Aug 19, 2007 7:14:18 AM

hey.. what's the whining all about? when i took the course i didn't have the slightest idea about the uni i'm going to study at. Guess what? i'm studying in Russia (OMG.. is it a communist country?). I'm under the Makysian government scholarship plan by the way.

Posted by: naboochadnezz | Aug 21, 2007 6:11:03 AM

Perhaps one method of learning may not be best suited for another. And oh, by the way, it's ironic how I chanced upon this blog :).

Cheers,
Sharon

Posted by: raZZbeRRy | Sep 9, 2007 9:12:25 AM

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