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The Excitement of Starting Clinical Medicine

Hslilucia1Lucia Li -- “I have a new philosophy -– I’m only going to dread one day at a time.”

This time last year, I was starting clinical medicine for the first time. Taking my first steps into a ward, not quite used to the prescribed chaos of day to day hospital medicine, everything a bit bewildering and wonderful. Over the past year, the "firsts"’ have become routine and the excitement wears off.

Which is why I’m so grateful for the arrival of the new first years. True, they have taken over the common room and filled in all the crosswords before I can get to them. But they also get excited about taking blood and watching appendectomies. It reminds me that, yes, what we see and do everyday is actually pretty cool. I was watching a partial lobectomy of a lung today, and the trainee nurse standing next to me whispered “this is amazing!” For a moment, I stopped trying to figure out management plans and just took a step back and thought, “yes, actually, wow!” It was nice -– to have that feeling of utter awe and amazement again.

The other thing is that I see reflected in the new first years the same worries that I had when I first started. Worried about how on earth I was ever going to get the hang of 5 different examinations, about when heart sounds would click (no pun intended) and sound more than just whooshing, and about hurting patients every time I touched them. And I realise how much more confident I am now with examinations and dealing with patients in general, after practicing on umpteen patients. It just goes to show how much we learn in that one year!

But what an insurmountable task it appeared to be at first… Because no matter how much I reassure my "children" in the first year that it will all come together before the exams, I am met with the same disbelief that I doled out to my "parents" in the year above when they told me the same thing. History certainly does repeat itself where medical students are concerned.

And in keeping with that, I realised something. I am half-way through my penultimate year. In 18 months, I’m going to qualify. By Christmas, I will have covered all major specialities except OB/GYN and peds. Theoretically, I should know enough to diagnose and formulate simple management plans for any adult male with a medical issue. Now that’s enough to give anyone palpitations.

December 12, 2008 in Lucia Li | Permalink


And when the money starts rolling in it will make it all worthwhile.

One of our doctors complained that 2 hours work was not worth the $1100 he was being paid! He needs to try a production-line job for $9 per hour with no sycophants and underlings to do his bidding.

When Mr Obama 'fixes' medicine and we are all civil servants,then those who are in medicine for the benefit of their fellow man will be the only doctors left(about 5%) and the rest will have found other careers

Posted by: Ant | Dec 16, 2008 2:07:25 PM

thanks, lucia.

you are correct. it is all too easy for us to get jaded,...and forget that what we do - especially when successful - is beautiful, if nothing short of heroic.

may we always be humbled by the privilege to help others...and like the previous poster said - be paid well.


Posted by: bruce | Dec 17, 2008 2:18:57 PM

I am a pre-med student currently doing a clinical placement in Australia and I can understand how you would find it boring/tedious after a while. But I am glad to hear that the "newbies" have reinstated your excitement about what you are doing because everyday to me is exciting. Even after seeing the same surgery 26 times in one week - I am still excited at the opportunity to see it again!

Don't forget how amazing it is that we all get a chance to do what we do - whether we be lowly 1st years or been in the game for 20 years... We should all throughly enjoy what we get to do everyday - Save lives!

Posted by: Amy | Dec 18, 2008 1:15:41 AM

Hi, I'm a patient lurker and enjoy medical blogs. Can you please explain to me what exactly a "ward" is? In my mind I picture many patients in one room just separated by curtains. If so, are these patients "charity" cases? Because in my many hospital stays (in the U.S.) I have only seen 1,2 or 3 person rooms.

Posted by: Emily | Dec 20, 2008 11:11:01 AM

You guys are hilarious. Why don't you try coming to Canada or another country with socialized medicine - or better yet, watch Michael Moore's movie "Sicko" and follow the lifestyle of a British MD as he drives his sportscar home to his swanky pad - I think you'll be surprised to learn that doctors in countries with socialized medicine make a pretty good living.

I've been practicing now for 6 months, so I know this first-hand. Plus, I was married to an ER physician for 10 years and he regularly took home in excess of 30K per month. I wouldn't call that a "civil servant's salary" and he certainly wasn't "in it" simply for the benefit of serving his fellow man.

Yeah, we have other problems here in Canada, like long wait-times, but doctor's salaries aren't one of them. And contrary to what many people think, there is no exodus of physicians streaming to the US - I've thought about going myself, to be honest, but only for the weather!

Anyway, I don't think you have to worry about Obama "fixing" the US medical system - nothing in the US will ever change as long as someone can make money from it. And I would say "someone" (ie. managed care) is making a killing off US health care. I'd hazard to say that Obama would get "fixed" before he'd succeed in fixing a system as lucrative as yours.

Although I am not a fan of everything Michael Moore does, I think this movie lays bare a lot of what's wrong with the US system. If you watch nothing else, watch the opening sequence where you watch a late middle-aged couple ousted from their home and moving in with their kids because they've been bankrupted by cancer and heart disease. Well, they should have had health care, you say? Here's the thing: they both DID HAVE health insurance.

Personally, I love being able to practice medicine in a country where I'm not hampered by wondering what tests and treatments my patient can and can't afford. In Canada, the only "doctors" that run into this trouble are veterinarians! Yeah, you're young and healthy now, but you won't always be young, and you may not always be healthy. I developed RA 2 months into residency, and am thankful every day that I live in a country that treats me with the care and dignity to which ALL citizens are entitled.

And to the "patient lurker" - a ward often just refers to a hospital floor with patients. As for the "charity" cases, hospitals in socialized countries have rooms just like everywhere else - some with one bed, some with two, and some with four. What you get depends somewhat on whether you have "extra" private insurance, but more often it's just a matter of what's available, and thus, luck of the draw!

Happy holidays to all.

Posted by: Jennifer | Dec 24, 2008 4:41:44 AM

Great idea...if you can excecute what you are saying here the project may be very successful actually.

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