1/2 Way To MD

“Meet me half-way, right at the border line between pre-clinical and clinical, that’s where I’m going to wait for you” (I had to!)

So um, I’m half-way through my medical degree! How can time possibly go so damn quickly during these last two years. I’m now moving from the pre-clinical part of my degree to the clinical stage, which is encompassed by more real-life learning with patients presenting with a myriad of their conditions. Not to say that the first two years, were not real-life. That stress was definitely real! Real-life in the sense that there will be real examinations and histories that will be taken which affect patient outcomes and interactions that will be formed, as you revolve around different rotations in the hospital setting. Aptly, I am nervous about all this, as I feel I am still in need of more learning before going through the interactions with my patients. I guess, learning is the foundation of the clinical years though, so throw me in!

Pre-clinical years, on the flip side of the Notre Dame medical school coin, consists of more learning via workshops, lectures, Problem-Based Learning (PBLs), clinical and communication, all covering the basic fundamentals in biochemistry, anatomy, physiology, pharmacology and all the other -ology subjects that are essential in medicine. All in the form of the famous Notre Dame learning style of spiral learning, where important concepts are reiterated and repeated consistent with how important it is. (That’s right, I’m looking at you Horner’s Syndrome). You learn what’s normal in the human body and then what can- at times- go devastatingly wrong too.

Pre-clinical, for me, accentuated that nothing is black or white, there are so many shades of grey in medicine; shades that you didn’t even know existed, that it can sometimes be overwhelmingly convoluted to see when one shade is different to another. Oh, that patient is on an antihistamine, and can’t have a blood thinner, as it will cause too much bleeding? Let’s find something else…Oh, that patient has heart failure and concurrent asthma? We don’t want to exacerbate the asthma, let’s find something else…I haven’t even mentioned the dive into the ethical rabbit holes yet! It’s like trying to complete a jig-saw puzzle that you think is 500 pieces, and then finding out it’s actually a 5,000-piece puzzle. At times, this can get quite overwhelming, which exemplifies the realness of an actual patient. A patient will rarely have a typical textbook presentation, but rather there will most likely be other underlying conditions and states that must be considered in the treatment and management, and that is the shade of grey that permeates medicine.

At the end of second year and the end of pre-clinical years, I was becoming jaded. Not due to the learning content being uninteresting, or Notre Dame’s curriculum being less stimulating than counting grains of rice, but rather it was this accumulating excitement to put into practice all the examinations, histories, communication skills and anatomy that I learned during the first two years. This, in a way, contradicts my thoughts in the first paragraph, however, I think they are not mutually exclusive. I am eager to see the realities of medicine and how the knowledge I extensively gained apply to real patients, but at the same time, will this be enough? Will I be good enough in this new setting of third year placements, that’s described as the longest and most difficult year of medical school? Is this my imposter syndrome seeping out through the knowledge gaps of the first two years? I hope not.

A very common game that many tutors play with medical students is predicting what specialties their students may go into, based on their personalities, abilities and general demeanour throughout the year: the sorting hat of medicine. Of course, this is no reflection of the student’s actual future trajectory, but it is interesting to note what these tutors think. My tutor took a long, hard look at me and I imagined the scene in the Terminator movie where T-800 (Arnold Schwarzenegger), analysing, calculating and examining through its artificial eyes.

She’s scanning me, ‘hmmm he always drinks Chai Lattes, wears white Reeboks Club Sport C, and thinks he can play sport. Definitely sports medicine’. Finally, her analysis was complete and luckily for me, my tutor didn’t have a specific specialty and instead said whatever I do go into, she knows I’ll put everything into it and work hard throughout the specialty. I’ll take this thought into the clinical years, first of all starting with my surgical rotation.

I’ll keep you all updated on this.

As always, stay safe, eat your pancakes and have a blessed start to the new year.

Anei

The three Africans, including myself, in my cohort.