Tuesday, 13 January 2009

The Occasional Reminder

That I guess every student needs to bring along as they study and learn their field (particularly those still having a few weeks before semester starts again, like me).

I Googled how to learn medicine and found several interesting search results. Two of them were particularly representative of what I felt in 2nd semester:
I signed up to be a doctor. I wanted to wear the white coat, to treat patients, to haunt hospitals, to prescribe medicine. But a medical course is not so easy. Before they teach you what you need to go out into the world and treat, you have to jump over a few hurdles first. You have to learn biochemistry. You have to learn physiology. You have to learn pharmacology. Many aspects of these subjects will not be necessary for your career. Entire chapters will be more appropriate for pure scientists than for medics. But for various reasons, you have to learn everything. It's good for you.

But it makes you forget. It makes you look at medicine as one long tortuous road with no end in sight. It turns you into a fact-memorising, exam-taking machine.

I did a traditional style course, something the Angry Medic is battling through at the moment and wondering if one of the shiny new style integrated PBL based fashionable courses would have been a better choice. I can’t really say because I haven’t done one, but before the traditional style course gets chucked out like those Dallas style shoulderpads at the end of the 80s, I’d like to remember the good aspects of the course.

Most of the time there was only one textbook to consult. When I was learning anatomy I looked in the anatomy book. Simple. None of this trying to learn the anatomy, physiology, pharmacology, pathology and treatment of a heart attack all at once.
By Dr K.

That bit in red there really describes what I face in the integrated, systems-based PBL-driven medical course. Sometimes I just wonder, what exactly does integrated supposed to mean? I find it hard to learn and understand a particular part of the body when I'm given only 5 days to study it all. Well, we do of course get more than 1 week to study each of the gut, the liver and the kidneys (and then there are weekends to recap), but in the middle of the week, what normally happens is that I'm lost in all the details of the anatomy, physiology, etc. of the particular organ.

And then there's the terror of solving it - the House moment: an attempt to explain every symptom the patient is having based on one single diagnosis. It's where Pathology - a really sick subject in my opinion - kicks in. It's cool, it's very "medical", elegant, etc., no doubt. But it also brings dread as you open the two-inch thick, hardcover Pathology text. The book I use organises stuff based on systems - digestive system, hepatobiliary system, renal system, haematology, etc. - and on the introduction page of each system, it lists almost all the possible ways of the system to get a disease (i.e. to get sick, which Pathology really is). Acute tubular necrosis, acute glomerulonephritis, interstitial nephritis, post-streptococcal what-not... a friend of mine once remarked, "it's a whole new language - you could be speaking about it with another med student and no-one else will understand what you're talking about."

Sheesh. Exam-taking machines. Exactly.

And the occasional reminder is what The Angry Medic ended with:
And there comes a point when you forget what you're doing this for. What it was that drove you, idealistic and bright-eyed, to medical school in the first place. What you believed the medical profession could do.

But every once in a while, along comes something to remind you. Along comes something that tells you that there is a world out there, with real living breathing patients to treat. This, for me, came in the form of this snippet from Grey's Anatomy a few weeks ago...
(You can go check out the website if you're interested)

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