Looking Ahead: Fourth Year of Medicine
It’s crazy to think that in under two years, I’ll be starting work as a doctor. As I enter my fourth year of studying medicine, it feels fitting to reflect on the journey so far and give a little insight into where this next year will take me.
This year, I’ve found myself feeling the least excited to get started. I can’t quite put my finger on why. Medicine is a career of constant learning, but in medical school, we have a set number of presentations and conditions we need to know for our exams. Now that I’ve covered all the body systems in the previous three years and technically completed all the content required for exams, I have a heightened awareness that there’s no new system to delve into. With exams looming in March and the sheer breadth of content I need to cover, I feel constrained, unable to veer off the "exam content" path. And I’ve never liked feeling trapped.
But those are just the negatives at the start of the year. I’m kicking things off with my community placement, starting with Psychiatry, followed by General Practice, and a few short rotations in Haematology and Rheumatology (though I’m not entirely certain about the latter).
Psychiatry feels particularly daunting. I’m not entirely sure what to expect, and dealing with mental states feels more challenging than addressing something tangible, like a wound. My general feeling is that Psychiatry requires a particularly thick skin. While you obviously want to help your patients, you need to be able to separate the condition from what impacts self and non-self. I suppose that’s true for all of medicine, but Psychiatry makes me a little more nervous than other specialties. Nevertheless, I believe that experience in Psychiatry is crucial, and there’s a place for it in all of medicine.
A recent experience in A&E highlighted this for me. A woman presented with a broken forearm after falling on an outstretched hand. As I took her history, my questions seemed to trigger her, and she became overwhelmed by her emotions, unable to continue. This was a patient with literally broken bones, but her emotions from a previous experience impacted her more than the obvious injury. I’m not suggesting she needed psychiatric treatment, but any doctor seeing her should give these emotions the attention they deserve. We shouldn’t just treat the obvious injuries; we need to treat the patient as a whole. For those considering a career in medicine, here’s your buzzword: Holistic Care.
On a more personal level, I’ve struggled with balance while studying medicine. I’ve consistently allowed work to get the better of me, making it my complete focus. The outcomes of this have been:
Neglecting my health
Losing connection with friends
Building poor habits
Constraining my thoughts only to medicine
Allowing my spiritual life to take a backseat
This year, I’m hoping to balance things out a bit more and develop a better plan to improve all these aspects. Medicine is important to me, but so are all these other pieces of the pie. I’ll be sure to write another post updating you on my progress and explaining how I do it. For now, I’m honing in on my core values, a task I recommend everyone try:
Write down your fundamental beliefs, your guiding principles for your behavior.
Stress-test these principles to see if they hold up when challenged.
Recognize which of these principles are non-negotiable and which have a time and place.
As for career aspirations, I’m keeping an open mind and using my time on placement to guide my future decisions. So far, ENT has been my absolute favourite, but I haven’t shut the door on anything. While the Head and Neck seems to be my calling, Emergency Medicine holds a special place in my heart following my experiences. It might be too soon to decide, but I find it fun to consider potential specialties, so I’m not planning on stopping that anytime soon.
To wrap up, I wanted to share a recent success: I’ll be presenting my work reviewing Hypoglossal Nerve Stimulation as a treatment for Obstructive Sleep Apnoea (with my phenomenal group) at the European Sleep Research Society conference in Seville this month! Exciting things are on the horizon!
