The Med Student Game

A couple weeks ago, I had a series of small group classes intended to teach Psychiatric interviewing skills. As part of the assignment, we had to interview a patient with a Psych issue, and write a formal note about the information we got from the interview. We have to write patient notes fairly often, but this one was a different format than I was used to, so it took a little extra effort (though they were nice enough to give us an example that we could copy from). After I did my interview and wrote my note, I emailed it to the Psychiatrist who led the group. A short time later, I got this email response from him:

Abby
you are both very good at playing the "med std game", that is making it easy for me to check off that you have done all parts of the required interview, and also you did a very nice interview--even though that is less a part of the formal scoring it is the most important of being a physician.
nice job

Every time I read this, I don't know quite what to think. The part about being good at the "med student game" gives me pause, because, while it's technically a compliment, I don't want to be the kind of student who just plays the game, and ignores the things that are actually important in learning to become a doctor. I'm pretty sure that's not what this doctor was saying, given the second part, complimenting my interview. Plus, this doc is the kind of guy who is enough of a pragmatist to know that we students have to play the game, at least to a certain extent.

But there are some people, I think, who only play the game, either because they don't want to worry about the actual important stuff, because they care so much more about grades and being "perfect", or because they don't have the skills to get through without "playing the game". I can't really say that these people are going about it the wrong way, because I certainly prioritize "the game" over learning for its own sake, like when I decide not to study a certain topic because I think it's unlikely to be tested, even though I can see how it might be important to practice someday. Med school is rough, and I'm not sure it's even possible to get through without learning to play the game well. So I guess I should be glad to hear that I'm good at it, but it is still an unexpected compliment.

A new chapter...

So, this blog has been pretty quiet lately, which was not intentional, but appears to have been an unavoidable side effect of second year medical school. I think it's probably more surprising that I managed to make a fair number of posts last semester than it is that I made almost none second semester.

But! The semester is finally over, and now that "summer" is here, I may actually have a bit more time for this. I don't really get a break in any meaningful sense of the word, as I am studying 40+ hours a week for my Board exam in a month, then I start my surgery rotation at the beginning of July. But this is much improved over last year, when I spent all morning and afternoon studying at school, only to come home and study a bit more before bedtime.

I don't want this blog to die off, because even though I haven't had much time for it, I still like the idea of track of this journey through medical school. Even if almost no one even knows it exists, hopefully I'll have some stories and insights over the course of my education that are meaningful to me. Someday, when I'm a happy doctor, looking back fondly on my med school days, I'll have a reminder of what things were really like.

My somewhat optimistic goal is one post per week, though I'm not sure if that will be manageable past July. But we'll see...

I think I'll end this post with a list of all the reasons why next year has to be better than the last two years. I've been told by several people that it will be, but I also thought that second year would be much better than first, and that didn't exactly go as planned. But maybe if I make a list, I'll be able to remember why the pre-clinical years were no fun, so I don't get too depressed with my crazy on-call schedule next year or whatever.

1. Patients! Finally, finally, finally, I will be able to stop spending every waking hour reading or thinking about reading about whatever random organ system. I mean, if course I'll still be looking things up and studying, but that should be nicely weighed out by getting to see and help real people (which is way better than the standardized patients that I had mostly been working with).

2. Individual attention. I didn't really think I'd mind that much, but I actually quite disliked not knowing my professors and having them not know who I was. Next year, there should be more opportunity to work more closely with Residents or Attendings or 4th years, or SOMEONE who will know who I am outside of the name on the top of the test. (Though I don't even think my current teachers had that, since our tests are computerized.)

3.Tests worth less than 50% of the course grade! This year especially, most of our tests were upwards of 60-70% of the total grade (and this is a single final exam, not two tests each worth 35% or something). That's stressful, having to worry so much about the single exam. And add to it the fact that most courses were curved, meaning there was no set grading scale and so no way to anticipate how well you needed to do to get whatever grade. Instead, I just had to hope that I studied harder than most of the rest of the class. In med school, that's less likely than it might have been at other points in my life.

4. Showing off clinical skills. I've generally gotten good feedback from instructors in my Doctoring class, saying that I do a good job working with patients. But that hasn't meant that much up to this point, as basically anyone who can talk coherently to a patient gets an A in Doctoring, so I didn't really have anything to show for it. But next year, this is a much bigger deal and a bigger part of our grades, so I'm hoping it will give me an advantage.

I'm sure there are more, but it's just about time to start getting ready for bed, so maybe I'll continue the list in a later post. Either way, this already has me looking forward to July. Let's hope I'm not deceiving myself!

What have I gotten myself into?

I die a little bit inside every time I see doctor bloggers complain that the 80 hour per week limit for residents is not enough time for them to learn everything.

Is is just me, or does 80 hours a week seem like too many hours already? I mean, I can see that 40 hours is really not a lot, so I'm okay with more than that. Plus, I understand that in residency, they push to get more experience in in a shorter time. And I know there is a LOT to learn, so it takes time to learn it all.

But hearing about what's coming at a time when I feel like I am already spending every waking minute studying or thinking about how I should be studying, makes me feel like the next 6 years of my life are going to be more of the same.

I guess it's good that I'm teaching myself to like coffee now, because it looks like I'm going to need it...