Third Year: Totem Pole Life

The life of a medical student is cyclic - up and down the social totem pole. In some ways, as monotonous as medical education may sound to the outsider, life in this curriculum is closely contrasted by great swings in celebration and tragedy. 

As first years, we are congratulated by not only the medical college but also our loved ones that we have survived the ordeal of tedious and mystifying selection process. We donned our white coats in solemn inspiration as we take the oath to forever obey the spirit of medicine. Within a few weeks of the bumbling excitement of taking the first steps in our yellow brick road to M.D-hood, we are thrust upon a rigorous and unrelenting curriculum. Knowledge in capacity we have never experienced are poured upon us in crammed time we never had so little of. Thanksgiving became a sobering moment for many relationships - the realities of a medical student's devotion of his/her path straining out the true colour of personal boundaries and selfishness.

As time quickly (and excruciatingly slowly) flies by, we experienced a sense of seniority and accomplishment as conclude the first year of medicine. It seemed astounding that we have learned as much as we have and adapted so quickly into this new pattern of life. However, this glorious feeling of survival and expertise was quickly vanquished with the start of second year. As if the first year of academic struggle wasn't monumentous enough, the second year of medical school shattered our self-confidence in our study rituals. We learned to adopt new strategies to studying, and once again we are thrust upon an even shorter study period to become accustomed to. For some, it was incredibly freeing to adopt a personally structured and paced study plan for the standardized Step 1 examination. There were no more obligations to study to the professor nor need for deciphering a professor's emphasis on certain material. For others (sadly, that is I), it was a struggle to continue persisting with the provided curriculum whilst concurrently studying a seemingly wholly different flavor that was Step 1. 

The conclusion of second year and Step 1 examination is one of huge relief. It is the sigh of completion of the preclinical academia as well as the daunting standardized hell. At the end of this tortuous academic year, we arrived at the pinnacle of our academic knowledge for medicine. We have become wisened denizens to the ways of first two years of medical education, and it is a rewarding feeling when we can provide the doe-eyed, terrified incoming class or rising second years with information and advice. It seemed like yesterday that we were such green students that had no inkling of how to balance all these resources or even input such massive information into the sulci and gyri. It seemed impossible that we were able to not only learn so much information, but also become the best students that we will ever be in such a short period of time. At the conclusion of second year, we had achieved the seniority within the prclinical class. 

But quickly, as third year rotations rolls around, I have learned that I am, once again, back at the bottom on this ever-changing totem pole. As the third year medical student, I am not only the least experienced among the team of medical staff, but I am also the least knowledgeable of all the relevant information. The first week of OBGYN rotation, I feel like a clumsy child trying to impress my adult friends with sausage-fingers dexterity. Ungracefully, I fumbled through the procedures, lost in the set construct of the hospital team. 

It is rusticating, alienating.

I know that I know so much, but yet, in the face of relevance and practical medicine, I know almost nothing. There is little translation of what I have learned over the two years of medicine into practical usage on the wards. At least, it doesn't feel like I am achieving any sort of helpfulness. Once again, I find that I am thrust upon a wholly different way of learning and perceiving my environment. 

Annoyingly so, I feel that I am useless and even idiotic - so flustered by the residents' questions that I can't even properly conjure up an adequate answer sometimes. I stand by as each member of the team bumbles busily without me. Each of them knowing exactly what needs to be done and how they integrate into this vital construct of rapid medical care.

While I stand dumbly on the side, hands free, with the stupid question of

Can I help with anything?

It is strange - chafing, even - to realize that I know so little about medicine and the care of patients as I rotate in my second week of OBGYN. I have observed my supervising residents works effectively as machines to balance the workload of managing multiple complex patients. I have seen them exhibit incredible grace and empathy with their patients while maintaining firm professionalism to persuade of the best possible outcome. They are burnt out and tired, but when they wash their hands and walk into the patient room, all of  the weariness and irritation of medical bureaucracy falls away.

And in these moments of observing the machine-like efficiency in the hurdle of daily chaos, I realized that this is what it is means to be a physician. It is a contextual adaptation of incredibly precise compartmentalization. The definitive, boom-boom-boom-let's-go mind of diagnosis/intervention/crisis management and the kind, unjudging demeanor in the face of patient suffering are the faces that a physician must wear and switch off in a moment's notice. It seems impossible to juggle such widely different mindsets simultaneously, but it seemed impossible to conquer an organ system's knowledge in two weeks at first. 

Impossibility, I have learned, is only relative.

And so, as I have stumbled through the first two weeks of OBGYN with many mistakes, wonders, and awe-filled moments, I have learned to become comfortable in my new position at the bottom of the totem pole, and I will continue to climb those rungs to the top until next time.