On finishing medical school

I have finished medical school. I HAVE FINISHED MEDICAL SCHOOL. It’s almost unreal to think how fast six blurry years have passed, and it still feels like a year ago that I first stumbled out on to the halls corridor to meet some of my, now, closest friends. But it’s true, medical school is finished. Well, aside from some shadowing time at my new hospital, it’s all over. No more nights of walking through the sticky floored union, no more going to the library more because of the social opportunities it offered rather than any of the books. Medicine is an odd degree, thrust together for such a long period of time I feel like I only just met my colleagues, but at the same time that I have known them forever.

Finals themselves are an interesting exercise in nerves and anxiety more so than knowledge. And the exams themselves were okay, but that horrible week (or for some 10 days who had the luck of an early finish) between finishing the exams and results was almost unbearable. I would much prefer that you walk from your last exam, thick brown envelope in hand to open immediately following the exams, rather than painstakingly dissecting them in your mind. The dissection is imperfect, all you can ever remember is the questions or stations that went wrong, and those that you do remember are only recalled through the haze of exam stress. The post-exam chat never helps, I have little to no interest in what other people put, especially when it’s the direct opposite of what I plumbed for. The irony is I can remember sitting by my friends in the pub when they finished their exams last year (I made the most of my intercalated BSc), and asking how it felt.

“You’re finished, can you believe it? It’s been FIVE years?!”

The universal response was a grin, and a reply of “Maybe finished, maybe finished”. As I sat there myself this year, I finally understood exactly what they meant. Coming out of the exams, there were certainly parts that were not great, a pyrexia history omitting any meningism questions, a smoking cessation history that fell apart pretty rapidly and a hip examination on a patient who couldn’t move at all… And all I could think was I hope I’ve finished, I hope I’ve done enough. The prospect of a summer elective cut short to re-revise was no more appealing than the inevitable phone call to the parents to explain the situation.

Ultimately, results day came after a fairly slow week of constant self doubt and loathing, and it was all fine. People huddled around phones scattered around the medical school, refusing to go and open the brown envelopes until they knew that news inside was good. I was no different, pacing around St. Pauls with my girlfriend after a slightly tense lunch during which I was no doubt abominable company. Finally the email came through and the phone call went to the parents, but not with embarrassment but joy.

Passing medical school is an odd feeling, almost like you’re an intruder. After working so hard for so long, to actually realise that goal is a bizarre thing. Statistically finals have the highest pass marks at most medical schools – it certainly doesn’t feel that way in the run up or on the horrible between OSCE evenings when you just want it to be all over. If you work hard you get through it. Being an intruder is something other people have commented on to me. The thought that the next time you’re on a ward it’s as a doctor is mad. I can’t quite believe I’ve made the grade, that I have the knowledge required to do the job.

That said, during final year I certainly felt like my knowledge improved. Probably in terms of volume only as finals approached. But more in terms of using what little bits of knowledge I’ve picked up along the way. It’s one thing knowing the theory about the treatment of asthma, and quite another treating a sick asthmatic. During final year, you get the opportunity to actually start this transition, to make the move over to a clinician from the theoretician. It’s an ongoing process, but it starts with trust, someone asking you to help, or you putting yourself out there. That’s probably the most important thing in final year, my best experiences (and learning) came when I just said yes to things. Obviously, when you’re on the tenth TTA of the day and someone asks if you want to do another that might not offer a great learning experience. But I’ve scrubbed on emergency neurosurgery cases after agreeing to take a referral form to a registrar (which all other students shunned!). So say yes, if someone asks you to do something, say yes; if someone needs help, offer it. The obvious caveat here is not going above your competency – and if someone is supervising you, makes sure they’re competent too!

Finishing medical school is great. It’s weird, but anything that reduces the number of exams you need to do is obviously a good thing (there are so many after all…). Feeling like an intruder is an odd thing, especially when you’ve clearly put the effort in and not just got in through a back door, but I think its all part of the gradual translation to being doctor. And say Yes.