Rite of passage (or, Delicious Irony)

Every medical student comes to a point in their career where they must perform their first digital rectal exam (DRE).

Today, during a clinic rotation, was my turn.

In a delicious twist of irony that I think was lost on my preceptor, another physician in the office was having a going-away party which we visited directly after this little procedure.

In other words, within minutes of performing my first DRE I was celebrating my new-found skill with a slice of...

...wait for it...

...chocolate cake.

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"I have never understood why medical schools have twenty year olds learning medicine."

While my age has been posted on this blog ever since it began over a year and a half ago, only recently have some commenters drawn attention to my age:

"Blogger, one question for you. How on earth did u get in to med school at 21? What was your life style like from high school through undergrad? " - anonymous

"I have never understood why medical schools have twenty year olds learning medicine. They have gone from high school to undergraduate to medical school and have absolutely no life experience. Of primary importance are the marks of the applicants; all else is secondary." - fossildoc

Before I begin I'd like to thank the many, many people who brighten my day every time they post a comment on this blog. Even if you don't agree with me (or my medical school's decision to accept me, perhaps, in an indirect sort of way?)...no offense taken. Keep 'em coming!!

It's interesting hearing this perspective when, first of all, I am by no means the youngest person in my class. Most medical schools publish statistics of their admissions class, which show that the average age is usually in the mid-twenties but the youngest person is often 20 years old on admission (and sometimes younger).

This is by no means the extreme, however. In some schools in Quebec, students are admitted to a five-year med program after only being out of high school for two years. And in the United Kingdom, students are admitted to a six-year med program straight out of high school.

Secondly, I sincerely agree with the fact that life experience is important. Personally, I took a year off and worked in a completely unrelated field and travelled between my undergrad degree and the start of medical school. I gained so much perspective in this year.

And not only is this my personal opinion, but many med school admissions committees would agree. If a spot comes down to two applicants who are equal on paper in terms of their academic qualifications, the applicant with more life experience will always be the one finding the thick envelope in their mailbox.

While fossildoc may have been right twenty years ago, and many schools retain a minimum mark cut-off, today it's no longer true that med schools admit students based primarily on their marks.

And as a result, the amount of life experience in my class alone means the people in my class are all fascinating and there are so many whom I admire for various incredible reasons.

In addition to life experience though, medical adcoms look for something even more important: maturity. Maturity is an important factor in medical students and indeed physicians and you'd be hard pressed to find a school that admits someone whose immaturity compromises their professionalism.

Given all that, however, I can empathize with these readers who question how young medical school applicants are. I submitted a forum post a while ago after being frustrated at the immaturity of some of my classmates:

"Most of the 3rd years in my class have demonstrated immaturity at one point or another, more so than the people who got in after 4 years or took some time off after graduating. By immaturity I mean anything from showing disrespect by talking loudly in lecture to uncontrollable giggling and crude comments during the genitalia examination clinical skills video. ... If it were up to me, based on what I have seen, I wouldn't allow 3rd years to get into medical school at all."

Needless to say I pissed off a lot of third-year applicants with that last statement, and in retrospect it was a bit extreme, but a) ruffling feathers on the interweb is fun and b) the number of mature young students compared to the number of immature young students - from my impression - is miniscule.

But while the ratio is low, the presence of a distinction demonstrates a point: the maturity of an individual cannot be inferred from their age. In other words, just because a student is young, doesn't mean they're immature. There are some students in my class who have stunned me when they revealed their age, because based on their maturity level, I would have guessed they were five years older than they actually are.

And that's the point I'm trying to make. Unfortunately I couldn't have said it as well as worriedandwaiting, who summed this topic up really nicely in a statement on that pre-med forum, and with whose comment I'll close:

Are you a better doctor because you're 25 or because you're 35? That question has no correct answer. Age is not the factor. Who you are as a person is what matters. It is your life experiences that define you as a person, so try to maximize this opportunity to grow as an individual. As we all know, some 21 year olds already have a lifetime of experience, while some 30 year olds still think like teenagers. It all depends on the person.

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Feeling lowly.

It's nice to hear that I should start to notice a feeling of "I am actually needed" eventually...

...even though I haven't yet been able to find any evidence that the feeling of "I have no idea what I'm doing" ever really goes away.

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Words I'd use to describe med school: Honour

There are a number of words I'd use to describe med school. This blog post is the first of a small series I'll devote to expanding upon these words.

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I've heard people joke about it before. "You know, you're lucky... as a doctor you're one of the few people who can get someone to to take their pants off for you within minutes of having met them!"

That's not necessarily always a fun thing, considering how unpleasant it is to perform a digital rectal exam on, say, a patient who has lost control of their bodily functions and hasn't showered in weeks.

But that borderline crude statement has a lot more to it than just humor.

Statements like that only scrape the surface of the depth of the honour it is to be able to practice medicine...something that we med students can occasionally tend to lose sight of when we are in the midst of 80-hour work weeks on the wards, or in our tenth 15-hour study day in a row, or when we've just been humiliated by a preceptor in front of both our colleagues and patients.

While I can use this blog to complain about finals or how much stress I'm feeling at times, I probably don't say enough that I do feel honoured to be a part of this profession.

There are so many ways in which this honour is revealed. Here are a few I can name:

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• Medicine: a profession to which people are willing to donate their bodies...their most personal possession....after they die. It's an honour to be a part of that.
  
• Medicine: a profession to which people are willing to give you a huge amount of trust just because you are a part of the profession. Depending on where you look, physicians may not be the #1 most trusted profession, yet around the world, they almost always fall in the top 10 (BBC: Doctors #1; Harris: Doctors #1; Ipsos Reid Canada: Top 5; Reader's Digest Australia: Top 10). It's an honour to be a part of that.
  
• Medicine: one of the professions in which there are so many sides and approaches to the common goal of health, and in which those various health professionals are starting to work harder to work together to achieve this goal. It's an honour to be a part of that.
  
• Medicine: one of the few reasons that a driver, though enraged by the thick of traffic, would still be willing to pull over. I've seen people grumble when a cop turns on the siren to whiz through a red light, but never when an ambulance has come through. It's an honour to be a part of that.
  
• Medicine: one of the few professions legally allowed to self-regulate by the Canadian government. It's an honour to be a part of that.
  
• Medicine: the reason why people will open up to me their deepest secrets, the greatest extremes of their emotions, their first and last moments on this earth...all because of my field of study. It's an honour to be a part of that.
  
• Medicine: one of the areas of study that thousands of the most intelligent university graduates fight for the chance to be able to enter every year. It's an honour to be a part of that.
  
• Medicine: one of the professions where you are able to call some of the most brilliant, accomplished, fascinating and devoted people your colleagues. It's an honour to be a part of that.
  
• Medicine: one of the professions with a longstanding legacy throughout centuries, and is continually looking back into its history and deep into its future to better itself for the good of the patient. It's an honour to be a part of that.

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Even if I could think of all the reasons why it's an honour to be studying medicine, I don't think all of them could be put into words.

That being said, I know I've missed some... if anyone is reading this and can think of some I've missed, I'd love to hear your thoughts in the comments!

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When the dust settles

It was just as if a hurricane had passed.


The merciless pounding stopped,

     and everyone began to come out of their makeshift shelters,

          wandering bleary-eyed into the streets,

               looking at the destruction around them,

                    assessing what little they had left of their friends, and social lives, and dignity.


And they began to talk to each other,

     wondering aloud,

          putting into words the thoughts they were all thinking...

"Did that really happen?"

          "I can't believe I made it. There were times when I didn't think I would."

               "Can it actually get worse?"

                    "I'm not sure anybody would understand what this was like if they didn't see it with their own eyes."

Yep... finals for the term are now done... and another semester is over.

Time to enjoy the precious few weeks of recovery before it all starts again in January.

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