I’m back! It has been almost a month since my last post. In that month I have felt TERRIBLE. At one point I thought I would never stop coughing and that I would get diabetes from my cough drop consumption. Don’t worry, I switched to sugar free. But now I’m about 89.32% better and have found the time to write again. (Which is code for I can stay up late and finish things). And so here we are.
It’s July. For most people July represents the middle of summer. Vacations, lazy days at the pool, short days at work. In medicine July means ALL THINGS NEW. As in, all the things are new. New medical students, new residents, new academic calendar. You see, I work in Academic Medicine. Which means that I work at an institution of higher education where we train medical students to become competent, caring, ethical physicians and then train physicians to be competent, caring, ethical specialists in their chosen field. Sounds easy, right? I will try to briefly introduce you to what the summer is like for those of us insane enough to participate in this great adventure of education.
Medical school is 4 years long and almost exclusively completed after a 4 year bachelors degree is achieved. In the first 2 years students spend their time in courses learning anatomy, the complexity of each organ system, structure and function of the body and its cellular systems, human behavior and so much more. They come to class, have small group sessions, read and read and read some more and take lots of exams. By the time they come to the third year they are ready to see how all they have learned can be applied to patients and diseases. Oh and did I mention they also have to pass the first step of the 3 step medical licensing exam? In the third year our goal for a student is to be able to see a patient, perform a basic physical exam and formulate a differential diagnosis. What that means is that when they hear a patient’s symptoms and know their history they can think about what diseases they are most at risk for and/or most likely to have. Only once that is done can we as physicians begin to think about what testing and treatment someone might need. Medical students don’t do anything without supervision. Sometimes patients will ask if the medical student is going to perform their surgery or deliver their baby. I can answer that with a resounding NOPE. What a medical student will do is participate in surgery with me where they will learn the hows and whys of that specific operation. They will check on their patients in the hospital and often serve as an extra set of eyes, ears or hands to ensure that all the details of patient care are taken care of and nothing has been overlooked in making sure a patient makes it safely home after surgery. In addition to all this they are reading, going to lectures, taking tests. At the end of the third year we hope they have chosen a medical specialty. Then they spend their final year of medical school spending time in areas of their chosen specialty, as well as interviewing for a residency position and taking the 2nd step of that all important medical licensing exam series I mentioned before. So for me July means making sure the syllabus and all the materials our third year students get and use equip them to learn the most they can about women’s health. It means making sure those 4th year students who have chosen my specialty have the best opportunity to train at the institution of their choice for residency.
July 1st also marks the day new residents begin their training. These are recent medical school graduates who have gone through a very competitive process to secure their place in a residency training program. Each specialty in medicine has residency training and each specialty decides how long that training should be. For example, OBGYN residency is four years long. Neurosurgery residency is 8 years long. (no thank you). While in residency these doctors have a focused practice where they will learn every detail of their specialty. It is also the time when they are trained to perform procedures and surgeries all in a supervised environment with the intention that at the end of their training they are ready to care for patients on their own. In the meantime they will spend up to 80 hours a week in the hospital where supervising physicians will provide guidance, support, and supervision. At the end of those at least 10,000 hours of training each resident will decide whether to join a private or hospital based practice, become an academic physician or, for those brave/crazy enough, pursue even more specialized training. One of our greatest privileges is to watch those residents graduate and know that they will provide the kind of patient care you would want for your family and friends.
It’s a long journey into a career as a physician. It can consume more than a decade of your life. In truth the learning never stops. For those in OBGYN we have a written and then oral exam to become board certified after residency. To maintain our specialty certification we read articles and participate in chart reviews each year. We attend conferences and workshops to learn from one another and maintain and improve our skills. We read articles and travel across the country and collaborate to find the most effective ways to educate our medical students and residents.
So if you see a medical student or a resident, give them a hug or a handshake or a pat on the back. During a time when there is a lot of uncertainty in healthcare they have made the choice to commit their lives to the service of others. When no one can seem to agree who should have access to care or who will pay for that care, they have dedicated a huge chunk of their lives to ensure that care is available no matter what. Now if you’ll excuse me, it’s July so I need a nap.