The Darkest Year?
A recent article in Slate magazine describes the transition from preclinical to clinical medical education as the “darkest” year of medical school. It is a year in which the disorientation of rapidly changing clinical environments prevents the formation of lasting relationships, as we shuffle from clerkship to clerkship; a year in which a flurry of emotions goes largely unacknowledged; a year in which the altruistic and empathetic qualities of medical students are threatened with destruction.
Many, but not all, medical students are negatively affected by the unguided plunge into clinical medicine. Some students find great longitudinal mentors which helps with this transition period. Several schools are also now investigating the benefits of integrated, structured curricular for students to digest their experiences and flourish in these transitions.
Finding a Mentor
For those of us interested in emergency medicine, there are a number of sources available for finding mentorship. If your school is affiliated with an emergency medicine residency program, don't overlook the core academic faculty. Their considerable experience can help guide you on your way to the residency program of your dreams. You may have met these potential mentors through your emergency medicine interest group (EMIG) or during your home emergency medicine rotation. Even if your school-affiliated program isn't your top pick, don't be shy in seeking advice from these folks on how to land the most competitive position you can.
If you're looking for a mentor who has been in your shoes more recently, I'd also highly recommend applying to EMRA's Student-Resident Mentorship Program. Residents from all walks of life are completing their training in top-notch programs across the country and are eager to share their knowledge and experiences with you.
Building these types of longitudinal relationships can help provide some continuity to your otherwise disjointed medical school experience.
Loving Your Patients
I have been lucky enough to meet Dr. Patch Adams twice during my medical school career. Both times he greeted me with an enormous hug. For those who aren't aware that he is a real person or only know of him from the popular Robin Williams movie, there's a fantastic video of him on YouTube speaking at the Mayo Clinic that will paint a much more accurate picture of his world view. For those who find the entirety of his ideas too radical to implement in the real world, I hope the one aspect of his philosophy that we can all embrace is his thrill of loving people.
Anyone can be taught to take a history, perform a physical, generate a differential diagnosis, or formulate a treatment plan, but it far more difficult to learn how to truly care...to be compassionate. It has been very rewarding to apply my clinical knowledge, but when I look back over the myriad of patients I encountered through my third year of medical school, the most memorable experiences were those in which I was able to make a connection with someone during their time of need. I remember the heartfelt thanks of a woman whose hand I held as a blur of more experienced care providers rushed about to treat her contrast-induced anaphylaxis. I remember the gratitude of a sleepless mother whose crying child finally dozed off as I massaged his aching ear. Moments like these are what I will treasure.
The Importance of Self-Reflection
With all that we are forced to endure as physicians-in-training, some days it can be difficult to remember why we embarked upon on this difficult journey at all. My challenge to those of you harboring these thoughts is to reflect upon your own most meaningful patient encounters and build a library of these memories to help fuel you through these periods of doubt. While cynicism is an expedient response to our daily challenges and may appear to be the path of least resistance, this attitude is not compatible with a fulfilling career dedicated to serving others. Take the time to acknowledge your emotions and remember what a privilege it is to serve others during their times of greatest need.