“I want to become a doctor” is expressed by many children; some do actually reach the stage where they enrol at a medical school. The journey as a medical student commences with over-enthusiasm and great anticipation to become a doctor. Few realise what really is in store for them; endless sleepless nights, anxiety and some even a degree of depression.1
Life as a Medical Student
The expectations of what becoming a medical student incorporates, is sometimes not met by the students and so, some experience disappointment. A good protective factor that a medical student needs to take on is the ‘desire’ to become a doctor. This would empower the student even if faced by multiple challenges, which are normal to come across during Medical school.1
On commencing the clinical years, the feeling of becoming part of the medical profession grows and is enhanced more on getting one’s own stethoscope. Going around the wards, clerking and examining patients gives fuel to the longing to be a real doctor. As the student reaches final year, panic and anxiety sets in.2 The hardship of the final year appears as an endless dark tunnel with a small dim light at the end. The fear of failing the finals and losing all those years of studying is a normal feeling among all medical students. Insomnia becomes second nature and the amount of coffee consumption increases drastically. Moral starts to diminish, as anxiety builds up when the exams start to creep. Nightmares may become a daily event and very commonly medical students begin to wish that this breathtaking experience comes to an end.
It is a normal anticipation among medical students that once they reach their goal to become a doctor, all problems and stress would disappear. This is a good strategy and aiming point in the last few weeks up to the final exams. Once the finals are over and a positive result is obtained, there is no turning back; the medical degree has been achieved! “So Goodbye medical school and Hello Hospital” is a common phrase expressed on the day results are out.
Life as a Junior doctor
The transition from a medical student to a junior doctor is over a short period of time. This rapid change in status comes as a shock to the newly qualified doctor. It is a normal feeling amongst junior doctors, that during the first few weeks, they feel lost and incapable to cope with all the stress that the job holds as a foundation doctor. The feeling of security that one experienced as a medical student dissolves away. The senior doctors might not always be helpful or around on the wards, so most problems that arise in the wards are up to the junior doctor to solve. Nurses can be the doctors’ best friend or their worst nightmare. It is important to get along well with the nurses from day one and be ready to listen to their advice especially in the beginning until one gets the hang of how it all works. There is a lot of knowledge that one can achieve from an experienced nurse, so one must ensure to get into their good books. It is important to maintain one’s status but not to the degree of having one’s ego overcome you, for that is the recipe for failure.
It is very normal to feel like a secretary during the day, as junior doctors are responsible for ordering and taking bloods, running after radiologists, organising consultations with different medical professionals, calling patients, getting bombardments of questions from patients and their relatives ... questions that one may not always be in a position to respond, etc. There would be a point in time where one would “feel fed up” or “over-worked” or feel that “this is not what one has signed up for,” but all of this would dissolve away when a patient comes up to say thank you for the work, or when one follows up a patient who had been admitted in a poor state and walks out of hospital as a brand new person. The satisfaction of being part of the medical team who managed the patient’s health condition is what fuels the daily life as a foundation doctor. Night duties, when one is completely alone on the wards, are the time when one starts to consider onself as a ‘real’ doctor.
Night duties and consulting the seniors
The first night duty causes a lot of distress to the junior doctor. It is normal to feel as if one is trying to walk under water. The most important thing is to take a deep breath, keep calm and know one’s limits. It is safer to call a senior if one is not sure or just wants to confirm the planned management rather than trying to deal with a patient alone. Preferably one always works along with another junior doctor, for two minds are much better than one, especially when an acute call is received.
The success in calling a senior doctor without having “the head chopped off,” is to be well prepared before calling them. It is essential to have taken a good patient history, performed a physical examination, taken parameters (including body temperature, manual blood pressure, pulse, respiratory rate, arterial blood gases if the oxygen saturations are low, peripheral glucose test and ECG) as well as, basic blood tests (full blood count, renal profile, cardiac enzymes if patient presents with chest pain).
On calling the senior it is important to be calm and show that oneis in full control of the situation, but would appreciate their expert advice. One should always present the case in an organised manner; giving the age and gender of the patient along with a brief medical history. This should be followed by the findings during the physical examinations and the parameters. If the patient would have already been started on any medication including oxygen, this should be stated to the senior. It is then up to the senior to ask any relevant questions if need be. It is vital to listen carefully to the instructions given out by the senior, and be sure to have everything ready and documented until the senior arrives to review the patient.
Becoming a doctor: the first step in the medical field
Once graduated as a medical doctor, it is the beginning of a new life routine; hospital and clinic responsibilities including night shifts. Now as a doctor one has the obligation to hand out any medical help needed for twenty-four hours every day. It is the doctor’s responsibility to maintain a professional attitude, both at the work place and outside.
The first two years as a foundation doctor, are the toughest years since junior doctors are the first line to all the problems that arise in the wards. Also, during these two years, one needs to start thinking about the future career; to which basic specialist trainee (BST) post one would apply for at the end of the second year. This is not an easy task to perform. It is normal to feel frustrated, as generally one does not have an exact idea which area is best or worse yet. It is common for junior doctors to experience this dilemma.
The essential thing to do during these two years, as a junior doctor, is to gain as much as possible, experience and knowledge while rotating in different departments. Making sure that one learns from one’s mistakes and asks for help when needed. The seniors are there to help out, even if one might not realise it immediately. If a junior doctor convinces the seniors that s/he is hard working, eager to learn and ready to improve his of her medical practice, one will surely find all the support from the seniors. The most important thing of all is to enjoy these first two years, for although they might not appear to be enjoyable, these two years are the foundations towards a long life serving the community as a doctor.
- Karaoglu N, Seker M. Anxiety and Depression in Medical Students Related to Desire for and Expectations from a Medical Career. West Indian Medical Journal 2010; 59 (2): 196
- Goodfellow PB. Claydon P. Students sitting medical finals – ready to be house officers? Journal of the Royal Society of Medicine 2001; 94: 516 – 520.