Finally Graduated

Here hangs proudly my graduation regalia.

Looks a bit like a dementor does it not? 

Well it looked okay on me. Apparently in New Zealand, the colour of the Medicine degree is Hot pink!…. I’ll never understand fashion.

Anyway! My graduation ceremony was yesterday! After 6 years I sat in a 2 hour ceremony where my name was called and I was awarded my degree to say I am now a Doctor. 

It was a super long day. But it was great. Friends and family showed up. My friend from Wellington even flew up just for my ceremony! It was a great day. 

Lots of people to be grateful for. It’s been a long ride. But I got there in the end. And from Monday onwards, it’s on to work! Officially a house officer. 

I can’t wait! Hopefully I will be a good doctor. 

We all had to take an oath yesterday. One of the lines were “I promise to uphold the reputation of my profession”. Now other than the immediate Taylor Swift reference in my head, I realised I don’t really know what that promise means. What is the reputation of my profession? Have I been holding it up so far? I don’t actually know. Hopefully it becomes apparent when I start working. On to Monday!

My friend got me this cute graduation Kiwi doll! Yay for finally being done!

Lessons From Medical School

I write this post on my last day at Auckland hospital. My last day of medical school. 6 years later… The most significant period of my life to date, has ended. It’s a real milestone. How do I feel…?

Meh.

It actually doesn’t feel particularly big or important. Because in 2 weeks, I’m back in hospital doing similar things to what I was doing this year, but getting paid for it, and not having the luxury of leaving work early, ever.

But I guess it is a big deal. 6 years of work I put in. It all feels a bit surreal. I definitely do not feel like a doctor yet. I doubt I will until I have my first ward call or unwell patient that I (hopefully) manage properly.

But then what does today mean? I think I should take this opportunity to look back and think about what I’ve learnt from medical school.

My 1st year – biomed. My pre-med year was a pretty significant year for me. I was straight out of highschool and working harder than I ever had in my school days to achieve a single goal – entrance into medical school. Once achieved, I had felt amazing about myself. I thought, hey I guess I do have the potential to do well in things if I work hard enough. During this year, I had made sure I had zero distractions.

My 2nd and 3rd year: Not working so hard on academia itself. Trying to learn what medicine was all about and where I fit in and what my skills were. Several times cut down by other students and taking several hits to my self-esteem. I learnt that theory was something I had major issues with. My knowledge needed to grow.

My 4th year: People in the workplace, people I know, people I didn’t know, people, people, people. I found I was quite naive. So very naive. Hospital hits you hard. But I didn’t realise until much later that my expectations of myself were not the expectations others had of me, and what level I was supposed to be functioning at. That made things way harder. I expected too much of myself. And crashed down. I also found that you cannot make friends wherever you go. Especially not at university or work. There will be people who you meet who will be nice, but they don’t know you. They’ve come along too late in your life to really understand what you’re all about. Don’t get too comfortable. It’s not a good idea. And with work, they are not your friends regardless of what you do. They are smiling and asking about your weekend because they need to work together with you in the most tolerable way possible. Do not think any more of it. It’ll only disappoint you.

My 5th year: Began to focus back on myself. Less on others. More reflecting, more skill developing, I found certain types of people and certain parts of medicine and the hospital do not agree with me. Accepting that I don’t know everything in medicine, and I never will. Even if I’ve revised it several times, and will not retain everything forever. I just have to keep revising and reminding myself of the knowledge I have and learn more at every opportunity. People tried cutting me down then too. But self focus and reflection is a powerful thing. Your skills are your skills and no one else’s. You’ve got yours that WILL work for you. I promise. My strengths, and my discovery of the love I have for gastroenterology. I also found I have great empathy towards patients apparently.

My 6th and final year: Things started to make more sense. More comfortable around the hospital and interacting with consultants. The confidence that comes with being needed and having a role. Not only being aware of strengths and weaknesses, but being able to use them to get things done as well as knowing what to do to fill the gaps. Plans needing to be made, looking ahead. Still many disappointments and nothing is certain, but accepting that and going with it anyway, is still pretty good.

Further lessons:
1. Never let anyone know that they get to you.
2. You could do your absolute best in everything, but still come up short and have bad things happen. Accept it.
3. Do not try to please everyone. No point. Doesn’t work. Regardless of what you do, people will still not understand you or trust your efforts.
4. Trust you. As you’re all you’ve got.

So looking at this, I guess medical school has been a significant part in teaching me about myself and how I should move forward.

Oh of course I also learnt medicine itself. xD But that’s more of an ongoing learning forever. I have to accept that.

And that’s my reflection over the last 6 years. It’s a brief one of course. More happened in these last few years than I can write about in one blog.

And many more to come when I start working in 2 weeks. There’s also my graduation next week which I will update on.

So for the last time, here is my med school. A student for 6 years and never again. I spent a little while sitting in front of it and reminiscing on this day. I’m on to bigger, better and older things!

Snapchat-1608802880

 

Home Stretch

Oh boy Oh boy Oh boy

So today I had my final practical exam of medical school! In psychiatry!

Happy to say I got a “solid distinction” in the examiner’s words. They even asked me if I would consider a career in psychiatry! Hahaha I wouldn’t, but it’s good to know I’ll probably be a good psychiatry house officer when I start working in November!

I celebrated this victory with Ice cream and a walk on the beach.

And that’s what this post is about! With the ending of my final practical exam, I now only have 4 weeks of medical school left for the rest of my life!! :O

My final rotation starting on Monday will be Obstetrics and Gynaecology. Back to the land where there’s far too much oestrogen in the air. 

But I’m not bothered! There aren’t any major assessments as part of this rotation.

I do have my final exam of medical school, the progress test, towards the end of October. But I am so over these after 6 years, I’m happy to just pass.

So, I’m literally on the home stretch now. 4 weeks to finish medical school, 2 weeks vacation, then graduation!

AND THEN,

Worklife begins.

I’m just going to leave those words hanging there for a bit.

I can say I am already looking forward to starting to work. Actually, I’m looking forward to the next few years of working. Getting to where I need to go. Not that I know where that is, but I do feel it’s time to start looking that way.

Medical school has been a huge part of my life in many ways. So many things had changed where when I first got in, I thought the hard part of life was over. And everything was sorted. I can at least say I’m no longer so naive.

But yes. Let’s get the next 4 weeks done and just keep swimming! 😀

A view of Rangitoto from my ice cream celebration

Hectic Real Quick

I do apologise for my absence for the last two-ish weeks. Things got hectic real quick.

Let me outline it for you. Last I spoke, was about paediatrics. That’s over so yay! Made some good connections. I expressed my interest in pursuing gastroenterology as a specialty and one of the nice consultants took me on to do a project. Specifically,  a case report.

Good thing about a case report is that it’s likely to get published. Buuuut it’s not exactly a “research project” so I’ll probably have to do an actual project later on.

Yeah the requirement to join the gastroenterology program is to have done a research project in gastroeneterology. I’ve got time though. And a case report is still neat. So I’ve been working on that.

Straight after paediatrics, began Psychiatry. I am placed this year, not in Mason clinic, but in a community facility. Which is interesting enough. I do find psychiatry interesting, psychiatrists themselves are weird, as usual. One of my consultants is really nice, the other uses 3 different e-cigarettes constantly in a pattern I call, “chain-vaping”. I doubt it’s really much of a step up from actual cigarettes.

Anyway! Psychiatry this year is very stressful because I have a practical exam at the end of the rotation where I take a psychiatric history from an actor and present it according to the DSM 4. Good old DSM 4 with its pages and pages of criteria but still managing to make the conditions fluffy and not really any easier to distinguish between. Sigh. So I have been cramming as much A B C criteria for the diagnoses as possible. Not. Fun.

I was also given my rotations for my first house officer year in these past weeks. They will be as follows:

Psychiatry (oh my God when will it end)
Gen med (Good. Good learning, useful, mhmm)
Cardiology (Interesting, should be fun)
General Surgery (Not looking forward to. Lots of admin, but if I do it now, never have to do another surgical rotation again so yay!)

I didn’t really want this combination, but pretty much all the combinations were pretty lame and at least I don’t have to do any runs I really dislike like orthopaedics or geriatrics. So good stuff!

In other news, my mood has been quite low lately. No particular reason that I can mention. My right brain playing up maybe. But life seems a bit bleh these days.

I wonder if I have some watered down form of bipolar disorder. But where a person with bipolar disorder would have a mood pattern that looks a bit like this;

Sketch (1)

Mine, looks more like this:

Sketch (2)

Yes I’m a whiner at the moment. I don’t have bipolar disorder and frankly my problems are no where near that substantial. They have it hard. I’m just complaining about something that isn’t there. I should get over myself. I guess it’s just a first world thing.

So yes, that’s what has been keeping me busy lately. Blogging helps, as always. Hope everyone else has been doing great!

Back To Paediatrics

Well a year and a half later, I have returned to the land of the children!  

A completely different hospital this time, thankfully. Because I had a less than great experience last year. 

But this year! I am allocated to the paediatric gastroenterology team! I was hoping my love for gastroenterology would balance out my fear/dislike of paediatrics.

And it does, to a certain extent. On my first day I learnt about 3 new conditions I hadn’t seen or heard of before which was super interesting. And my consultant is extremely nice, which makes things so much better.

But I’m still not feeling the paediatrics vibe. 

Beyond the fact that children scare me, I am not cut out for the people the grown-ups turn into around children.

I cannot handle or do baby talk.

Like just no. People don’t realise how ridiculous it sounds to others.

Sometimes I think even the kids judge some of the adults and their attempt to comfort them using baby talk.

You just end up saying things that make no sense. 

There was a crying baby on the ward round, so my house officer took off her brightly coloured lanyard with her nametag on it, and waved it in the baby’s face. (Which by the way I don’t approve of. There could be millions of germs on there) but then, the nurse in the room let out a dramatic gasp and said “see that?? You love a good nametag don’t you!!”

…???

What.

That doesn’t even make any sense. And it’s not something a kid would stop crying to.

And of course this kid didn’t stop crying. I mean it wasn’t going to be like “yes Sharon I do love a good nametag thanks. I’ll stop crying now”

I mean honestly. So unnecessary.

And the other day on ward rounds, a child was hiding behind the curtains in his room and the registrar was trying to examine him. My house officer out of nowhere looks at me with the most serious face and says “where’s Timmy??” (Not his real name). For a second I was confused if she was seriously asking me something.
But no. She was doing it for the child’s benefit. He of course ignored her. 

Oh God. I cannot do that. I talk to kids normally. And I do okay-ish with examinations. 

But yeah I don’t know. Definitely cannot be a paediatrician. 

Thankfully the rotation this year is only 4 weeks and I am currently on my 3rd week.

But seriously people. Stop with the baby talk. It’s not cool anymore. The babies are judging you big time. 

Getting Compliments

So I just finished 3 weeks of my immunology rotation. I knew zero information about immunology before starting this rotation and now I know a little bit more than that.

Anyway! I had a consultant on this rotation who I had briefly during my general medicine rotation. He’s also an immunologist. Who knew!

He is without a doubt, the nicest, most down to earth consultant I had ever seen in any specialty. He’s always ready to help literally anyone with any issue, regardless of their position in the hierarchy.

He is extremely respected as a consultant by his department. He’s just generally nice and funny and smart.

I have massive respect for him too. Not only does he teach and answer my questions clearly and lets me see patients in his clinic, but he also acknowledges my presence wherever and whenever he sees me. Even when I am on a ward round with a different team. If he walks past, he waves and smiles sincerely. 

Which, I can say from 6 years of experience, is a Huge deal. 

Anyway the point of this topic is that for some reason, he seems to think I’m great. 

Now. I’ve mentioned before that I’m awful at receiving compliments and basically not good at being given any attention at all. Dr. AJ (This consultant), told me I’m really good and it’s been a pleasure working with me in both general medicine and immunology.

Err as great as it was to hear that, it immediately made me 10 times as nervous around him. 

Okay I don’t know what it is, but if someone likes me and gives me compliments like that, I feel like they have these expectations of me that I’ve got to live up to. 

Which makes me super nervous because I have no idea what I’ve done to have these expectations of me.

I still think I’m pretty average. 

Yes I realise this is probably a self-esteem issue but whenever I realise that someone seems to think I’m good at something, (specifically something I don’t believe I’m necessarily great at), I start freaking out a little bit.

Which is the last thing I should do because it’ll make me overthink everything and make mistakes. And it also seems to manifest as this weird giggly version of me. It’s very bizarre when I get compliments I get uncomfortable to the point where I think the best thing to do is laugh it off. 

It’s really not the best thing.

Giggling like a 5 year old is hardly what you want from someone you just told was extremely professional or intelligent or whatever. 

Oh God is this one of things I have to hope will go away with time? 

I seem to have a long list of those particular traits. I’m starting to worry they won’t just go away with time. Blechh. 

Anyway that’s my self reflection.

Point is though I’m super grateful to have met Dr. AJ and so grateful I was able to impress him, even though I’m not too sure what I did. 

Good News

I am pleased to say that I have been matched to a hospital for my first year of being a House Officer!

All that time I spent on my application and stressing has paid off! Yaay!

Which hospital, you ask? Middlemore Hospital in Auckland.

Yes I know what you’re thinking. I’ve mentioned a few times before that I dislike Middlemore and I really want to leave Auckland in my first house officer year. Yeah. I changed my mind.

I just finally have a plan for the next two years. Middlemore hospital is a great hospital. I’ve just got to learn to tolerate the people and other annoying things. And I think I’m at a place where I can do that. So I focus on more important things like what would most benefit my knowledge and career.

Anyway after weighing the pros and cons, I applied to Middlemore and it’s a massive relief that I have been matched to my first choice!

Feeling like I am finally getting some good news now. The bad luck cycle has ended (touch wood).

More on that soon!

I have to now fill in an application to the hospital itself and a bunch of other admin things need to take place before I get my job offer and things start getting real. But I am super grateful that I got the hospital I wanted!

I am sure I will start to face the anxiety of not being ready to be a doctor yet, soon.

 

In The Middle Of Nowhere

Woah it’s been a whirlwind of an elective. And I’m sorry I’ve not been updating on here about my actual elective. Other things have been happening during this time that put my stress levels super high and got in the way of my blogging about nice things regarding my elective.

And now my elective is over! I’m leaving in 4 days for home! Super excited!

Time in India has been quite interesting! Had a really good time in the emergency department where the doctors let me do pretty much everything from being part of resuscitation, doing ABGs, (my first successful one made me so happy I felt like such a nerd), and I even successfully intubated a patient who couldn’t breathe.

Very neat. Lots of hands-on stuff is why I chose this elective. So that’s a good thing.

Most of the rest of the time though I was observing doctors and talking to patients. I saw some pretty neat signs like Janeway lesions which are super rare, Eisenmenger syndrome which I’d never heard about back home, and even heard the bruits of a bilateral arterial stenosis. Pretty cool stuff.

My rural hospital experience was pretty interesting too. Met a doctor who has single-handedly been running this clinic from 25 years. She is the lone medical officer there among about 15 nurses. She does literally everything. From seeing 40 patients a day, to delivering babies, to home visits, to colposcopies. Literally everything. Her knowledge was amazing. She basically knows more than any general practitioner I had seen back home in New Zealand. Not suggesting that they were incompetent or anything. But this doctor was just pretty extraordinary.

And then there were the patients. I could seriously appreciate what poor health literacy meant, in India. A woman had been given a prescription for her hyperthyroidism. She lived quite far away from the clinic and had lost her prescription. So she went to her local pharmacy and asked for “thyroid medication”. She was given thyroxine which is the treatment for an underactive thyroid that would worsen the condition for someone who had a hyperactive thyroid like this woman did. She had no idea of the difference. And of course it’s also the pharmacist’s fault for giving her that medication without a prescription, but still. She didn’t know the difference. And that had serious effects on her health before she was able to return to the clinic and the doctor had told her to stop the thyroxine and provide the correct prescription.

I also saw an elderly couple who both had complications from type 2 diabetes. But both of them, were beggars that lived at the local temple. The doctor at the clinic told me how difficult it is to offer diet and lifestyle advice to people like this. Because hey eat more fruits and vegetables doesn’t mean anything to someone who can’t control what they eat or if they eat at all.

Super intense stuff.

The rest of Coimbatore city was pretty quiet. Not much else happening. So I spent a lot of time writing my report for this whole elective. I did get some cool pics though! 

Coimbatore is bordered by mountains so mainly a lot of interesting flora and fauna!

I’m glad to be getting home after so long. My supervisor went on leave for the last week of my elective so I get an extra week of holiday before I get back to hospital in New Zealand. Should be fun!

So. The verdict.

Was my elective life changing? No. No it wasn’t.

Did I still learn a lot?

Yes. Yes I did.

Don’t Smile Please

So the other day a family friend said to me “You really don’t look like a doctor. You look too small”

Before I could get angry, he proceeded to say “you know what you have to do? You gotta have attitude. You shouldn’t smile. If you smile or laugh, people won’t take you seriously”

I stared at him for 5 seconds. 

What in the heck?

This is actually a popular idea I’ve heard. But I’ve never heard it being said so blatantly. 

For some reason, people think that in order to seem put together, you gotta be serious all the time. You gotta have the attitude of a professional. You gotta have that command. And that command, comes with a serious face.

I think it’s the whole, in order to be experienced, life needs to have made you cold and hard. 

And I don’t really get that. Just how much value is attached to this kind of thing? I mean realistically it’s only a first impression kind of concept. Like when you walk into a room and greet someone with that attitude, they’re meant to be like woah. But after that nobody wants someone around who’s constantly serious, right?

And more importantly, how well you work should be ultimately what people should respect about you, right?

I mean that’s my thinking. 

Of course I could be analysing this all incorrectly. It could just be me who looks like I’m too small and needs to be more serious.

But to be honest, life is serious enough. I just try my hardest not to let that show on my face. 

Frankly, I don’t care very much about how others view me. But as I’ve mentioned I’m not cut out for the workforce. And this may in fact be a legitimate thing I should be concerned about maybe…

Oh well. I don’t know. I’ll find out next year whether people will take me seriously as a doctor or not.

On The Spot

I’ve always wondered how I would react in a situation in the community where something happens that needs medical attention. I’d heard from some friends who had experienced such situations. 

They had either pretended they weren’t medical students or they had risen to the challenge somehow and at least made sure the person ended up in a hospital for further care.

I had my situation today. Far far away from home. 

On the way to the hosp on my elective in India, I saw two motorbikes fallen over and 3 people on the ground. One of them was a man who was already getting up and helping the two girls. One of the girls looked fine and she stood up with help. The other girl however, lay on her back, crying, clutching her left leg. 

At this point I stopped and thought I should do something to help. Scary thing that. Realising that you’re actually in a position that gives you the responsibility to stop and help. I felt hideously unprepared.

Anyway I approached the girl on the ground and my immediate thought was oh my goodness should I introduce myself as a doctor? Because I wasn’t one. But if I didn’t, they’d think I was just a bystander and not really cooperate. 

But I couldn’t stand there and have this internal conflict. I looked for any evidence of fracture or bleeding, etc in that leg. After going through the whole DRSABCD acronym that they’ve drilled into us. By this time a lot of ppl were on the scene and the girl was helped up and she could walk. Yay no fracture. Yay no bleeding. 

My expert advice was to take her to the nearest hospital. Something many others had already figured out. A TukTuk pulled up and the girl hobbled over into it. I tried to comfort her as best as I could and told her she didn’t have a fracture. But she needs to be in a hospital to assess her leg further. She was still in tears and didn’t want me pampering her knee at all. This is probably when the magic words “I’m a doctor” would have helped. 

But I couldn’t do it.

Okay I don’t know why. Yes because it’s the truth, but not saying so probably indicates a lack of confidence in my abilities. Because I’m nearly done. I should be able to handle things like this. I should be able to be a doctor. Nothing major is going to change when I get my degree soon. I’m essentially all done with my training. 

So I suppose I did have an element of lack of confidence.

It ultimately ended well because the girl was okay and I helped a bit I think. 

But if there is a next time, I gotta be more confident. Hopefully that’ll come when I’m put on the spot.