My Mid-Med School Crisis

OK, maybe it’s not really a crisis. It’s a “I’m so physically tired, and sick of always smiling and pretending I’m loving each of these rotations and the crazy hours some of them require, and I can’t get motivated to study for the exam that’s coming up at the end of the rotation, and I can’t wait to go to sleep as soon as I get home, but I can’t stop thinking about my patients, and how soon I have to return to work, and I’m thinking that maybe I should have gone to nursing school or physical therapy school…” kind of crisis. It is the last rotation of third year, OBGYN, which is interesting but not something I jump up and down about, but I have to relearn all the anatomy and pathophysiology, because it’s on the step 2 board exam that’s coming up this fall. I look at the words on the pages of all the books I bought to remind myself of the hormonal changes during menstruation and pregnancy, of all the terrible things that can go wrong during pregnancy, labor and delivery, and my eyes start to wander as I reread the same sentence over and over and over again with no retention of the material at all. Hopefully I will continue to see and take care of enough patients that I will pass the exam at the end of the rotation by just remembering what I experienced in clinic and in the hospital.

OK, I’m just going to bitch for a bit more, so any of you readers that are pre-med and don’t want to hear about the parts of med school that suck, you may want to stop reading right now so that I don’t burst your bubble, the same bubble I was in 3 years ago. I recall some backlash I had from a pre-med student after a very negative post during my second year, I think it was after taking a neuroscience exam, and he or she really was uncomfortable with my ranting…so if you are still reading, and you don’t want to me to shed some light on the reality of med school, you’d better stop reading now.

Where was I? Oh ya, so the most interesting thing about OBGYN so far, is that the residents and attendings seem to be living up to their reputation….which is that they are a group of strong minded, and sometimes cold doctors, just a few notches down from surgeons. Which makes sense since OBGYNs spend at least a third of their time in the OR, either doing C-sections, or surgery on the female reproductive organs, so I imagine they have to have some of that ego and determination that comes with the power of cutting open someone’s uterus to take out a baby (sometimes within a minute, from first cut on skin to delivering the baby, if a “crash” c-section is required to try and save a baby’s life).

Yes, they are a bit….hard around the edges, and because most of us always answer “no” to the first question asked when meeting them for the first time (“are you thinking about going into OBGYN?”), you then become invisible. I even had to withstand the slightly condescending tone of a third year resident who after telling him I was going into physical medicine and rehabilitation replied, “Oh that’s good, we need people to go into that field…”, as if it’s a few steps down from the OBGYN pedestal. Then last night the same resident remarked how OHSU students aren’t very high “caliber”. It was after midnight, and I was so tired I decided I wasn’t going to point out that since I too am a student at OHSU, which he is aware of, he is indirectly insulting me to my face. When I did ask him what he meant, he replied that OHSU students just don’t work very hard in the OBGYN rotation, or don’t seem very motivated to learn the information. Thankfully my sense of self is strong enough at this point that I just let him comments slide, but told him that maybe it’s just that most students just aren’t interested in his field of medicine as a career. Or maybe, (I thought but did not say aloud), maybe the students are just tired of working 80 hour weeks by this point in the third year, or maybe the learning environment (cold residents and attendings that ignore you, don’t include you in on patient discussions, and don’t even know your name) doesn’t inspire the students to learn.

I guess I just feel like my battery is running so low, that all I can think about is when will I get to sleep again, when can I sit down for a meal with my husband and daughter, when can I get 30 minutes of exercise, when can I tidy up my house, when can I make a nourishing meal, or when can I see my old friends.

But I guess that makes me self-centered, to always be wondering when I can take care of myself. That’s why I am having a “do I really have what it takes to be a physician” crisis. I was talking to my friend who is currently on the rural rotation that I was just on in Burns, as I checked in with her to see how her first few days were going. I was happy to hear her say that her preceptor (a doc I got to work with for about 5 days while there), told her that I really worked my butt off, that I was put through the “ringer”, in part because the hospital had its busiest month since it opened. He then followed up that validation with the comment that today’s medical students have unrealistic expectations of wanting quality of life while in medicine. He told her that the saying “you have to take care of yourself before you can take care of your patients” is bullcrap, that patients come first, meaning physicians should just sleep and eat whenever they can.

I think this old school thinking is the real bullcrap….and yet there is a small part of me that wonders if he is right, wonders if I just don’t have the physical or emotional constitution to survive this process. Sigh….for now I don’t tackle these big philosophical quagmires about quality of life while in medicine. Right now I just try to get through today, tonight’s shift at the hospital, and the next chapter in my OBGYN study books. Thanks for listening to my gripes, I promise to try and be more uplifting in my next post. Key word, try. Cheers!

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