Secret Diary of an Arts Graduate
Thursday, June 9th, 2011
“So, what did you do before you did medicine?”
Me? Oh, I did a Bachelor of Arts.
“Do you mean Science/Arts?”
No, no, I mean Arts. Just plain Arts.
“A minor in psychology or biology perhaps?”
[Pause] “But how did you get here?”
Same as you, buddy. I read some chemistry books and wrote some essays and sat an interview and someone, somewhere, whom I’ll never meet, let me in to this crazy profession and it has been one of the greatest things I’ve ever done.
What did I do before medicine? I read Foucault. I went to political rallies. I deconstructed the military-industrial complex. Engaged in week-long arguments about Marxism. I backpacked on almost every continent on Earth. I drank soy milk. Actually, I still do most of those things.
I received my acceptance letter into my medical program when I was somewhere in North Africa in my hiking boots. I knew nothing about medicine, except that illness entailed suffering, and that I wanted to be of service to others. And that the MBBS seemed to involve chemistry or biology or something like that.
When I turned up at the door of my medical school, with my bleeding heart, windswept hair and empty pockets from all that globetrotting, I had never worn a lab coat nor touched a microscope. Suddenly, I had examination questions about histology slides that, frankly, looked like pink and blue milkshake material and I was left wondering how to get through.
Fast forward two years. I’ve passed everything (so far!) and I’m over half-way to being an intern. I think I’ve gathered a few kernels of advice for other non-science folk.
Here is the go:
1. EXPERIMENT WITH NEW WAYS TO LEARN, QUICKLY:
Medicine and science is a totally different skill set from the humanities. Experiment, experiment, experiment with different ways to learn. I used the first 10 weeks of medical school learning not very much medicine, but learning a lot about how to learn. I did most of my first year immunology by standing at an easel, using colour pens to make elaborate diagrams and drawings of immunological cells and responses. I knew I would fall asleep sitting down at a desk, and I also needed a page big enough to carry both explanations and definitions of millions of words I’d never heard. For anatomy, I mostly made my own art books of drawings, which gave me a break from textbooks. Although I probably missed out on a lot of content early in my program, I’m glad I’ve found ways to study that work for me.
2. START MEMORIZING STUFF:
Rote learning gives us tools to start solving problems. It’s boring, it’s boring, it’s boring. I know. Rote learning was considered the lowest form of thinking in my humanities education. It was considered robotic and uncreative. But your patients need you to know zillions of facts at the snap of a finger. I have started now to appreciate details and patterns, which weren’t necessary for my humanities education. Revision is your mission!
3. ACCEPT THAT TEXTBOOKS MUST BE READ AT A SLOW PACE:
I somehow deluded myself that I could read 50 pages of Snell’s “Clinical Anatomy by Regions” per day and finish the book by mid-year. You know, because I read 50 pages of a novel per day during my undergraduate degree. Medical text books need to be sat with and struggled with slowly for concepts to sink in and congeal into some useable structure. Be patient with yourself and your pace of reading. We’re all painfully slow!
4. BUY AN ELECTRONIC MEDICAL DICTIONARY:
Use it lots and lots. Best, get one for your phone that you can carry around with you. I regret sitting through entire afternoons of lectures that I only half understood because a key word escaped me.
5. IGNORE YOUR PEERS (SOMETIMES):
Your peers are likely to present you with intricate explanations of the molecular basis of x or y, and you’ll feel bamboozled and intimidated and wonder how you’re going to catch up. Especially if you enter a graduate medical program, you’ll sit in PBL with people who have earned PhDs and Masters Degrees. Accept that we all have different starting points, and, when it all gets too much, ignore them!
6. HIT THE WARDS:
If you’re part of a graduate program, you’re likely to have the opportunity (and challenge) of seeing patients on the wards very early in your degree. Some students in our position felt that they didn’t have enough knowledge of disease processes to talk to patients about medical things, and avoided practice with patients. Actually, a lot of my first year of medicine was just about getting used to talking to patients about anything, taking on the role of “doctor” and learning to listen. For my first few weeks, I’d go to the wards and just say hello to patients, explain to them I was a student, that I didn’t really know much yet, but I wanted to get to know patients. It made me comfortable talking to the nursing staff, helped me start establishing rapport quickly, and also made me comfortable around all different sorts of people. It also made it much easier to conduct “proper” medical histories and examinations later down the track.
7. DON’T ASSUME YOU’RE “GOOD AT TALKING TO PATIENTS”:
Upon learning that you’re a “humanities person” many people will respond with, “Oh, you’ll be great at talking to patients!” Not true! Medical history taking and examination is not a regular type of conversation. It requires knowledge, experience, and a friendly demeanour. In my opinion, in that order. Taking a history is part of a clinical decision making process. It’s focussed, structured and each question has clinical significance that you need to be able to interpret. I don’t think it’s a skill that comes naturally to anyone, so make sure you don’t get lazy on that front.
8. RESEARCH AND PUBLISH:
Do not fear or ignore research opportunities offered by your medical school, both formal and informal. You are now a bona fide (student) clinician-scientist. Research will give you much more than you invest in it. It will give you skills of scientific scrutiny that no lecture will give you. It will make you more cynical, more creative, and more wonderous. You’ll get the opportunity to stand up at conferences and present your work to fancy researchers and doctors. You’ll be challenged in your assumptions by your supervisors, and you’ll discover ways to make your thinking more careful, more accurate and more robust. Research can be done formally, as part of an honours program or somesuch, or informally. There are countless opportunities in every department of a teaching hospital to do research. Send emails, make phone calls, visit potential supervisors, and find a project that challenges you.
9. DON’T DISCOUNT CAREER OPTIONS:
Just because you aren’t yet a “hard core” science nerd, and just because something like General Practice and Family Medicine seem more in tune with your current skill set, don’t shy away from getting involved with other specialties. It’s easy to do a haematology rotation, compare yourself to people who did a Medical Science degree, and think it’s not for you. NONSENSE! All these words, facts and patterns are learnable and you will become a science nerd in time. Go visit the cardiac cath lab, assist in knee replacements, attend the endocrinology clinic, check out radiation oncology, because you’ll probably be surprised by what draws you in.
Kids, the going will get tough! You will sit in lectures where you do not know the majority of the words. You will be told by teachers that “you should have learnt that in your undergraduate”. You will be baffled and intimidated by the vocabulary and knowledge of your peers. You’ll read chapters of Robbins and forget them the next morning. We all do. But guess what? You’ll also help deliver babies, replace knees, remove gallbladders, reduce fractures, be part of teams that cure cancer, and save lives. I’ve touched blood and guts and shit and frankly, I’m both more humble and more confident for it. Medical school is freaking extraordinary.
Good luck! Stay strong! Smash it!