Have you thought about how tough medicine is and whether it’s worth staying in it for the long run?  Have you thought of doing other things with your medical degree such as those suggested in Part 1?

So you may have, but what are the reasons for why medical students get disillusioned? Let’s take a closer look…

“As an intern, nothing you do matters”

In final year, you’re striving to reach the light at the end of a tunnel, only to realise that the light is just illuminating the entrance of another tunnel. This might seem the case when you are comparing interns to registrars and consultants, but what if you compare interns to other people in society?

I remember a conversation with Rob, someone I no longer know. Last I heard he was roaming Australia in a van, driving anywhere that was away from Sydney. On the bus one evening, he tells me: ‘I don’t know what I’m doing in life. My job is meaningless. I have no stories to tell. I wish I was you.’ Even after one day in a hospital, we have a story to tell. Some of life’s most incredible stories are medical. Everyone knows it, especially television producers.

The TV producer might focus on the boy born without limbs or the horribly disfigured trauma victim, but what about the significance of everyday ward tasks. One of my current patients was hospitalised for an inguinal hernia repair – one of the most common surgical procedures. He now has an enterocutaneous fistula, feces draining from his abdominal wound, and has been in hospital for nearly two months. He was the victim of several medical and nursing errors and during my term, I saw this once jolly old man who even managed to enjoy his hospital food, transformed into one who is depressed, apathetic and is fed via a nasogastric tube.

It’s dreadful for the patient,  but you can still squeeze something positive out the awful situation – even when you are doing the ‘nothing’ tasks of an intern, the blood forms, discharge summaries, consults and others, if you do them well, you are preventing another patient from a similar fate.

One thing that keeps me going is knowing I won’t end up with the same complaints as Rob.

“There’s just too much to learn”

What are the fourteen branches of the maxillary artery?¹ What are the fifteen eponymous signs of aortic regurgitation?² One of the worst things about being a student is constantly being reminded, usually by your consultant, that there is so much left to learn.

One of the best is realising how much you already know, across such a wide field. Exams only seem to test the knowledge we lack, but take a second to consider how much you know about psychiatry, surgery, paediatrics, obstetrics, basic sciences and much more – although most of us won’t admit it. Many registrars have said to us final year students: “you will never be as smart as you are now…unless you do BPT.”

We grumble that it takes at least a decade to become a consultant. But then, in what profession can you walk straight out of uni and be a boss? It’s a long ladder, but the view from the top is worth it.

“We work too hard, and for little reward”

I guess to appreciate this, you need to find some perspective. You can often get perspective from your patients, seeing the suffering they have to deal with, and being thankful you are spared. Often though, it is hard to appreciate what you can gain from patients when you are focussed on their creatinine, their CT results and their urine output. Sometimes it can be easier to gain perspective from the real world, the one outside the hospital walls, the one where we spend less and less time.

A surgical attachment can begin and end in darkness. I walk to the station in the chilling, gloomy pre-dawn light every morning at 6.00 am. Even then, the station’s little news-stand is open, manned by a solitary middle aged lady. She knows that she’s at the mercy of her product – people will only buy newspapers if the front page is enticing, and she has no control over that. In the evening, she is still there, desperately hoping to sell another magazine, a Herald or perhaps even the Telegraph. Oblivious, commuters bustle past her, screens in their faces and headphones in their ears. She works longer hours than a surgical intern, doing a thankless job just well enough to pay the rent. There’s nowhere for her to go. That stand is not going to get any bigger, she’s not going to establish a successful news-stand franchise. When yesterday and today are the same, the worst thing is knowing tomorrow will be the same too. Suddenly, eleven hours at hospital was nothing for me to complain about.

1. Deep auricular, anterior tympanic, middle meningeal, inferior alveolar, accessory meningeal, massteric, pterygoid branches, deep temporal arteries, buccal , sphenopalatine, descending palatine, infraorbital, posterior superior alveolar, artery of pterygoid canal
2. Austin Flint murmur, Corrigan’s, de Musset’s, Duroziez’s, Quincke’s, Traube’s, Landolfi’s, Becker’s, Muller’s, Mayen’s, Rosenbach’s, Gerhardt’s, Hill’s, Lincoln’s, Chen’s