aAfter 4 years of long study, I received my medical degree this year. It was an adventure, but the post-exam slump in activity left me pensive. Long before orientation week, one aspiring clinician told me that he still considers his time in medical school to be some of the best years of his life.
Looking back on my own experience, I started to think that maybe that person needed to get out more.
To be fair, my perspective is framed through a markedly different context. I entered medical school as a student at a (very) mature age, so the best years of my life may have already passed.
Nevertheless, I escaped with a wealth of medical knowledge and some important life lessons. I will introduce the main three.
Patients don’t have to choose between medical proficiency and a kind, engaging bedside manner
“First, don’t hurt yourself” starts with self-care.
I once worked in a bureaucratic job in the health department with a wonderful Zen woman. One day we were in a meeting and we all had to discuss our goals for the next reporting period. Usually people list aspirational KPIs, but her number one goal was “self-care.” Afterward, she and I had a fun conversation about prioritizing self-care and happiness at work. We agreed that by taking care of ourselves, we can do a better job for the communities we serve.
Years later, during a lecture on medical ethics, I found myself pondering the oft-repeated phrase, “First, do no harm.” I remembered my colleague. I wondered where “first, do no harm” begins. Is it the first intervention in patient care? Or is it to ensure they are safe and healthy enough to practice medicine in the first place?
The sad truth is that, despite its purpose to improve the health of communities, the medical profession has developed an almost paradoxical aversion to protecting the health of its practitioners. Poor mental health, exhaustion, burnout, and their associated physical effects are common among medical professionals, and it is easy to imagine how they can harm patients.
Therefore, it is important for medical students to develop self-care strategies that can be applied in the workplace. I’m not just talking about the odd spa day (necessarily). This means making time for regular exercise and hobbies, seeing friends and family, and accessing medical services, including mental health support, when the pressures are high. Self-care may even involve doing the scary thing of saying “no” to your superiors, but it’s a very necessary skill in any profession.
Of course, be prepared to focus on your job, your patients, and their needs. But also realize that burnout doesn’t help anyone, and in some cases it can be harmful to those around you.
My strategy in this regard was to follow the lead of my former colleagues. I began formalizing self-care as a professional goal by incorporating it into my medical school study plan and fleshing out strategies with my supervisor. Sure, I got some weird looks from time to time, but what was I really going to say? After all, we’re in the business of health.
Medicine is not an identity
Physicians sometimes seem to transcend their own mortal lives to fully embrace the glory of medicine. In a profession based primarily on the application of scientific principles, as if it were a spiritual calling, this is a strange way to behave.
Remember, medicine is not an identity. You can practice medicine, but you can’t be medicine any more than you can be a salad spinner. Give it a try and you’ll find that you’ll find the same interest in social events.
Of course, I appreciate the excitement that comes with starting a medical degree and the tendency for students to focus almost exclusively on their studies. But I strongly advise against anchoring your identity, self-worth, and ability to feel joy solely to your professional ambitions.
Aim to study and practice medicine, among other jobs that bring you joy and make you feel valued. You don’t have to be good at these things. In fact, there’s a lot to be said for doing publicly what you’re bad at, because it makes you immune to embarrassment when you fail. . The important thing is to build up self-esteem outside of studying medicine. Backups come in handy when you have a tough day on the ward.
Medical care is uncertain, but kindness remains the same.
When I entered medical school, I was struck by how many people seemed to be preparing themselves for fast-paced careers in life-saving treatments and miracle cures. I blame Hollywood for airing long-term follow-up series that track patients’ progress through rehabilitation, outpatient visits, and dependence on their primary care physician to more realistically portray the health hazards that often accompany them. We are considering a petition asking medical dramas to do so.
Preliminary observations (along with considerable experience as a patient) tell us that medicine is rarely a silver bullet. As students, we learn to cope with illness rather than treat it. Treatment of diseases is often guided by a risk-benefit analysis between the severity of the disease and the impact of interventions. In some cases, that balance can become unstable, causing anxiety for patients and their loved ones.
In my opinion, the only constant should be bedside manner. Make yours better. Please be kind to me. Let’s try to empathize.
I’ve heard some doctors say that medical proficiency trumps well-developed interpersonal skills, but I don’t think so. Patients don’t have to choose between medical proficiency and a kind, engaging bedside manner. You should have both. The former may save lives, while the latter may still be curative. Perhaps elusive medicine begins with the way we interact with patients.
Roland Bull is a Canberra-based freelance writer and comedian.
