On the transition from theory to practice

In my opinion, the medical curriculum is construed in a way that rigidly juxtaposes theory with practice. The first two years are heavily focused on learning seemingly disparate, fragmented pieces of knowledge; Laundry lists of pharmacotherapies to treat gastric ulcers and the intricate complexities of the upper and lower limb muscles. With each lecture, I remember feeling overwhelmed by the sheer magnitude of each topic, that felt so barren and decontextualized in my mind. As I accumulated this fortune of knowledge, I found myself questioning if my ability to meticulously memorize would render good clinical skills. I wondered if my education could be quantified in the facts I retained, and the hours I studied.

This year, the long-awaited promise of the practical application of studies was fulfilled: I entered clinical placement in the hospitals. However, in this new environment, while I had expected to find certainty and reaffirmation of my love for the degree, I was confronted with the gaping inadequacies of my knowledge. Such inadequacies shone brighter than my new white coat. I felt my earlier courses had not prepared me for the translation of my theory into real patients. My framework of the human body was purely mechanical and haphazard: it lacked the feeling of familiarity or intuition.

Additionally, I felt the distress of apprehending and affirming my vague role within the hospital. Yes, I was a medical student, however the term was enveloped in connotations and loosely defined values. I was the amateur that wished to hone my skills. I was the diligent listener that lacked the clinical competence to answer patients’ questions concerning their medical care. But first and foremost, I was an apprentice that wanted to maximize my education while respecting the sensitive nature of a hospital environment.

It was in the midst of this doubt, when I finally began to learn, quicker than I had ever experienced before. The branches of the brachial plexus from first year, I had long forgotten, despite my prior cramming, however, the crescendo-decrescendo sound of a patient’s aortic stenosis murmur is engraved in my mind. The golden hue of a jaundiced patient remains vivid. This learning was tactile and sensory; it escaped the two-dimensions of a textbook.

In this way, I have begun to form my own medical identity within the walls of a hospital. Through observation and active engagement, I am redefining my prior assumptions about the role of a doctor. As medicine is a far-reaching interdisciplinary field, doctors can be holistic in their approach to care. As I have learned, treatment is not black and white, but a spectrum of conservative, medical and surgical management.

This year has served as “eureka” moment in my education, where I have been confronted with the routine of my future profession. The first two years, it never quite registered that I was really going to be a doctor. It was a latent idea, that lacked the perspective of hospital placement to make this goal tangible. But now, as I am halfway through my res year, I am faced with the imminence of my medical career. In a year and a half, I will be graduating. I will be on the ward, with newfound accountability, its accompanying apprehension and again, the need to redefine my role. The silver lining being that, by then, when someone asks for a doctor, I won’t be looking around or down.