After four long years of study, I wrapped up a medical degree this year. It’s been an adventure, and the downturn in activity post-exams has made me pensive. Way back in orientation week, an enthusiastic clinician noted that they still consider their time at medical school to be some of the best years of their life.
Reflecting on my own experience, I’ve begun to wonder whether that person needs to get out more.
To be fair, my perspective is framed through a markedly different context. I commenced medical school as a (very) mature-aged student, so it’s entirely possible the best years of my life were already behind me.
Nonetheless, I did escape with an abundance of medical knowledge and some important life lessons. Here are the main three.
‘First, do no harm’ begins with self-care
I used to work with a wonderfully zen woman in a bureaucratic job in the health sector. One day we were in a meeting where we all had to discuss our goals for the coming reporting period. People usually listed ambitious KPIs but her number one goal was “self-care”. Afterwards, she and I had a great chat about prioritising self-care and wellbeing in the workplace. You do better work for the communities you serve when you look after yourself, we agreed.
Years later, during a lecture on medical ethics, I found myself pondering the oft-repeated phrase “First, do no harm”. I was reminded of my colleague. Where does “first, do no harm” begin?, I thought. With the first intervention on the path of patient care? Or by ensuring you’re safe and well enough to practise medicine in the first place?
The sad truth is that, despite its objective to improve health in the community, the medical vocation has been guilty of an almost paradoxical aversion to safeguarding the health of its practitioners. Mental ill-health, exhaustion, burnout and the physical effects that accompany them are common among medical professionals, and it’s not difficult to imagine them resulting in patient harm.
Consequently, it’s important for medical students to develop self-care strategies to apply in the workforce. I’m not (necessarily) just talking about the odd spa day. I mean carving out regular time for exercise and hobbies, seeing friends and family, and accessing medical services including mental health support when the pressure is mounting. Self-care may even involve the terrifying prospect of saying “no” to a senior, which is a much-needed skill in any profession.
Of course, be primed to devote yourself to your job, your patients and their needs. But also recognise that burnout helps no one – and may even result in harm to the people around you.
My strategy in this respect was to follow the lead of my former colleague. I began to formalise self-care as a professional objective by inserting it into medical school learning plans and fleshing out strategies with supervisors. Admittedly, I sometimes got some funny looks, but what was anyone really going to say? We’re in the business of health after all.
Medicine is not an identity
Doctors sometimes present as if they’ve transcended their mortal lives and wholly subsumed medicine in all its glory. As if it were a spiritual calling, which is an odd way to behave in a profession largely based on the application of scientific principles.
Remember that medicine is not an identity. You can practise medicine, but you can’t become it any more than you can become a salad spinner. Should you try, you are likely to be just as interesting at social events.
Of course, I appreciate the excitement that comes with commencing a medical degree and the propensity for students to devote themselves almost exclusively to their studies. But I staunchly advise against pinning your identity, self-esteem or your capacity for joy solely to your professional ambitions.
Aim to study and practise medicine among other pursuits 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 publicly doing things you’re terrible at – it immunises you against the embarrassment of failure. . The point is to store some self-worth outside your medical studies. The reserve will come in handy when you’ve had a punishing day on the wards.
Medicine is uncertain, but kindness is constant
On commencing medical school, it struck me how many people seemed primed for a fast-paced career of life-saving treatments and miracle cures. I blame Hollywood, and am considering a petition that would require medical dramas to broadcast lengthy follow-up series tracking the patient journey through rehabilitation, outpatient appointments and GP-dependency to provide a more realistic depiction of what an adverse health event often entails.
Preliminary observations (along with considerable experience as a patient) tell me that medical treatments are rarely a magic bullet. As students, we learn to manage ill-health, rather than cure it, and treating disease is often a risk-benefit analysis between the severity of the disease and the repercussions of intervention. Sometimes, the balance can be tenuous, leading to uncertainty for patients and their loved ones.
The one constant, in my opinion, should be bedside manner. Make yours good. Make it kind. Make it empathic.
I’ve heard some doctors say that proficiency in medical science supersedes well-developed interpersonal skills, but I don’t believe that. Patients shouldn’t have to choose between medical proficiency and a kind and engaging bedside manner. They should have both. While the former may be lifesaving, the latter may still be healing. Perhaps the way we relate to patients is where the elusive art of medicine begins.
