Happy

My concern preceding the last rotation was entirely unwarranted - I just loved it and had a great time. I have a feeling that the next rotation will be similar.

It is funny, if I enjoy the work then I don't mind putting in a few extra hours here and there. Naturally there is a limit, but I would rather be in a job I liked and stay for an hour or so extra each day than be in a job where I felt miserable and bored. Of course, all things are a trade-off, and working in an excessively stressful environment with huge mountains of overtime would destroy any benefits of working in a field I loved, and I would rather be bored and go home on time.

So like all things, it is all about balance.

Anyway, I can't believe that we are now in the last rotation of internship. It has gone so quickly, and yet so much has happened. The first half of the year was probably one of the most challenging of my life, and the second half was more about learning how to enjoy work again.

I really don't know how much more I have to add to this blog, seeing as how it started out being about life in medical school, and now that internship is over, it feels like I don't have much more to say about work. I don't know if I'm ready to bow out just yet, so I'll pop in and post every now and again, but it feels as if life has somehow moved on.

The important part is, I'm happy. :)

Congratulations, Interns of 2012!

The job offers have starting trickling in for next year's interns.

I can't believe it was only one year ago that this was me. So much has changed since then. My career aspirations are still the same, but a lot of other things have shifted slightly sideways.

So, to next year's interns, I can share with you some things that happened to me, and you may also experience in the first half year of your working life as a doctor:

You will find your feet as a junior doctor. Granted, like me, you may spend the first couple of weeks absolutely scared out of your skull. But you'll get used to it and after a few months, you will manage to have some nights where you don't dream of clinical scenarios and ward rounds all night long . . .

You will face challenges, both personal and professional, that you will overcome with varying degrees of success.

People will find their way into your lives, if you let them, and these people will change the way you see the world.

Some people will loosen themselves from your lives and move on and you may miss them for what they used to be to you, but that is okay because we all change.

You will grow up, some of you will become more cynical, but some of you will become more zen and learn how to enjoy the small things in life, and many of you will do both.

You may go from being terrified at choosing to write and dispense that first script for a drug (probably an antibiotic) to writing them in 30 seconds flat and knowing the number in a box off the top of your head.

You will hopefully come to see that being a doctor is a job, not some mystical calling sent out to you from the universe. I think this is good. If you see it as a job rather than an entitlement or a state of being, you are more likely to realise that you need to work hard at it to be good, and more likely to leave it at work when you can. You may also realise that other doctors are people just doing their jobs, too.

You will encounter death, grief and loss. If you can meet this with compassion, dignity and humility, it will be better for everybody involved.

The first death you need to certify will probably be in a room full of grief-stricken family. Know what you are doing and have a plan before you walk in, and although this is your first time, hide your uncertainty and terror. Be kind.

Document, document, document. This will be reinforced whenever you look back at your notes after something has happened, and you find that you clearly documented what you needed to. Document!

Good luck! And don't forget to take care of yourselves, both physically and mentally.

And onwards

I have finished our second rotation of the year, and this was the one I dreaded the most - surgery. I like the idea of surgery and I can appreciate how some people love it, however I am not one of those people.

I know what I like and surgery isn't it. I prefer taking my time with patients, having reasonable starting and finishing times and access to cups of tea and chairs when appropriate (yes, this is a little facetious, but it is the little things, right? ;) ). I like the sunshine, and I like vitamin D. I love seeing the patient as a whole person, and while there is a possibility for doing this in surgery, many of your relationships start and end within the space of a few hours and you get to say good-bye to the patient, having fixed their issue to the best of your ability.

I met some absolutely lovely patients whom I felt very privileged to spend time helping. One of the wrenching things about working in a hospital is that you get to see a lot of terrible things happen to lovely people. You need to find some a healthy way of dealing with this.

I don't think I realised this so much before now, but the staff at the hospital do get attached to their patients and many come to genuinely care. I have seen staff at every level get emotional away from the eyes of the family and patients when then need to. It is a part of being human and I never want to lose it. Of course, excessive attachment is bad and scary, but it is normal to form some sort of bond with people you spend hours looking after every day, particularly when they are with your for weeks or months.

I will also miss the staff I have worked with. A lot of the surgeons are good fun, most of the nursing staff are helpful and really know their stuff, and I will really miss just how helpful our ward pharmacists are.

I'm just not a fan of working in surgery. Fortunately I got the opportunity to do so with some really caring and helpful people, who made it all bearable. In the end I got through, and I think I did a good job while I was there, which in the end is what really matters to me.

Strange Things To Be Jealous Of . . .

. . . when you would rather not be on your way to work.

1) The magpies by the side of the road. They get to be outside all day and leaping around on the grass. You get to be inside doing paperwork.

2) The people out on their morning walk at the crack of dawn, while you are already in your car on your way to work. They have more leisure time and will probably live longer lives.

3) The person who cleans your house. Some days medicine is too stressful and you would rather wipe benches and clean toilets.

4) The mother getting her kids ready for the school run in the morning. Because sometimes you question your life choices.

5) Your pets, who will still be on your bed when you have been at work for 6 hours and it will be at least another 7 hours before you are home again.

6) Your spouse when he/she is sick for the day, for the same reason as number 5).

Most days I am glad to be where I am. But every now and again there are moments when I look out and dream of being elsewhere.

Pushing through

Yes, I'm still here.

The current rotation I am on is quite demanding, and I am regularly clocking up more than 60 hours per week.

Still, I am not over-tired and am learning quite a lot. Frankly, it would be hard not to learn.

In a few weeks I am hopefully going to be 2/5 of the way through my intern year.

In the Australian system, we enter a specialist training program after being an intern/resident for a year or more. This means we get to see a bit of areas that we have no interesting pursuing and theoretically get a well-rounded grounding as a doctor.

There are a lot of advantages to this and only a few disadvantages. One of those disadvantages is that I am now too tired to type any more because this rotation is sucking a lot of time and energy out of me (but this is okay), so this is all I'm going to write.

Take care.

And the good news?

I got my first preference for internship!

I'm so relieved. And a little scared.

I think it will all become more real when the paperwork starts to arrive.

Exams, again

We have our exams this week for O&G. They consist of a long T/F paper, and two OSCEs where we are given a fake patient (who can be male and is also the examiner and an O&G physician to boot!) in a structured assessment situation.

I'm mildly nervous, but much less than I would have been a year ago. We have been through so many exams in the past few years that it seems so mundane and normal.

The thing that is starting to weigh on my mind is internship. I have two lots of rotation exams (including this one), one elective rotation, one MSAT at the end of it all, and then I am technically a (junior) doctor.

In studying for these exams, I keep seeing myself actually being in these situations in a year or so. This is helpful for study, as it really makes it stick, but on the flip-side it is also scary.

Quite a lot of girls I went to highschool with are now experienced nurses in the system, with over ten years on the job. I have lost contact with them over time, but it would be very strange to interact with them in a work situation, particularly as a junior doctor. I actually think that most of them would be good to work with, and if things get uncivil, we can threaten to show the rest of the staff pictures of each other in dreadful 90's garb and fluffy hair. ;)

I'm also possibly going to be doing internship at the hospital where I have worked for years in my previous profession, which will also be odd. On the bright side, I have a good reputation there in my other role, so hopefully that will make the transition a bit smoother.

I have worked and studied in the same corner of the world for my whole uni and working life. As Mr TGWTBS has said, it will be a bit of an adventure if and when we get to go elsewhere, in the not-too-distant future.

One week and one day to go

In one week and one day we get our first offers for internship. It is a very exciting time.

It has been very interesting that I have made it this far, mainly because I have been focusing so much on taking things one day at a time.

I'm trying to work out where the following years may take me, but it isn't easy, particularly as some information is hard to come by. I don't feel like I can call people and ask just yet, as I'm still only a medical student, and email responses are either slow or don't happen. That said, I have received a couple of very helpful responses.

Fun times are ahead.

Now to wait

For three and a half weeks until our provisional offers come out.

At least now I know my odds. It isn't a shoe-in, but it isn't the worst, either.

Fortunately I also have a very unpopular hospital within driving distance of my home as my second preference. I don't quite understand why it is so unpopular, as I have heard good things from people who have been interns there, but I can imagine. It isn't a big centre with a load of support. Their interns work hard and learn a lot. I guess it is in a poor area that is too far to drive from most areas in the big city, so they would have to move closer to an area that they don't like. (I would deal with the long drive, I think. I live on that side of the city.)

One of the problems with our current system is that the government panicked at the doctor undersupply and then gave the universities free reign to increase medical school places and medical schools which they did exponentially, so we are on the lip of a tsunami wave of fresh graduates.

This means that the two largest hospitals in the state will have 95 interns each, another has 85, and smaller places have also increased their intake to help cope with the increase, so that we don't have massive numbers of unemployed interns.

This is good in theory, but what do you do with 95 interns? You put them in education sessions. You double them up on the ward. You put them in radiology, pathology or GP surgeries doing educational work, or the scut work that they are capable of. You send them out to smaller places or private hospitals, which could be good as long as you are getting appropriate work.

This isn't to say that the interns in those big centres aren't going to work hard. They do work, but some of their rotations aren't ideal. On the bright side, they get shiny doctor's facilities to use. Free fancy freshly-ground coffee is a bonus of sorts.

Their experiences will be a little different to the people who get to be based at the smaller hospitals, both metropolitan and semi-rural.

As I am still dreaming of all things psych, and most centres have psych units with registrar positions, I didn't really need to make contacts in the big hospitals, which is a relief. I have applied to a smaller hospital (600 beds) that only takes a few interns and has more residents (PGY2 and above) to deal with the more medically complex rotations (e.g. transplant medicine). It was slightly oversubscribed, so I have to wait to see if I got a place, but the odds are good.

I don't have anything against the larger places, but 95 interns in the one hospital is an immense number. I do better in smaller crowds. Now to wait and get on with life in the meantime.

Master Procrastinator

Our ballot closes very soon.

Clearly (from the blog design change) I am procrastinating.

Perhaps I need to pull my finger out and do something that would distract me a little better - like, perhaps, studying? :P

Intern applications have started!

I have put my name down in the ballot process.

We can watch our results live as the numbers change over the two weeks, keeping an eye on how full our preferred hospital is, and changing preferences if we need or want to.

This means that people tend to shift their preferences if certain hospitals become over-subscribed to maximise their chances at staying in the big smoke. It also means that less people need to be balloted after the date for change of preference closes, because most hospitals don't end up being massively oversubscribed.

Fingers crossed!