Bureaucracy

The fourth year of medicine is pretty good. You get a fair bit of choice over what you do and where. You get less call. There's no block exams and evaluations are considerably less stressful.

Where fourth year (and the process leading up to fourth year) is terrible is in its bureaucracy. Medicine, as a rule, is organizationally complex, which leads to a number of rather problematic inefficiencies. Today's fun bureaucratic hurdle is registering for the MCCQE Part 1. It's an important exam, without a doubt, the only standardized test we take in medical school. It's also part of our licencing.

As part of the registration process, the Medical Council of Canada (MCC) requires identification. Completely reasonable, this is a non-trivial test that is one of the few milestones we insist on to ensure potential physicians are sufficiently knowledgeable. Any cheating in the form of impersonation would be a serious concern. So, they have a fairly stringent requirement - a notarized copy of a current passport. It's a bit specific since not everyone has a passport, and many other valid forms of ID exist, so I wish they would be a bit more flexible in what documents that would take. However, in my case, I already had my passport notarized for CaRMS, so I can reuse it for the MCCQE Part 1.

But wait! Apparently a notarized copy of the document that gets me into other countries isn't good enough for the MCC on its own! They also insist on a separate, MCC-specific form, with two passport quality photos attached and to have that notarized as well. Why? No clue!

So, now I need to get more passport-quality photos, fill out this needless form, and get it notarized. My school is kind enough to have notaries available, but of course, they're only available during regular working hours in my school's city. Not terribly convenient for fourth year students on elective across the country who, even with the nicer fourth year schedules, are still never going to be available during regular office hours without taking time out of electives. I could have had this completed at the same point I had the passport notarized, but of course, had no idea this was a requirement and was never informed of the requirement by my school despite this happening every single year.

Sadly, situations like this occur frequently in medicine and cause numerous headaches for providers, patients, and families. This is just a taste, but it follows a familiar framework. We've got multiple organizations who are not co-ordinating well on a task that is a joint responsibility, with one organization putting up needless hurdles and the other failing to anticipate challenges in overcoming those hurdles. As a medical student with my future career on the line, it's extremely annoying. I can only imagine how patients feel facing similar circumstances with their health in the balance.