Saturday 3 June 2017

The Worst Part of Medical Training

While working on another post, I found the following paragraphs saved as a draft post. I'm not sure if I'm the author of these words and suspect that I'm not, yet can't find who wrote them originally. I have a feeling this was a forum post that ended up getting deleted, that I copied because I felt the words were worth saving.

I present them here as I found them in my draft folder - if the original author comes across this and wants them removed, I will happily do so. However, I think these paragraphs provide an important context to medical training which should be shared.


"I have to highlight this for those considering or early in their medical training, because it's a part of medical training no one appreciates until they're in it.


As a trainee, there will be times where a patient's treatment is below what you consider acceptable. The worst is when there's a preceptor acting completely inappropriately. All you can do is sit back and watch the carnage unfold. If you're lucky, you'll be able to debrief the patient and provide some more appropriate guidance, as well as a bit of simple human empathy.



More often you're simply a cog in a system failing patients that, because you're new to that system, you don't understand and are ill-equipped to navigate. You act the way you think you're supposed to act, even the way others expect you to act, and it causes harm to patients in one way or another. Everyone goes along like it's normal or, worse, thanks you for your part in it. Yet, you have to continue with your role as that cog, because as a trainee, you have no alternative short of quitting. As you gain experience, becoming more knowledgeable about medicine as well as the healthcare system you're now a part of, you start to see opportunities to work around the system to avoid causing harm, to lessen it, or at least to warn patients of what's coming so they aren't blindsided.



This is the worst part of medical training - not the long hours, not the pressure to perform, not the vast amount of knowledge you need to acquire, not even the (fortunately uncommon in my experience) instances where you're personally treated poorly by preceptors - but the time where you're made to be complicit in bad care or outright mistreatment of patients. You don't have the power to change it, and so ultimately you aren't responsible for it, but it sure doesn't feel like it at the time."



I am now about a month away from starting my residency. This is definitely the part of my medical education thus far that I hated the most. It's the part of my upcoming residency I most fear. This is the dark side of medicine, the part that doesn't just challenge your ability, but compels you towards the corruption of your own ideals - ideals which the profession purports to share and uphold, yet frequently betrays.

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