“Good doctor” or “Good enough, doctor”? {part ii}

Continued from part one, here.

Gone are the days of stringent oral examinations where a board decided whether you were worthy of the title ‘Doctor’ based on your clinical performance and your basic medical knowledge. It’s been replaced by right-or-not MCQs that don’t take marks away for wrong answers (which is what happens in real life) and which offer no feedback, so you don’t even know which questions you got wrong.

You get a letter grade, which isn’t even reflected in your degree. How fair is it for a C student and an A student to be propelled into the public without distinction when the difference in quality of care will be considerable?

I won’t allow for people who are “bad at exams” because, let’s face  it, all of medicine is an exam. Every patient is a test, and you either pass or fail. If you can’t handle the pressure in medical school, you sure as hell won’t be able to handle it when a patient is coding in the middle of A&E and you’re the intern or, God forbid, the senior resident on call.

A tighter hold needs to be kept on the keys to the medical profession.

Please don’t feel like I’m elevating medicine to some pedestal. For one thing, it’s already on a pedestal. For another, every profession should demand high standards of their workers. It’s only unrealistic to expect that to happen because then all the substandard people would just be living on the streets.

Standards are there for a reason, and they ought to be upheld. I don’t like the wishy-washy mass-produced MDs that are currently flooding the market, but until the powers-that-be are backed up against the wall and held accountable we probably won’t have any kind of change in medical school output.

At the end of the day, don’t we all want (to be) good doctors?

Good doctors. (I couldn’t resist).

‘Good Doctor’ or ‘Good Enough, Doctor’? {part i}

Disclaimer: I am not a perfect med student. (I hover somewhere in the vicinity of fair to middling and I make up for it with overeagerness). These opinions are not intended to disparage but merely comment on the milieu of medical school in the 21st century. Also, this was written about a year ago and you know how my opinions change. (Like the weather).

One of my tutors once asked, “What do you call a doctor who had to take the MB;BS twice?”

“A doctor.”

It’s no secret that medical school is difficult. It’s meant to prepare us for the rigors of medical practice, after all. But the way we are assessed now (letter grades) and the way we will be assessed then (whether the patient lives or dies) are much too different to allow for a smooth transition from being responsible for your GPA and being responsible for a person’s life.

The System has Changed

This system has changed over the years, but I’m sure it used to work in the beginning. You know, before 300+ class sizes and the advent of so much medical and information technology. Back when doctors actually had to (gasp) know their stuff to graduate.

Consultants are ripe with stories of the 20-something people class sizes and their passion in dealing with patients. In between bowling you over with the sheer amount of knowledge their brains can hold, they quip about naughty mnemonics and lengthy discussions on unrelated topics in the middle of an exam.

All this from people who still can’t figure out how to work their iPhone. (And yes, I understand that they were young and human and therefore made mistakes just like us, but they were still somehow indefinably better and I think it has to do with our generation and where the world is on a whole).

The system used to produce stellar doctors.

But I don’t think the system works any more.

Sometime around the shift of emphasis from getting good grades to simply passing, the standard of medical student and eventually medical doctor began a slow trend downward. The system is set up to filter out those students who are obvious failures (non-attendance, awful grades, etc) but it turns a blind eye to the ones skating barely above the pass mark.

The people who slip past the cracks are the dangerous ones: those doctors who graduate without knowing much because they managed to avoid doing any “real work” in med school. The idea that our class will contribute to this growing demographic is unsettling.

Part One of a two-part post on instant gratification medical school. Read part two here!

on Hypocrisy

Google defines hypocrisy rather succinctly as

The practice of claiming to have moral standards or beliefs to which one’s own behavior does not conform; pretense.

I mostly fall into this trap when I claim to have moral standards and beliefs that I want to adopt, but I’m just. . . not quite there yet. Like arguing that I’m totally considerate to my friends, but neglecting to call them and say hi or tell them when my team is doing a procedure we all need to see.

I also fall into this trap when I’m not quite sure how to explain what I believe so words fall short of actions and it looks like I’m trying to pull the wool over your eyes when really I’m just trying to get it out of my own. But my actions are pretty consistent when it comes to beliefs.

On the other hand, my actions are totally erratic when it comes to standards and behaviour. Guilt tends to force me to act contrary to normal for a little while . But then I slip back into my old habits, and all my pretty speeches are centred around who I want to become, not who I am right now. (And, really, which one’s more important? The first one, of course).

But is that really hypocrisy, or just a standard failing of human character?

Another type of hypocrisy happens when the person identifying the hypocrite is herself a hypocrite and the very act of calling someone on their hypocrisy only serves to underline that fact even more. They are pretending to stand on some moral high ground when really they’re about as superior as Anakin facing down Obi Wan after he got his legs chopped off. And nothing irritates me more.

I’m always surprised when people quote me to. . . me

Most times the only thing that lets me write without anxiety is the thought that no one’s reading this anyway.

Where this delusion defense mechanism falls short is foreseeing the eventuality that someone actually does  read what I’ve written. Because if I get caught up in that then while I’m writing I’ll be panicking about people’s reactions: “Oh no, what if they hate it? What if they love it? What if they hate me? What if I’m too mean? What if this changes the way people think about me?”  (This paranoia being different from the regular: “Am I being too diplomatic? Am I being to biased? What if someone interprets this the wrong way?” that goes on no matter what I’m writing).

Having people (in real life! Gasp!) comment on/about the things I write is like having someone tacklehug you while wearing a butterfly fairy princess costume. Scary as hell, but surprisingly sweet.

How do you feel about people talking about your blog offline?