Sunday, September 2, 2007

Some reflection

I've just completed the second essay I had to write for this silly portfolio we have to hand in tomorrow. The first essay was infinitely painful - writing up a case report on an ethical issue we had witnessed this year - and I've spent the past few evenings struggle to get that one done.

The second essay I wrote tonight - a reflection of my personal and professional development over this year. It was actually quite cathartic; writing this essay actually felt quite similar to writing a blog entry, so I'm cheating and using it as both. Here goes!!

Third year has been an interesting year; it’s a vastly difference experience to second year. It’s been busier than ever, but despite the busyness it has somehow managed to be less stressful, something I am immensely thankful for, because I am not sure if I could cope with the stress of second year and its barrier exam again. The third year barrier exam that looms in a mere months time somehow does not seem such a daunting task after having been through one before and passed out the other end, and after having successfully made my way through the Long Case exam that was the major stress-inducing object to deal with this year. I’m unsure of whether my reduced stress is due to improved coping, lower motivation to be able to induce stress, or heightened perspective of where I’ve been, where I’m going and what I need to do to get there. Either way, for my sanity’s sake, I am glad.

That’s not to say this year has been a walk in the park. Yes, it’s been very busy, and compared to the last two years, the busyness is less focused and frustrating, because it seems less outcome driven. The year had barely started; our first few days at a new hospital (in Orange) and already we were being bombarded with EBM, PPD and CDT presentations to prepare. Where was the time to study? And what did our lectures have to do with our PBL topics for the week? And what about our ICAs – when were we supposed to learn anything relating to them? And what about the ICAs we never got allocated – will I never learn anything about Respiratory or Neurology?

This year was filled with many unknowns and unanswered questions. I kept waiting for a mystical ah-hah moment, when everything would suddenly snap together and make sense. I continue to wait.

But comparing myself now to where I was at the start of the year, things have changed -just as previous third years, when imparting their wisdom to us - told us they would. Somehow this crazy and confusing system I’ve had to muddle through for the last 7 months has worked. Sure I’m still no pharmacist, but I know a lot more about many more medications than I did this time last year. Flipping through most patients’ medication charts I can make reasonable sense of what their main medical issues are, instead of the bewilderment I felt last year. And sure, I still stammer and give stupid answers whilst in the middle of an operation getting grilled about anatomy by surgeons, but now I welcome it, not dread it, because it’s a great way to learn.

One area I thought I would feel more confident about by this stage is procedural skills. Unfortunately they are something that I continue to feel that if I don’t do them with regularity, then I need to learn again. The only thing I feel vaguely confident in at this stage is venepuncture. Cannulation, ABGs and suturing are still stress inducing experiences for me. I have discussed this with my supervisors, who say don’t get caught up with these things now, that by the time pre-internship arises I’ll be bored with cannulating ten patients a day, that now is the time to be on the wards talking to patients and practicing history-taking and performing physical exams. Taking this advice on board is something I have tried to do, with varying success at times, and is something I am still aware of.

As third year draws to a close, I am stunned by how quickly it has come and gone. I am filled with awe about everything I have learnt this year, and disgust at all that I knew last year but have now forgotten. I’m also starting to think about next year, and all the new experiences that will bring with anticipation. Not to mention the year after.

Anyway, I'm glad that's over and done with. I'm going to go have a glass of wine now, and celebrate its completion, as well as the fact that instead of having a 7:15am vascular tutorial tomorrow morning, we're having it at 2pm instead. I get a sleep-in yay. Much more civilised!! I'm even going to try and go to the gym beforehand as well!

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