By Maisie Hands
I dread the question that plagues the undifferentiated medical student – “what are you going to specialise in when you finish?” I have been asked this countless times by Continue reading
I dread the question that plagues the undifferentiated medical student – “what are you going to specialise in when you finish?” I have been asked this countless times by Continue reading
In medical school, we are constantly assessed through various modalities including assignments, examinations, OSCEs and MCRs. However, there is a growing body of research which suggests that certain experiences on the ward are highly predictive of students developing strong clinical acumen. This list can be used to formatively self-assess your progress throughout the course.
1. Unwittingly following your registrar to the bathroom
You trail after your registrar like a lost puppy, from ward to ward, clinic to clinic. You follow them down the corridor that doesn’t seem to lead anywhere… and then they enter the bathroom. A good registrar is someone who signposts when they are going to the toilet.
2. Fainting in hospital
This can happen on the wards, in theatre or in clinic. It is not a sign of weakness; rather, it is a true sign of commitment to medicine. Just remember to faint away from the patient, especially if you are scrubbed.
3. Deciphering a drug chart
The scribbles on drug charts resemble the trail of a spider that tap-danced across the page. Deciphering this brings into play the pattern-recognition skills from section 3 of the UMAT. Hospitals that use electronic prescribing systems fail to provide this exceptional educational opportunity.
4. Meeting the MET call criteria for low urine output
A wise registrar once told me that the hospital systems just would not function if not for the hidden workforce of unpaid medical students. As a consequence, you build stamina to go through days with early starts, no food, no water, no opportunity to void and mild AKI
5. Anxiously awaiting or sending a fax
Healthcare in Australia is amazing in its ability to provide universal care and to single-handedly support both the historic pager and fax industries. A device on which you can receive but not send messages is essential for maximising efficiency.
6. Substituting meals with coffee
An average small flat white with regular milk contains all three macros: 7 g fat, 8.8 g carbohydrates and 6.2 g protein. If you have a nice intern, registrar or consultant, then who says there is no such thing as a free lunch? Or maybe that was payment for the 10 discharge summaries you did yesterday afternoon. Wait, coffee doesn’t count as lunch…. Or does it?
7. Getting conned into a research project
When a seemingly innocent clinician pitches their idea to you, beware of phrases such as “it’ll look good on your CV” and “it won’t take much time.” Trawling through medical records to extract data for “only a few patients” is a similar experience to repeatedly banging your head against a brick wall.
8. Obstructing the hallway
Physicians think, surgeons cut, medical students obstruct.
Earlier this semester alongside 9 other Monash Medical Students, I had the wonderful opportunity of attending the AMSA National Leadership Development Seminar (NLDS). I’m writing this piece to share the thought provoking and inspiring lessons shared by the presenters: including what it means to be a good leader, how to be politically engaged and mental health in medicine. Thank you to the NLDS team for their hard work putting together this wonderful event, and to MUMUS and the Monash Medicine Faculty for their generous financial support.
The NLDS brought together a variety of speakers with diverse backgrounds to share their opinion on what makes a good leader. A universal theme carried across all the presentations was the importance of character – namely having integrity, being kind and being humble. Other traits which came up again and again included the ability to build a team and empower team members, being persistent and resilient, creating a safe culture of trust, and being approachable. It was particularly interesting to note how many of the skills required as a leader differed according to context. For example, many of the political leaders emphasised the importance of not blindly accepting the status quo and being able to motivate team members, as the process of advocating for and passing a policy can be very arduous and faced with many roadblocks. Contrastingly, leaders with a more entrepreneurial background emphasised the importance of resourceful problem solving, identifying how problems are formed from first principles, and knowing which problems are viable to solve. It seems like the technical skills required for leadership differ depending on the context, but the foundation of leadership lies in one’s character and ability to work well with others.
The major theme of the conference was political engagement. I’ve always been intimidated by the prospect of being politically engaged after watching Question Time on national television (and much more intimidated after watching Question Time in person). The conference brought in influential political leaders and policy makers whose talks elucidated an empowering message that we as medical students are not just idle observers of policy changes. Rather, medical students can influence policy change through political engagement, such as being involved in advocacy groups, writing to your MP and organising a meeting with your MP. Our efforts can influence issues as diverse as abortion laws, asylum seeker rights and medical workforce policy. It was interesting to hear multiple presenters talk about the unique role of doctors as one of the most trusted community members whose opinions have great influence: one speaker commented that her most successful advocacy campaigns have been when medical students and doctors have been involved, and likewise a former politician explained how politicians love to work with doctors and often try to recruit them. With the immense trust society places in the medical profession, we are in a unique position to influence policy in the best interest of our patients both as doctors and as medical students.
A confronting topic which recurred throughout the conference was mental health in medicine. The Beyond Blue National Mental Health Survey of Doctors and Medical Students found that 1 in 5 medical students had suicidal thoughts in the past year, and more than 4 in 10 medical students were highly likely to have a minor psychiatric disorder. Several speakers emphasised the importance of being honest, not just about our strengths but also our vulnerabilities. Too often in medicine, because of both the culture and the type of personality that medical schools inadvertently select for within candidates, medical students and doctors hesitate to reach out for help. To create widespread improvements in the mental health status of medical students, a systemic culture change needs to be implemented: by making it easier to report bullying and harassment, enforcing safe working hours for doctors, and creating avenues of seeking help. A message that really stuck with me is that ‘the behaviour you walk past is the behaviour you accept’: a leader leads by example, and that means confronting and calling out unacceptable behaviour when it occurs and not being a passive bystander. When we progress into senior leadership roles in hospitals it is our responsibility to ensure that we enforce a safe culture for junior doctors and medical students to feel comfortable asking for help and reporting distressing behaviour.
The most exciting take home message from this conference was the idea that as medical students, we do have the ability to have a positive impact in our communities and we are not just passive bystanders to the status quo. This can be through many mediums like political advocacy and entrepreneurship. In my opinion the simplest and most important way we can all be leaders in our everyday lives is through having the character of a leader: one of integrity, kindness and humility.