Fourth Year II

Third year has gone by all too quickly. The days are long, the year is short. This brief immersion makes me realize how vast medicine is, how many nooks and crannies there are, how many potentials. I've only touched upon the surface of what exists; I've never seen an ENT surgery, I don't really know what a radiation oncologist does, I'm terrible at reading wrist X-rays. But I think third year is about learning how to navigate this complex medical system rather than learning everything.

It is an inculturation of sorts. We learn what things are important in clinical medicine, and most of the time, they are in stark contrast to textbook medicine. Patients' insurance status matters. The day of the week is important. Horses, typical or atypical, far outnumber the zebras, even in a tertiary academic institution. We learn how to work in teams, work with patients, work as students. How do you introduce yourself to a patient when it's your first day on the rotation? Half the parents knew more about childcare than I did. But I learned to identify my place in this confusing spiderweb of health care delivery.

Over the year, I've been gathering more and more responsibility like a rock rolling down a hill. But a third year clerk always has the option to sit and watch if we don't feel comfortable with things like calling a consult, delivering a blue baby, or running a family meeting. But as I look ahead to fourth year, I'll be expected to do those things, difficult in different ways. It's like taking one of the training wheels off; I'll be okay for the most part, but a steep hill is really the test. I'm feeling pretty apprehensive but I have some measure of confidence that I can manage the learning curve. Everyone says that fourth year past the sub-interships is a great year; it's a breath of relief between the grind and rigor of third year and internship, and hopefully I'll take advantage of that.