Fourth Year

Fourth year is fantastic. Compared to third year, fourth year really is wonderful. As a third year medical student starting on the wards, I was hesitant and lost; I felt inept and stupid. I was busy trying to learn but didn't know anything. I spent too much time acting rather than becoming. But now (especially after my sub-internships) life is fantastic. I was talking to one of my classmates about this; you can tell who the fourth years are simply by the way they carry themselves. They aren't frequently frazzled; they walk about with an air of composure, perhaps arrogance; they have this false sense of security because they survived the supposed hardest year of medical school. It's kind of funny, and I think I do it too. Indeed, I used to get anxiety before I saw a new patient as a third year; I'd pre-template my notes, scribble down my physical exam findings as I did it, think of things to ask and then fail to ask them. But after a year of delivering babies, trolling the emergency department, placing lines in the ICU, and stitching people up after surgeries, I feel a lot more confident when I see patients; I worry less and care more. The knowledge base is also interesting; I don't think I know much more now than a year ago; indeed I probably knew the most book-medicine right after boards. But third year really solidifies a foundation of knowledge that I haven't really appreciated until now; I realized I learned how to think, organize information, talk the language in medicine, reason methodically, and present my thoughts on the fly. I tackled the steep part of the learning curve during third year, and now things are so much easier. As a result, I have much more time to enjoy with friends; I've been to the ballet, I've been reading, I've been dancing, and I've finally realized why people say fourth year is such a relief.