Playing doctor

It’s Halloween, and everyone is playing dress-up. The funny thing is that I feel like I’ve been playing dress-up every day for the past year. I alluded before to how the practice of medicine is, in large part, about putting on a show, and I feel like, as a medical student, this is more true than at any other stage of training. We’re not only trying to convince our patients, our residents, and our attendings of how competent we are, but I think, to an extent, also ourselves. It’s no wonder that impostor syndrome is rampant among the med student population.

When I was doing my clinical rotations as a 3rd year, I was often told that I should strive to have my patients regard me as “their doctor.” It wasn’t rare for my superiors to introduce me as “Student Doctor” (which, though technically correct, is a title that is, in my opinion, designed to mislead patients) or “Doctor,” and I occasionally even dared to use the “Student Doctor” moniker to refer to myself. The truth is that I’m closer to being a “real” doctor than I’d like to think. But until then, I’ll keep putting on my costume and playing my part. Fake it ’til you make it, right?

Process of elimination

The studying continues, despite the fact that I’ve forgotten quite a bit of the medical knowledge that I once had. I’ve made it a point to try to do a set of practice questions every day and, despite the fact that I feel like I have no idea what I’m doing when I stumble through the questions, I seem to be doing better than I expected. I find that in most cases when I get the correct answer, it isn’t because I know my stuff. More often than not, it’s because I had some vague intuition that one of the answers felt more friendly than the others. I guess I should be glad that the questions are multiple-choice!

Medical knowledge during med school

So… I’m still studying for USMLE Step 2. I’ve been slowly but surely making my way through my admittedly over-ambitious stack of review books and practice questions and, as I’ve been doing so, I’m realizing more and more that I’ve forgotten an enormous amount of information since I took Step 1 a year and a half ago. It would have been bad enough if I had gone straight through to 4th year, but taking a research year means that my brain has become quite the rust bucket in these past few months. I hope that I’ll be able to brush off some of these cobwebs in time to not fail.

Meanwhile, my 4th year friends seems to be in much the same state as myself. Many of them have already completed their important rotations are now cruising along toward graduation. They say that 4th year is like having a vacation for half a year. I certainly hope that that will be true for me next year. Is it too early for me to have senioritis?

The White Coat effect

Last year, while I was doing my clinical rotations, I got used to being able, essentially, to go anywhere and do anything in the hospitals. This included using physician computers, accessing restricted areas, boarding staff elevators, and feeling free to ask staff members for the door codes to physician workrooms and lounges. Security guards cheerfully waved me through metal detectors with a “C’mon in, Doc!” despite the fact that my pockets were bulging with metal equipment, and nurses held the doors to medical supply closets open for me. And this is with my short med student white coat– few lay people seem to know the difference between the short white coat that medical students wear and the long white coats that the MDs wear.

I’m taking a year off to do research this year. I’m about 2 months in now. Among other things, doing a research year means that I’m spending a great deal of time hanging around the medical campus without my traditional medical student get-up on. More specifically, it means I’m leaving my white coat at home most of the time. And I’ve noticed the difference. I look young for my age, and I often get mistaken for being college-age, or even, on occasion, high school-age. The white coat seems to give me an air of importance/authority that I otherwise don’t seem to have. It could be that I just feel a little more self-conscious without it, but I swear that I’ve been getting just a few more questioning glances and “Can I help you?”s and just a few fewer welcoming smiles and “Have a nice day!”s. It’s odd how one little piece of clothing can make all the difference in how people look at you.

My USMLE study schedule

The road to a career in medicine is paved with standardized testing. There’s the SAT for college admission, the MCAT for medical school admission, a Shelf exam for each 3rd year clerkship, the 3-part USMLE, and then some arbitrary number of specialty Board exams depending on one’s specific career trajectory. As such, I’ve managed to become quite experienced in the matters of paying several-hundred-dollar registration fees, buying dozens of prep books never to be read, and procrastinating away all the study time that I had originally planned for…well… studying. I have enough experience, anyhow, to know my own habits. I’m scheduled to take the USMLE Step 2 CK in November, which means that I’m due for a freak-out session any day now. Hopefully that will motivate me enough to crack open the books that have been sitting idly on my shelf for the past 2 months.