When you’re a medical student, two things are certain. The first is that you’re going to be some sort of uber-specialist and either cure cancer or rake in the prestige or both. The second is that you have absolutely no clue about how the profession works. You’re also told you must be very clever, and this continues when you’re a junior doctor and someone asks you what you do and you say ‘doctor’ and they ask you what you want to go into and you say you don’t know.
Now that it’s getting toward the end of my internship it’s becoming uncomfortably apparent that it’s time to pick something. All through medical school I was going to be an oncologist. I’d had family members with cancer, I’d had a healthy enthusiasm for all things cancer molecules in medical school and dammit, physician training was in some way noble, like you were becoming one of the guardians of humanity. Simple right?
And then I started working. Doctors are expected to put up with a lot of things because they’re paid reasonably well. And the way we’re bashed in the media as Mercedes-driving, rich, corrupt, minions of the big pharmas with no ones best interest at heart means we don’t garner much public sympathy. So we’re expected to put up with a lot of things. Like when you’re on sick relief for the night shift only the night shift person doesn’t call in sick until 6pm when you’re just leaving your full day of work for the day which started at 8am, meaning you have to stay at work until 6am the next day. You’ll be fed a line about how you should go home and sleep which makes you wonder if they’ve seen the traffic outside because by the time you get home, it will be time to turn around again. And there’s nowhere for you to sleep in the meantime. Apparently there are rooms but no one knows where they are and they sure as hell don’t tell you during orientation. So you stay up for 24 hours and in your 22nd hour of being awake the nurses call you to ‘just come and review this guy’ and you get there and find that the guy is really sick and your brain is an unholy fog but somehow you manage to call a MET call and convince the blood bank to give you a bag without their results yet. And then once the guy is stabilised you sink into your chair and realise just how close he came. Or the fact that in your contract, you get a half hour break. For the whole day. And how you essentially change your entire job every ten weeks and while your contract says you’re supposed to get a roster for the afterhours work (which you do on top of your dayjob), two weeks beforehand, you invariably never do and simple things like planning a trip to the GP becomes impossible and suddenly a year has passed. But alas I digress, there’s a lot of good about the job, I just had to let that out.
Suddenly things like bucketloads of prestige, nobility and curing cancer get lost in this mire of tiredness and endless collections of blood, and missed birthdays and Christmases. So you start thinking about what’s really important to you. Things like time. And no nightshifts. And fewer weekends. And actually seeing your patients faces instead of their med charts and notes aside from a cursory ‘can I just have a quick listen to your chest?’ because in your head there are a million more people who need reviewing. All that bullshit as a medical student about certain specialties being more ‘worthy’ than others evaporates.
So you start thinking about becoming a GP. And this amazing dichotomy presents itself where people say things like “oh it’s good for women” and “oh you’re just going to be a GP?” I’m sorry? Just a GP? Suddenly you’re not as ‘clever’ as anyone else who wants to do say, neurosurgery, or renal medicine. You’re certainly not going to earn the same money. A family member told me they were disappointed I didn’t want to be a surgeon after a few surgery bosses had encouraged me into it.
But what if the ‘clever’ people decided they wanted something else? That they knew they were perfectly capable, and hell, even interested in those so-called higher specialties but for the purposes of life satisfaction (as opposed to job satisfaction) went down a path that was just as satisfying and gave them more time? What if that was perfectly okay? This is blasphemy in medical school. And the idea that you should want normal working hours and a good life is almost laughed at, it means you can’t hack it. Or in my case, don’t want to. And shouldn’t have to. I have a friend, whom in medical school, was a quintessential overachiever, perfect in every way, and really really nice. And going to be some sort of superspecialist. She turned to me recently and told me she was considering paeds or GP because physician training was a shit life.
The social pressure to not be a GP, this idea that you are in somewhere not clever anymore (what, did I just get lobotomised overnight?) because you pick this path (which by the way is it’s own college and own specialty training program now, it’s not a matter of finish med school and hang out a shingle), is just status anxiety at it’s ugliest. If I were the sort of person who put more weight in how I appeared to others and less to myself, I might pick a really hard specialty, kill myself passing it, and become the sort of hardened doctor everyone hates. I tell you this now – that uncaring doctor everyone has met was not always like that, once upon a time they really did care until something burned them out.
I got into medical school. I passed the GAMSAT spectacularly. I didn’t fail any exams while training, I kept up with my cohort, I beat them in some areas. I graduated medical school and now I get great feedback from each rotation. Surely that’s enough? Suggesting that GPs are in some way lesser because their college has their shit together in terms of good hours for training and fair exams is the sort of howling insecurity that pervades the field. But it is as it is and in spite of all this, the idea of it is growing on me more and more every day, in spite of what anyone else thinks.
And really, if you don’t define yourself, someone else will and you wont be you anymore.
Bake. Love. Run. 