“Mentorship is about getting to know someone and learning how he or she finds passion in his or her medical career.” writes Marissa Camilon, MD. “As young learners, we are drawn intrinsically to passionate people; whether their energy is shown through lectures, clinical work or even in simple conversations.”
Not only do mentors give advice, provide encouragement, offer insight, and connect you to a wider network; they can actually provide you with the perspective needed to figure out some solutions on your own.
12. Medical school is just a phase. It won’t last forever.
Just think of all the hurdles you’ve crossed to get to this stage, the endless tests and exams you had to take before you ever qualified to become a medical student. So is the journey through medical school, it is but a fraction of what lies ahead in your medical career. Stay optimistic!
13. Quitting is not an option.
“I’m fully aware of how rigorous medical school is, that prepares me to face any challenge during the course of study.” says Adarju, a medical student, who is also a spoken word artiste and a public speaker. Like the famous expression, “When the going gets tough, the tough get going.”
14. Cultivate healthy friendships.
Keeping the right company in medical school not only improves your emotional wellbeing, it also strengthens your focus. Seek like-minded friends who have a similar passion for the journey. They will not only ask to hang out with you for pizza, they will also suggest sleepovers where you can study together for your next Pathology test.
15. Find what works for you and make it work.
“I studied myself, I’m a lecture kind-of-person, I learn more in class than when studying by myself. So I attended more lectures and studied minimally.” says Dr. Popoola.
16. Remember why you started.
For some it was the admiration for the likes of famous Neurosurgeon, Dr. Ben Carson, while for others it was simply a deep-seated desire to make a significant difference in their community. Whatever your motive was for applying to medical school, don’t allow the pressure from the workload to kill your dream.
When you have a great relationship with those who believe in your dreams and want you to excel, not only does their flow of support (whether through uplifting words, cash or gifts) boost your morale; you also do not want to let them down, which motivates you to even go the extra mile. Your support network can be your greatest cheerleaders while in medical school, and also for a lifetime. “There’s no one in this world who believed in me like my mum did, even when I didn’t believe in myself or my performance in tests or exams. She was just exceptional.” says Dr. Tamie.
18. Eat healthy.
It’s no news that a lot of medical students barely have enough time to grab a cup of coffee, before they hit the ground running; And because of their fast-paced schedule, they mostly survive on fast food and energy drinks. The truth however, is that it takes a healthy medical student to become a healthy medical doctor, and a balanced diet not only increases your physical stamina, it also enhances your mental capacity.
19. Focus on becoming competent rather than just getting good grades.
While good grades are important for you to graduate from medical school, you need more than good grades to become a competent doctor. So don’t be depressed because your grades are not so impressive, just keep working hard to become the doctor of your dreams.
20. Listen to podcasts.
Whether you’re interested in purely medical podcasts like EM Basic or you prefer a wider variety of topics such as TEDTalks, listening to podcasts is a good way to keep your motivation coming.
All medical students need encouragement from time to time; And staying motivated through the rigors of medical school is in itself a challenge.
From my experience and those of other past and present medical students, here are some practical ways to keep the motivation coming through medical school, which I’ll be sharing over the next few weeks.
1. Discover yourself.
As a medical student, you’ve likely spent most of your life in a school environment (Elementary to College); now is the time to not just focus on your schoolwork alone, but also learn about yourself- your purpose, your values and your principles. You’ll be surprised at what you’ll find out.
2. Learn new skills
Medical school opens a world of other interests to you, where you can develop new skills like writing, photography, baking, video editing, or music; plus the Internet offers you great DIY resources.
3. Take online courses.
It is true that you’ve chosen the career path of medicine, but there’s so much you can learn about other fields like the arts, humanities, social sciences or technology. There are a variety of free courses online that you can look into.
There’s enough stress to handle already with the overwhelming work load in medical school and sometimes discouraging grades. It gets worse with putting extra pressure on yourself and criticizing every mistake you make.
Volunteering especially for medical causes (health fairs, blood drives, health awareness campaigns etc) is a good way to feel invaluable while giving back to your community. You don’t have to wait until you graduate before you find some meaning in the medical path.
6. Listen to good music.
Good music is like therapy for your soul. You’ll have some low output days, and rather than allow yourself to sink into depression, why not listen to some cool beats with amazing lyrics? Music is a great tool for internal motivation.
Listen to this inspiring song: I’m a Winner(MTN Project Fame version)
7. Watch Medical Shows.
Medical shows are not only a (fairly good) source of medical information (think terminologies, procedures and diagnosis) and humor, they also fuel your passion for medicine. Grey’s Anatomy, House and Chicago med are a few of them.
8. Start your own business.
Even as a medical student you can become an entrepreneur; apart from the financial renumeration, it also gives you a sense of self-worth and personal satisfaction.
9. Keep a journal.
Having a journal helps to boost your morale when you reflect on how you overcame a previously challenging time; it also helps you to keep an account of your journey which will be relevant in sharing your experiences in future.
“For me it was mostly the thought of being a good doctor (that kept me motivated) says Dr. Johnson, “I was always like someone’s life is going to be in my hands one day and I sure want to be able to save…I don’t want to be the doctor that doesn’t know what she’s doing.”
I hope you find some of the tips helpful, you can let me know some other ways you stay(ed) motivated in medical school.
PS– If you enjoyed this post, you might also enjoy:
It’s no news that scaling through medical school is challenging. Learning how to manage the stress that comes with it, is therefore a necessity.
Like I shared in an older post, a minimal level of stress, called EUSTRESS, is required for proper functioning in everyday life. When it becomes overwhelming however, it is known as DISTRESS which is counterproductive.
In this post, I have shared some tips that worked for me in managing stress as a medical student. I hope you find them helpful.
1. Start each day with a plan
As a medical student, I usually planned my day using both a to-do-list and a schedule.
A schedule is like a customized calendar that highlights specific activities for each day, especially those that demand a big chunk of your time (Eg Mondays for shopping, Tuesdays for taking out trash, Wednesdays for laundry, Thursdays for cooking, Fridays for blogging and so on)
A schedule helps you to manage your tasks, so that you can have sufficient time to get each one done, without neglecting others.
A to-do-list helps you to manage your time, so you get to maximize your day and account for every important activity.
A To-do-list on the other hand, is like a reminder, that lists out everything you want to get done before the day ends. It’s important that you do not overload your To-do-list. As a rule I don’t put more than 10 goals to accomplish on my To-do-list everyday.
Both are important to monitor your daily productivity, stay balanced and avoid crashing. To maximize them however, you need to apply the priority scale principle.
(PS: Check this blogpost for what a priority scale is and how to use it).
2. Practice healthy habits
It is true that you become whatever you’re becoming. Work at becoming a healthy doctor. Don’t just preach it, practice it!
They are quite simple really. But you’d be surprised at how many medical students break most or all of them.
The work is demanding enough, so you can’t afford to break down, not if you can help it.
Learn to take care of your body, so that your body can take care of you.
One simple advice, have your breakfast everyday!!! It’s a great way to avoid energy drain especially during ward rounds.
3. Make time for me-time
In other words, learn to unwind, relax and rejuvenate so that you don’t burn-out.
And if possible, have a “No-Studying Policy” for at least one day in a week. Sundays are perfect! Just take time off to take care of you.
You might like to stay indoors and get refreshed. For instance, I found out that taking a couple of hours at the beginning of the month to have a retreat was spiritually uplifting.
Or maybe you prefer the company of friends, think indoor games, movie nights, beach outings or even a boat cruise!
And if you’re several miles away from home (like I was), hanging out with your homeys on phone or skype, will go a long way to relieve any tension you might have accumulated over some days. Having your support network (friends and family) around and allowing them to pamper you for a while, when you’re having a bad day is always a blessing.
4. Attitude is everything
In this path you have chosen, there will be some tough times but you must learn to hang in there.
Learn the 3As of keeping a great attitude: Accept. Adjust. Adapt.
Accept the things you can’t change, adjust the way you respond to challenges and adapt by doing the best you can.
Your motivation is your responsibility. Find out what works for you and use it to your advantage.
As a medical student, I started a blog, practiced meditation and yoga, subscribed to podcasts/blogs, improved on my culinary skills, and read a lot of novels and other non-medical books. There’s an endless list of what you can do too.
5. Take one day at a time.
I can’t over emphasize this part. It’s understandable to think about what’s next after medical school, licensing exams, areas of specialization, and what not. If taken to the extreme however, it does more harm than good. Whenever you find yourself getting overwhelmed, try to declutter your mind and focus on what is right ahead of you – the next class, the next test, the next semester or the next clinical rotation.
Thank you for reading,
If you’ve enjoyed this post, you may also enjoy these:
Here is the final part of my MDCN Experience. I’ll be sharing some of the highlights and challenges I had in my Centre.
First, I’d like to thank Dr. Tosin of lifewithtwotees.com, who was kind enough to blog about her MDCN experience (July-October 2015). I was privileged to come across her blog a few months before I returned to Nigeria. Fortunately, I got to do my MDCN remedial course at LUTH as well, and her tips were helpful.
The Medical and Dental Council of Nigeria (MDCN) is the umbrella body for medical doctors and dentists practicing in Nigeria. A primary function of the council is the issuing of provisional licenses for foreign trained medical and dental graduates, and inducting them into the Nigerian Healthcare System.
The license is issued to Foreign Trained Doctors (FTDs) after a satisfactory performance in the stipulated exam, following a 3-month remedial course at specified Tertiary hospitals.
The MDCN remedial program which takes place twice (January-April/July-October) every year, cuts across different Teaching Hospitals in the country. The usual centers are:
– Lagos University Teaching Hospital (LUTH), Lagos.
– Ahmadu Bello University Teaching Hospital (ABUTH), Zaria.
– Obafemi Awolowo University Teaching Hospital Complex (OAUTHC), Ile-Ife.
– University of Benin Teaching Hospital (UBTH), Benin.
– University of Nigeria Teaching Hospital (UNTH), Enugu.
(For more information about MDCN, visit mdcn.gov.ng)
Tales from LUTH
The last MDCN Remedial Course (January-April 2017) was held at Lagos University Teaching Hospital, Idi-araba, Lagos. I resumed a week after the program had commenced and I discovered there was a lot of catching up to do already. To add to the stress, I had to be going about looking for a suitable accommodation. Thankfully, I found one in Mushin, and moved in with a friend about 3 weeks into the program.
Like I mentioned in my previous post, the earlier you get settled into the program, the easier it will be.
Tbh, the 3 months duration was pretty intense, much like a boot camp experience. In comparison, my medical school days were such a luxury.
There were Foreign Trained Doctors from all over the globe: Egypt, Hungary, Ukraine, Russia, St. Kitts, Dominica, St. Vincent, Ghana, South Africa, Sudan, London, Uganda, Ireland, India, Canada etc
Over 300 candidates registered for the remedial course at LUTH. First, we were divided into four groups (A-D) for our clinical postings, then further divided into subgroups for the different units.
On week days, we had ward/clinic activities in the 4 major departments (Medicine, Surgery, Pediatrics and Obstetrics/Gynecology). We resumed anytime from 8 a.m. to 1 p.m., depending on the department/unit. We also had logbooks for attendance where the Consultant/Senior Registrar available in the unit would sign.
My postings were in the following order:
1. Pediatrics (Infectious disease/Cardiology unit)
Since I resumed the remedial program a week late, I spent the shortest time in that department.
Highlight(s): The usual ward rounds which included bedside patient examinations and drilling, an outpatient clinic with the consultant (who took her time to teach us after we had clerked some patients); and a departmental seminar where a project was proposed by a SR, followed by an interesting debate with the topic- The Doctor: The King Or A Pawn? Several arguments where made for and against both labels, but the moderator’s conclusion was that the doctor is neither the king nor the pawn, but a visionary leader who is to adequately head the healthcare team.
Challenge(s): I was a little flustered while in the unit, because of a particular SR who made me nervous on several occasions. I’d missed a rather cheap question (something on an antibiotic) and she seemed to pick on me afterwards. Thankfully, that was the only posting where I experienced such a challenge.
2. Obstetrics and Gynecology (Reproductive Endocrinology and Fertility Regulation unit)
Highlight(s): Outpatient clinics and ward rounds. The Regs in O&G really moved stuff, so I learnt a number of important things, like how to use the Partograph.
In one of the clinics, I clerked a patient with another colleague, and our top differential diagnosis was Amenorrhea, only to be told afterwards by the supervising Reg, that it was simply a case of Secondary Infertility!
Shame no fit catch us that day, but we live to learn, and thankfully we did learn.
Challenges(s): Well, the experience was quite pleasant although I didn’t get to observe any labour & delivery or c-section because of the unit I was posted to.
3. Internal Medicine (Renal unit)
I had an interesting time here as well. There was a lot to learn on a daily basis. The team members were quite accommodating too.
Highlight(s): Ward rounds and Outpatient clinics.
Challenge(s): It was quite sad to see a number of patients suffering from chronic renal insufficiency, not able to afford payment for their dialysis.
4. Surgery (General Surgery unit)
This was eventually the least stressful of my postings.
Originally, I was posted to the Neurosurgery unit, which I accepted in good faith, despite the rumors of unpleasant treatment from the unit.
To cut the story short, the few days my colleagues and I spent there was “not it”. We were a bit restless trying to be punctual at all costs and to adhere to the rather strict guidelines of the team.
Eventually, we were kicked out by the Chief Reg himself, because we failed to turn up for the unit call that weekend! All our pleas fell on deaf ears.
And how relieved I was, because I had gotten so worked up anyway.
The General Surgery team members were a lot more accommodating and less intimidating and I did learn a couple of things from them.
Highlights: Ward rounds, Seminars, Clinics and Minor Surgeries. It was overall an interesting experience for me, not just academically but also socially.
Challenges: I was unable to observe any of the major surgeries, during my posting, due to a limited supply of surgical scrubs. One thing common to the Operating rooms both in my med school and LUTH was this, the “Nursing Sisters” were in charge! Whoever they refused to help remained helpless.
The lectures took place from 2pm to 5pm, from Mondays to Fridays. On some days, we were lucky enough to finish on time and on not-so-lucky days, the lectures ended much later. All lectures were either in PowerPoint or PDF format, and our class representatives did a great job of getting them across to us.
We were exposed to a variety of lecturers, some were really nice and enthusiastic about teaching us, they were not just concerned about the remedial course, but also inquired about our general welfare and how we were coping in the Nigerian environment; a few were indifferent, they simply taught us and left, and we had a number of sarcastic ones, who spoke as if training outside Nigeria was a crime itself.
The courses we covered were quite extensive:
– Obstetrics and Gynecology
– Internal Medicine
– Chemical Pathology
– Morbid Anatomy
– Community Health
My favorites were Anaesthesia, Community Health and Psychiatry.
Tuberculosis, Malaria and Sickle Cell Disease were high yield topics that came up in almost every course.
We learnt some interesting mnemonics too e.g.
SHADE for Family History
NASORATI for Patients Biodata
5 Cs forh/o Presenting Complaints
Overall, it was a worthwhile experience and I enjoyed the MDCN remedial course. For those hoping to participate in subsequent ones, I hope you find the experience equally enjoyable.
The MDCN exam is relatively easy to attempt, if you have the right kind of information.
I’ll share a few tips that worked for me, which you can apply as well in preparing for the exam.
1. To thine own self be true.
Know why you’re in Nigeria. Not all that came to write the licensing exam, plan to use it. For some, practicing in Nigeria is a second, third or fourth option. Roughly a quarter of the candidates in my centre were planning to port (i.e. Return Abroad). If you’re not ready for Naija wahala, just sit at home and chill. And if you’re in it for real, then make sure you double up.
2. What you don’t know, you don’t know.
You may have to unlearn and relearn some things, especially with history taking and physical exam, because Naija stuff get levels and as far as “they” are concerned, it’s either their way or no way.
For instance, when I saw the way they palpated for enlarged lymph nodes in a patient, I just humbled myself and went to learn it.
Another example was learning to use the Mercury sphygmomanometer, which I wasn’t very familiar with. When you’re not sure, just ask. It may be embarrassing at first, but it’ll be to your advantage later on.
3. Listen with sense.
Not everything you hear is true…learn to sift through the noise and hold on to the fact. There will be rumors to your left and to your right, and some of them will overwhelm you but you must not allow your heart to fear. Remember, it is just MDCN, not an exam to enter heaven 😂
4. Be present when it matters.
Not every tutorial, not every call, not every seminar counts…but MOST of the rounds and classes are important. MDCN requires 70% attendance (of ward activities/classes) for you to participate in the exam; and over 80% of the exam material will be covered during lectures. Be wise.
5. There is no time to waste time.
Start studying the moment you resume…unless you’re a specific kind of genius with a type A brain, your plans to start studying just a few days to the exam won’t work. Trust me, the work load piles up on you like toppings on a slice of Pizza. Just like med school, you can use some of these STRATEGIES to scale through the MDCN exam. Past Questions are the main resources you should revise with for the exam. Don’t be lured into buying giant textbooks and whatnots. The truth is, you don’t need them.
6. Beware of 419.
There are evil people ready to scam you of your money, abuse your body (Dear Ladies, take heed) and rob you of your integrity. You don’t need the backdoor to succeed in the exam, nor any “special help” from those in-the-know. Exam Malpractice is a grievous offense and the examiners take a lot of measures to curb it. If you’re caught, you’ll be asked to face the music.
7. Don’t lose your Confidence.
This is by far the most important tip. YourConfidence is your greatest ally. Prepare as much as you want, if you lack confidence, you’ll mess up. It took me weeks of motivational articles, positive self-talk and prayers, to get myself mentally ready for the exam. Thankfully, I was able to scale through it.
The Exam Format (LUTH Centre)
From the information I gathered, the exam varies from Centre to Centre. In Lagos University Teaching Hospital (LUTH), where I sat for mine, the exam was 3-fold.
PAPER 1- 150 MCQs
PAPER 2- PICTURE OSCE and Clinical Scenarios
Day 2 (Main OSCE)
Station 1 (Pediatrics): History taking from the mother of a jaundiced baby.
Station 2 (Surgery): Abdominal examination for a patient with suspected Acute Cholecystitis.
Station 3 (Obstetrics): History taking in a woman who presented for Antenatal care.
Station 4 (Medicine): Cardiovascular Examination in an otherwise healthy young man.
– For the MCQs, it’s advisable to do as many questions as you’re certain about and leave the rest. We were made to understand that “negative marking” was implemented for our exam, and a lot of candidates in my centre were affected.
– Each OSCE station was timed for 5 minutes, so it’s important to work within the given time. The more you practice with your colleagues, the easier it is to achieve that.
– Arrive early at the venue of your examination, you don’t want to be stressed out before you start. And have a light breakfast if you can, you’ll be glad you did.
“You can get horses ready for battle, but it is the LORD who gives victory.”
Proverbs 21:31 GNB
This is for the Foreign Trained Doctors who want to take the Nigerian Medical Licensing Exam conducted by the Medical And Dental Council Of Nigeria (MDCN).
(Pls note that the exam is applicable to both citizens and non-citizens of Nigeria).
Having successfully participated in the last licensing exam that took place at the Lagos University Teaching Hospital (LUTH), I will share a few helpful tips:
1. Resume the MDCN remedial course early and learn your ropes quickly. The earlier you get settled into the program, the easier it will be for you.
2. Know how to take the routine vital signs (BP, RR, PR) and the normal values across age groups. It’ll likely be your first test, and if you’re on point, you’ll be the BOSS.
3. Be confident and always say what you know. Silence is assumed for ignorance. Even when you’re not sure, just say something.
4. Guys, don’t forget your ties. Without it, you don’t belong on the ward. Come along with your ward coats, scrubs (preferably green if you’ll be in LUTH) and name tags too.
5. Malaria and TB are super high yield. Learn all you can about them beforehand.
6. Revise your history taking and physical examination skills ( especially CVS, RS, ABD and CNS). You’ll be glad you did.
7. Stand TALL, let no one intimidate you. Bad belle people dey Naija. They don’t really like how you went to spend “their” dollars abroad 🙄🙄
8. Don’t go solo, your colleagues will usually know something important that you don’t know.
9. If you could scale through medical school (no matter where you studied) you can survive MDCN. Don’t let anyone tell you otherwise.
I have received lots of encouraging feedback about this post where I shared some important lessons from my medical school journey.
As a follow up, I have put together few tips that helped during my medical school days. I hope my blog readers who are medical students will benefit greatly.
These are strategies that worked for me and they are quite simple to apply:
1. Have a study schedule
I can’t overemphasize this. This is the most important studying strategy to use. Having a schedule helps you to know
– WHAT you want to study
– WHEN you want to study and
– HOW LONG you need/have to study
2. Start with what you know
I like to ask myself what I know about a particular topic before studying it.
For instance before you study about Bacteria, try to brainstorm on what you remember from your high school Biology or premed Microbiology, then continue from there.
Ask yourself these: – Have I heard of this topic before? – What do I remember about it?
3. Make use of multiple resources
This was a major strategy that helped during my clinical rotations. By multiple resources, I mean videos, textbooks, Q banks, lecture notes andeven study groups.
For instance, you canstart by watching a video on Burns, then read it up in a textbook, then revise what you have in your lecture notes, and finally discuss it with your study group colleagues.
The more channels you have carrying the same information into your brain, the more likely you are to retain the info.
4. Test yourself
This is another very important tip. There’s no point studying for hours, if you can’t answer a few questions in between.
It’s a good habit to jot down some questions for you to answer when you’re done studying a topic or better still make use of practice questions.
Testing yourself helps you to differentiate what you actually know from what you think you know.
5. Maximize your non-studying hours
This is one of the simplest strategies you can apply. Whether you’re taking a shower, doing some laundry, or sitting in the hospital lobby, you can task your brain with simple actions like recalling the definition of diarrhea or listing the ABCs of ER resuscitation.
6. Attend classes/seminars/rounds
I’ve come across lots of medical students who skip classes as tests/exams approach, claiming that they need more hours to study. In my opinion, that’s not always the best choice to make.
Medical school is about self discipline, there are a lot of other things you can cutback on while preparing for an exam eg TV, Sleep and Social media.
As much as possible try to attend those few classes preceding your exam, you might be fortunate to get one or two tips that will be of help later on.
7. Make it real
One way to add fun to your studying is to make it as real as possible, in your everyday experiences.
Practical application of medical knowledge is the most authentic way of making it stick.
While in medical school, I used to tease my flatmates (also medical students) about food poisoning by Bacillus Cereus and other organisms, when leftovers were not properly kept.
There are pockets of opportunities to apply any new knowledge you’ve attained on a daily basis.
I know it’s a real struggle for many medical students to find the balance between knowing enough to pass and knowing enough to practice.
The truth is if you don’t know enough to pass your exams in the first place, you can’t move to the next semester, and then you won’t be able to graduate as a medical doctor.
You may find yourself debating on whether to learn about all the facial muscles, their origin/insertion as well as their blood supply/drainage, or to just focus on the few important ones that might come out during your exam.
My advice is that for now, you should focus on knowing enough to pass from the level you are in, unto the next. With diligence and focus, you will build up on what you already know while you gain newer knowledge.
Most importantly, ask God for wisdom and direction as you study. Should any of the above strategies fail, don’t stop PRAYING.
I have decided to share with you the top 7 lessons I picked from my journey through med school. The lessons are not just specific for medical students though, anyone can apply them to any phase of life they are in.
1. DECIDEWHAT YOU WANT.
Have you ever asked yourself “what do I want out of medical school?”
It’s not enough to have the desire to become a doctor. You have to know why.
For some, it’s the admiration for famous Doctors like Ben Carson, and for others it’s the motivation to contribute to the cause of humanity e.g. finding a cure for HIV/AIDS.
Whether your purpose for deciding to become a doctor is simply PASSION or PRESTIGE, or a combination of both, take some time to reflect upon it, and know if your goal is worth the effort. Trust me, you’ll need this at some point in your journey.
2. DISCOVER YOURSELF.
What are your strengths and weaknesses? Are you a morning or a night person? What motivates you? What distracts you? These are questions you have to answer. Self discovery is one of the most reliable tools for success. As important as it is to learn from people’s experiences, there isn’t much room for trial and error in med school. So discover what works for you early and go for it.
3. GET HELP WHEN YOU NEED IT.
No student should be an island. The med school curriculum can be tough. It’s ok if you don’t understand a particular concept in Biochemistry or you find it difficult to set an IV line. You’re not alone.
That’s why you have your colleagues and seniors. Most of them are ready to help you because they were likely in your shoes at some point too.
Ask until you understand the what, why and how of your question.
You’re in school to learn and that’s exactly what you should be doing at every opportunity you find.
Ignorance is sometimes pardonable but arrogance is not. Don’t allow your ego to rob you of your dream.
4. ENJOY THE LIFE OUTSIDE THE BOOKS.
My Biochemistry Lecturer quoted this phrase almost after every Friday class. The point is Med school can be all-consuming and is very time-demanding, but it’s still the most flexible period you’ll get, compared to other phases in your medical career i.e. Internship and Residency.
Be careful not to trade what’s IMPORTANT to you, for what is URGENT.
Don’t miss out on ALL other interests because of medical school, you may never have some opportunities again.
The key is BALANCE.
5. RUN IN YOUR OWN LANE.
In med school, you’ll meet some high-flying students. Since it’s typically a gathering of the best among the rest, be careful that you don’t get intimidated by other people’s accomplishments. Whether in the classroom or on the ward, there will likely be students that perform better than you. The key is to focus on your journey and not theirs. You are not sure of their destination.
6. BE PATIENT WITH YOURSELF.
Success is a PERSONAL affair but self-criticism paralyses.
That you’re not seeing results doesn’t mean you’re not putting in efforts, maybe you just need more time than others to get it right. Patience is the key to facing the challenges you will encounter.
One of the factors that motivated me during med school was seeing myself doing things I had challenges with initially. I’ve learnt how to be patient with myself over time as I learn new things.
7. YOU ARE MORE THAN YOUR GRADES.
This is so IMPORTANT. Unless you’ve got the genius gene, chances are you’ll face some discouraging bumps in your grades, despite your best efforts sometimes. Don’t let that stop you from reaching the goal. I had some really depressing scores a couple of times, but I had to keep going by faith.
Failure is just a bend, it is not the end of the road. Keep moving!
One of my favorite mantras was: “WITH GOD, MEDICAL SCHOOL IS DOABLE.”
And Glory to God, I conquered it.
CHAPTER 12: PSYCHIATRY POSTING.
And to the last of my clinical postings, welcome to the Psychiatry department.
A place of several tales, some sad, some strange and others absolutely shocking.
Psychiatry was a bitter-sweet experience for me. It was the one post I excitedly looked forward to, telling all that cared to listen that I knew what I wanted and I was determined to embrace it.
For as long as I can remember, I have been fascinated by mentally-challenged individuals, whether in literature or on the roadside. I often wondered how some people ended up becoming weird, homeless, unkempt or completely dysfunctional. While most people would see such individuals and turn up their nose in disgust, I would often take a second or third look at them, and imagine if they have any family or home to call their own.
Medically speaking, the factors that lead to mental (and specifically Psychiatric) impairment, can be genetic, neurologic, environmental, or a combination of these.
On the other hand, some indigenous folks (at least where I come from), believe that mentally-impaired people might actually be demon-possessed or under spells. Of course, it seems a ridiculous way to think but cultural/religious sentiments have a way of shaping our perspectives.
As a Christian, I believe that demons do exist but I also know that mental health has remarkably improved through medical care over the years.
So all through my medical school journey, I really looked forward to my Psychiatry posting.
I mean I’d liked the idea of Mental Health for years, and Clinical Psychology was one of my favorite subjects during my pre-clinicals. Even before I completed my Secondary School Education, I already had much interest in Psychology. And because I wanted to study Medicine, I decided I was going to become a Psychiatrist. Hence my fate was sealed (or so I thought), until I actually started my Psychiatry rotation.
Despite the pep talks my colleagues who had done the rotation ahead gave to me, I wasn’t prepared for my encounter on that first day…
The Mental Health institution in SVG is situated apart from the General Hospital, and is currently (temporarily) located in an area called Orange Hill, which is along the countryside.
The institution which is more of a community than a facility, gave patients the privilege of roaming the immediate neighborhood with little or no restrictions.
On my first day there, we went in to see the female patients. I was stunned to say the very least. All I saw basically was a sea of faces staring mindlessly about, with some out of touch with reality. How could anyone live this way? I wondered. I left the place all sobered up and emotionally drained.
As the days progressed into weeks, I got to know a number of the patients and their story. We followed up some of them repeatedly in the outpatient clinic and what an experience it was.
The cases we saw ranged from mild/moderate depression to cognitive impairment to acutemanic episodes to chronic schizophrenia to parasuicides, andthe likes. And some of their stories would always remain with me. One of such remarkable cases was that of Ms. X:
Ms. X was a known patient with Bipolar disease who was admitted to the Casualty department during an acute manic episode that was triggered by an emotional experience. I had never seen an adult throw such tantrums before. This patient was hyper, continuously jerked her limbs against the bed restraint and cussed loudly. It was quite a sight. She was later transferred to the Mental institution. Over the next few days, and after a number of medications, the patient significantly returned to baseline.
Despite the emotional circumstances, Psychiatry posting was an adventurous ride for me. I got the opportunity to travel to parts of the island I had never been to. There was a community outreach where we had to visit patients in different villages like Chateurbelair, Rosehall, Troumaca and Spring village. Those areas were on the leeward part of the island.
We also had occasion to hold outpatient clinics in Stubbs and Georgetown which are in the windward side of the island, as well as the Prison.
My Preceptor, Dr. K. Providence, an amazing woman dealt kindly but firmly with all the patients. According to her some of the patients can become very manipulative and threaten the caregiver. The most difficult patients to deal with are usually those with criminal charges. They are prone to take the “victim stance” where they make others think they are being victimized. This was especially common among the prison inmates.
We learnt how to take Patient history, do the mini mental status exam (MMSE), PHQ-9, CAGE questionnaire, BECKS Depression inventory, andother forms of assesment. We were taught to be confident and empathic while handling difficult patients.
My colleagues were fun and supportive. The interns, nurses, social worker, counsellor and clinical psychologist made a good team to deliver care to the patients. This was important because many of the patients we saw had social issues as well e.g. Lack of employment, drug use (Marijuannna especially), alcohol abuse, lack of finances, domestic abuse, homelessness and social stigmatization.
Aside the emotional demands, Psychiatry also gave room for lots of adventure. I saw new places, met new people and learnt new things too. And I took lots of pictures too.
Studying during my Psychiatry posting was perhaps the most interesting. I used Lange Q&A (Psychiatry), PRETEST for Psychiatry, Kaplan step 2 videos and Paul Bolin’s YouTube videos for Psychiatry to study. Any material on Psychiatry with DSM V criteria updates, should serve you well.
And to the big question. Would I be interested in pursuing Psychiatry as a speciality? I like it enough in theory but I’m not sure I can handle the clinical aspect, so I honestly can’t tell yet. So fingers crossed until then…✌✌
Kudos to all the Psychiatrists out there. Thank you for making a remarkable difference in people’s lives.
Thank you for reading,
PS: Here ends the Chronicles Of A Student-Doctor posts. I appreciate all the feedback and support I got. I hope I can share aspects of my post medical school journey with you in subsequent posts.
Welcome to the Obstetrics/Gynecology department, where we cater for women from adolescence to menopause.
The Obstetrics/Gynecology department comprises of two co-dependent units:
1. Obstetrics unit: also called the maternity unit, which is concerned with childbirth and the care of women giving birth.
2. Gynecology unit: which is concerned with functions and diseases affecting the reproductive system of women.
In the hospital where I did my clerkship, the two units were on separate wards. The Obstetrics (labor) ward was divided into three sections:
(Maternity ward entrance, MCMH)
Section 1: For patients in active labor.
Section 2: For immediate postpartum patients.
Section 3: For high-risk patients on observation e.g. Preterm labor, Pregnancies with comorbidities like Hypertension/Diabetes.
There was also a special room for Patients with Preecclampsia (who are high risk patients) and two Delivery rooms.
The Gynecology unit was on the Female Surgical Ward, and we had rounds whenever our patients were admitted there.
Obstetric clinics ran twice weekly (Family planning clinic and Antenatal clinic) while Gynecology clinic was once a week.
We had surgeries on Wednesdays and emergency cases were scheduled as needed.
(At the MCMH Theatre)
Shortly after starting the posting, I had the opportunity to attend the 20th Annual Perinatology conference organized by the Pediatrics/Obstetrics departments of the MCMH, and attended by doctors, medical students, midwives and other stakeholders from the Hospital and Ministry of Health, Wellness and the Environment. They presented and discussed the maternal/neonatal morbidity and mortality over the past year. According to the speakers there was an overall improvement in maternal/neonatal care in the country. The event was both fun and enlightening for me.
(At the conference with two of my colleagues and the medical officer, Dr. Cumberbatch. Photocredit: SVG Health).
(The Senior Register, Dr. Pabilona giving her speech during the conference. Photocredit: SVG Health).
Some of the presentations I saw during my 6-week posting include: Cervical Intraepithelial Neoplasm (CIN)
(CTG procedure: which was typically left to the medical students).
Surgery cases: Bilateral Tubal ligation
Cervical Cerclage (secondary to incompetence)
Dilation and Curettage (D & C)
Ovarian cystectomy & salpingectomy
I came across different kinds of patients too: the nervous, the confident, the cooperative, the indifferent and so on. Generally most of them were easy to relate to.
Then comes the most dramatic part. In my opinion, there’s nothing as fascinating as watching a live birth. The delivery room experience is awesome. Let me try to paint the scenario as I remember it:
A woman in labor is rushed into the delivery room, with the midwives and other birth assistants in attendance. Sometimes a doctor is there to take the delivery as well. And the partner or a family member of the patient is usually allowed to come in.
The midwife-in-charge yells, as others encourage and soothe the woman in labor. The baby’s head would then gradually descend as the midwife helps to manouver it. When the entire body of the baby comes out, usually with a distinct cry, another midwife states the sex of the baby and time of delivery. Then comes the clamping of the umbilicus which is eventually cut off under sterile condition. After a few moments on the mother’s chest amidst tears and smiles), the baby is transferred to the nursery.
Shortly after an oxytocin injection is administered intramuscularly to facilitate uterine contraction and the placenta is delivered. After ensuring that there is no part of the placenta missing, the woman is cleaned up and returned to the ward. Occasionally we’d encounter a difficult delivery that requires a procedure like episiotomy.
This wiki article gives a breakdown of what takes place during the process of delivery.
A major highlight of the posting is that I got to assist the Senior Registrar for two mini-surgical procedures…which is every medical student’s dream! Yaay!! 😀
(At the Operating Theatre, Yours truly).
Then the Preceptor I worked with is one of the most dedicated doctors I’ve met. She’s well respected not just in the Hospital but all over SVG as a country. On my last day in the department while giving her final assessment, she gave me some insight on boosting the self confidence I need further along my medical career.
(Dr. Camille Nicholls. Photocredit: SVG Health)
Recommended study materials:
· KAPLAN step 2 videos
· Blueprints (Obstetrics and Gynecology)
· Case Files (Obstetrics and Gynecology)
· First Aid for the Obstetrics & Gynecology clerkships
* * *
My ObGyn posting was one of my most remarkable clinical rotations. Although it was quite demanding and challenging, but it was quite enlightening too. The midwives, nurses, doctors and other students I worked with were quite dedicated and there was great teamwork. I was able to learn a lot from the rounds, teaching sessions, presentations and procedures. I had to clerk and admit patients, draw their blood samples and so on. Seeing as mothers bonded with their newborns was always heartwarming. It gave me reasons to seriously begin to think about motherhood! I wrote this post just before I finished from the department.
So would I consider a career in this specialty? Hmmmn…maybe not. I personally don’t think I can stand the process of taking a Normal Spontaneous Vaginal Delivery (NSVD) every other day, or being called to the theatre for an emergency Caesarean section or Evacuation of Retained Products of Conception (ERPC).
Shout outs to every Ob/Gyn Doctor out there, thank you for the amazing job you do. 🙌🙌
Thank you for reading!
PS: I have one more post to go for this series. Thanks to everyone that has supported me so far.