The Realities of Medical Training

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“I realized with alarm that I hadn’t learned how to save anyone at all, not Dr. Sanders or Lazarus or Jimmy or Saul or Anna O., and that what I was thrilled about was learning how to save myself.” ~ Samuel Shem, The House of God: The Classic Novel of Life and Death in an American Hospital

As a young girl, when I was asked “what I wanted to be when I grow up”, I usually responded with some combination of a helping profession (i.e. a social worker like my father) and writing (usually a poet). When I was in high school, I am not sure how I responded, but I do know that medicine was not at the tip of my tongue. Given that I didn’t have any physician role models in my life, it likely seemed unattainable and the path too unknown. I knew that I liked sciences and math in high school so I set my university sights on a Bachelor of Science degree and the rest as they say is history.

Dial ahead to present day and our son is now on the precipice of finishing high school and submitting university applications. We fully realize how daunting it is for someone at the young age of 17 to be certain about what career path he wants to take. Colin, my husband, and I have encouraged him to not look to far ahead at the end goal for now, but to follow what interests him for step one as an undergraduate degree. Given his current interests, especially in Biology, he is also setting his sights on a Bachelor of Science degree . Not surprisingly, with two physician parents, the assumption by many is that he will be striving for a career in medicine, however, he also knows about the road that lies ahead because of his two in-house resources. Being a physician is undeniably a noble profession but one with an admittedly arduous path.

Our son’s process got us to thinking about some of the realities that we didn’t appreciate before embarking on a medical career – we were both a little naive. In an attempt to shed some light on these realities, Colin and I would like to share the following points about our medical training journey.

1)  Workload is medical school felt like double to what it was in undergraduate university (which felt like double to what it was in high school) – This may seem obvious and expected, but at times it seemed insurmountable. I quickly realized that better time management was paramount to survival. Fortunately, cramming was never my method for studying – not to mention, it wasn’t feasible to process and retain the amount of information required in medical school. Colin and I graduated in 1998 so I am sure some differences exist today and I would imagine technology has offered some enhancements to learning. Of the medical students I have spoken to about current workload, it remains a challenge.

Learning time management strategies at this stage is key.

2) Prioritizing self-care in medical school is essential – Despite the amount of time spent learning and studying during medical training, your mental and physical health require care and attention too. My stress has always reformulated into anxiety so I knew regular physical activity would remain a priority to manage my stress. This was made easier by the fact Colin also believed this to be true for himself and we were together throughout our medical training. We had to be more creative with fitting it in during clerkship (clinical rotations in medical school) and certainly during residency where long hours including on-call duties are the norm. Our alma matter, the University of Western Ontario (now the Schulich School of Medicine & Dentistry), has got it right with their Vitals initiative promoting wellness during medical training.

Developing self-care habits early on during medical training will lead to a greater likelihood that they will continue throughout your career.

3) Getting into medical school and finishing is only step one toward becoming a practicing physician – Truthfully, neither Colin nor I really knew what residency was when we first entered medical school – now that seems unimagineable to us. By third year of medical school (we had a 4 year program), we had to consider our options for a specialty so we could align our electives to increase our chances of getting into our program of choice. That can be difficult when you haven’t had a broad exposure to all of medical and surgical specialties. By fourth year, you were starting the application process through CaRMS which matches candidates to residency programs. This process required lengthy applications and travel to interviews, while continuing medical school at the same time. The reality, without residency training, you will not work as a physician, so this process albeit challenging, determines your future.

Having a mentor(s) throughout the specialty decision and matching process can really shape your outcome.

4) The biggest exam you will ever write is after your residency – Two other huge exams you have to sit as part of medical licensing in Canada, LMCC Parts 1 and 2, take place during the final year of medical school and first year of residency. However, the most significant exam you’ll ever write takes place at the end of your residency training to either be a qualified specialist (FRCPC or FRCSC) with the Royal College of Physicians & Surgeons of Canada or a qualified family physician (CCFP) with the College of Family Physicians of Canada.

Colin’s certification encompassed 5 years of residency to become a radiologist so this was an exam that he prepared for over the course of a year. We were reminiscing about a 6 week review course he took in Washington, DC where he lived in a place the size of a shoebox (didn’t even have an oven or kitchen sink) and he was fearful given there was a sniper targeting innocent people in the area. My certification encompassed 2 years of training, holding the same gravity in terms of importance for the ability to practice.

Residency training and specialty certification is stressful, but approaching it with perspective and having support makes the process rewarding and manageable.

If either you or someone you know ever have any questions about staying well during medical training, I would love to hear from you!

SaraTMD

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