The echoes of my steps resonated within the expanse of the hospital garage. As I made my way to the end of the aisle to my stall, a couple caught my eye.
A tall man, his hair only beginning to turn grey, faced a woman of similar age, dressed in a beautiful white summer dress. Next to them a car, its trunk agape, half packed with a box of personal belongings and a white plastic bag full of clothes sat waiting. Still, they stood, pausing, ruminating.
They stared longingly into each other’s eyes, a deep seeded pain overwhelming them as tears trickled down their delicate features. A warm embrace as they held each other tightly and wept.
I wondered what terrible tragedy had befell them. Did a loved one’s health take a turn for the worst? Did a loved one just pass away? Did their mother, father, daughter, or son, just perish from this earth? I could not help but wonder.
But it was not my place to ask.
I watched helplessly as they buried their heads in each other’s shoulders and comforted one other.
I continued walking.
For the students who have survived their foray into clerkship, congratulations for making it this far. You are only a year away from finishing your medical schooling. Here are some words of wisdom as you draw closer to the end as an undifferentiated stem cell and down the new path as a resident.
A narrative piece by docedace.
And I wish I could tell you a story about fancy heroics - about an exploratory laparatomy, a chest thoracostomy, or a patient that coded and I was the last person to perform the chest compressions that brought them back to life. But I can’t. But I can tell you that I saved a life.
There was a time when I did not hide behind a veil of anonymity on this blog. It was many years ago now. But since reaching that conclusion, I have always tried to keep my two identities separate. Having said that, how to separate two sides of the same coin?
The majority of my readers have yet to meet me in person but a few have. Some of my initial readers were within my close circle of friends and acquaintances. It would come as a surprise on a few occasions since, that I have met people whom I have been acquainted with that also read this blog. Some of these people discovered it by accident, never fully realizing it was I who penned these posts. Others heard from a friend of a friend, as these things tend to go.
But recently, I met a complete stranger who recognized me at a bus stop. It was a chance encounter, based on the memory of who I was before I became the anonymous Tom of the Medical State of Mind.
"This may seem crazy, but I think I follow your blog."
"I beg your pardon?" I was taken aback.
"Do you keep a blog? I think I might be following it."
"What blog is it that you follow?" I decided I would neither deny or admit to anything.
"The Medical State of Mind."
I paused. The gig as they say, was up. I gave a smile in acknowledgment. It was a strange feeling to be recognized this way in public. I knew nothing about this person yet they knew everything about my medical schooling experience for the last four years. While everything I share publicly online I curate heavily and have no regrets, for a brief moment, I felt naked and exposed.
We spoke a bit about my blog, about school, about where my training would take me before this person thanked me as we boarded our separate buses.
A digital identity in today’s world is an extension of who we are in reality. It is an inseparable presence that we must all be conscientious of. Everything I write is heavily curated, fictionalized, and anonymized to protect those mentioned in the experiences I have had in these last four years. But the one thing I hold constant and true on this blog is myself. It was this honesty that led to this chance encounter with a stranger.
I have always been comfortable with who I am and what I write. However, out of respect to my faculty and my governing college, I have explored a different path to allay their concerns. The encounter left me not with a feeling of anxiety or fear but of relief and acknowledgment. While there are risks with social media in any situation, when used appropriately I am confident it can make a difference, as it seemed to for this individual.
At least one thing is certain though.
We live in a small world.
The crux to any good application is the reference letter. You could have a stellar application but if there is no one to vouch for you, it can be an uphill battle to the specialty you want, especially if it is highly competitive.
Since 2002, the residency application process has been managed through the Canadian Residency Matching Service (CaRMS). Everyone who is a Canadian medical student is automatically enrolled into the service. Others can apply to be apart of the process. For medical students in their final year of training, this is where the magic happens.
One of the first major challenges of applying to residency is making yourself presentable, to tailor your experiences to the career you want to achieve. The last year of school is generally reserved as the time to pursue electives in the various disciplines.
In general, every school has certain requirements that must be achieved, such as having at least one elective in medical, surgical, and primary care specialties. Beyond that however, you have the flexibility to choose whatever you want to do.
At some point in the natural order of things, you begin to realize that the journey to medicine is not as straightforward. There was once upon a time when being a doctor meant knowing everything about everything. In this day and age, that has become an impossibility.
With that in mind, you reach the crossroads for a second time: what should I do with my life?
There are many ways to conceptualize the thinking process but it always boils down to three simple questions you should ask yourself:
For example, someone who enjoys working with his hands, is comfortable not knowing the full picture and likes a wide but shallower pool might be better suited for emergency medicine.
These three questions are fundamental to understanding where your values and interests lie. As your education progresses, take a moment to reflect. You might be surprised how often and how dramatically things change.
The most crucial time to consider these questions is in the clinical year. Consider how your newfound experiences change or reinforce your choices.
This becomes important when choosing your fourth year electives.
Making the Match
Part 1: Knowing Yourself
Part 2: Choosing Electives
Part 3: Understanding CaRMS
Part 4: References
Part 5: Research and preparation
Part 6: Creating a schedule
Part 7: Travel planning
Part 8: Interviewing
Part 9: Ranking
Certain universities publish class lectures as a podcast stream that can be revisited at a later date. For the student who likes to review material or have it explained to them, downloading a podcasting app is a great place to start. In addition to class materials, here is a list of free podcasts that I have listened to over the years to get you started:
What do you listen to?