Posts tagged fourth year

A Word with Fourth Year

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.

  1. Stay healthy. Surely by now you will have managed to find a daily routine that allows you to work hard but also enjoy time away from medicine. However, third year is also a time when one can pick up bad habits. Plan ahead, and take this opportunity before residency begins to really iron out the sore spots in your life.
  2. Explore your interests. Fourth year is really about finding your career interest and honing in on that goal. This is where you can start to expand on your career choice and take electives that give you inspiration, skills, or both. 
  3. Prepare early. Residency applications are meaty things and the deadlines come sooner than you think. Research the programs early, write cover letters early, and think about planning your electives early and in line with the residency matching schedule. 
  4. Have a backer. In third year, I mentioned that making a good impression was important. That trend continues on in the fourth year electives as well. The good will and social capital you accumulate with your attendings are what will fuel good reference letters. For a competitive program, these letters, particularly if they are from respected members of the faculty, can make or break an application.
  5. Study and keep studying. Elective choices can change the entire atmosphere of fourth year. While flexibility is welcome, it is never a license to take the easy road. Still take some time to read and study. At the end of it all, regardless of what program you match to, the licensing exam tests you on all facets of medicine.
  6. Big brother, big sister. When you began third year, you were the fresh face on the ward. There was some stuff you knew back then but a tonne more you had no idea about. Remember how stressful and terrifying it was once.
    Now that you are a fourth year, do not forget how that felt. When you meet a third year student on your team, help them along, guide them, impart your experience to them. Remember the kindness of your senior students and residents and pay it forward.
  7. Have fun. Medical school goes by very quickly. As a student, there is a flexibility and freedom that you will simply never come across again. Enjoy your rotations with your peers. Make the most of your electives. Take the residency interview tour as a nation-trotting adventure. Never forget to have fun on this job.

Related posts: A Word with First Year. A Word with Second Year. A Word with Third Year.

MD: A Degree in Review

It still shocks me that I am only a few days away from beginning my residency. Four years have come and gone. I now have a degree and letters behind my name to show for it. This last year has presented with its own unique challenges and a lot has changed in four years. Let’s have a look back.

Year One

It was here that I first learned how to correctly use my stethoscope, how to speak with patients, and how to act like a doctor. These were my baby steps. I studied a whole host of topics, covering the broadest and biggest organ systems. It was also here that I learned anatomy and had the privilege to work with cadavers. 

Year Two

In many respects this was the most stressful year. While clinical work is taxing in its own right, nothing came close to the mental toll this year had on me. Studying was both a necessity and a compulsion. Easily I spent entire days sitting a library, reading, memorizing, understanding. I had never studied that much in my entire life.

Year Three

This time, the stresses of clinical work were balanced between the mental and the physical. By far the most challenging year of all but also the most enjoyable. Having sat in class for the better part of my life, now I would have to do.

It was an adjustment to work in a hospital, to see volumes of patients, to do call shifts. But I adjusted and grew used to the pace of the ward. Gradually, I learned to move from knowing how, to showing how, to doing.

Year Four

On top of the clinical work, I had a number of additional challenges this year. I had an all encompassing OSCE, residency applications and touring, and a licensing exam to complete. By this point, clinical rotations were not quite as overwhelming or scary as they used to be, but I still had many hard days.

The brunt of the stress this year came from the latter additions. Those three things were for all the marbles, and the consequences of missing any one of those were a constant worry. The OSCE wound up showing some of my weaknesses that I would need to improve on. The CaRMS tour would take me across the country from colder to coldest winters in Canada. The licensing exam ended up being a two-week mad dash to the finish line. For six months, the pressures mounted through these three main events.

But I eventually reached the end of my four year journey. I graduated, I was admitted to a residency program, and I passed my exam. 

It has been a roller coaster ride through four years of medical school. I am happy I could document it all here in these posts. Now I start a different journey through residency and look forward to reflecting more on this new adventure.

Medically-Themed.
A medical graduation would not be complete without some obligatory medically themed treats for graduates, families, and friends. Here are some of the cupcakes that were available to us today.

Medically-Themed.

A medical graduation would not be complete without some obligatory medically themed treats for graduates, families, and friends. Here are some of the cupcakes that were available to us today.

Graduation: Part Three

For the third and last time, we walked across the stage to receive our medical diplomas from the dean of medicine, conferred to us by the president of the university. Convocation was the final chapter of our graduation. 

Finally after eight years of university schooling, I was an alumni. It took tremendous amount of academic fortitude to reach this point. But it also would not have been possible without the support and understanding of my family and friends. These are the unsung heroes, the honorary MDs who were there when I took my first blood pressure reading, who volunteered for my abdominal exam, who learned and taught me about being a patient and being a physician. 

Graduation: Part Two

The graduation festivities continued today with valediction speeches and some key words of wisdom from classmates and physicians respectively. Instead of donning the white coat today, I received my graduation gown for the hooding process. This is the act of conferring an academic hood to signify the completion of my degree in medicine. In addition, we all swore our Hippocratic oath for the first time while preceptors and physicians present for the event reaffirmed theirs.

To Hang Up One’s Shingle.
In the early half of the nineteenth century, this colloquialism came into use. When a new establishment was constructed, an extra roofing shingle would be used to create the signage. Initially, the term was associated with lawyers opening up a new firm before also being applied to doctors, then any professional starting up.
As newly minted physicians, we were offered a ceremonial shingle. Generously gifted to us on behalf of the alumni community, it is a welcome gesture into the medical profession as their new colleagues.

To Hang Up One’s Shingle.

In the early half of the nineteenth century, this colloquialism came into use. When a new establishment was constructed, an extra roofing shingle would be used to create the signage. Initially, the term was associated with lawyers opening up a new firm before also being applied to doctors, then any professional starting up.

As newly minted physicians, we were offered a ceremonial shingle. Generously gifted to us on behalf of the alumni community, it is a welcome gesture into the medical profession as their new colleagues.

Graduation: Part One

"Nelson Mandela once said: ‘It always seems impossible until it is done.’"

That was how our graduation ceremony began. We were ushered into a hall where our friends and family were gathered; some of our preceptors were also able to take the day off to watch us make the transition into residents. It would be the first of three parts to my graduation.

A number of speeches were planned for the event. Some recounted the establishment of the school, its goals and its aspirations; others offered words of wisdom, advice from one generation of doctors to the next; each had a special place in the ceremony.

The main event for the day however was the donning of our white coats. Gone are the days of short white coats that separated us from our attendings. As the roll call came out, establishing where we had matched to for residency, we each received a long white coat, embroidered with the coveted title we had worked four years to achieve:

Doctor.

The Exam Is Over

Sir Winston Churchill once said: "If you are going through hell, keep going."

Today, I finished writing the MCCQE part one, a seven-and-a-half hour endurance test that could procedurally scale its own difficulty as I wrote it. Just when I thought I had a good handle on the material, the questions of the next section would get harder. The more worrisome trend was when the questions seemed to get easier: did I make a lot of mistakes?

It was an exam that prevented me from resting on your laurels, generating questions that were matched to my very own ability to answer. And yes, this did happen on multiple occasions.

But no more.

While I still need to wait for the results of the exam (and I hope I passed), I have slogged through hell and survived. 

Now, the real celebrations can begin.

Turning Twenty Six.
Celebrations included a hearty breakfast, a fancy dinner, and a day’s worth of group studying for the MCCQE. Hopefully next year there will not be higher priorities that need to be addressed. 
Thanks to everyone who has sent their well wishes today. Stay awesome, folks.

Turning Twenty Six.

Celebrations included a hearty breakfast, a fancy dinner, and a day’s worth of group studying for the MCCQE. Hopefully next year there will not be higher priorities that need to be addressed. 

Thanks to everyone who has sent their well wishes today. Stay awesome, folks.

Study Week

I expect I will not be posting very much over the course of the coming week as the MCCQE part 1 is fast approaching. I thank you all for your patience and understanding.

I hope to see you all on the other side.

Sincerely,
Tom of the Medical State of Mind