The third year of medical school has long been a pivotal point in training. Recently, however, the tradition of monthlong "rotations" -- a speed-dating introduction to the major disciplines of medicine and the issues patients face -- has come under fire.
A year ahead in medical school, my friend had been a constant source of support and inspiration, offering study tips for courses and warnings about professors and, when he had neither, hilarious spot-on imitations of classmates and teachers. Patients he was beginning to see in his introductory course on the physical exam seemed to adore him, too; a few even wanted to set him up with their daughters.
“When we’re done with medical school and residency,” he always said, “we’ll be the doctors we’ve always dreamed of being.”
He stopped saying that during his third year of medical school.
One evening that year, I ran into him in the hospital cafeteria. The third-year schedule of rotating every few weeks among teams of doctors, trainees and real patients had left him gaunt. He showed me a stack of index cards, one for each patient he had been assigned in the last week.
“I got an ‘appy,’ a gallbladder and a breast biopsy,” he said, referring to patients with appendicitis, a gallbladder infection and breast cancer. He pulled out one card highlighted in yellow and smiled. “I also got a Whipple,” he said, referring to a patient with pancreatic cancer who needed that potentially complicated surgery.
“That,” he continued without flinching, “was awesome.”
My friend wasn’t the same. The patients had been reduced to their diseases.Read more...