Med student plague

I need more discipline. I don’t have the structure in my daily life that I think a medical student needs. And before anyone starts to think that I’m being hard on myself, about how all med students think they’re inadequate but they’re just being anal–trust me, you don’t understand. I am doing very, very little in the way of being a med student as soon as I get home from work. At work, I scrape by, and I do care about my patients. I care about results, and seeing them improve, and I care about getting at least some questions right on rounds. But all the promises I make to myself to study the things I don’t know during the day, completely fall through as soon as I’m out the hospital door.

I know there is so much lacking in my knowledge and I need to fill in the gaps–and I’m just not. It’s not good medicine, it’s not good patient care. And I can’t narrow it down to whether it’s terrible of me to take this degree for granted, or whether it’s somewhat acceptable given that I know the two specialties I’m looking at (psychiatry and family medicine) are non-acute, non-stressful, non-urgent settings where it’s okay if I don’t know answers right away, and that I’ll have plenty of time to look things up and still be a good doctor, and–in psychiatry at least–the scope will be narrow enough that I won’t have to deal with every kind of serious medical condition under the sun.

But I guess what I’m most worried about is why I feel even remotely okay with this overall lack of motivation. I’m in a highly coveted spot, and I’ve already fought my way through two years of this program, and I still have friends (medicine hopefuls) reminding me how lucky I am to be here and how instantly they’d switch spots with me. So why is it that even when I know I need to brush up on a topic, I don’t feel compelled to urgently fill in that gap? Is it still not sinking in for me that in two years I’ll be actually responsible for people’s management, with no one around to cosign my orders? Is it burnout already, barely 3 months in? Or is it something as simple as, the topic doesn’t interest me unless it has a direct application to a patient I’m in charge of at the moment? I’ve been telling myself through preclinical years that it’s okay if the information didn’t stick with me at that time, because I’m the type of learner who will memorise a disease once I see it in a live human. That’s been the case with most of my patients so far–I’ve become an expert on AIDS-related illness, PEG tubes, anemia, simply because they affected my direct patients’ quality of life–but that’s still no excuse. It’s nice to have a clinical picture to a textbook disorder, but it can’t be the case every time, and I should come to terms with the fact that I should still be able to recognise a rabies infection, even though I’ll likely never, ever see it.

It’s one of those times of nagging self-doubt; not crippling, not affecting my day-to-day work, but just enough to make me question why I’m so amotivated, and more concerningly, why I’m able to justify it. But hey, with my internal OSCE and final approaching in the weeks ahead, I’m sure if nothing else, the fear of failing those will light a fire under my butt to get some good studying in.

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