It's all fine and dandy...

When I interviewed for medical school, my second interviewer gave me one of the questions I thought was the best of my interview trail. He asked, "if you were stricken with a terrible illness during your time here, would you continue with your medical education?" Ignore for a second my current situation; I thought this was a particularly good question because it obviously highlighted the students committment to medicine and their resolve to complete the degree irrespective of the challenges they might face. I answered "absolutely," with no qualifiers, and he thought that was an excellent answer. Clearly, I got into the school!

However, it's never quite so simple. Medical school isn't just about passing, failing, and earning a degree. You work with real people, real patients, patients you can hurt. This is a conundrum that medical education faces constantly. We can talk about how many safeguards there are when medical students are doing the operating, but do you really think if the chief of surgery's own kid is splayed out on the table a medical student is going to make the incision? There is an inherent risk to having medical students at all in an operating room, learning any procedure, or participating in a clinic. But we accept that risk (knowingly or unknowingly) because it's necessary for future generations to have doctors at all.

This is all fine and dandy and is the subject of chapters if not whole books on medical education. However, the whole idea presumes that medical students are continually getting better and more adept at their chosen profession. What do we do then, if a medical student isn't getting better? What if the illness my interviewer talked about affected my abilities to do manual tasks, to understand instructions, to learn? How will I know when it does?

My fear is, whether I'm just biding my time until that happens with none of the benefit for patients. While I don't believe I have the problems above, I am well aware that they could pop up very suddenly and at any time. What I'm not willing to do is put patients at unnecessary risk. What is their benefit from me being in the clinic or the operating room? If I make a tragic mistake, where is the benefit I could point to that says, "I needed to be there?"

My point is, as I walk into the wards a year from now with as little responsibility as I will have, I still can cause a "screw up." I know every medical student can, and likely will, cause a "screw up." But if I allow that to happen just because I'm too proud to give up my education for a brain tumor, how is that okay? The current answer is that I'm not just being babysat. I'm like every other medical student going on to become a doctor. That's the thought that keeps me here now.

Either way, maybe some qualifiers would have been wise on my interview three years ago. Or at least I could have thought about how unbelievably hard that question has proven to be.

Mike