Dear upcoming third year student who must be so incredibly thrilled to be done with the Kreb Cycle,
Welcome to the year of being ‘The Wallflower’! Now bear with me before turning the page and shaking your head in disbelief. Dictionaries define ‘wallflower’ as someone who is shy and thus blends into the sidelines. I think the word, if you take out shy, defines third year in a nutshell. You’re about to embark on a year of switching rotations. A journey of constantly feeling uneasy and then comfortable only to have to fall back into that uneasy emotion in a matter of days or weeks. You’re going to pass through every emotion in the book. The bad ones (nervousness, awkwardness, discomfort, confusion, pity, anger, fatigue, sadness, apathy, helplessness, jadedness), but I promise, also the good ones (pride, awe, wonder, curious, comfortable, confident, decisive, empathy, sympathy, appreciative, contemplative, joy, happiness)!
Now you must be thinking, ‘What a depressing letter to read’, but I urge you to forge ahead. Third year means you’re the least experienced of the medical team. You’re going to have plenty of moments where you don’t feel like you’re helping or that you’re actually more of a burden. Residents and attendings will discuss plans at rapid fire, and you’ll feel lost to the terminology, trying desperately to figure out when is the right time to ask a question or rapidly browsing through UpToDate to figure out what exactly is happening with a patient. As the patient workload increases, you’ll start to feel like someone just merging with the sidelines. A wallflower.
I write this letter to remind you all that when you’re starting to feel like that, please remember that this is not a bad thing. Your duty as the third year medical student is to not come up with drug dosages or perfect solutions to a patient’s decompensating heart failure or treatment of ovarian cancer. You are there to learn. To be constantly curious. To observe. As the wallflower, you get a special advantage over residents and attendings. You have more time with patients and more time with your thoughts. So use that time wisely, open your eyes and ears, reflect, and truly take in your surroundings.
On emergency medicine, understand how swiftly death and disability can fall upon humans and build compassion for those patients lost in the frenzied haze of white walls and numerous diagnostic tests. On neurology, appreciate how intricate the human brain is but also understand that complex neuro terms fall on deaf ears of patients. On surgery, acknowledge every kind of fear people have going under the knife and be in awe of how intricate the human body is. On medicine, think beyond the heart failure and cirrhosis to what living and social situations your patients will encounter post-hospital. On pediatrics, embrace your inner child, revel in the innocence of babies, and step into the shoes of a worried mother or father. On family medicine, truly wonder why a patient is not progressing in care – transportation, culture, unsafe neighborhoods. On OB/GYN, be awed by the miracle of childbirth and learn to be gentle with sensitive matters of unwanted pregnancies, miscarriages, and vaginal bleeding. On psychiatry, draw up your empathy and do not let their illnesses define who they are.
Appreciate the residents and the attendings. Be in awe of how they juggle their patients and their home lives. Thank those who take time out of their busy hands to teach you. Be grateful to the nurses, PAs, NPs, techs, and support staff who guide you in the right direction. Welcome the caffeine and infrequent extra sleep hours. Hold the patients’ hands that want to be held. Offer a tissue to those who are crying and return the hugs rarely given by patients. Smile. Make eye contact. Communicate. Listen.
This year will be the game changer in your medical career. You’re going to learn what specialty is right for you, and you’re going to learn so much about medicine and human nature in general. Just remember to take with you the lessons you’ve gathered and observed and let it guide your future practice.
‘The best way to find yourself is to lose yourself in the service of others’ – Mahatma Gandhi
Enjoy third year!!!
(I write this as I come to the end of my fourth year of medical school as a piece for the upcoming third year students at my med school as well as a reflection on what MS3 was like)