Thursday, March 22, 2012

If I knew then what I know now...

I'm no longer a freshman med student. I like to think that it shows, and that I carry myself with at least some of the confidence and ability that I wish I actually had(!), but a lot of the time I get the feeling that I just look a bit of a twat. Of course, this is low self-confidence speaking (I hope), but last year it wasn't just that.

A lot of us apply for med school expecting it to just be a means to an end - four or five years med school = doctor, and then life is easy. We all say that we want to help and cure people, but it is easy to overlook and underestimate the key word there - people. I know that, certainly in my case, I knew that being a doctor would mean talking to patients every day and their relatives, and dealing with difficult and unexpected situations. However, I failed to anticipate just how difficult this might be.

Let's go back to a patient consultation from my first year. I was sat with another medical student and a patient. I introduced the two of us and then proceeded to ask questions. Rather, I proceeded to ask a question. The patient answered the opening question, and I allowed the golden minute we are taught is so crucial to starting a consultation. The golden minute became the golden two minutes, and would have very easily become a golden three minutes had I not been with another med student, who, after this, very promptly took the reins and continued the consultation to its conclusion.

Actually, this isn't a specific consultation. In fact, it is the very large majority of my first-year patient contact experiences. Of course, I could talk to people, otherwise I would not have got past my interview stage, but clearly I had a problem with continuing what should have been an easy conversation. In addition to this, I would be fidgeting, moving about constantly, staring wherever there was not a pair of eyes, and basically making the patient feel as uncomfortable as I looked.

I think this is probably one of the biggest problems that a med student with an autistic spectrum disorder might face, and it is one that I still struggle with occasionally, but in my years of study, I have come to realise that it isn't as bad as it might seem at first glance. I have also come to realise that good communication is very important when dealing with patients, and I am trying so very hard to become a better communicator. I have the odd moment, and I won't pretend it isn't difficult, but it is clearly a very important aspect of being a doctor.

As I said, I knew before applying for med school that it would involve a lot of patient contact. Naively, I thought I would be fine with it all. When it came to it, I wasn't. But if I knew then what I know now, would I have still applied? Definitely. Being forced to be a better communicator is good not only in a clinical setting, but in every day life. How I am getting over the difficulties of talking to patients is something I will probably talk about more in a later post, and I still get stressed over the prospect of having to talk to a patient, but, while in my first year I was cringing with embarrassment after consultations, I now come out of more and more with a good feeling and an overwhelming sense of pride that I did something good.

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