Expectations before joining a medical school and the reality after that

Expectations before joining a medical school and the reality after that
By Dr. Yohannes Mengistu

(Editor’s Note: Yohannes is a sixth year physician in training in Bahir Dar, Ethiopia. Please note that PGY1 or intern year in the U.S. is the fifth year of medical school in Ethiopia. American medical students will identify with much in this piece, as many things about medical school are clearly universal. Yohannes draws to relax and we’ve included some of his drawings in this blog post, including this exquisite representation of Hippocrates.)

When medical students were in lower grades, we all have been asked about what we need to be in the future. And probably more than half of us answered that we need to be a doctor, and others perhaps an engineer or a pilot. That didn’t come out from nowhere but it shows that the respect, attitude, appreciation and expectations the society have towards the medical profession is significantly high, which stayed painted in our little active minds since then and through time.

The impulse to become a physician, starting from observing a family member or a close relative cured or improved from a clinical condition after seeing a doctor and to the point of seeing the society’s assumption of a doctor as a full-blown professional with much respect has laid the base for student’s positive image on learning medicine. Then, who wouldn’t want to be a doctor? Who wouldn’t expect a lot from medical school? The expectations students have for medical school, even if not necessarily the same, largely shares a common understanding which is not completely, but to a high extent different from the reality.

In preparing this article I interviewed around ten intern doctors, friends of mine, actually, about  their expectations for medical school, how they joined this profession and the reality they faced, in order to show the real life experience of doctors. Here are their direct words briefly.

• “Expectations for medical school and the reality means just like dating a lady on Facebook with beautiful profile picture….” 

• “I already expected a difficult course, but it is much more difficult once I got immersed in.” 

• “I expected a beautiful working environment, good payment, better life style and even better eating habit, and harmonious relation with senior doctors, but it is completely different. You may not even get time to brush your teeth, wash your own cloths. You literally live for your patients and about the relation with senior doctors…. leave it. (laughing)” 

• “My expectations were not much since I knew friends of mine who learn medicine. But who said medicine is difficult!!! It is easy but just boring and depressing to the point of descending oneself in despair.” 

• “I am in for the sake of my mother and I wasn’t expecting much, and fortunately I found it so interesting and the working environment is full of opportunities for the betterment of oneself, plus helping others gives you the utmost inner happiness.” 

• “I didn’t expect anything extraordinary because I chose to learn medicine just because I thought I was capable of doing it. And thanks to God, I am successful now. By the way medicine has no difference with other departments for me because we would have said everything is difficult if we were in another department before facing medicine. Everything is relative and life isn’t easy for anyone.” 

• “Well, I thought I was going to be a doctor by just simply getting into medical school (laughing) but it is clear we need to suffer. A suffering disproportional to our age, payment, status and on top of that our GRADE (evaluation). Still I am thankful for getting this chance to see all these challenges of life and become stronger. Strong enough disproportional to my age, payment, or my status.” 

• “My expectation for medical school was, I think, awesome, because I see doctors treat their patients with hospitality, their interaction is very caring, they are listeners and ethical, but don’t expect to see that as a medical student. Sometimes it is humiliating when a senior doctor disrespect and yell at us. I know it is to make us stronger, competitor, challenging and helpful to our patients. But you need to face that!” 

• “The view I had for medical school, as I am one of the members of the community, it is the same, MUCH respect and expecting more from doctors. So I wanted to be one. But the reality I faced didn’t meet the expectation I had for medical school, but my expectation of myself. It makes me stronger, my communication skill increased and everything, even if the time to fill my pockets and help my family is longer than I thought.” 

The experience shared by all these intern doctors might not be the same, but one can easily see their common and usually unsaid thoughts about their career (including mine). Our expectations about medical school was shaped by the point of view of mainly society and the high school community towards the profession, even if our personal interest and motivation played an undue role. For example, many people used to advise me to join the engineering department because of my talent in drawing, in addition knowing that only few selected bright young and high scorers join medical school.

Therefore, personal interest has undeniably played the greatest role. Then, the reality we face after joining medical school is somewhat different from our expectations in that we are experiencing the real life situation here, the hardship, the hard work, struggle, challenges, the ups and downs to the point of saying “I didn’t know it was this hard, and I wish I had known earlier.” But, despite saying that when asked, we took the chance of discovering our untouched strength in our way through the tight learning system. Who would get this chance? We haven’t witnessed any successful and noble figures in history attain their achievements without going through challenges just like a medical student undergoes.

The competitive nature of the learning environment, the frequent exams and tests, and, lastly, seeing the suffering of human beings in the hospital each day may have a negative impact on our thoughts and increase the risk of having mental problem, adding on the risk for drug addictions. But our job is not to stand and join the sorrow and the pain of our patients, but to use our brain and help them. Being there for a suffering patient, helping him or her fight the illness and trying our best to help them be healthy and competent citizens is the most rewarding and promising part of our life, giving us inner peace. Who would get this chance? It is not easy to carry the responsibility and be the one between death and our patients. This gives us two images on the profession – good and bad. We all need to face that before totally being called a doctor, which was the dream many of us had since childhood.

Considering the life outside the learning and working environment, we, medical students, stay longer in university than others, which increases the bond between classmates, dorm mates and the hospital staff in team work, developing strong relationships, while also having fun. One student said: “You will never be alone here.” And the place we have, the respect and the motivation we get from our family as well as the society, is the most important thing. Whenever we felt desperate, helpless, or fail on exams, we may not bear the situation well, but ultimately we get support from our family, who are there for us whatever happens, building our morale, motivating and advising us from an adult point of view on the struggle they had and becoming a role model for us. We think we are the only ones to understand the discrepancy between our expectations for the profession and the reality we face. No! Our parents and other family members can feel and read the tiredness and the struggle we have, from our faces or by only hearing our voice through a phone call. Standing by our side, they pay a considerable amount of sacrifice as well.

Lastly, the expectations we had for medical school and to become a doctor may or may not match the reality we face, but one way or another, the road for attaining our goal is facing the reality, no matter what.

 

Dr. Yohannes Mengistu. He is currently serving his intern year at the Bahir Dar University College of Medicine and Health Science in northwestern Ethiopia, after which he will begin residency. He has worked on the Standing Committee of Professional Exchange and serves as Vice President for External Affairs for the Ethiopian Medical Students Association-Bahir Dar, a branch of the International Federation of Medical Students Association (IFMSA). You can contact him at [email protected].