After a few requests, I return to blogging again with apologies for my recent absence! I really wanted to write a recap of third year - this transformational year in the life of a doctor - but I kept putting it off while studying for Step 2 and thus missed my window... but now I bring to you my thoughts about fourth year of medical school after approximately 2.5 "sub-internships."
1. Fourth year is great! As I've been told all along, fourth year is the light at the end of med school tunnel vision.
One thing that makes fourth year great is the vacation time. I actually took my first month off to take the USMLE Step 2, which is the second round of sitting in front of a computer for 8 hours straight. This time, I did not even come close to having a panic attack (which is probably my biggest accomplishment so far this year) and happily, I did way better this time around. I think that is a combination of the test being more focused on clinical knowledge than basic science, which is much easier for me to study, and simply having a calmer attitude about the whole thing. Despite the fact that my Step 2 score actually matters as much if not more than my Step 1 score, there was so much pressure surrounding Step 1 that I think my score primarily reflected that stress. Anyway, moving on - vacation! After taking Step 2, I had the amazing opportunity to go to London, Cinque Terre (in Italy), Nice and Paris with my family. When lying on the beach in Nice speaking French with my former host mom, I truly wondered why in the world I had chosen to go to medical school! But in the end, it was a great time to spend with my family and a refreshing reminder that the world is much bigger than the 10 minute walk between my apartment and the hospital! I am going to have a lot more time off this year to spend with my family and friends, and I will also be going to Ethiopia and traveling around Eastern Europe in January and February! This year is going to be great.
Another - much more medically relevant - aspect of fourth year that is awesome is my role in the hospital. I have truly loved my sub-internships (or "sub-Is" as we call them) this year. A sub-I is a month long rotation in the specialty you are going into where you are supposed to act as the intern, aka the first year resident. They serve two main purposes - to prepare you for intern year and to impress the people in your specialty in order to get letters of recommendation. I have loved my sub-Is because I'm finally getting to do what I love - OB/GYN - and I'm actually decently good at it. Gone are the days of feeling completely lost and worrying more about where the stapler is than how your patient is doing. Now I can actually give confident advice to patients about their problems and even give preliminary diagnoses without running it by the attending first. I'm trusted to do more procedures and have more responsibility. I also have more time to connect with patients. Although there is still so much more for me to learn and so many skills for me to perfect, I feel like I actually know how to be someone's doctor. :) It's an amazing feeling. It confirms my hope that I will truly love my job and look forward to going in to work every day for the rest of my life.
2. Fourth year can be kind of frustrating. It is mainly the sort of legal/logistical aspect of it, but essentially, I am no different than I will be at the time (almost exactly 8 months from now) when I will graduate and have an MD behind my name. Unfortunately, I will not be any smarter or much more knowledgeable than I am now. Especially during my inpatient rotation on Labor and Delivery, it was frustrating how I couldn't help more simply because I'm not legally allowed - for instance, I can't sign prescriptions, put in official orders, or write certain notes. In some ways, I'm happy I don't have those responsibilities. I'm glad I did have this time to learn more because that will help me be a better intern eventually. And it's nice to avoid any flack when something goes wrong... :) But it also kind of feels like I can't really learn until I'm fully responsible for something. Which leads me into my next point...
3. Fourth year makes me afraid for intern year.
I think I've gotten a pretty good picture of what it will be like to be an intern, both from doing my labor sub-I and from hanging out with the interns, and it scares the heck out of me. Intern year is this perfect storm of an enormous increase in responsibility, consistent sleep depravation for month after month, and having to adjust to a new city and make new friends. All while working 80+ hours/week. And wanting to be perfect at everything I do right away. And at work I will suddenly be responsible for everything that I was just whining I can't do now - without any more know-how than I currently have. It's truly birth by fire. In many ways I think intern year will be amazing. I'll go from having delivered 8 babies to delivering hundreds. I will finally have the privilege of being the primary surgeon on a case. I will learn an amazing amount about patient management. But these past few months are the first time I really contemplated what interns lives are like and it is truly a fearsome thought.
4. Fourth year is full of fear of the unknown. In addition to fear of the known (I know I will be doing intern year somewhere next year and it will be difficult) fourth year is also a year of unknowns and possibilities.
Tomorrow is the first day I can turn in my residency application. While I am looking forward to flying all over the country and experiencing what different programs are like, this senior year is just like the other two in that I have no idea where this year will take me. Either it hasn't really hit me yet or I have been talking about the Match for so long that the idea doesn't seem crazy to me anymore, but on May 20th I will open a letter in front of an auditorium full of my classmates and find out where I will spend the next four years of my life. At this point, I feel very peaceful about all this and believe that I will end up where God wants me. I think I will be happy with whatever program I match at. I have a feeling, though, that the anxiety and fear will increase as I go along this process, so that's why I included this last point. Also because I like the symmetry of having four points for fourth year.
Sorry again for my relative absence (especially following such a morbid post last time) but hopefully I will be able to keep up a lot better now!
