Editor’s note: We are proud to publish “On Being a Medical Student,” in-Training’s 1000th article — written by one of our editors and writers, Brent Schnipke. We would like to thank all of our contributors, staff and most importantly, you, our readers, for making in-Training so successful.
Earlier in the summer, I was speaking with a friend from medical school while we were studying for Step 1, the big test taken by medical students at the end of second year, and he remarked, “There’s really nothing quite like this. We probably don’t even realize how strange it is since we’re so ingrained in it.” He was right: the demands of medical school often make it an all-encompassing undertaking, one that can be difficult to explain to those outside it. We try to explain anyway because it’s all we have; that’s why so many of us have chosen to contribute our stories to the in-Training community and others. What follows is my attempt at one such reflection.
Being a medical student is complex because of many conflicting tensions. One example of this tension relates to the label of “medical student.” We are never far from the temptation to let this label define us. Much of this can be attributed to the nature of medical education: immersive, time-consuming and, at times, academically and emotionally difficult. Consequently, our friends, family and significant others come to accept a norm that we are always busy. This can be complicated by the fact that many of us often like the way that this defines us: we sometimes like being the crazy people who stay up all night to study, joking about our coffee addictions and bragging about how little sleep we get.
However, the tension arises because we just as often don’t like what we are doing. We often are too busy and it is sometimes really difficult because we can’t attend social events and family gatherings. We really do study, quite a bit. Each new challenge is a reminder to be humble; there will always be more for us to learn. We may not always enjoy studying, running to the hospital at strange hours and more, but we justify it by reminding ourselves that we are in one of the most prestigious degree programs in the world, and so we take pride in our profession.
However, I want to get at a more significant tension. Almost daily, we live in between “not yet” and “here we are, right now.” The tendency for most people — including doctors themselves — is to view medical school as a stepping-stone, a rite of passage, an in-between time. I feel this myself; I often think of what I am doing only as the necessary steps to reach a goal. It is often just the means to an end. Speaking with residents and doctors, I find the belief is even more pronounced; many doctors will give barely a nod to the existence of medical school in their own past:
“Oh yeah, biochem and all that. I hated that stuff!”
“You’ll learn it the right way as a resident anyway.”
“Just gotta study and make it through!”
“Second year is the worst. After that, you start learning important things.”
The implication is that medical school in and of itself is unimportant — a required step, of course, but not as important as the things that will come later. Thus, we all rationalize our way through it. How else can we make sense of the gratuitous amount of debt, the years of life invested and the massive delayed gratification?
However, while I am often guilty of it myself, I take issue with this mindset. I don’t want to be an “in-between”; I don’t want to see my education as a purely utilitarian object. I don’t want these years of my life to be only a means to an end. The truth is, I am here right now: I am a thinking, living, breathing human, and my experience matters right now. My value isn’t based in the fact that I will eventually be a doctor, that I will eventually make a big salary or that I will eventually know enough medicine to really help people. I have value because I am a person. That fact didn’t change when I got accepted into medical school; it won’t change if and when I finish medical school, either.
Basing our worth on our future is dangerous for two reasons. I’ve already mentioned the first: this mindset is close to dehumanizing medical students, the person who is here now. The second is the fact that none of us are guaranteed tomorrow. While it is tempting to believe our lives will have meaning in the future because of something we have earned, we can’t depend on that. I was reminded of this while reading When Breath Becomes Air, the incredible memoir of Dr. Paul Kalanithi. He reminded me, in the most emotional and eloquent way imaginable, that life is beautiful and must be appreciated while we have it. Any one of us might reach the end of our training and find that we are unable to practice for one reason or another. This is a sobering truth, and while it is just as valid about other professions as it is for medical students, it is especially true for us because of the significant length and rigors of our medical education and training.
So, how do we fight against this mindset? How do we resist the temptation to see our education as a necessary evil, and instead choose to see each day as the joy and blessing it is? I submit that there are many ways. We can, sometimes, take off the white coat and be with people not involved in medicine. We can protect time to spend with spouses, significant others, family and friends. We can take time for ourselves to rest, exercise, travel, read and employ other forms of self-care. We can resist the urge to make our only label “medical student.”
And of course, we can write about our experiences. Communities like in-Training exist because medical students do have things to say. We write to process the things we see each day. We write to help other medical students know they are not alone. We write because we have stories to tell; stories that matter right now, because we matter right now. We write to remind each other and the world that we are more than just doctors-in-training: we are people with meaningful stories that just might be worth sharing.