Medicine attracts intelligent, caring and driven people. There’s the thrill of diagnosis, and the reward of successfully treating identified illnesses. Naturally, alongside that personal reward comes responsibility and – especially in the eyes of recovered patients – respect.
Being a doctor myself, I’d say we’re entitled to some pride in our achievements. You need high academic performance to get into medical school – that doesn’t happen if you don’t work at it. Throughout university education, you’re caught between internalising information, trying to have a life, and working out exactly what you want to do when you graduate. It isn’t easy. There are so many hurdles to trip over that making it through to the status of junior doctor (and beyond) is no small achievement.
So feel free to let your head swell a bit. Not many can achieve what you have. And what helped you earn your doctorate were the skills that were taught to you implicitly and explicitly through years of education. Things like:
- Listening to lecturers and more experienced medical professionals
- Reading medical journals and textbooks
- Memorising facts
- Self reflection
- Recalling the right information when needed
- Physical precision
- Dedication to your calling
- Neglecting other areas of your life
- Study-cramming until late at night
- Pushing the limits of caffeine consumption
These are some of the skills you need to succeed in medical school – and like any skill, use them often enough and they’ll become part of your personality. Your default setting, so to speak.
So what do you do when NHS targets change (again) and you find yourself struggling (again) to meet them? Which of the skills that pulled you through medical school will help you the most?
Can cramming help? Are there some nearly-illegible scribbled notes in the loft that’ll save you? No.
Will your ability to pull facts and diagnoses straight from memory help you when the waiting room is filled well beyond capacity and your shift length makes it literally impossible to treat everyone? Not entirely.
But it’s only reasonable to expect that the years of crushingly difficult training you’ve put in, to get where you are, would have kitted you out with the tools to tackle the challenges you face – at least more often than not. How would you expect doctors to be affected – mentally – by the discovery that this expectation isn’t likely to be met?
This default setting that’s been drilled into you for over seven years (longer if you count the years of education before university) is rendered ineffective in the face of the demands that impact us most on the front lines – and you’d be forgiven for feeling ineffective. The result is stress.
A major cause of stress is feeling overwhelmed by expectations; feeling that your skills are not to the standard of what has been asked of you – or the standards you expected of yourself. It becomes something of a sick joke that it’s the negative aspects of your developed skill set that allow you to exist within the kind of working culture we inhabit: the propensity to sacrifice swathes of your personal life, a sense of dedication against all consequences, and an unholy capacity for caffeine.
This is a combined failure of the institutions which train doctors and the industry that welcomes them afterward. Focused as they are on the strict absorption of medical information, these institutes put far less effort into preparing graduates for the professional life that awaits them, and offer little in the way of realistic insight into where support can be found when required.
And it will be. Because modern medicine is changing quickly – medicine as a whole has always changed quickly – and media are more involved with it than ever before. This means patients are ever more aware, and exposed to a heck of a lot of negative information (both right and wrong) about the medical industry.
The public have been conditioned to think of doctors as all-knowing sources of knowledge. Sure, we know a lot about our respective specialisation – but things change over time. That’s how science works. And change is what you have to be prepared to do if you’re going to prevent your career being ruined by the expectations formed during your education.
The truth is there are some skills in your default settings that’ll help you. Thank goodness all that borrowed student loan wasn’t wasted. Those reflective practice essays and diaries encourage you to mull over what has gone well and what hasn’t. You’ve gained an in-built inclination to read the journals and magazines you subscribe to, and to seek out and welcome new information.
Talk to new graduates and find out what has changed since you completed your degree. I guarantee something major is different now. In fact, at least half of what you were taught is probably wrong.
Medicine is a science and it changes. Life is dynamic so you must adapt. Embrace change, adapt your practice when necessary, and learn to become empathetic, attentive, and responsive to human connection.
Those aren’t the only answers to managing the stress of working in healthcare – but accepting change, and your place within it, is a mindset that will help you tackle the next target when it comes. Bolster that outlook with an appreciation for not just your own wellbeing, but also the wellbeing of your colleagues, and we’ll all have a better chance to change ourselves, and the systems within which we operate, at a manageable pace.
Because, like I mentioned earlier, we should all demand a working culture that doesn’t force us to rely on the least positive ‘skills’ our early development ingrained in us. It seems deeply unfair that while the knowledge you strived for can – and must – change over time, your entrenched familiarity with exhaustion, stress, extreme demands, and the bottom of a gigantic cup of coffee should remain a concrete fixture throughout a lifelong career.
Existing on the edge isn’t a skill. It isn’t resilience. And we need to stop accepting when our employers and educators tell us it’s part of the package.
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