In a continuing, entirely accidental, theme for the day, we were repeatedly told today of the similarities of third year and entering prison. Our first tale was of the panopticon, an eighteenth century prison design that allowed one prison guard to watch all prisoners simultaneously. This was, of course, impossible to actually do, but because the prisoners couldn't see who was being watched at any particular moment, they had to assume they themselves were being watched and adjust their behavior accordingly. The corollary for us is that, even if our attending physician isn't directly visible, our actions may still be judged by other members of the medical team, so best to always be on one's best behavior.
The next pearl of wisdom came from my advisory dean. He is amazingly adept at saying borderline impolitic things in deceptively discrete ways. As my house (not Ravenclaw but you've got the right idea) sat with this dean for lunch, he described what he calls the fee-for-service system of the medical hierarchy. Playing off the payment system doctors use to bill patients, the idea is that if you want something from the resident (i.e. to scrub in on the next surgical case) you may better your chances by offering to do some of the menial work the resident needs done. Essentially, there can be an element of quid pro quo, tit for tat, or, in the words of Matron Mamma Morton:
That's not to say we don't have a right to our well-payed-for education as medical students, just that we can make things a whole lot easier on ourselves if we make things easier on the even more overworked people above us.
We were also reminded that the residents we will be working under for our first clerkships are just as new as we are, with most of them starting residency on July 1st, having been "doctors" for a grand total of a month. If they are from international medical schools, as is often the case at a couple of our hospitals, they may not even have gone through a similar system or know what what is expected of us. So, we shouldn't be afraid to let someone know if something seems off.
The final item of the day and of our entire transition to clerkship week, was a somewhat awkward ceremony where we heard various speeches about the wonders of third year, we recited a decidedly non-Hippocratic oath, and we watched fourth year students present awards to residents they appreciated during their third year. This is kinda like making newly sentenced inmates watch a ceremony for the best prison guards as voted on by their soon to be cell mates. I guess it's sorta nice to see who are some good mentors for next year, but I'm already so overwhelmed with all the other things going on that I doubt I'll remember any of these people when I get to the wards. And the folks who would most appreciate watching these residents be recognized, such as the vast majority fourth years who have actually learned from them, aren't present. Anyways, odd. Not bad, just odd.
And with that, we concluded our transition from the classroom to clerkships. We have a glorious five-day weekend to exercise any remaining demons (or just exercise) before donning our mini-white coats and buckling down for what has been billed as our most exhausting and exhilarating year of med school.
TIL: If your supervising physician tells you to go home, go home. This is not a test. Your grade will not be affected. Leave. Use the extra time to stock up on one of those basic needs you've been ignoring, such as food or sleep.
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