Writing this after all the dust has been settled with my post-internship/graduation drama and has given me enough time to reflect on my year long ordeal. To sum it up, it was an overload of personal and professional experiences, a once in a lifetime opportunity that I'll never do again if given the opportunity.
Let me start chronologically and see where it goes. So I started my internship late due to some family issue...wait. Let's go back a little further, to my results of the final year M.B.B.S exam. I was with my mom on holidays in Kaziranga National Park in Assam and had just finished the evening safari. We came back to a roadside restaurant where some nice pork was being served. While having the dinner, I got a call from one of my buddies, “ ಬ್ರೋ, ಪಾರ್ಟಿ ಯಾವಾಗ, ನೀನು ಪಾಸ್ ಆದೆ” roughly translating to “Bro, when is the party, you passed.” I was dumb struck, not because of the result. But for the fact that things just got real for me and tough times were ahead.
So, as mentioned I had to start the internship late and got paired with 3 other batchmates to start working. I had a pretty good idea of how things were supposed to go as my seniors had been preparing me for this day. Had a decent plan in my mind, as some old quote goes “Work while you work, play while you play” and this was the former. I had a schedule which gave me serious work in the first six months and relaxed rotations in the second half of the year. And which almost worked out pretty well.
As an extra person in every rotation I was seen as an escape for most of my colleagues, as I had to pick up the slack. I don't blame them, as the work in most of the rotations were pretty hectic and any relief they got was a boon. This was also a great time for me to improve my various skills that I will require in the future. Let it be professional dynamics or performing various procedures, I grabbed the opportunities like a first bencher. And due to such work I was given opportunities to handle wards independently, teaching of medical students, dealing with the monthly statistics and other odd jobs here and there. I have a lot of experience with patients and diseases, but not sure if it's ethical to share, so I'll skip it.
Coming to the objective of writing this, the difficulties and the lessons learnt. I’ll make a list and talk about it a little
- Timings: This was the most stressful part, keeping up with the timings. As a late riser, I faced most issues with my early morning routine, getting ready just in time or a bit late for the rounds, to the OT, or to the labour room. Getting calls in the middle of the night, coming back home at 4am and then being back by 7am. Sleep after a while became a luxury. Some might say this is inhuman and we as healthcare workers need our basic needs met and be treated more humanely, but let me give the counter-argument. Healthcare everywhere is just barely holding on, let it be either lack of personnel or infrastructure, it's not great. And overworking is a valid issue, until we solve the problem of having more numbers of quality healthcare professionals, our time and rest will be a luxury. Some might say “Oh, look at the H.O.D he's not here”, but then you get to know that he was in is clinic from 7am and will go back there and stay till 11pm,and you realizes that it is not just the residents that are overworked, EVERYBODY IS.
- Food: Might sound like my maa or grandma, but yes my weight was an issue. I was always hovering around 60-65kg before internship, during early internship I was 60 or less than 60. Was it due to my working or lack of access to quality food or eating whatever that was available in a jiffy, but then I realized that I can take exactly 15min off and go home get refresh with some quality home cooked food and be back at work with a full recharge. It was either this or spend some extra cash eating outside, which I wasn't keen on doing. But by the time of writing this I’m 70+ kilos which is pretty satisfying.
- Resource Management: This was not-a-surprise to anyone, the lack of most amenities, one time it was gloves, then normal saline, then something else, etc, etc, etc. This makes us use the available resources to the fullest extent and do a lot of ‘jugaad’ with everything. This helps me understand the value of things that were given and not bother about when will the next item become available. Makes you appreciate and use things in a limited fashion.
- Infrastructure: As all things government, the infrastructure was poor, no duty doctors room, no access to clean restrooms, no dedicated canteen, no dedicated parking spots and a lot of other things that weren't available. Some can be blamed on the usage of 200-year old buildings or the lack of interest from the authorities to modernize, at the end you just move on.
- Colleagues: This is the most annoying aspect of my experience, as an extra intern I had the opportunity to work with most of my batchmates and I’m sorry to report that they were just BAD. Even though I shouldn't comment on their clinical skills or knowledge, I can say that as human beings they were not the best, barring 25-30 odd ones out. Everyone has this sense of entitlement that comes with becoming a doctor, which I’m not totally against, but that paired with other flaws just doesn't make any sense. The lack of compassion for fellow humans, the chronic disregard for protocols, cutting corners and general borderline unethical behavior. I think this is similar to people demanding their rights but blatantly disregarding the duties. I had a few good apples in some of my rotations and I was able to do some good work. Sadly, this was one issue that I couldn't just let go and had to resort to either constant reporting or just confronting the colleague. I wonder if this is the reason the assaults on healthcare workers is on the rise.
- Consultants:I've great appreciation for most of my consultants, and it sounds biased that I had to suck-up to them a lot and now I’m showing appreciation. A few consultants that were absolute gems were Dr Dinesh and Dr Chandrashekar from Surgery, Dr Arvind from Pediatric Surgery, Dr Savita from Pediatrics, Dr Mamatha and Dr Sudha from OBGYN, Dr Raveesh from Psychiatry, Dr Lingraj from Orthopaedics and Dr MAK from Community medicine. Most of them were extremely helpful in my professional growth and to certain extent personal too. Sadly this list of great doctors is pretty short, because there is a lot of mediocrity out there. Kinda foreshadowing for my batchmates here.
But most of my time was spent with consultants who were just extremely demanding for the sake of it and most work done under them was just pointless. During such instances I would question my life choices and just go on a weird philosophical tangent. It's quite difficult to work under such conditions, bite the bullet and get it over with.
- Knowledge: I was never the smartest in my class of 150, I was quite frankly middle of the road. But what surprised me most was all the smart people in the class struggling to do the clinical work, and see them acing the daily rounds then struggling later during the actual work. Strange times we live in. The perceived knowledge gap that I had was quickly solved by just reading up for half an hour and would greatly help in doing my job right.
Final conclusions, first and foremost don't be a prick. Being a nice person overall helps you a long way, let it be the ward boys to patient family members, paramedical staff or my colleagues. This has helped me avoid a lot of unnecessary confrontation, and the headache associated with it. It has also helped me take early time-offs, longer lunch breaks, greater assistance with the paramedical staff and in general improvement in the quality of my work environment.
Always be prepared for the worst thing to happen. Sounds pessimistic, yes it does, because you are not in an art class where every imperfection is attributed to the character or something else intangible. The understanding of what is at stake and what needs to be done takes a lot of preparation, and due diligence, which does not happen with optimism or hope, in my opinion.
Smart work will be the key in the long run. I’m tired of people saying hard work is the only way. But being smart about where you work hard must also be mentioned. I’ve had a few friends who just burnt-out due to the lack of smart work ethic.
“Be Roman in Rome '', this is an extremely important survival mantra that needs to be taught everywhere. There are certain things expected of you in certain situations, be that and get it over with. Going out to party, don't act like a doctor, switch off your diagnosing mind and have fun. Going to meet the Dean, be formal. Being a doctor is becoming what the situation demands of you, a sympathizing friend, a strict warden, a comic for the kids, a nightwatch, a handyman or a smart-ass.
Be water, my friend. - B. Lee