is a medical student in the Class of 2020 at Western University
It was my first week on service for internal medicine as a third-year clerk. I had finally begun to figure out the labyrinth of charts, forms, and computer apps that went into my interactions with patients. I still had four of the eight pens I’d started with and had managed to misplace my sacred “pocket guide” only twice — so, all in all, I was off to a good start.
I was told by my senior to go see a patient who was in ICU step-down and had recently been transferred to our care. I hurriedly went to the computers and started reading up on the patient’s history.
Mr. C had a long and complicated history. He had initially presented to the hospital with signs of cholecystitis but later developed multiple complications landing him in the ICU. After a flurry of resuscitative measures and close monitoring, Mr. C was finally deemed stable enough to be transferred to the ward. ...continue reading →
is an Internal Medicine Resident (R1) at the University of Toronto. Check back the last Thursday of each month for a new featured piece as part of his series (Doc Talks: Reflections to Reality)!
Arnav Agarwal, CC3. I starkly recall etching those three words as I signed off on my first clinical note on a warm September morning. I wish this could be in pencil, I remember thinking. The idea of permanently associating my identity with a patient’s story and offering a proposed impression and plan felt outlandish — I barely had my own impression and plan figured out. How was I going to help patients and make a difference when I could hardly find my way to the right area of the hospital for my first day? And, a more weighted question: could I really practice medicine?
Indeed, the two years that followed were defined by gruelling academic intensity unparalleled by the prior two years of pre-clerkship. A rigorous clinical schedule was now paired with the expectation to prove theoretical capabilities every six to eight weeks. Uncountable sleepless overnight shifts on-call were matched by long days and weekend shifts. The unwavering anticipation of new learning experiences was paralleled by the uncomfortable sense of needing to constantly impress those around us and hold our own in a seemingly foreign environment. ...continue reading →
is a medical student in the Class of 2019 at the University of Toronto
“Intersectionality” was always a term that I saw in academic discussions, but never something I consciously thought of as it pertains to my own identity as a person of colour — a Chinese-Canadian — and a woman. This changed in my third year of medical school, when I was no longer in the safe space of a classroom but in the real world as a clinical clerk, interacting with people from all walks of life.
In the hospital, I grew accustomed to patients, nurses, and sometimes even colleagues assuming I was a nurse based on my appearance: a small, young-appearing Asian woman. But it wasn’t until a 5-year-old patient took one look at me and said with conviction, “You’re not a doctor, you’re a nurse! Because you’re a girl and girls are nurses and boys are doctors!” that I was overwhelmed with the feeling that I did not “naturally” belong in the space of medicine. Of course, there is nothing wrong with being a nurse — they are amazing, competent individuals and I don't know how hospitals and clinics would run without them — but it's the automatic assumption that I am a nurse (which my male colleagues do not face) that is problematic. ...continue reading →
Yara Abou-Hamde is a medical student in the Class of 2019 at Western University
Dear Mom and Dad,
When you arrived in Canada eleven years ago with four young children, you knew you had given up everything familiar to give us a chance at a more secure life. What you did not know then was that your only daughter would go on to pursue a career in medicine, adding stretches of foreign terrain.
Now, I have made it to clinical clerkship. It has been a dream. You know how much joy I get from learning on the job and being able to provide care to patients. It has been both exciting and relieving to know for certain that I have chosen the right career path for myself. ...continue reading →
It was an ordinary Wednesday in clerkship. Handover went smoothly, and postpartum rounds were going well. New moms on the ward were happy and healthy. Aside from the fact that CaRMS applications were opening at noon, it seemed like just another day in the life of a clinical clerk. If you squelched the nervous excitement induced by CaRMS opening (were we really going to be residents so soon?), everything was great. Blood pressures on the ward, other than ours, were pristine.
I started to experience a cramping flank pain by midmorning. Really, it had started the Monday before, but I’d chalked it up to exhaustion from a long night on call. Or maybe some weird peri-menstruation cramps, even though the timing was off.
I fidgeted in my chair as I scribbled away at SOAP notes. Just make it through the morning, I thought. Ibuprofen was waiting in my brilliant orange bag downstairs in the resident room.
This piece was originally created for and showcased at Creating Space V (a White Coat, Warm ART exhibit in Vancouver, BC from April 24 to 28, 2015). It collects words and phrases that have been lost during clinical training, some due to superstition, others due to social pressures or encounters with patients.
Get Back Home
Take Good Care of You
Kevin has also published a piece titled "Learning From Experience" on our Blog. For more of his work, check out his or follow him on Twitter @AbootMedicine.