My Writings. My Thoughts.
I leave too early, hoping that google maps has given me an accurate time estimate.
Arrive 630. Drive straight past the entrance and do a U-turn. Despite U turn, still turn into the wrong car park. End up with a long walk to a back entrance. 6:40am.
Entrance I am standing at does not open until 7am. I have no pass card. Loiter until another staff member lets me in. Wonder why staff member assumes I am a good guy.
Walk straight ahead, following the “exit” signs to the front entrance. Switch staff send me back the way I came to find my ward.
Try to get a cup of coffee, but coffee shop closed.
Retrieve my pager from the ward. Great. Enough time to do a quick post take ward round before compulsory orientation. Have no access to computers, and interns aren’t present. Unable to determine which patients are mine to see, so go for coffee.
Coffee shop still closed.
At orientation lecture, pick up handouts and take place in middle of back row. Staff member lays three more stacks of forms on front desk and announces that we all need a copy. Climb over chairs to get required paperwork.
Message from husband. I forget to take schoolbag out of car. Bad mother.
7:45am. SMS conversation with my new interns instructing them to see pre-operative patients, check all ward patients to identify urgent problems and meet me in theatre to triage at 8:30am.
Fire accreditation, bullying policy, admonitions to hand in pay sheets.
8:40am. Fill in feedback form for orientation saying it has ruined my day. Still haven’t seen my patients.
8:45am. Arrive in operating theatre. Reprimanded for not seeing patients yet. Asked to leave and review all inpatients before returning to theatre.
9am. Find interns and review inpatients, using emailed handover from previous registrar. Most patients do not speak english. Charts are the wrong colour, so I struggle to find bowel charts and fluid balance sheets. Hospital is a maze.
10am. Phone call from operating theatre. Why aren’t I there? They need someone. Run back. Within two sentences, surgeon identifies the only two patients I haven’t found yet on my ward round. Surgeon radar. Asks me to leave theatre to book an abscess drainage procedure because intern may not get it right.
Call intern to make him swap with me. Intern scrubs with consultant to finish list.
Search for radiology department. Find radiologist. Wait for radiologist to finish another procedure. Get approval for procedure. Rewrite request on different form. Find appropriate interpreter to help patient to consent for procedure. Run back to theatre.
Just in time for rectal washout. Intern still operating with consultant. I rinse, stretch and staple. Scrub in to help close the abdomen. Can you be bothered? Of course, its no bother at all.
This year I will sit an exam. This exam is the exit exam for surgical training and is the most important exam I will ever sit.
So important that it’s the main topic of conversation with medical friends. So important that I have been getting out of bed half an hour early every day to have coffee-study with a friend before ward rounds at 6:30am. So important that my husband is basically a single parent. So important that I spend a lot of my free time volunteering to be interrogated on topics I don’t know well by people who may potentially employ me, and I would prefer didn’t know amy limitations.
So important that today the majority of surgical exam candidates across victoria and even australia unscrubbed from operating, failed to call the next patient, and generally ignored their job to sit by their email. These are people who would give up their breakfast for a chance to “cut.” The application form for the pre-exam course arrived promptly at 12pm and we all scrambled to fill it out and resubmit. First in best dressed for a course that we already all have annual leave for. The fax number was engaged for half an hour. I luckily chose to submit by email. Gotta wait to see if I got in, but I returned the form within 7 minutes.
Wish me luck!
One day this weekend I was caught up in a conversation with a 90 year old patient. She told me of growing up in the twenties in rural England. When her mother was “confined” with her younger brother, she would be taken down to the local village in her “pushchair” to purchase the perishables for the day (as nobody had domestic refrigeration). She told me a neighbour claimed she was just like her aunt and she would grow big and strong and this scared her, because she was scared of the aunt.
A beautiful scene, an evocative description; a moment of peace in a weekend rush. Thankyou.
Recently, a colleague told me I am old. I like to think of myself as “comparatively old” and I’m pretty sure that’s how she meant it.
I’ve taken a circuitous route through surgical training, which means I am much older than my colleagues at the same level.
After finishing my medical degree and working as a hospital medical officer, I applied to surgical training. I spent two years as a surgical registrar, in 2003 and 2004. The surgical training program at that stage would have taken four years, with an exit exam in the fourth year. That would have made me a consultant surgeon in 2007, when I was 32. However, I took a detour.
I decided to do a PhD, which I completed and of which I am incredibly proud. That normally takes 3 years at a minimum, and mine took three and a half. I spent some extra time having three kids, of whom I’m also incredibly proud. So that means I took a six year pause in total, and returned to full-time training in 2011.
This year, I sit my exit exam, and I will finally be a consultant surgeon in 2014. I will be turning 39 that year, so a considerable detour. Perhaps I am an old woman.
I am a better doctor for all that I have had in my life. In medicine, progression is stepwise, so your job title and level is a marker of your progress. I feel self-conscious of this, and spend too much time casually dropping hints that I have done other things.
I’m not sure I would do it again. I love who I am as a clinician, and the skills I have. But I’m really, really ready to give up being told what to do. Just one more year.