Play it as it lies

The most useful thing I learned in my recent six week stint with the psychiatrists is that psychiatrists are doctors too.  Here's the evidence:

1. They know all about "Code Brown".
2. They get really annoyed at inappropriate referrals, such as the person with confusion due to an infection that the ED docs think is bonkers and should get detained and given anti-psychotic medication rather than something more appropriate such as, say, antibiotics.
3. Their handwriting is illegible.

With regard to point 3, although it's illegible, it does have the benefit of being voluminous.  They write so much that often you are able to get the general vibe of their notes even though the actual words are gibberish.

In contrast, the surgical team I've just joined, while they also have unintelligible writing, don't seem to be able to use sentences in their notes.  To be fair, this is probably because they are scribbling madly, desperately trying to catch up with the surgeon, who conducts the round so fast that windows are shattered by the sonic boom.

It's pretty intimidating getting thrown into the midst of this as a student because it means that anything in the notes is thruply confusing.  Not only is the handwriting terrible, the actual text is just bizarre abbreviations of things that you wouldn't understand even if it was actually written out in full.  On the round this doesn't matter so much because as a student my main tasks seem to be to hold the tongue depressors in case anybody wants to do some Playschool craft projects and to not get trampled underfoot by the aforementioned rampaging surgeon.

Clinics though - clinics are a different story.  Today I was given the job of taking notes, which is fine (in fact, the surgeon told me I was a "born note taker", which may actually be an insult, but anyway) except it means that I'm holding the notes and hence also have the job of flipping around in the previous notes and trying to answer questions about the previous appointments.

The surgeon would turn to me and ask something like, "What was the original plan when Mr Smith first presented last year?".  I'd find the page and see that it would seem to say something like, "P) OPO f/u A/S2 w C+R".  Now if you're roolly smart like me you can mentally adjust for the scrawlings and say, "Outpatient followup up in 1 month with a chest x-ray".  Which is fine. 

But the next line says, "2. FFfFt + ananas - ref/ chok", and what do you do with that?

I can't figure out what it means, nor even what it might mean.  The nihilistic part of me wants to throw caution to the wind by saying, "Klaatu barada nikto", just to see what happens.  However, that is not how you establish credibility on day 2 of a new clinical placement.  It's more suitable for a morning tea in week 5 when everyone already knows you're a bit of a nut.  So I simply say, "It looks like the plan was for fffffft, ananas and ref chok."

The surgeon pauses and stares at me long enough for my heart to skip two beats.  "Hmm, fair enough.  It wouldn't be my approach but I'm pretty conservative", he says, and carries on.

Survey

Dear Doctor,

Sorry to disturb you from your busy consulting schedules but I would like to take 5 minutes of your time to fill out a brief questionnaire for a research project that I am undertaking in order to pad my meagre résumé.

The central research question is, "How well did your medical degree prepare you for life as a doctor, and how could we change the course to ensure that students in my generation are able to be spoon-fed all the required information so as to learn it with a minimum of effort, preferably so we don't even have to turn off our games consoles?"

To answer this question I have constructed a survey designed to make you feel superior to us as you reminisce about how things were better in "the good old days" and to subtly demean the quality of our education.  Hopefully you will be able to identify the mismatches between the curriculum we are being taught and the real experiences of working doctors, with a view to throwing out all the rubbish that I think sounds too hard to learn and reducing medicine to a shortish handbook of single-page protocols to be followed blindly so as not to crimp my lifestyle too much.

If I can cause a big enough stink with this, and suck up to enough senior doctors, my future career path is assured.  So thanks for your generosity in sharing your wisdom, intellect and education with me.  I mean us.

Question 1: Which parts of the medical course do you think could be chucked in the bin because they are nothing but a vague, hazy memory viewed through the bottom of a pint glass?

Question 2: What extra training would have eased your transition into full-time doctoring?  (This could cover technical knowledge such as the number of a good tax lawyer, practical skills such as how to get the most out of the Porsche Cayenne tiptronic transmission, communication skills such as the best way to humiliate and demoralize medical students, and administrative skills such as ... ha ha, just joking, we all know that administrators have no skills worth mentioning, right? If it's worth doing, a doctor does it!)

Question 3: Do you have any suggestions as to how these deficiences could be addressed with the minimum of further effort from myself, but the maximum publicity?

Question 4: If you play golf, would you be willing to play a round with me in the spring?  You can have as many mulligans as you like and I'll laugh at all your jokes too.

Thank you for your time and relative dimensions in space,

PTR
Medical Student Extraordinaire