Experience Comes With Time

It’s always been said that experience comes with time. That’s something you can’t rush, as it takes exposure and learning from mistakes before things become ingrained into one’s repertoire of knowledge and skills.

And so, that’s what I’ve realized the beginning of this year. That I have definitely gained a year’s experience of being a doctor.

It’s strange in that going through my rotations, I always felt in a way that I wasn’t making much progress. I’d get familiar with a rotation, start to get comfortable, and then bam! It’s time to move onto the next rotation, where I am completely unfamiliar with the environment, and the jobs that I’m supposed to do. And it’s from the fact that I’m always moved to new units and wards that keeps making me feel like I have made no progress at all.

It hasn’t only been till the beginning of this year, where I am currently in Emergency rotation again that I can actually feel the progress I have made from last year. Taking a history is much smoother, as I am familiar with certain presentations and know what questions to ask, what differential diagnoses to consider and what relevant investigations to order.

What also surprises me, is how my just seems much more organized with things. Last year, I relied on a clip board and paper, scrawling almost everything the patient told me. This year, I still bring a clipboard and paper, but find that I spend more time listening to the patient, and only note things down that I will forget like a list of medications, or a list of their past medical history. I’ve always been in awe of the doctors that could take a history without a pen or paper, and recall nearly everything about the patient history. I thought they possessed some super human memory capabilities, something that I was lacking in. But I feel a step closer to that now 🙂

Another thing that happened last night, was when the consultant told me I did a “good job” at the end of my shift. I had never been told that last year, but being told that last night really made my day. It was something I never would have expected, not the least in the Emergency Department anyway.

Taking from all this, the past year has definitely given me some experience. I’ve learned from mistakes, I’ve become familiar with common presentations, I’ve gained some experience. And now I can see why most consultants have grey hair. It’s taken them a lot of time and experience to get to their position, and it isn’t something that can be had overnight.

Having Gone Through Hell…

If I were to use one word to describe my ED rotation, I would use the word “hell”. In saying this, I feel that I have learned an incredible amount of things from my ED rotation, but at the cost of my self esteem, and perhaps a little bit of my sanity.

It wasn’t the stress of seeing unfamiliar patient presentations that freaked me out the most, but rather in dealing with the senior doctors and the culture of degradation of junior doctors.

As junior doctors, we were thrown in the deep end. We were doing the same job that a registrar in ED would be doing, working up the patient, performing appropriate investigations, and making referrals. It was tough work.But this tough work I could cope with. It was even challenging, and something I learned a lot from. The thing I couldn’t cope with, were the staff. Not all were terrible, but I could say that a few were quite bad, with one particular man who seemed to be hated by everyone, including surgical registrars.This man yelled at me on the second day of work. I got yelled in front of almost all the other ED doctors for asking my senior doctor to describe an open fracture he had seen earlier that day, so that I could relay it back to the orthopaedic doctor. Words to the effect of “incompetent”, and “idiot” were used. That night, I couldn’t sleep, dreading the next day and fearing how it would turn out. It wasn’t until just a few days ago, that I found out other colleagues have cried at home from this very man yelling at them.

And so, for the next few weeks, I was mentally tortured by this very man who we had to run all our cases through. He would question my competence as a doctor, carefully pointing out my mistakes, and how I had forgotten to do things such as chart regular pain medications, hence why the patient is suffering excruciating pain.

On more days then not, I sat on the edge of my bed, thinking about the mistakes I made, and questioning myself whether I was competent or not. It was self abuse, and completely self defeating. I would dread the next day that I had to get up to go to work. Finishing work was the most relieving feeling ever, but on days that I was yelled at, or pointed out numerous mistakes, even that feeling of relief was taken away, to be replaced by frustration, anger and thoughts of worthlessness at the end of my shift.

To me, I felt worthless at my job. I wasn’t getting the support I needed, I never got the encouragement or acknowledgement that I was learning from my mistakes, or doing a better job than I was doing in the past. They didn’t take the time to explain my mistakes, and how I could avoid such mistakes next time, but they pointed out my mistakes, reinforcing the message that I was doing badly. In hindsight, I wasn’t doing badly, but I was doing something in which they held unrealistic expectations of  me as a junior doctor.

What doesn’t kill you only makes you stronger right? In that sense, I feel stronger having put up with such degradation, and the subjected self torture. The biggest lesson I learnt was in dealing with ***holes in medicine. Learning to deal with other people – it’s an important life skill, and it will surely help you to survive in this big bad world.