The End of an Era

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Today I officially finished my internship.

In Australia, after you finish a medical degree, you have to work for a year in a public hospital under probational registration before you are granted full registration as a doctor. I spent my internship year at Monash Health, which I truly enjoyed, and completed five x 10-week rotations: Inpatient Psychiatry (Youth and Young Adult), Acute Assessment Unit, General Medicine, Upper Gastro-Intestinal Surgery (Hepatobiliary) and Emergency Medicine.

I won’t deny that it has been a tough year. At times, the days have dragged. At other times I marvel at how quickly the time seems to be flying by. You enter a new department, lost and clueless, trying to learn all the nurses’ names, keep track of room numbers and figure out where the damn radiology request forms are kept. Just when you settle in, you’re shuttled off to your next rotation. There will be moments when you are bombarded with so many jobs that you just want to hurl you pager onto the ground and bawl. Disasters will happen in bunches: one afternoon, a patient began to die of bowel obstruction while another, simultaneously, had a heart attack.

The wonderful thing about internship is that you work, and you earn money, and you don’t often have to work too much more than what you’ve been rostered for. And outside of work, you have a freedom that is different from being a student. I played soccer, ate out, bummed around with friends, watched movies, read books and travelled without worrying about having to go home and hit the books. It was great, and I treasured it, because I know it’s a rare period in life to have so few obligations.

My first year of working life has also taught me that I am not invincible. I do not have endless reserves of energy, and my health may not be perfect if I do not put some small daily effort into looking after my basic needs. In fact, I am definitely someone who needs more than an average amount of sleep. During my general medical rotation, when I got 6-7 hours of sleep per night on weeknights, I struggled to make it to the end of the shift each day. Running around doing jobs kept me awake, but any time I sat down to do paperwork, I’d be yawning my head off. During my surgical rotation, where the roster was more irregular, a 5:30am wake-up would completely knock me out for the next few days. And when I went into my last rotation, Emergency, where I was swinging back and forth between morning shifts, evening shifts and overnight shifts…my body clock pretty much started waving a white flag. I got headachey, exhausted, and had abdominal pain and pretty horrible IBS.

It probably didn’t help that during this year I really wanted to keep up my social obligations. I played in up to three futsal games per week, went to dinners and parties, and even dabbled in Dungeons and Dragons for a good few months ;P (Yes, that counts as a social obligation…) I suppose this year has taught me the challenges of establishing a work-life balance. Everyone talks about it, and it always seemed so straightforward–just make sure you do heaps of fun stuff outside of work, no? But it’s a little bit more complex than that. You will have to make small sacrifices on both sides to get the balance right. Sometimes you will choose to uphold commitments and you will be very tired. Other times you will have to learn to say no, and put your own welfare first.

So I now have three weeks of leave (YAY, YAY, YAY!) and on February 3rd I’ll start work as a resident in psychiatry. Last week I did feel a little scared. I had a moment of profound realisation: I may never look after a patient ‘medically,’ ever again, if I keep going down this road. I may never put in another IV drip, or ponder the cause of a patient’s low blood pressure, or perform basic life support. My general medical knowledge will dwindle and fade, despite my best efforts not to forget. And I will become a pseudo-doctor, a part of the system that the other doctors don’t really regard as real doctors. Will I love it or hate it? I don’t know.

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