I actually mentioned this as number 6 on my list, but it is as fine a point to start with as any other. Poignantly so with the latest spate of medical strikes that have occurred in different counties all over the country.
I don't know if there's any analogous experience outside of the medical field that can really prepare you for what practising medicine really entails. I should know: I've taken quite the long route to get to where I currently find myself - 10 years of post-secondary education (4 years of Pre-Med Biology and close to 6 years of Medical school). Interspersed somewhere in there is some volunteering and doctor-shadowing.
The medical profession is still one of those very revered fields (seems like the reverence currently far outweighs its economic incentives). I'm making a calculated guess that any parent would feel proud if they were to hear that their child had chosen to pursue a medical career; sadness may creep in, though, when they realize how much money they would have to invest in that decision. So we make the decision to follow this path, put in all those hours of work and commitment, choose the right schools, get adequate extracurricular activities that reflect well on our character; also, lest anyone forget, medicine today, just as it was in the past, is learned through apprenticeship; therefore, having a good mentor in the field helps keep you motivated, and can show you up-close the sacrifice entailed in your career choice.
So, when you eventually make it past medical school, you eventually settle down to one year of basic serfdom aka "the internship". I'm thankful here in Kenya we only spend one year doing our internship, because my Ghanaian colleagues have to spend two (dreadful) years as interns. As I mentioned earlier, learning medicine is done through apprenticeship; the nature of that apprenticeship can very often mirror boot camp at the mercy of an unkind Drill Sergeant. I would be lying if I claimed that any two internship experiences are alike; some people have relatively calm internships, while some people (myself included) go on to have troublesome internships (the universe can be so unkind). You may find yourself dealing with many a cantankerous consultant; if you're unlucky, the medical officers might also decide to make your life a living hell. In my case, I run across the foul trifecta while I was rotating in the Obstetrics/Gynaecology Department - the Consultants, Medical Officers and even some of the Nursing staff took turns dishing out grief.
It really is quite the sad turn of events. Despite all the knowledge we rack up in medical school, nothing quite compares to full hands-on experience with a living breathing patient. What we do in medicine is definitely far from the norm. Normal people aren't supposed to do the things we do. Normal people aren't supposed to see the things we see; poking/prodding/probing and incising/ligating/exploring the human body all while assuring you that we mean you more good than harm is a hard deal to pull off. And in case you haven't noticed, a lot of your friends in the medical field are a tad unhinged - possessing a wry sense of humour and unmatched fortitude. It's just the nature of the business, and unfortunately, you pretty much have to learn it on your own.
That's right, there is plenty that is learned on the job. One of the more fascinating facts about medicine is that despite the fact that we deal with death on quite a regular basis, no one actually teaches you how to deal with it (breaking news to the patients' relative, how to inform someone that they have a poor prognosis); no one lets you know how to deal with the fact that your actions (in)directly may lead to a patient's death; also, no one teaches you to develop the sense of detachment from the patient that keeps you objective come what may. Something else they may not emphasize is that you also become really adept at knowing your limits with regards to saving lives. Sometimes you walk into the ward and you have a pretty good feel about the patients most likely to perish on that day. At first, it unnerved me a bit that nurses would just mutter that
"the patient in bed so-and-so is a goner!" (rephrased).Dastardly as that might sound, it actually is a "good" thing because it lets you know where to focus your intervention the most. Also, it lets you know who needs to be referred out for special care that you may be unable to provide. However, if you're in a resource poor setup dealing with poor patients who obviously can't afford to go anywhere else, then you prepare yourself for the worst. We don't get to wash our hands of the impending death, but we can at least assuage our consciences of the guilt.
Sometimes people assume that this stuff is easier to deal with because (apparently) doctors make a ton of money. Personally, on many occasions, I've had people step up to me and state that "medicine is a calling!" When you have people from all walks of life constantly reminding you that your chosen profession is a calling, you better believe that the money will definitely not be commensurate to the amount of work you'll put in. If the money's the reason that you're choosing medicine as a career, I'd prefer that you chose one of a host of other jobs that require less schooling, afford you more free time, better salaries, and a life free from frivolous litigation and egotistical individuals. Apart from medical professionals, the only other professionals that gets reminded so much of being "called" are probably teaching staff. (that's not exactly what I'd consider good company!)
Despite all the challenges and pitfalls, there are many good doctors who are in this profession and conscientiously make the effort to care for their patients no matter what the circumstance; who aim to do good by their patients with whatever they have at their disposal. They take care of your precious defenseless children, they support you in your times of weakness, will care for your aged relatives when their feeble bodies fail them, and will add life to any person's days that they encounter.
It is a hard life, but it's a life that I enjoy; I've witnessed some crazy stuff, but it's interesting to share treasured war stories with my colleagues from time to time. Though, I do wish the government would do its part in helping us take care of our patients. I would definitely prefer the job satisfaction that comes with being able to adequately address my patients' needs over a pay rise. The government has absconded its commitment to the health sector and the majority poor; without giving us the tools to care for this society, they turn us into mere palliative specialists. Like I've already mentioned, I have already learned to be pretty detached in my line of work - for my own sake, and my patients' too; but having my hands tied any further would only make me bitter, cynical and ambivalent...qualities you do not want in any of your doctors.
Take home message: if you choose this life, prepare for a gamut of challenges, and for the reward to mostly be in the work itself. That being said, you should also remember that it is a noble profession, it is God-ordained. Not many jobs have as immediate of an impact on the people served; so embrace it, and make your mark in this world as only you can.