Saturday, May 19, 2007

Two down…Four to go!

As of yesterday, and pending exam results, I am officially done with my second year of medical school. 2/3rds of the way done with my time in St. Andrews, and 1/3 of the way done with my entire medical school career. It's quite scary actually. Having read so many news articles and blog posts about problems in the healthcare systems in both the US and the UK, I get worried of what the future holds in store for me. However, my long-term fears are overshadowed by my short-term fears, namely my exam results for this semester, and the USMLE Step 1. Having seen more and more examples of how much there is left for me to learn to even pass, let along score well on, this exam, I have decided to start studying (although lightly) this summer, rather than leaving it all until the summer after my final preclinical year. I've been mentally compiling a book list (and hoping that my parents will shell out even more money towards my education than they already have). Besides my sister's copy of First Aid for the USMLE , I've already purchased a copy of Goljan's Rapid Review Pathology, and will be looking into some other titles like Board Review Series Physiology and Lippincott's Pharmacology. Hopefully I will be able to focus and motivate myself to actually spend a significant portion of my summer reading medical textbooks. We'll see how that goes.

However for the rest of the summer, I will hopefully be returning to my local Emergency Room to learn from the amazing professionals that are ER doctors and nurses. Last summer I shadowed a couple of ER docs, but as a Medical Student Observer. My role was literally to be a shadow – wasn't technically allowed any patient contact – no histories, no exams, nothing. It's understandable, seeing as how we're not a Teaching Hospital. But it's a bit frustrating KNOWING how to start an IV, but not being allowed to do so. So I found out that the good people at the MDU (Medical Defense Union) do free indemnity insurance for their Medical Student members, membership of which was also free, and I signed up for (to get a free dictionary) at the beginning of first year. So I went to their site, filled out a simple form, and now have a document stating:

    "Please accept this letter as confirmation that you can look to the MDU for discretionary benefits during your elective in the USA, including:

  • Assistance with clinical negligence claims and indemnity for legal costs and damages awarded against you
  • Subject to each claim being considered on its own merits there is no limit on the value or number of claims which can be considered for any member who has this type of student membership
  • Access to our 24-hour medico-legal advice
  • Access to indemnity for Good Samaritan acts"

However, there's a catch:

    "These benefits are available provided that:

  • The elective is authorised and approved by the Dean of your medical school.
  • Any work that you undertake is at the request, and under the direction, of an appropriately qualified practitioner.
  • Any work that you do must be within your competence and expertise."

Now as you can see, I have emboldened one of the main hurdles I have to get over: getting permission from the Dean of my school. I have sent him an email explaining my position, but have yet to hear back from him (apparently he is out of town till Monday – hopefully I will hear word then).

Now, if everything goes well with the Dean and the MDU, then the last major hurdle I would have to jump is to actually get the hospital to let me do things. When I get home, I am going to try and set up an appointment with whoever is in charge of Medical Privileges. This might be hard to do, but I am going to try my hardest. Hopefully I can combat the "our insurance doesn't cover you" argument with my MDU form, and provide a scope of practice for me that is approved by my Dean. I am very sceptical that I will be able to convince them, however, which is why I am trying not to excite myself too much. But honestly, is it such a big deal that I want to practice my H&P's? I'd rather not spend three and a half months lying around at home doing nothing (it sounds appealing now, but quickly becomes boring). This is why I'll also be taking an ACLS (Advanced Cardiac Life Support) class, to hopefully get a certification that I can add to my CV.

That, and I can always look forwards to our family vacation.


Until next time,