A neccesary mental switch:who you were to who you must be 

During my first year of Medical school, I applied to be on the Committee of Admissions, in which I would help interview new applicants for the School of Medicine. During my interview the Dean of Admissions had asked us all a question that I had never considered before: How will you deal with the fact and pressure that you are holding an individual’s life decision in your hands? Before that moment, I had never thought that by interviewing someone for Medical School I would be altering their life. I was in my second semester of school and by then I was just simply going through the motions: studying, sleeping however much as possible, and trying to do the best I could in my classes. It was not until that point that I had considered the fact that after my first day of Medical School, my life had been completely altered in ways that I had never imagined.

Applying to, and entering into medical school, is unlike anything else an individual will do in his or her life. It’s not just another step in your education; nor is it just a “career path.” It is a truly life-altering decision. From the moment we enter school to the moment we become practicing physicians (and arguably even afterwards) our life is completely planned and structured. We are no longer the person we used to be, and we have little time to develop into the person we would like to become. The mental and emotional switch that must occur within ourselves in order to be successful physicians isolates us from those outside of Medicine. We will see things and do things in our lives that very few in this world will ever have to do. Under the Hippocratic Oath, we are obliged (even if against our moral will) to help those in need, whether or not they are our patients or if we are supposed to be working that hour; we are required to keep an open, and unbiased mind towards everyone we encounter. And, we are doctors from the moment we enter into school until the moment we retire.

This is not a 9 am-5 pm, 5 day-a-week job.

One of my clearest memories from Orientation week was when our Dean of Students informed us all that as Medical students we no longer simply represent ourselves, but we are now “ambassadors for this school and for this field.” At the time it struck me as an odd thing to say to a group of students who were barely paying attention, and were just excited to be here. I was confused as to why all the faculty and staff we met constantly told us about the changes we would encounter as first years—this is just school and we’ve all been in school our entire lives thus far, so why or how is this any different? I was accepted into medical school for the student and person I am, so why would I have to change in order to fit this field?

However, very quickly into the semester I realized the meaning of what they were saying. Now that I was accepted into medical school, I came to understand the weight that the title “medical student” actually bears. As I met undergraduate students who were struggling to secure a seat in my position, family friends looked at me with a newfound sense of respect, and patients felt comfortable asking me questions despite my vast lack of knowledge. I soon realized that even if I didn’t feel any different, society saw me differently simply due to this new title. It was as if I needed to start acting the way a medical student was ‘supposed’ to act: hard working, mature, respectful, and responsible, even if I wasn’t on the hospital campus. It is as if I started to evaluate my actions through the question, “is that how I would want my doctor to act?” I know that some readers may think that’s a stretch and perhaps I am reading too much into it, but I feel as though not only the information we learn in school is relevant, but Medical School itself is a learning experience. It presents us with emotionally trying experiences, stress beyond compare, and situations that will test our endurance and who we are at our core. I truly believe that the ways in which we handle such situations defines and refines who we will be as future physicians.

For example, I try to handle every stressful situation as if it were me in an Emergency Room facing a patient who was beginning to code. What would I do? Freaking out and hyperventilating is clearly not an option nor is doubting yourself and your knowledge going to help your patient. So, if I don’t want to handle those situations in such a manner, why should I handle stressful situations in school any differently? Personally, I feel like one of the hardest things that we deal with as first year medical students is having to transition from who we are, or were, before school started to who we must become as future physicians. It is a necessary mental and emotional switch that must occur and unfortunately, not everyone is ready or even aware of it. We must understand that from now on, the way we act, feel, and handle stressful and emotional experiences must be in accordance with the kind of doctor we want to be.

I know countless classmates who want to go into Emergency Medicine or oncology, but just shut down when faced with stress. Before exams they are overcome with anxiety attacks, wonder if being a doctor is the right choice for them, and just completely shut down. Such a manner of handling stress has always worked for them in the past, so why not continue to implement it? However, I feel that Medical School is designed so that we can learn and develop proper coping mechanisms and healthy habits that will train us for similar situations in the future. Believe me, the stress and emotions you face in your first year of medical school is not nearly what you will face as a doctor. If you don’t transition from who you were to who you must become, regarding such circumstances, it will only hurt your patients.

But such a transition is not limited to just how we handle stress and emotions. It also relates to the mental switch that must occur when understanding why you are learning all of this material. I see so many students everyday arguing with professors about grades, trying to get those two extra points so that they can Honor that course. It seems as though they have forgotten that this is no longer about being and doing your best to get the highest grades—now you have to actually learn and understand this material so that you can save peoples’ lives in the future. No one is going to care if you graduated the top of your class, if at the end of the day, you haven’t truly learned anything. I completely understand that the nature of “pre-med” necessitated such attitudes of getting the best grades, and doing whatever you can to be a competitive applicant; however, it is time to transition to the thought that you are finally inmedical school; now you actually have to know this material for beyond the exam.

During Hurricane Sandy, I learned the meaning of yet another necessary transition: the transition to maturity and the responsibility of a medical student. Many of the first and second year students took refuge in the school due to power outages and the weather. It is inevitable that conditions would get tight, restless and rowdy, with almost 40 of us sharing just a few classrooms and a lounge. However, when the power of the hospital and school finally went out, it was as if all of us had lost control. The generators kicked in, but it wasn’t enough light for any of us to get work done. Most took that as an invitation to play games, and run around as if it was “cool” or “fun.” Had they forgotten that just a few floors above us in the ER patients were fighting for their lives? Yes, generators kicked in for those on life support but generators can only last for so long and only supply so much to the hospital. What about those who had flooded the ER with medical emergencies during the storm? Or those who needed help but it never arrived in time? What about the nurses and staff upstairs who were probably overwhelmed and scared that their patients were all coding and there wasn’t enough manpower, or even power, to support them all?

When the security guard came to ask us what we were doing in the building and why we were there, everyone kept saying “Don’t worry, we’re medical students” as if the weight of those two words would be enough to reassure him that we belonged there.

“Medical students.”

Yes, we were. So why were we behaving like that? As medical students, during such a time we should be volunteering our services and help, not taking it as an open invitation to roam the empty dark halls of the school and spread chaos. Doctors in the hospital always let us shadow them and handle patients ourselves, because they trust that as medical students we are mature and responsible enough to understand the meaning and weight of our title; that we can understand that all of this that we’re going through is training us for our futures. As medical students, we have ourselves and our lifestyles under control and understand that we are now adults, responsible for human lives.

It is necessary and vital that this mental and emotional switch occurs; it is a transition from who we used to be to who we must become in order to be successful physicians. This is not undergrad. This is not pre-med. This is a choice that we made, and every choice has consequences. It is time to understand that your training to become a doctor starts Day One of medical school. The sooner we realize that, and all it encompasses, the better we can be.

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