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What are clinical years really like?

Updated: May 5, 2020

By Rayhan Munavvar

On 8th April 2020, on my 23rd birthday and after almost 5 years of medical school at the University of Nottingham, myself and most of my year group graduated, three months earlier than originally planned. This was in order to facilitate our role in the current crisis. It was an unexpectedly premature end to our time as medical students, and whilst our names were added to the doctors’ register, we found ourselves accepting that we are now doctors.

On the other side of the coin, I know many students at the very beginning of their clinical years, who have been disappointed to find themselves unable to start the placements, they had so long been working towards. It is a difficult time for students, without work or any certainty of future studies, each day can feel wasted. If it is any comfort, when normality eventually returns, it is evident that there will be no dearth in opportunities for students of all years, clinical and pre-clinical, as our health service and training take greater importance in the minds and ballots of the nation.

Starting clinical phase is something you will unlikely feel prepared for. In your first placement, you spend months learning to keep up with the enormous machine that is our NHS. The ‘hospital-speak’ changes in each department you go to, and you wish you had been given pre-clinical teaching on the art of not getting in the way. You may not realise it until your final days of placement, but these skills will inevitably and silently be hard-wired to reflex over 48 months. In the pursuit of making that new world that you have been dropped into muscle memory, students rarely acknowledge how much an achievement their efforts really are. Trust me, as awkward as it feels and even when there are bumps on the way, you will take steps and strides to make the NHS your home.

I know many, myself included, worry about whether they have enough knowledge to be at their level. Clinical knowledge is something that feels like it comes and goes. You go in, armed with your first two or three years of dissections, textbook and lectures study, to find that somehow it does not always fit with what you see on the wards and in clinics. Do not lose hope or confidence – you are here to learn, and to re-learn. As you engage in placements, your understanding will increase, and you will start to recognise areas where you need to expand your knowledge. That’s why sometimes whilst gaining knowledge, you feel as though there is still so much you should know. That will not stop when you are a doctor, in the medical world we always have so much more to learn, and you will not be expected to have it all committed to memory when you graduate.

What is essential to make it through your clinical years; to graduate, to work and to serve, is to preserve your sense of self. You have all made it to medical school because in that painstaking admission process, you were judged to be someone who can work hard and make difficult decisions to help people in the most difficult times. In the pressures that come with, you must never lose that most humane quality in yourself. As well as caring for your patients, that most certainly means looking out for your colleagues, and taking care of yourself always. This is something that will be reiterated to you over the years, but which you may only learn as it gets tougher and tougher to balance. This line of work can take a lot from you, both physically and mentally, but you do not have to let it. Do not fall into the trap of letting medicine become your entire life, because when you do, it only makes being a doctor harder. And always seek help, it is not a big step to be honest with others or with yourself that you are finding something difficult. Chances are people will understand, they will have faced similar challenges, and their help might just make a world of difference. But inevitably, the best and often the only way to successfully rise to these challenges, is together.

Everyone has different ways of keeping sane. For me, my faith has been present in every moment. Having trust in God that no matter how tough things get, we will carry on, has gotten me through the darkest of times. But for you, this could be anything. Knowing that after you clock out, you have a tournament to train for, a band to play in, or a loved one to cherish time with is what will keep you coming back onto the shop floor, still switched on and ever ready. And this is what will allow you to keep enjoying your work, regardless of what challenges may come.

And this is the most important advice I can give to anyone, commencing or currently engaged in their clinical phases of study. Things aren’t going to be easy; they most certainly weren’t for me. But even with the challenges, I will always remember my clinical years fondly, and most certainly miss them. This is a unique time, where you have so much to learn, so much to contribute, and so much to develop yourself professionally and personally. Treasure this time, make the most of each placement, always make time for yourself, and don’t stop enjoying yourself along the way!

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