A fly on the wall

In the ecosystem that is the hospital, medical students are at the bottom of the food chain. We are the dumb and mute stragglers trying to infiltrate the tightly knit herd that is a ward round. We are the unwanted.

I study at a large teaching hospital, where there is up to almost two hundred medical students roaming around at one time. We are expected to spend as much time as we can on the wards, either shadowing doctors or taking the initiative to speak to patients. Ward rounds happen every day like clockwork, and it is often what students end up attaching themselves to, hoping that we will learn something. We are constantly told that medical students are an important part of the team, that we will be appreciated and involved. And sometimes, that is true. I have had some positive experiences of being taken under a doctor’s wing, taught novel information and helping with exciting tasks. My most memorable encounter was with a surgical registrar, who led me for a day into different surgeries and all the while making conversation and getting me to participate. He went out of his way to drag me into interesting cases, waiting for me to scrub in and was one of the nicest people I have ever met. He even made small talk. Small talk! I am typically a person who hates such conversations, because I don’t always see the point in it. But when you are walking alongside a doctor from point A to point B in a vast hospital trying to run mindless errands, silence is not golden. Silence becomes awkward. By the time afternoon came and I had to leave due to upcoming tutorials, I was contemplating excuses to stay with him. Mind you, I’m usually using tutorials as excuses to escape from ward duties!

But when I think about what other fascinating tales I have to tell, I have very little to share. Despite spending two, long years at this hospital, I am ignored much more than acknowledged. And by more common, I mean the ratio is likely 100:1. Being a medical student often means accepting your role as the fly on the wall. Actually, no, at least a fly on the wall gets swatted at every now and then. I have survived three hour ward rounds without being acknowledged or even looked at, all the while still having to pretend to look interested and profusely express my gratitude at the end of it. A lot of the time, the consultant doesn’t remember my name because they never learnt in the first place. I am called, “you,” or just simply not referred to. Yes, they might ask a question at one point to show they know you exist, but there is little to no effort beyond that. Do they know that I know they are trying to get rid of me when they say, “Go with ____, they are doing something more interesting?” I gratefully have never been rejected or insulted by a senior, but I have heard stories of students being rudely turned away or mocked. It makes me think, do they remember what it was like being a medical student? The feeling of somehow always being in the way. The feeling of having wasted a day despite spending the entire duration on the ward. The feeling of investing hours into “ward experience,” and ending up leaving with no new knowledge. The feeling that a day at home perusing over textbooks might have been a day better spent.

I am not asking for every spare moment to be spent on teaching me, because I know it is not their obligation. It is hard enough trying to manage and treat hundreds of patients, let alone being responsible for the education of naive, inexperienced trainees. I can understand not feeling motivated to teach, because it takes extra effort and well, you don’t get paid for it. But some niceties and common courtesy you might bestow upon a colleague could genuinely make my day. Perhaps a hello, or asking what my name is. Perhaps a quick question to test my knowledge or an interesting learning point when we are standing around waiting for something. Is that too entitled? I understand it is a rite of passage generations of medical students have journeyed through, but that doesn’t mean I have to like it all the time.

I am complaining too much. And yes, it is always a two way street. I need to be proactive and take the initiative to ask questions or help out. I will admit I do not always put myself out there, I am a shy person and have spent many hours waiting for the right window of opportunity to ask my question (which is stupid because what constitutes the right window?). I wrongly think I will be judged harshly or mocked if I have the wrong answer to a question. Then I kick myself when it turns out I was right, but no one will know because I stood there, mute. And when I do try, there are limitations to my efforts. Discussions during ward rounds often fly straight over my head, and there are so many unknown unknowns I cannot even scramble together a relevant question. Other times, the doctor will pause momentarily to answer my question, before their eyes glaze over again as they forget my existence, ending the conversation before it has even begun. It makes it hard to want to keep pestering them.

At the end of the day, I am grateful to anyone who takes time out to teach me, and whilst I may grumble now and then about being ignored I will never walk into an encounter selfishly expecting and demanding attention. Being a forgotten fly on the wall may save lives, therefore how can I ask for that to be changed? The one thing I can do is hope that in twenty years, when I am leading those ward rounds, I can remember how that surgical registrar treated me and be kind to the students who will walk in my footsteps. Thus ends my petulant whining for today.

9 thoughts on “A fly on the wall

  1. An interesting point-of-view, Doctor-to-be. As a patient at an understaffed public health clinic in Los Angeles, I find it distressing that, on several occasions, I have been attended to by a medical student and not my regular doctor.

    Liked by 1 person

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