Pre-Medical/ Non-Traditional Student
"You’re applying to Duke?
But why? You’ve got a job, good money
Why not find a man, settle down, have kids
Like your mother?
Do medicine for what?
You've tried once already, still got chance meh?
Your clock is ticking, horh.
Better think twice, ya?
Or else you will be on the shelf."
Pre-Clinical Medical Student
Our degree is titled MD:
“Doctor of Medicine”
Not “Doctor of Surgery”
The country is cutting the number of specialists every year,
They want us to be IM or GPs
And even if you make it, so old already bro,
Are you sure you want to be tying knots on call
In the dead of night when you’re forty?
Medical Student on the Wards
“Didn’t your school teach you
the proverbial ‘Song and Dance’?
of clinical examination?”
It’s a tale as old as time;
Have you even examined patients in the ward?
You know what, never mind.
Go back and study your script,
Don't waste your time here.”
(Mutters: Students these days, sheesh!)
Research Year Student
“Your thesis was impressive,
It's a shame that your findings were not significant.
You could have sent in a manuscript for publication
Or at least submit a poster to conference.
(I even know of folks who've started on their third manuscript already.)
They say it helps with residency applications, you know, tip the odds in your favor.
Pretty much everyone has a ‘first author’ nowadays.
Do something about that before you graduate, yes? Still got time!"
Final Year Student
“How many cases are you presenting today?
Just one? That’s all?
My nephew in the other medical school
comes to wards before the HOs arrive,
He reads up on ALL the patients in the ward team
And he presents them to the ‘Con.
So, you are only presenting one patient?
You are a graduating student, for crying aloud...”
House Officer/Intern
“Lokun, must take blood again ah?
This morning take already lah,
I scared needle one, leh. Bo pian ah?
Okay lorh, can make less pain…
AH!! OWWW!! Mati ah!
You sure got do before anot?
Why you have to poke me? So many times!
Poke also no blood
Missy poke so many times but got blood
Go away, siam!"
Consultant/ Attending
“Another resident went on no-pay leave?
Man, this truly is the strawberry generation
Back in the good ol' days,
We went on calls back-to-back
Did what we had to do
And we made it, didn't we?
If they don't have the iron in the belly
How are they going to survive
The rest of their career?"
Did you hear about that house officer?
She was doing so well,
Nominated for ’Best House Officer’ even
But she took her post-call off today
When the team is busier than usual…
Hmm, so much for team-spirit, huh?
Oh well.
Post-Script
Dear diary,
Why did I choose to become a doctor?
Poet’s reflections:
Impostor Syndrome is the state of feeling inadequate, that one is a fraud. A self-professed imposter believes that their success is falsely attributed to them, that their position or state of being is counterfeit. The absence of the word 'syndrome' from the title reflects the persona's belief that they are not merely suffering from self-projection of personal inadequacy, but that their self-concept has completely embraced the identity of an Impostor.
Merriam-Webster defines Shame as ' painful emotion caused by consciousness of guilt, shortcoming, or impropriety', and 'a condition of humiliating disgrace or disrepute'. To shame someone is to obliterate their standing before others and inflict profound damage to their standing, esteem, and self-concept.
I wish that I could add a disclaimer: "warning: this piece is entirely fictional, any resemblance to real persons or events is purely coincidental", but we know that with a few changes of names and descriptive details, these soundbites are sadly familiar to many. A more astute observation would be that shaming starts as early as pre-medical days, and is as enduring as the medical career itself.
In conflict narrative, a person is pitted against the physical environment, the society/system, fellow people, and against themselves. But woe to the young doctor/-to-be – on the receiving end personal shaming yet also audience to the shaming of others; beset by themselves, other medical students, attending doctors, other healthcare professionals, non-medical peers – without relief. Is it a wonder that the persona no longer treats Impostor Syndrome as a pathological state of maladaptive behavior, but as the true sense of self?
I hope that this piece does not become a turning of tables, nor do I wish for this work to be used to shame the shamers. As with many issues surrounding health and healthcare, the first step to change is to acknowledge that shaming exists in this place, both in medical education and practice, and then to start with one’s self. If we may recognize ourselves among the throng, perhaps that is a good place to start giving thought to one’s ways, lest we who are with sin cast the first stone at our fellow sinners.
While giving a voice to the collective experience of fellow medical students, I hope that this piece prompts self-reflection: How can we address instances of shaming that we witness? What comes to mind when someone shames me, whether unintentionally or otherwise? How can I turn the proverbial lemon into refreshing lemonade?
“If you know yourself and know your enemy, you will not fear the outcome of a thousand battles.”
~ Sun Tzu, The Art of War.
Glossary
PRE-MEDICAL STUDENT
Meh, horh - Singaporean slang suffixes added to make phrases more colloquial
PRE-CLINICAL MEDICAL STUDENT
IM - Internal Medicine (Internist)
GP: general practitioner, either formally trained as a family physician via family medicine residency, or (more often) a non-resident locum physician working in private practice.
MEDICAL STUDENT ON THE WARDS
'Song-and-dance' - a perfectly memorized and executed sequence of steps in clinical examination ('dance') and presentation of findings to the examiner ('song').
In medical schools awarding the MBBS degree (undergraduate equivalent of MD), conferment of the medical degree is done upon passing of a series of highly rigorous examinations. Test items are repeated frequently across years, thus generations of medical students have consolidated study notes ('scripts') aimed at acing these exam stations.
As the format of examinations in graduate medical schools may differ from that in the local undergraduate setting, it is unsurprising that graduate medical students are unfamiliar with the clinical examination routine expected by their senior doctors, who were trained in a different system familiar to most.
RESEARCH YEAR STUDENT
‘first-author’: a publication in which one was the first author (i.e. the main driver of the research project)
FINAL YEAR STUDENT
HO: House Officer/Intern
‘Con: Consultant/ Attending Doctor
HOUSE OFFICER / INTERN
Bo pian (Hokkien): it can’t be helped, there’s no other way except to do (this)
Lokun (Hokkien): doctor/physician
Lorh, leh, lah, ah, horh - Singaporean slang suffixes added to make phrases more colloquial
Mati (Malay): to die/ to be dying (used as hyperbole in this example)
Siam (Hokkien): scram, or, get lost
CONSULTING-ATTENDING
Strawberry generation - a strawberry is good looking on the outside, but easily squashed. A term used by seniors/ to mock the young for being weak/ unable to withstand pressure
