All in their sweet seventeens, each a bright student from their respective school was on their very first day of medical college. The College Dean welcomed us saying that from that very day all of us were Doctors and there was nothing that could change that. All went well, people were attentive in class, almost full-attendance every day and some really thought that they had met their friend for life. Cut to that, the results of the first internal exam and the celebrity intoxication of just entering medical school were completely washed off. From then on for the next four and a half years, people would bunk classes to prepare for an exam, study only when there is an exam, or doze off in lecture halls after the attendance was marked such that it doesn't dwindle below the required 75%. College life is never rosy as shown in the movies and medical colleges, life is just amidst thorn plants that have forgotten to flower.
Where exactly is the problem? Until school life, we are very much spoon-fed and not all peers are at the same level. Here, you are put in a super-competent cluster that thinks and does things almost the same way as you do. Also, when you are left on your own, the entire situation makes you feel threatened. What's more complicating is that all are in the same boat, but wouldn't come together to prevent it from sinking due to ego clashes, insecurity, and jealousy. Really? Absolutely, yes. If one comes up with a suggestion or willingly helps others, they become the 'showoff'. On the other hand, if you just mind your business, you'll be 'unkind'. You are always labeled and there is no way one can fit into all or even be made to feel welcomed. Most tasks assigned to you at college are graded individually. It makes sense because they are ensuring you are good enough to survive by yourself once you are out of college. The class strength of medical schools is a hundred and above. Plenty of my classmates couldn't recognize their peers even at the end of five and a half years. The batch is split into multiple groups for clinical rotations into different departments and schedules keep changing almost every month. This considerably lowers the interactions with other groups. The exam patterns are also based on learning and reproducing facts with very little scope for combined activity.
Do I mean to say that there is no chance for friendship in medical school? Certainly not. People do find friends but don't cordially learn with their acquaintances. Let's see what a group of best friends for over 5 years who met in medical college feel about learning and retaining so much data.
I'll go first, " I always try to arrive at the simplest explanation for a topic, if I can make someone else understand through my explanation, I need not revisit those topics."
Friend 1: "I visualize the content in my own body like sending a mini camera into that part and imagining what is said to happen."
Friend 2: " I understand better when I read something right from the basics rather than facts. It is time-consuming but establishing connections helps me retain a lot better.
Friend 3: "I prefer to watch related videos, and animated stuff and understand a lot better through pictures."
Friend 4: "I study regularly which helps me retain information a lot better. Also, coming across a relevant clinical case makes it easier."
Surprisingly, we have never had this conversation before. Each of these methods seems so good but not one of us would have covered the entire syllabus this way. If only we had permutation and a combination of these methods, it would have been much easier at college. Why we didn't do this? We have no idea. But back then we felt, it would have affected our friendship. Is it really necessary to be friends when you are a part of a study group? Can't study groups be exclusive?
What about the seniors you might ask. Won't they make great mentors? Quite a number of seniors are horrible bullies. Ragging at medical colleges is so common, extremely bad, and makes headlines almost every week in some parts of the country. A majority of them just stay away from juniors so as not to get involved in anything. A few angels take time out to get to know their juniors and guide them to not make the mistakes they did. Well, this only happens if you are the chosen one.
Professors too, don't find enough time to counsel these rookies as there is already plenty on their plate. Most of the lectures are didactic with all the conversation happening on one side. In the clinical postings, it is the exact opposite, it's always a shower of questions, where students are humiliated every now and then for the slightest of mistakes in front of both their peers and patients. For fear of embarrassment, most students shy away from approaching teachers for help. Learning is at its best when the students are comfortable and inquisitive. Not being put to shame for not knowing things before class. This is also the reason why people forego lectures and seek refuge in the libraries to learn it all by themselves for hours at a stretch.
The pandemic brought a huge change in the way medical students study. With colleges and libraries shut, people resorted to online learning. Plenty of paid and unpaid resources, varied options to choose from, and a perfect way to study in your shell. Some of the faculty here manage to reach out and also clear doubts of students. This should be an advantage, right? But what it led to was, people inattentive in classes, missing clinical postings, and only studying to score in exams. Most of these online resources are marketed toward competitive exam preparation with a vast index of topics and crisp notes. So, instead of concentrating on graduating with a professional degree, students get into the race for entry to higher studies. A senior Professor, Dr. SP Kalantri, in deep remorse tweeted, "NEET has decimated the joy of learning and teaching. Classrooms are empty, wards are deserted, and students feel that learning medicine at the patient's bedside won't help them get the postgraduate seat."
Online Study groups are a boon to these lonely medicos. These are small online communities that share study tips, notes, and updates on exams. Some of them also extend as support groups where one can vent out their problems and seek solutions. Certain groups get on video calls and study together. Student influencers with their aesthetic Pinterest backdrops and an enviable collection of stationary also offer insights to study and cope with various problems that we face in medical school. All these offer great networking opportunities and exposure to even people in the remotest of places. But they are more like an escape from the toxic college environment and finding love for learning online. If only these learning models can be replicated in real life at the college level, life would be so much better.
As doctors, we are expected to lead teams in the future. Leading by example in minuscule things like initiating new projects or taking up responsible roles in a team project would only build confidence later on. Multi-disciplinary treatment approaches require us to collaborate with colleagues from other departments very often. Stories of conflicts between departments to take responsibility for cases are something we are very familiar with. When will one get to learn to behave cordially with their acquaintances? Above all, why aren't people who are celebrated for their kindness, and compassion towards their own kind? Getting a second medical opinion is an absolute right of the patient. As professionals, we must put forward our solutions to them. It is always up to the patient to make an informed decision for his own body. Doctors often malign each other and being critical of their contemporaries is also not unheard of. Due to the absence of this simple civility patients might even tend to question the whole concept of treatment when doctors don't agree and respect each other.
Competitions are a part and parcel of every endeavor, in any field but not so venomous as in the medical field. We are way ahead of the times of denial, people accept that toxicity in the field exists greatly. Some quit due to the very same reason. Some succumb to this culture and accept it as a way of life. Most of them are between a rock and hard place and suffer throughout trying to find a balance. These destructive acts would not only spoil the work environment now but also come in the way of future innovations. The only possible way to eliminate these would be to find a solution at the ground level.
We find memes calling out the toxic culture referring to med-students as snakes, funny and relatable. But what we forget is that we are products of this very culture which shouldn't be difficult to get rid of. Medical college life has plenty of scope for holistic learning loaded with a good deal of opportunities and adequate time to upskill yourself before entering the outside world. Exams are here to stay, but what happens after they are done? The person sitting next to you in class is not your potential rival but an affable companion. Create, Collaborate and Co-exist. Also, don't be a slithering reptile.