By By Vietrez P. David-Abella, MD
Medical Boards
posted 6-Jun-2015  ·  
702 views  ·   0 comments  ·  

Just like that, medical school was over.  April 30, 1991 was the last day of our internship. The next day we would be turning over the frontline of the Philippine General Hospital to the next batch. We gathered at the main lobby just before 12 midnight, euphoric that all that sacrifice would soon pay off with the cherished M.D. at the end of our names. Although there were still some exams to hurdle, requirements to pass, and clearances to process; THIS was the day that I had been looking forward to, 7 years ago, though never clearly visualized, clouded as it was with day-to-day survival.

The fireworks were fitting, as we went around PGH, signing each others' uniforms, congratulating one other, thanking staff who shared in our clinical life. But it was a bittersweet moment: it was also a time of parting for most of us, each to pursue his or her own career.  Many had decided to go on to specialization, either abroad or locally. Some had decided to plant roots in various frontline communities.

Wherever we intended to go, we felt that our years at the UP College of Medicine had prepared us adequately. Whatever knowledge that years of book- and journal-reading had not crammed into our heads, we knew how to look for. Whatever skills that hundreds of procedures, such as intravenous insertions, blood extractions, cut downs, nasogastric tube and indwelling urinary catheter placements, suturing, etc., had not taught us, we could acquire, given more training.

We were excellently trained to be menders of body. But we were not taught to mend souls, because that must be gained in a lifetime of touching lives and being touched in turn. And our lives as clinicians was just starting.

As soon as graduation was over, with academic requirements and documentary requisites completed, farewell outings and celebratory parties done, we buckled down to studying for the board exams. That time, review schools were not yet in vogue, so it was self-study for most of us. A few weeks before the actual tests, friends got together to review as a group, and find out from each other how much they already knew, and spur themselves to cram into their heads what they didn't.

For the entire month before our scheduled exams, the skies seemed to commiserate with our gloomy state. It rained all the time, which was just as well, focusing us on the task ahead. We were concerned though, that floods might deter us from getting to our testing centers, which was at the University Belt for most of us. And indeed, on the first day of the four-day intellectual marathon, some examines came in late because of some inundated Manila streets.

After day 2 of the 2-weekend exercise, some of us took movie breaks to refresh our minds and prepare ourselves for the final lap. It was do-or-die: although for the upper 10% of the batch, the goal was getting into the top and a lifetime of bragging rights, for most of us, we got it into our heads that the curse of the once-in-a-decade Board failer was upon us. That thought was banished 4 months later, when the results finally came out, and we tucked the 1991 Boards under our belts.

Then there were applications to residency programs. While some continued on, reviewing for the U.S. Boards, a handful proceeded to their community outposts. I had my sights set to general surgery, so I had a few months' respite before the arduous 5-year surgical training ahead.

Surgical residency is a mentoring process: it cannot be gleaned simply from books. It must be learned from actual patients, under the guidance of a mentor. One can self-learn, but at great expense to society in terms of lives lost or maimed. Surgery, like most scientific disciplines, builds up on the knowledge of previous generations. This is why we have books, publications, and now the Internet: to share what we know to benefit the future generations.

Medical school was but a compass to guide us how to extract history, do physical examination, arrive at a tentative diagnosis, and what tests to request to confirm the diagnosis. Then finally, what treatment to prescribe. Surgical training would be the actual trek in the woods, the start of a journey through uncharted lands.

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