Anonymous

I knew from the beginning that if I were to write a blog that included my experiences of medicine, and possibly some of my experiences with patients, it would need to be anonymous. I've mentioned this briefly before but it does need a post of its own to explain this.

Posts like this one, and one in my head about a patient I saw die, seem to require anonymity to protect the patient's identity as well as my own. Of course I do everything I can to protect the patient's identity anyway (changing identifiers etc), so that even the patient themself wouldn't necessarily recognise themself in my blog. But it's easier to ensure nobody recognises the patient if they don't already know which hospital, city or even area of the country the patient was seen in, or which medical student or doctor they saw.

There's also the issue that I don't particularly want my future patients to read this and know that it's their doctor, looking after them, who wrote it*. They could easily lose faith in me or not want me to be their doctor. It's not that I'm lying to them, but my doctor-face that I present professionally is confident and professional, and different to my blog-face and the things I share on here - my fears and failings, along with some potentially more contraversial thoughts.

I talked to a (non-medical) friend recently, and told them I had to re-take an exam and only narrowly passed a few others; their response was "I'm glad you're not my doctor" - I can see why. But once I have passed, I am deemed safe and competent enough to practice, and I'm no different to any other doctor. I hope my patients would see that, but some wouldn't and there's no need to tell them all and make an issue out of it.

I don't necessarily want all my colleagues to know that this is me, I don't want my consultants to know my fears and failings - if I did, I could tell them.

My posts about my medical school have sometimes been far from positive, but I don't want to bring them a bad reputation, just because I blog negatively about this medical school and people may not about others. And you never know, they could pull me up on things I've posted - it wouldn't be the first time a student had been reprimanded for things they'd put on the internet.

Since my posts about my family aren't always complimentary, I don't want them to see this blog and know that it's me, either.

If this blog weren't anonymous, I'd need to censor it and be more careful of what I wrote and how it could come back to bite me in the future.

I'm aware that other medical students don't always blog anonymously. The medstudent in the link implies that being proud of what she writes is part of why she doesn't blog anonymously. That's not to say I'm not proud of what I've written, I am to some extent (the mopey and despairing posts, less so), but I think the reasons for anonymity far outweigh the reasons against.

I hope that doesn't make me a coward - I don't think it does, but I'm sure it could be suggested.


If you know me personally and want to share this blog, feel free to but I'd prefer it if you don't blow my cover. Please do share it, it would be nice to have more people read it, but please don't share it in connection with my name or identifiers. This post has been a long time coming, and it's because of this bit that I haven't really felt able to share this blog with people I know until know. Apologies to people I know who've come here, you've got 34 posts to get through if you want to read this blog!

*If you don't know me, and you've read this, would you want me looking after you? Really?

There are no laurels to rest on

Nice as it was to learn that I'd passed all of my recent exams, that silver lining had a cloud. Yesterday I was given my exact marks for the exams, and discovered that my two recent practical exams were very, very narrow passes. By 4 or 5 marks, and since the overall exam has over a thousand marks, that is tiny. I scraped through both exams, and it was very very close. Too close, there's no margin for error.

The day of the big exam was a "good day". I'd done a load of confidence building and affirmations, put my positive mindset on, and got in the best frame of mind. Nothing at all went wrong, and I was the best I could be for almost all the exam (although towards the end of the three hours I did get pretty tired, everyone does). So if my absolute best is to scrape through with the tiniest margin of error, what happens if I'm not at my absolute best next time? I might have a streaming cold, a headache, too much nerves, a grumpy examiner - anything that could lose me those 4 or 5 marks.

This has at least put the frighteners on and given me a considerable kick up the rear to get me back into revising and not sitting around beinig complacent, but for a good 24 hours it pushed me too far. I think there's a scale of:
complacent, unmotivated, not working enough ----to---- motivated, hard-working, slightly scared but in a healthy way -----to---- panicked, totally terrified, unable to work, so convinced of failure what's the point in working
and I went from the left end to the right end, completely bypassing the healthy middle. An email from a friend, an email from a mentor, and some time with the other re-takers later, I'm feeling a bit less chicken-heady (I am no longer running around with my head chopped off, which I was mentally doing this morning). I'm towards the right of the middle and it would be good to get even further towards the middle.

It would be easier if I knew what I was actually doing wrong in the exams and had some idea of what to improve, but no, that would be too easy. Medical school is a cryptic crossword. It's very frustrating to have a station which I thought went amazingly (patient/actor clearly liked me, I asked all the questions for the diagnosis and all the others to rule out a differential diagnosis, I answered the viva questions brilliantly - I am not a show-off, but I thought it was my best station of the day), the examiner gave largely positive feedback comments, with the only negative that I was "a little slow to get through all the points" - this does at least suggest that I got through all the points, to fail the station getting a little over 50% of the marks. How does that work?!

So in the absence of really having an idea of what to improve, I just need to spend the next three weeks becoming the most incredible doctor all-round that there could possibly be. I will dazzle and amaze all the examiners. A tall order but who knows what could happen...

And I will not spend the next three weeks wondering whether these horrendous results suggest that actually I'm not really ready to be a doctor, and it would be much safer for me and the general public if I did re-take the year, learn how to be a good doctor, and make a better attempt next year when I actually know something. That is not productive thinking. But it is tempting.


The above is yet another reason why this blog is anonymous. My patients don't really want to know how much I've failed, or how close I came to failing. At least, they don't want to know that and then continue to be treated by me. And I will want them to continue to be treated by me - it would be embarassing for me and problematic for the hospital if not. Much as medicine is trying to break with the tradition of paternalistic "the patient doesn't want to know X [often that they had cancer]", I feel it's appropriate here if only for my own peace of mind. I want my patients to have confidence in me. If I pass, I've passed and I am good enough to be their doctor. If they knew the numbers this may be less obvious.