Discouraged

I had some discouraging experiences with patients today. Roamed around for ages trying to find patients for a long case (this is where we spend 1 hour with the patient, get a full medical history from them and perform a basic physical examination). Obviously, not all patients in hospital are well enough for this, but usually the doctors on the wards give us names of patients who are not going too badly and are well enough to talk... but none of the patients I approached wanted to speak to a medical student. Not only that, some of them were quite rude about it too. As though a medical student was the worst pest they've ever come across. Worse than tele-marketers. Worse than beggars on the street. Or so it would seem, from their tone, anyway. As though they would prefer that med students didn't exist. Little do they care that medical students need their practice and learning in order to become the doctors that look after them (to whom they at least DO show respect) - why would they care about how good the interns are in two years time? They just want to be comfortable, now!

It's just frustrating. It takes a lot of mental motivation and stamina to psych oneself up to do a long case, preparation of notes etc... and when the patient says no it's very deflating. What happened to the days when public hospital patients felt grateful at the free treatment they received, and sought to repay some of that in what ways they could? Not to say that all the patients are like this - some are great, and I am really grateful that they are there, not only because I can do a long case, but because they are the ones that are keeping the training of medical students possible. Literally.

I believe, from reading bits and pieces of things on the internet and talking to friends overseas, that things are different in America. There, the teaching hospitals (i.e. the hospitals with medical students) have very strong affiliations with medical schools. The fact that teaching is a priority is seen in the fact that on their websites, they attract clientele by proclaiming that they are a teaching hospital (and hence have good know-how, technology etc), and that their names, if a big hospital, is actually the name of the medical school. None of this 'clinical school' within public hospital thing in Australia, their medical school IS their hospital - it's one and the same. I still remember in neuro block that on the first day, in our orientation, we were told by the neurologist that 'you can come to clinic, but you may not get a lot of teaching, depending on how many patients we have, because it's primarily a service-provision clinic, this hospital is mainly for service-provision.' Get the hint? 'We don't want you here disturbing our work, kiddos.' Yet it's not his fault. It's not his fault that there is a lot of pressure on public hospitals, already overworked and always running behind, to crunch through patients and produce, produce, produce. It's the system. And one person can hardly change the system.

It sucks. But it's a bigger problem. It's not just medical students. Interns and residents, who are supposed to be 'doctors-in-training', are the mules of the public hospital, forced to work, work, work, prohibited from attending their training sessions (which is against their contracts), prohibited from having lunch (which is against their human rights). And it's a bigger problem than that. Australia is known for its lack of emphasis and investment on education and training, on research and development. In such a society where the focus is on living a relaxed life here and now, where learning is not valued, where 'tall poppies' are frowned upon, where the eye is not cast upon the future, is it any surprise, really, the lack of support for medical students? As the great Aussie catchcry goes -

"You'll be roight, mate!"