Fourth year medical students get away with ... a lot

I want to say that we get away with murder, but I don't want some news organization picking up this blog post and saying that medical students are killing patients. We're not! It's just an expression! We are just flying under the radar during our last few weeks of student life. Let me explain.

Fourth year of medical school after the match is largely viewed as vacation time--whether or not you are assigned to be in the hospital. Most students know where they are going for residency, and they know their grades no longer matter. Many people go backpacking across Europe for a few months or "learn Spanish" in Costa Rica or Honduras. My school has quite a few fourth year requirements, so a good number of my classmates are around the medical school campus. However, even if they are supposed to be on the wards, the vacation mentality still prevails. A year ago, students would read about their clinic patients the night before, take copious notes, and maybe even read up on a few of the patients' diseases; now, it's not unusual for the same fourth-year student to slip into clinic an hour late, hoping no one will notice but not too concerned if someone does.

Where did this mentality come from? How do we get away with this slacker behavior? My guess is that this mentality is largely passed on from our supervising residents and attendings. They remember with great fondness the trips they took at the end of the their medical school years and often overlook students' behavior. They know that the next year will possibly be the toughest of our lives, and they are more than willing to give us a few breaks before the insanity begins. I can't tell you how many times in the middle of the workday my resident has told me to run along homeand enjoy my fourth year. How many times can you say no to that?

I haven't been bending the rules too much, but I have been enjoying the free time that comes with relaxed rotations lacking call. My husband and I found an apartment in what my realtor said was one of the worst rental markets in years. Anyway, with that squared away, I've enjoyed the extra time to read. Some recent excellent books include the following:

• Second Opinions by Dr. Jerome Groopman. While some students might shy away from reading about healthcare during their few vacation weeks, my fear of making mistakes during residency is very real. This book was also so engrossing that while reading it in a waiting room I asked my doctor to give me a few seconds to finish the page! The author does an excellent job of illustrating cases when doctors make mistakes. I finally got my hands on How Doctors Think from the library, and I'm looking forward to reading his suggestions on avoiding mistakes.


• Dreams from My Father by Barack Obama. Next year's presidential election will be insane. How was there already a debate among the Democratic Party candidates? Anyway, I'm trying to learn as much as I can about each candidate, and Obama's first book flows just as well as his stump speeches. I'm not half Kenyan, half white growing up in Indonesia and Hawaii with a mixture of Muslim and Christian family members, but his story of struggling to find a place in the world is one everyone can relate to. I'm pretty sure Hillary's autobiography won't be as interesting, but I am eager to read her thought on the Clinton healthcare plan.


• The Omnivore's Dilemma by Michael Pollan. Wow, I consider myself an environmentalist, but I had not spent much time thinking about where my food comes from and the environmental and nutritional consequences of industrial agriculture. Now that I know, what am I going to do about it? I have a small action plan, but that's another post.

Yes, I like reading nonfiction. My problem with fiction is that if the story is good I'll want to stay up all night to finish it. If the story doesn't make me want to stay up all night, then why would I want to read it?

Anyway, since this post was supposed to be how chill the end of medical school is, it should come as no surprise that I will be on vacation for the next two weeks and likely not posting at all. (I'm bringing How Doctors Think and Bridge for Dummies with me.) However, when I return, I'll be moving to my new apartment and have just a few short weeks before the beginning of intern orientation. I'm sure this blog will get much juicier then!