Sep 7, 2023 6 min read

6 Things I wish I knew before becoming a Doctor

Night after night.

I was 15 years old when I spent my first time shadowing a doctor in a hospital. I was always fascinated by the intricacies of the human body. Apart from breaking my arm as a kid, I didn’t really have much experience in the hospital except for when I got seriously ill when I was about 10 years old.

Anyway, I was shadowing this endocrinologist consultant for a week and before I started, I didn’t really know what to expect.

An endocrinologist is a specialist who diagnoses and treats disorders related to hormones and the endocrine system, which includes glands such as the thyroid, pancreas, and pituitary gland.

The week went by in a flash and I remember it quite vividly even today. I was a pretty shy kid back then and I was just trying to soak it all in. Tagging along with the doctor who was constantly running around. Most kids like me back then try to get work experience in a hospital or volunteering so that they can say in their personal statements how it fascinated them and changed their lives. And how it’s always been their dream to be a doctor.

For me, no such thing happened.

I find it a bit odd that people can be so certain about what they want to do so early on in their life. With no real life experience. The hospital was cool and everything. But there was nothing during that week that stood out to me.

Except for one moment on the last day.

I was shadowing the doctor and something happened. The consultant received a call from the emergency department informing him that a patient had been brought in with uncontrolled diabetes. We went and found the patient in a critical condition. They were unresponsive having missed insulin doses and started seizing. They had diabetic ketoacidosis.

Essentially, it’s a severe insulin deficiency which results in ketosis. Its a medical emergency. The doctor quickly assessed the situation and instructed the team to administer treatment to stabilise the patient’s blood sugar levels. I took a step back was watching him work and was kind of in awe. He assessed the patient quickly and recognised what was wrong based on the medical history and clinical signs.

He delegated tasks to nurses and doctors politely but firmly. It was all happening super fast. The patient thankfully stabilised and was transferred to ICU for observation and treatment. I was pretty amazed at the skill and dedication shown by the entire medical team.

As I left the hospital that day, I felt I witnessed something significant. I realised that being a doctor is more than just treating diseases – it was about making a real difference in the lives of patients and their families.

Reflecting on that moment, there is so much to medicine than you think..

Let's get into the 6 things I wish I knew before becoming a doctor.

1. You have to be an organiser.

You need to be efficient with administrative tasks. You’ll find yourself doing lots of these and you just need to get good at doing them thoroughly but promptly. You’ll be writing tons of discharge summaries. Ordering blood tests and diagnostic scans. Sending referral requests. And documenting in the patients notes. You have to document everything. Documenting is never a waste of time. I found it quite hard to get adjusted to this in one of my rotations where I would go around with the consultant on the ward round. We would see each patient and it felt so quick. You don’t even have time to prepare the notes sometimes. You have to write the latest scan results, blood tests, fluid balance chart and their observations. As well as checking the drug chart and their medications, looking to see if there’s anything contraindications or anything that should be stopped if they’re having surgery. And then you’d then have to listen and observe the encounter with the patient and then document the patient’s vitals, examination findings and the management plan.

I would be doing this pen on paper by the way. Frantically trying to keep up. Then you would repeat this for the other patients on the ward round. The consultant would be walking to the next patient whilst you’re furiously scribbling away.

Any of my colleagues that get to do this on computers, count your blessings.

So yes, it might be difficult at the start to get adjusted to but being efficient with these tasks can save time and improve patient care.

2. You need to learn to prioritise tasks well.

This cannot be understated. As a doctor you’ll find yourself on the wards a lot. You’ll be seeing lots of patients and you’ll often have a limited time to spend with each one. You’ll have lots of jobs for each patient and they’ll pile up quickly. Prioritising tasks helps you manage your time effectively and manage a heavy workload. Prioritising also ensures that more urgent cases are addressed first. You have to create or follow efficient systems. Asking the person that worked the rotation before you can help you to find out what the common tasks were or what systems they used that really helped them day to day so that you can learn from them.

3. Take responsibility for your actions.

Don’t cover up mistakes. Learn from them. We cover up mistakes, not only to protect ourselves from others, but to protect us from ourselves. This is the basic perspective of mistakes – that failure is a profoundly negative thing. We associate mistakes with something to be ashamed of in ourselves, and judgemental about in others.

It has deep psychological and probably cultural roots.

I remember a senior colleague made a prescribing error. It wasn’t serious enough to cause actual harm to the patient, I think the patient might have had one dose of what was prescribed. But regardless, it was picked up on before it could cause further potential harm. What impressed me the most was their candour and integrity. They notified the patient, their family and explained what had happened. As well as documenting all the events in great detail in the patients notes.

💡

“Learn from the mistakes of others. You can’t live long enough to make them all yourself.’” - Matthew Syed

You were a human before you became a doctor.

Mistakes are sometimes not the actual problem, the issue arises when the mistake is not picked up and no one is notified and it escalates.

If you operate with an open disclosure policy, you’ll find that your reputation will improve.

Why?

Because people prefer working with those who are perceived as safe. If you accept your limitations and are willing to learn, people will be more likely to want to teach you and be a part of your development. Also reflecting on these events are important. When we identify errors, we acknowledge them and take action to prevent them in the future – that is when we learn from our mistakes.

For a few months now I’ve been trying to reflect every day and part of the reflection includes something that I’ve learned each day.

4. Understand the importance of communication skills.

This one might seem like a no brainer. You’re taught in med school the importance of communication. Medics should be able to communicate clearly and effectively with patients and their families. It's crucial to listen actively, empathise, and communicate information in a way that patients can understand.

They might not understand what a CFTR protein mutation is and how the autosomal recessive inheritance pattern of the genetic disorder is the reason why their child has cystic fibrosis. Good communication skills can help build trust and create a positive patient experience.

5. Be self-aware.

This next one is important.

Think about when you’ve have a super high pressure day at work. Non stop emails, overdue tasks, colleagues asking for updates, finishing work late. You might find yourself being snappy with family, friends or even your colleagues. It’s no different in medicine. When you’re under pressure in the hospital and a patient is unwell, you’re tired, stressed and you have a mammoth pile of jobs to do. It can be easy to let your frustration and stress leak out.

You need to be cognisant and conscious of your feelings. And it’s important for maintain good relationships with your colleagues. The first step is to recognise how you feel. Then take appropriate action. Taking a break to reset or doing some breathing exercises might help when you’re stressed.

Always be kind, humble and smile.

6. There’s more to life than medicine.

When you’re starting out it can be intimidating. New environment. New people to work with. It can feel like you’re under pressure a lot with the work load. Long shifts and working nights. 70 hour weeks. You can sometimes feel a bit dissociated from the real world. Burnout in medicine is a real thing. At times it might seem like it’s taking over your life. The days are long and you’ll be working weekends, nights and everything in between. I also feel we kinda live in a world where we are seemingly forced to take one field or career and stick to it for the rest of our lives and let whatever title we get define us.

Just enjoy the process. Spend time with family. Exercise and don’t give up on your hobbies and good habits. Buy that ticket to visit your friends. Go on that holiday. Your “job” doesn’t have to define you.

Life is too short.