It's eight pm on a Thursday and a pretty quiet night for
those on call. The black leather couches of the lounge
are draped with slumped forms in white coats and green
scrubs. A mish-mash of residents and clerks stare blankly
at the TV, styrofoam containers of takeout dinner in hand.
From a distance, they're all wearing the same clothes,
carrying the same equipment, referencing the same booklets.
But are they really so similar?
Med school has often been referred
to as the 'great homogenizer.' Students from various
backgrounds are often entered into the program because
of the sum of their unique traits. But after four years
of the same training, does medical school homogenize
all its graduates? After the four years are up, graduates
are expected to fit discrete criteria to get into residency
programs. At this crucial point, they may discover that
the traits that once separated them from the pack have
either been lost or transmogrified into skills shared
by all their other colleagues.
ADAPTING
TO THE ENVIRONMENT
Dr Eric Menendez, a lanky guy with sharp eyes and pointed
features, is a first year emergency resident. He's dressed
the part with greens, white coat and runners —
you would never have guessed that he's an avid scuba
diver. Sitting beside him is Ben Harmon, a third year
clerk with a Master's degree in cell metabolism and
a former rugby champion to boot.
Did medical school homogenize these
men to better fit the role of doctor? Neither of them
thinks that this is the case. "Med school doesn't homogenize
you, but to a certain degree, you have to adapt to become
a doctor," argues Dr Menendez. Does this mean that what
makes you shine during med school interviews has to
be sacrificed? Family medicine resident Dr Henry Gurinder
laughs at the mention of the word 'homogenize.' The
former ski instructor responds without hesitation that
yes, med school is homogenizing, but as for your individuality,
"You get it back. You lose it during training, but you're
still the same in the end."
When everyone's educational background
before medicine is drawn out, it soon becomes apparent
how diverse these people are. One doctor got her degree
in classical music, followed by a nursing degree, before
she entered medicine. An attending physician, Dr Georgina
Rao, pipes up, "I was an engineer, and I hated it" —
the engineering ring still adorns her pinky finger though.
BIRDS
OF A FEATHER
What then, of the idea that students are being changed
to fit the role of what they eventually want to be with
respect to residency programs? All the jokes about orthopedic
surgeons, the quips about internists; they must arise
from somewhere. "The stereotypes tend to hold," says
Dr Gurinder. Both Drs Rao and Menendez agree. "But who
you are remains the same regardless of training. Certain
specialties just attract a certain personality type,"
pipes in Dr Menendez.
What about the people who don't
fit these stereotypes, who refuse to be homogenized
or conform to specialty expectations? Can these outliers,
if you will, still succeed? Dr Menendez answers with
a firm "No. Someone who isn't willing to miss their
child's first steps will never be a surgeon, because
that's what it takes." It would seem that surgeons need
to be tougher than most.
FITTING
INTO A SPECIALTY
Ben recalls a conversation with his fellow clerk and
rugby teammate a week earlier. The conversation had
been peppered with complaints about fatigue and feeling
overwhelmed but ultimately ended with, "You just don't
go home post-call in orthopedics. You just don't." On
hearing this, Dr Rao adds, "Ortho... It changes you.
If you don't fit, you're out." Everyone appears to agree
that success in a chosen specialty is influenced by
one's ability to fit the criteria of that program.
So what happens after all the training
is finally complete? If you truly get your individualism
back, would those who've been in practice for some time
be able to vouch for that? Dr Rao would but concedes
that there are definitely some programs where members
tend to be very similar indeed — it depends on
the specialty.
When spending the majority of your
waking moments with the same people, it isn't surprising
that you begin to resemble each other. "Maybe it all
comes down to cognitive dissonance. Sometimes it's tough,
and you either have to change your behaviour or your
perception to make it through," says Dr Rao. So, while
med school is designed to select and strengthen similar
traits in students, they do retain their uniqueness
underneath it all.
Note: All names have been changed
to protect the identities of the interviewees.
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