人生沒有用不到的經歷

 

最近讀到「30 things every med student should have and should know by graduation」。美國學士後的四年醫學教育，相當於台灣六年制的大三~大六，換句話說，台灣的大一與大二就是美國的醫預科。美國的醫預科從大二開始，想要讀醫學院的大學生會選修生物醫學相關課程，台灣的醫教改革忽略這點，把美式的基礎/臨床整合教學硬搬到台灣，還規定大二不准修醫學課程，結果是，大三苦不堪言，因為解剖/生理/病理/微免/臨床以前毫無概念，現在一起灌進來，醫學生「只能」依賴共筆，否則很難活下去。

當你以「老鳥」的姿態在學弟妹面前展現時，回到寢室坐在書桌前拿起原文書翻開幾頁，問問自己，你所讀與你現在的年級，在醫學院裡是不是「草包」！下文中，版主最欣賞的兩句話是：
By graduation, you should know
That you can’t change the med school you attended, the residency program you’ve been matched to, or the fact that you’ll be applying to fellowship all over again in a few years. (意指：如果你上不了你想上的醫學院，你可以努力讀書，爭取申請到好的醫院做住院醫師；等到醫學院畢業時，你很難改變未來的一切。)

That the grades from your clinical rotations may not have been stellar, but at least you never have to go back to being a third year med student. (意指：第三年醫學生在醫院很菜，你現在已畢業了，即使見習的各科分數不亮眼，學養不要比第三年醫學生還菜。-----美國第三年醫學生相當於台灣的大五醫學生)

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By graduation, you should have … 
1. One attending who you want to emulate when you become a physician, and one who you vow never to be like. (attending=attending physician, 主治醫師)
2. A copy of Netter’s anatomy textbook never owned by anyone else.
3. The perfect tailored suit for your residency interviews, and the perfect outfit for the resident happy hour the night before.
4. A stethoscope, ophthalmoscope, and reflex hammer you’re not ashamed to carry around.
5. Step 1 scores you are proud to leave behind. (Step 1 是USMLE 的Step1 基礎醫學；這句的意思是 “你可以為通過且拋開了Step 1 的分數而感覺驕傲”)
6. A patient story moving enough to retell until you’re an attending.
7. The realization that you’ll actually be an attending one day, and a loan repayment plan in place after graduation.
8. A Facebook and Twitter account cleaned up enough that any future patient can see it.
9. A resume that shows all your hard work during med school.
10. One classmate who helps you study, and another who helps you let loose on weekends.
11. Extra gauze, sutures, and trauma scissors in your white coat pocket.
12. Something engraved with “Your Name, M.D.” because you totally deserve it.
13. The knowledge that yes, after four years of hard work, you do deserve that M.D.
14. A sleep mask, a good coffee maker, and a plan for dealing with the night shift during residency. (醫院值班室的燈常開著，睡覺時要戴上眼罩, sleep mask)
15. A foundation for an incredible career in medicine, both in residency and beyond.

By graduation, you should know … 
1. How to become a competent physician without becoming jaded.
2. When you’re going to squeeze in a significant other, and maybe even kids. (意思是：想辦法在眾多優秀的同事中擠出頭，你的診斷功力如何？臨床技術如何？研究能力如何？)
3. How to ask for help, challenge your resident, or disagree with your attending without failing the rotation.
4. When to shoot for Honors and when to be satisfied with that Pass (that Pass 意指那些run過的科).
5. How to ask your resident, “Is there anything else I can do?” in a way that communicates perfectly that you would like to go home.
6. The names of the Surgeon General, the “father of medicine,” and the barista at the hospital coffee shop. (這句話有點諷刺，意指：當衛生部長告訴你醫學的崇高理想時，你還不如去買杯咖啡提神，因為你手邊有一堆事要做。)
7. How to sleep on a call room mattress, even if you already have a bad back.
8. Where to go — whether it’s the Student Lounge or the hospital gym — to clear your head when you’re coping with an emotionally difficult patient.
9. That you can’t change the med school you attended, the residency program you’ve been matched to, or the fact that you’ll be applying to fellowship all over again in a few years. (這句話很重要，意指：如果你上不了你想上的醫學院，你可以努力讀書，爭取申請到好的醫院做住院醫師；等到醫學院畢業時，你很難改變未來的一切。)  
10. That the grades from your clinical rotations may not have been stellar, but at least you never have to go back to being a third year med student. (意指：第三年醫學生在醫院很菜，你現在已畢業了，即使見習的各科分數不亮眼，學養不要比第三年醫學生還菜。)
11. What you would and wouldn’t do for Honors or perfect board scores. (意指：畢業了，你不能再做蠢事，從現在開始，你已進入專科領域，要知道該做甚麼，不該做甚麼，因為專科考試會考。)
12. That nobody gets away with not studying, not giving presentations, and not taking responsibility for patients and still does well.
13. Which attendings are kind, which attendings are harsh, and why you can learn from both types.
14. To take responsibility for medical errors, even if they weren’t solely your fault.
15. Why some say life really begins with internship.