A Medic Comes Of Age

Studying medicine in Cambridge is very different from studying it in other universities. No, I don't mean that Cambridge has a higher incidence of complete psychos amongst their med students, or that we have the highest rate of med student suicides in the world, or that Cambridge medics have a greater predisposition towards brain damage (cue schizophrenic Editor comments! --Editor), though all of those are valid points. Rather, it's our medical education system that I'm taking issue with today.

Medical education in the UK is tending towards Problem Based Learning, as adapted so successfully in some universities like Liverpool and Manchester, where students are set problems and have to work solutions out on their own. Other universities teach integrated courses, where pure scientific knowledge is taught alongside clinically relevant facts. But not in Cambridge. Here, whilst our counterparts at other unis are learning nifty stuff like history-taking and how to take blood without amputating a patient's arm in the process, we spend the first three years of our extremely traditional medical education sitting on our arses in lecture theatres being force-fed A-Level science gone bonkers. This revelation may put a dent in your trust in Oxbridge medics, but we only properly get clinical knowledge in our fourth year; before that, whilst other medics see patients every week and indeed have their lectures delivered in a hospital, we enter a hospital on an average of twice a year. (Barring any of us being hit by a bus, of course.) This former Oxford pre-clinical student, who recently entered clinical school, writes on a blog I discovered this week:

I'm eagerly waiting for Monday. A glance at my timetable tells me that within the first two days I'll be getting down to the sort of hands-on clinical work that I've merely fantasised about for the past three years. I've enjoyed being a scientist, but next week I have to start learning how to be a clinician.

I know exactly how he feels. As a result of this underexposure, Cambridge medics are starved of clinical experience. We long for cuts, bruises, broken bones, dislocated limbs, and gory injuries to treat. We yearn for the sound of sirens, code blue alarms, A&E doors slamming open, and the opening theme of Casualty.

In short, we're hungry for blood.

A typical Cambridge medic

And so it was that yours truly volunteered to be on the first aid team at the Nottingham Games last weekend. The only non-Nottingham medic there, I was assigned to the futsal pitch along with about four other Notts medics.

Ah, futsal! With its rough sandy pitches and sweaty angry players, I was going to get all the cuts, bruises and gashes I could ask for. Armed with my trusty first aid belt and my BRC qualification card, I marched onto the futsal pitches with my head held high and my chest puffed out, just the way they taught us in that Communication With Non-Oxbridge Humans class (kidding! --Ed). I was ready, oh yes. Bring on the injuries. The Angry Medic was here, baby, and he was brimming with confidence and ability.

It was about then that the first football soared out of the sky and hit me in the face.

Fast forward to about two hours later. I'd treated just over a few thousand cuts and bruises, become breathless rushing up and down the pitches, and been laughed at by no fewer than three Nottingham medics for not knowing basic principles of clinical treatment. I was so busy talking to an injured player, trying to calm him down, that I had dabbed a bit of bloodied gauze into my container of antiseptic, thereby contaminating it, and only realised I'd committed a cardinal sin when I got yelled at by the first-aider in charge. "What about sterility, you idiot?" she spat, yanking the container away from me. "What DO they teach you up there in your smug ivory tower?" I stood there flabbergasted. But...but I'm a Cambridge medic! I don't MAKE mistakes, you plebe! I was about to open my mouth and make a feeble protest when the fat referee ran up again and screamed "MEDIC!" despite being only a few steps away. (Someone's been overdosing on war movies. --Ed) First-Aider Trunchbull glared at me whilst nursing Bloody Patient #1. I decided to make a dignified exit and slinked off to see Bloody Patient #2.

It was about then that I realised that none of these Nottingham medics had higher BRC qualifications than I did. All the preparation they'd gotten was a briefing by an A&E doctor that lasted a few hours. The big difference was that they spent their days in a proper hospital. They went for lectures there, got to tag along on rounds, and sat in with GPs seeing patients. They picked up useful clinical tips both from clinically relevant lectures and from being in a clinical environment. These people knew things I wouldn't be learning for years to come.

I realise it was absolutely naïve of me to expect any sort of reward for my work, but in all my wide-eyed med student innocence, I really was expecting at least a ‘thank you’. Surprise surprise, the job was absolutely thankless, and the only reward we got was the satisfaction of sending yet another beaten-up player back onto the pitch. But by lunchtime we were running really low on supplies, and replenishment was slow to come. The management was too busy to bother with first aiders. Then the patients we saw in the morning started coming back with complaints. Some were legitimate, but others came either for attention or, I suspect, for the pure glee of irritating hapless first aiders. Some players didn't like the way we taped their Hansaplasts on. Some didn't like the size of the bandages we gave them. When we ran out of medium-sized plasters, some refused to take bigger plasters even though we assured them that having a bigger plaster would affect neither their sporting prowess nor the number of female spectators yelling their names from the sidelines.

It was a looooooooong day. But by the end of it, dishevelled as we were, I was happy. I'd seen blood and gore, and learnt stuff that I wouldn't otherwise have for a few years. I hesitate to say it, but (cliché alert! cliché alert!--Ed) I became a better medic for it. So is the medical course in Cambridge worth it? I honestly don't know. Like my old headmaster said when he came up to visit us last week, many medics know what they're giving up when they accept an offer here. But they're willing to make that sacrifice for the sake of the big fat Cambridge coat-of-arms on their degrees. I'm not convinced it's the best way to learn medicine, but in the end I don't think it really matters. I've seen great doctors from Cambridge and great doctors from Hull, and it's convinced me that, just like any other profession, it's what's on the inside that matters. All the same, I’d like a little more blood on my shield before I go out into the great big battlefield that is today’s world.