Friday, October 26, 2007

The Reason I'm not a Doctor part 1

A few years ago I thought I wanted to be a doctor. I wanted to do more for my patients and be the one to make the medical decisions, especially when I saw how awful some doctors were. I knew I could do a better job and I knew that I was committed enough, after-all I would be giving up six years of my working life when I could be earning, traveling, getting married, plus I would end up at least $100,000 in debt. But my dreams were shattered by my betters.

I had been told that it was difficult to even make it to the interview stage, so when I received an invite to attend such an interview, I began to get my hopes up. "I'm Professor Stickler" the owner of this voice was a tall, broad shouldered man with a head of silver. He looked the antithesis of your stereotypical diminutive, bespectacled professor. "This is Sir Edward Jones" he indicated the man to his left. "And on your right is Dame Catherine Smith" he said, indicating the woman on his right.

Needless to say, the introductions didn't put me at ease, instead they seemed to highlight the vast gulf between these privileged personages and my humble background. I didn't come from a medical background. Neither my father or mother were doctors, and until such things as taking government loans became commonplace to pay for university, we never had the money to pay for such an education.

The interview began and I answered the questions to the best of my ability. I even felt I answered them well, until about twenty minutes into the interview. They began a part of the interview that Sir Edward Jones described as a "Vital and Integral" part of the interview process. It was scenario time.

Scenario 1, part 1 I want you to imagine you are a young family doctor and you have a patient, a young man in his early twenties, who has been battling cancer for the last year. During that year he's tried every treatment that is available, often with awful side effects, but all to no effect. In fact he's been told that he will most likely die. Now, as the family doctor, you've just discovered a new treatment that only has a 50% chance of working. Regardless of whether the treatment works or not, it will have horrendous side effects, much worse than he has had yet. Now, what do you do? If you decide to tell him how do you go about this?

This was my questions. I won't give the answer I gave just yet as I'm curious as to how others' may answer. What I will say is that it was during the course of answering this scenario when I realized that I wouldn't succeed in being accepted into medical school.

1 comment:

Peter said...

I would put myself in the patent's shoes. If I was going to die, I would want to go out with a fight. If this was the only thing available that gave me even a small chance of survival, I would take that chance.

Now, prior to giving any advise on the new treatment I would have to find out everything about it in the first place, in order to give an imformed opinion. Can't send him off willy nilly.

Being a doctor, you would have to inform him of the side effects and the chances of survival. The entire procedure would have to be explained to him in words that he could understand.

I would not ask him for an answer right then and there. I would let him go home to discuss the matter with his family. Even to seek an second opinion. Either by referral or for the patient to seek independent advise.

I would then ask him to come back after he had made a decision.

Telling him before he left, that the next time he came back, to have a written list of questions for me. In case he couldn't recall them all on returning.

I would like, if agreeable, to have his mother and father there or someone he trusted, on the next visit. In order to explain it to them as well, in case the young chap did not understand the implications or procedure and to put them in the picture totally.

If he decided to go ahead with it, I would also recommend counseling for him and his family. To better prepare them both in case the outcome was negative and to prepare the patient mentally for the steps ahead. Not forgetting to suggest he get his papers in order.

Well, I'm not a doctor but this is my best shot for your question.

Did I pass?

Regards
Peter McCartney
Sydney Australia