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Today was my last day on the Upper Gastrointestinal Surgery team. It was a short rotation of only a fortnight and most days I felt that I was a shadow behind the registrar and interns. After a few days of pestering the registrar about filling out the forms for my assessment, he finally agreed to stick around and do them with me.

I was asked to perform an abdominal examination on a patient with marked clinical signs. I don't usually have trouble with clinical examinations, though things changed quite quickly when I had the surgical registrar watching me. It only took a few moments before he started asking me questions about what I would do and what they meant. Soon, I just started fumbling everything, making mistakes and answering in the form of questions, almost to clarify my own answer. He reassured me that he wasn't trying to intimidate me, but I suppose intimidation comes with it.

We walked outside and spoke about some of my clinical examination techniques and I confessed that I hadn't done a single abdominal examination in the surgical rotation thus far. He was upset about that and asked me why I hadn't practiced on the patients under his care. My response was that I was preoccupied with other tasks. Eventually I realised, after a long stare, that it was my commitment and my responsibility to practice during my time on his team. Fail.

He then gave me some feedback on the term altogether.

"Some doctors have the ability to walk into a room and establish a rapport with patients. Trust and commitment. Dissipate concerns quickly. This is your goal. This is my goal."


I took a while to take that in. My communication wasn't very good and that required improving, however this would take me a very long time to change.

"It's not your behaviour that needs to change for this to happen. You have to change as a person before you can communicate more effectively with your team members and also your patients."


This was hurtful and he realised that, but he had a point. A good point.

"Every single examination a medical student, intern, resident and registrar endures has flaws. All of the examinations have some element of technique that can be learnt without grasping the content or knowledge that is being tested. Except one test."


He paused for a while. I was pondering about the Viva Voce examinations, but quickly decided one could easily fly through that one as well.

The answer wasn't that obvious, but when it was expressed as it was, it became clear as day.

"The only test a medical student and doctor has to pass; the only one that ultimately matters is the one that has the patient as your examiner. When you are lined up against a bunch of your colleagues and a patient chooses you to take care of them. That test, is flaw free."


What a profound thought.

I wondered then what patients thought of me. How did I behave toward them? Did I make them comfortable? All the things I have practiced myself with patients - did they feel taken care of? Was the courtesy obvious?

My thoughts were replaced with doubt. Soon... I was drowning in it.