The ‘Hypocritic’ Oath

Photo: Eva | Flickr

It is an old joke in the medical field – more often than not, the Hippocratic Oath eventually becomes the ‘Hypocritic’ Oath. It all starts at the medical school interview, with the standard question being “Why do you want to do medicine?” We then take a deep breath, flash our most confident smile, and regurgitate the well-rehearsed lines that we have practiced oh-so-many times.

What baffles me is why would anyone want to submit themselves to five years of torture, with the guarantee of stress induced by the monthly assessments that always come too soon. There is also no telling what sort of patient would be assigned to you. It does not matter if you do not speak the language – you are still somehow required to present an intelligent case about the assigned patient and conduct a discussion worthy of the lecturer’s time. If you fail at any of the above, rest assured that when the results bar graph comes out three weeks later, you would be the reason for the far right end of the bell-shaped curve.

The variety of ways that the medical curriculum has been structured to test students also fascinates me. Besides the case presentations earlier on, there are also other modes of examining devices such as multiple choice questions, structured answer questions, BCQ, MEQ, OSPE, OSCE – even I do not know what they stand for! With the constant need for adrenaline, I would not be surprised if our adrenal glands have somewhat atrophied due to overuse compared to the general population.

We rotate over the 10 odd departments that make up the study of medicine in the second part of the five-year programme, and some we enter with more gusto than others. I remember that my first clinical exposure was to the department of surgery, followed by medicine and family medicine. I completed my psychiatry, orthopaedics, paediatrics, and obstetrics postings during my following semester. Each study of medicine mentioned above has a 500-page textbook as the recommended text. More often than not though, most of us make a beeline for the ‘Medicine Made Easy’ series.

Psychiatric wards can be scary and a riot at the same time. Some patients talk a mile a minute, while others walk a mile a minute up and down the wards. We had an Alien vs. Predator moment between two patients that required the nurse to jab them both with sedative drugs, while we medical students watched in fascinated fright behind the protected glass windows.

Semester 8, also called the ‘honeymoon semester’ due to its lack of major exams (the minor tests still exist, mind you), starts off with two months of electives and selectives, followed by a short repeat of orthopaedics, psychiatry, and family medicine. Next comes a barrage of short two-week ‘minor postings’, which make up the more specialised fields of ophthalmology, dermatology, ear, nose and throat, and emergency medicine. Wielding an ophthalmoscope, standing cheek to cheek in front of the patient and peering into his eye, straining to see something – anything – can break the will of many. But nay, we are told that practice makes perfect, so off we go seeking another dilated pupil to repeat the exercise.

Ah, but it is only the calm before the storm – Semester 9 is an absolute killer. If the short four-week hectic postings of internal medicine, surgery, gynaecology and paediatrics, anaesthesiology and radiology are not enough to drive you mad, then the ultra-short study break of 2 weeks before you sit for a major exam definitely will. The final semester, the last lap before you reach the golden gates of graduation, requires you to shadow the house officers in a small, secluded hospital. That basically summarises the curriculum for the clinical years of medicine. The first two and a half years were absolute bliss compared to this, as we only had to attend daily two-hour lectures and the occasional added clinical sessions. And then off to the mall we would go, heels clicking, to do the things that KL-lites do.

And yet, after all the exams, toil, blood, sweat and tears, medicine is worth it. The same ideals that we had set out with are still buried deep inside us. So on graduation day, when we say the Hippocratic Oath, we do not think about what we have sacrificed or will be sacrificing. I think our thoughts will be along the lines of what lies in store for us equipped with this Midas touch of healing.

We know that tremendous power is in our hands as we can prolong or shorten life, save a limb or chop it off, cure the patient from cancer, or cause them the sufferance of years of treatment if caught too late. And that, my friends, makes medicine worth it.

Jonitha Nadarajah, 25, is a medical student in International Medical University (IMU), Malaysia who hopes to graduate in 2010 before selling her soul to the Ministry of Health in return for gruelling underpaid labour. She also vows not to accidentally kill any patients.

Note: The above entry was written in 2010 for What’s After SPM?, published in 2011. This non-for-profit book project is a collaboration between Leaderonomics and a team of young Malaysians. Click here for details on the project and authors.

Click here for more articles.