It was mid-2010, during biology class in high school. The second quarter of the academic year had begun a few days ago and we were going to have our first lecture, which was about cell biology. I was mesmerized by the complex processes that occurred in a microscopic, molecular level that would result in the building blocks of the correct (or sometimes incorrect) functioning of higher order systems, and as we began to review each organ system I knew that this is what I wanted to get into.
So, when the time finally came, I applied and entered medical school. Medical education in Panama is comprised of various stages, before becoming able to attain an unrestricted license to practice. Medical school is begun straight from high school and lasts approximately 6 years, divided in two foundational years of basic subjects such as organic chemistry, molecular biology and biostatistics, two years of basic sciences (anatomy, physiology, pharmacology, etc.) and the last two years are strictly clinical, doing one month rotations through different specialties and subspecialties.
After graduation, the newly minted MDs are expected to take the national Certification Exam, which qualifies them to begin their mandatory two-year internship, comprised of a first year in a big public hospital in the main cities, and a second year in a more rural setting. Interns that do exceptionally well during their first year can opt for a paid research or teaching fellowship during the second half of their second year. After this, you're qualified to apply for an unrestricted license to practice general medicine.
As I am now awaiting graduation in less than a month as I'm writing this article, I reflect about the experiences I've had the privilege of having ever since I began this journey. Apart from remembering my first interest in the intricacies of the human body, the most important synthesis I can make about my short clinical experiences so far would be about what it means to combine scientific and technical knowledge with empathy, and a sense of understanding of the patient's feelings, in order to properly and effectively deliver high quality care.
We tend to dismiss or become numb of the human suffering as we advance in our training. I've seen interns, residents and even attendings with horrible bedside manner, treating the patient as another statistic, or something that needs to be discharged right away to make room for the next one. Part of becoming a good physician, or even more important, part of our obligation and responsibility as health care providers, apart from the proper translation of thousands of pages of textbook knowledge into diagnosis and treatment, is to not see the patient as a clinical case, with symptoms, signs and injured organs, but as a fellow human being that comes in their most vulnerable moment, and confides to us their deepest fears, thoughts and discomforts.
I believe that alleviating their suffering involves not only solving their physical problems, but reassuring and comforting them as we guide them in our attempt to restore them to good health. This set of beliefs are what I strive to carry with me as I keep progressing to the next stages of my career, and to always put the need of my patients above my own.
Luis Felipe Rivera
Latin University of Panama School of Medicine
Sixth year Medical Student
Back to the October 2019 issue of ACP IMpact