Cytomegalovirus (CMV)

Maybe old age is kicking in sooner than I expected. I just overheard part of a conversation and I’m unsure whether I need a hearing aid or whether they really said the following:

“is it because she’s got Psycho-medley virus?”

1024px-BTEhearingaids
A pair of BTE hearing aids.  Source.  CC BY-SA 3.0.
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Apple Humble and Custard

I have been thinking about where I am in the training pathway. In terms of seniority, I’m at the bottom of the pyramid. These thoughts may well linger until I’m a consultant, which is at least a decade away and it seems soooo far. I knew this well before applying to medical schools, but at that time I was more concerned with getting one of my ancient bunion feet through their well guarded, reinforced doors.

Being mature medical students, we may have achieved other things in life but in the eyes of the healthcare system we are still simply medical students. Previous accomplishments on our CVs might have granted a small sense of pride and demonstrated ability but might now be irrelevant. Regardless of whether we were once CEOs, engineering post-doctorate geniuses, professional sportspeople or stay at home mums/dads, it almost doesn’t matter and as mature medical students we have to swallow the same helpings of humble pie as our younger classmates. I suppose I could say force fed as there’s not much that can be done about the situation – it’s just how it is. Many skills, particularly interpersonal, management and organisational skills are definitely transferrable but knowing the inlet angles for turbine blades of a specific jet engine probably is not.

Being older often helps with patients, but not always with staff. When meeting any new staff there is always a familiar eye dart” from face down to name badge – searching for the words that denote one’s grade and thereafter how to behave towards the badge-wearer. Everyone does it and at all grades, due simply to the hierarchical structure.

Different members of hospital staff have widely differing opinions about medical students. We may be seen as being: useful, helpful, eager or sometimes useless, lazy, hindrances. Last week, a consultant said to me: “Hey you medical student, I’m too busy, go with Dr Smith”. In her eyes I was nameless even though she’d just done the eye dart thing and my name didn’t matter because I was “only” a medical student. Another time I was dismissed with a: “Shoo-shoo medical student, I need to use that computer” They need to remember that not so long ago, they were also “Hey you, shoo-shoo medical students.” I have no issues with those younger than me telling me what to do and don’t need or deserve special treatment, but good manners are fundamental and rudeness is unnecessary.

In military terms I’m an ageing cadet in basic training, no tours of duty under my belt, no medals. I’m still hoping just to make it to the passing out parade with proud family watching. Already in my 4th year of training but not yet even a private. I’m in the meat grinder again, somewhere near the beginning, being obediently churned through but this time hopefully emerging as well trained mincemeat (mutton dressed as lamb?) ready for action in the NHS.

Frozen meat grinder GW 300 – Seydelmann. Source. CC BY-SA 3.0

Sometimes I think about my previous job, a job that had little wrong with it, paid the bills and allowed me to live a decent comfortable life. A perfectly good and even enviable job. When I gave it up, I told myself “There may will come a time in the future when you’ll miss this job, the job in which you worked hard to reach a senior position, the job which surrounded you with great people and which you may regret giving up.” I told myself that, I did. But I also told myself I’ll regret it even more if I don’t try – so I thought “f*%k it” and hit “Send”

So, in truth I do miss being in a position of seniority that roughly correlates with my age, my ex-colleagues, the relative flexibility of my previous career (oh the flexibility!) and having a salary!

But (and a very big butt): aside from the odd crass ignoramus, I love what I am doing. Everyday I’m seeing and learning fascinating things that few others can or will ever see. The new born whose first breath I witnessed, the young man who walked right out of hospital but who only a few days earlier was unconscious and critically ill, the lady who can see clearly again, the caretaker who walks pain free after his hip replacement. It’s not always a happy ending but just to meet these people and catch a glimpse into their lives is a huge privilege. Also being taught by those rare breeds of doctors and consultants who know exactly how to teach and genuinely care whether medical students are learning or not.

So my medical student colleagues old and young; persevere with cultivating that thick lichenified skin, we are bottom of the pile – munching humble pie, but on top of the world and there are infinite helpings of great custard.

Too Old for Medical School?

‘How old is too old?’ and who can determine that? I came to the conclusion that ‘only you know if you’re too old’. My logic was that, assuming I worked till 65, I’d still be able to practice as a doctor for more than 20 years which is not insignificant and more if I worked till 70 – which looks likely considering what the UK government are doing to the NHS.

However, being twice the age of the usual applicant and with medicine being so competitive, I also worried what admissions tutors and interviewers would think.  Although there’s no upper age limit ‘officially’, I thought there might be hidden or unofficial discrimination.

I felt that the odds were stacked against me. In the end I worried needlessly. If age related discrimination exists in selecting candidates for medical school then I seem to have bypassed it. I hope the offers I received can reassure other mature grads and “oldies” who are thinking of applying. Age shouldn’t stop you applying. Finances, family commitments, what stage of life you consider yourself at or perhaps a loss of job status maybe, but not age. At one medical school interview I was asked a question indirectly related to age: “How do you feel about studying alongside people who might be much younger than you?” but that was it. In fact it was only the admissions tutors at some Access to Medicine courses who were less positive and who thought I was too old whilst no eyebrows were raised or eyelids batted at any of the medical schools.

In short, if you can show that you’re: 1) committed & motivated 2) realistic about the consequences involved and are not going through a “mid-life crisis” and obviously that 3) you have the potential to make a good doctor, then you’ll have a good chance of getting in. Age just won’t be an issue.

How I thought medical school admissions would see that points 1 – 3 were met:

  1. Long term voluntary work and/or healthcare experience and/or shadowing in a caring environment. I think this is important as the experience will; show you’re committed, help you to write a better personal statement, help you construct convincing answers in interviews as well as giving you access to members of the healthcare profession so that you can ask all the questions that you really should have. It will also show that this isn’t a career change made spontaneously and that you made the effort to place yourself in a healthcare environment to experience it for yourself. It takes time to build up experiences with patients and even to arrange volunteering so start early.
  2. Think about how you’ll finance the course, loss of earnings, what it means to immediate family, partner & children. You may currently hold a position of seniority, how would it feel to give that up and start right at the very bottom? It’s pretty scary you know! Consider how you feel about working notoriously long hours, that not all patients get better and how you might deal with making mistakes. Ensure you know the career pathway well and all the steps involved in becoming a doctor. Why not become a nurse?  How would you answer this question in a medical school interview?
  3. Craft an original but honest personal statement, communicate well, be shiny and charming at interview

Obviously there is the academic side plus you need a good score in entrance exams but otherwise don’t waste time worrying about age.

Here’s a nice report about Equality and Diversity in UK Medical Schools by the BMA. I’ve also put a few links to blogs from older medical students and news articles here

If you’re thinking of applying but haven’t –  what’s stopping you? If you’re a current medical student who is older than average I’d love to hear about your experiences!