One of the most difficult things about the MD/PhD training program is that every time you start to get good at something, you have to switch to something totally different. It’s not that there is never any overlap, but you are usually a stone’s throw away from square one, if not smack in the middle of it. Also, if you were starting to gain any kind of clout, you slide immediately back to whipping boy/girl.
The first is when you start medical school. Almost all medical students are starting something totally new, in a new language. It isn’t until you take Step 1 of the Board Examination at the end of second year medical school that you begin to feel like you know something—however meager—about medicine. It took two years of hard work, but you know something. At this point most medical students proceed on to third year, which in a lot of ways is a step down again, since it is very clinical and different from the classroom learning of years one and two. Also, although it is building on the foundation laid during the first two years, there is an enormous amount of new material to learn. This is also prime whipping boy/girl time, as you are the lowest man on the totem pole in the hospital (although some would argue that interns have it worse, and in a lot of ways this is true). However, you proceed with your classmates, so you at least have peer support. And that foundation of knowledge is still fresh and strong to learn the new stuff.
At this stage, MD/PhD students go to graduate school instead of clinic. This means that you start completely over. New classes, a totally different set of things to know, new (and often strange) people, etc. It isn’t until you are finishing up that you feel you are just beginning to learn the field you have chosen for your PhD. You have become attached to a new set of people who you have to leave again, and you have had plenty of time to forget all of that nice foundation you spent two years building up. You’re starting 3rd year with a group of people who are largely strangers, most of whom are 4-8 years younger than you (whippersnappers!!). If you are lucky, there might be a few other MD/PhDs returning with you to 3rd year, and if you are really lucky, you might like some of them, but it is unlikely you will have any rotations with them. You start completely over—again.
I’ve been told that there is not quite as much attrition in the medical knowledge as you fear; that it comes back faster and better than you expect. I hope that is true, but it still feels like I’m starting over for the third time in six years. But at least I get to stick with the clinical stuff for a while—probably about six years—before starting back in lab. Also, even then, I will still be doing clinical stuff, so in a way, I’m finally starting the job I’ll have the rest of my life. The one I've been working towards most of my life. Finally. There will be other ways in the coming years in which I'll be starting at the bottom of new ladders, but at least they will be ladders above the ones I’ve been climbing so far, and not on totally different walls, if you get my meaning. It’s a good feeling.
TODAY ON LITTLE HOUSE: Carolyn goes through menopause, becomes despondent, and fears Charles will no longer love her. Instead, they get remarried. Is there any issue this show doesn’t tackle?!?