Medical student reflections - Callum Fraser 2023 essay prize winner

Tell us a little about yourself
I’m a recent graduate from the University of Western Sydney School of Medicine, set to begin my internship next year at Sydney’s Royal Prince Alfred Hospital. My career interests are variable: I’d always seen myself in a surgical role, but I’ve increasingly begun to take an interest in psychiatry.

I think of myself as someone with a hobbyist personality who dabbles in a broad range of areas. I read as much as I can and write when I can be persuaded to; some of my interests include sociology, computers and technology, architecture, jazz (both listening and playing), D&D, literature, and typography. (Given our topic is self-care, it seems only appropriate to begin with a nonmedical introduction!)

This year’s essay theme on doctor and student self-care is one that really resonated with students and was reflected in the number of entries. What did you learn in the process?

I think that approaching the end of my medical course and preparing to enter the medical workforce has led me to increasingly recognise the degree to which the professional and private lives of doctors are deeply intertwined. Doctors marry within the profession at very high rates, and are only too happy to talk shop with other doctors even in casual settings; on the flip side, doctors’ personalities and self-concepts have a strong impact on how they choose to conduct consults, and studies of medical consulting styles show that the values, attitudes, and expectations that doctors bring to their consults can have a strong impact on the success of the therapeutic relationship.

This has some interesting consequences for us, both as doctors and as people. I think we owe it to ourselves to consciously set aside both time and mental space (all too often we allow for the former but not the latter!) away from medicine—time in which to develop other aspects of ourselves, time in which to not be doctors. (It is seeing our medical identities as inalienable from our broader selves that is often a major obstacle to even seemingly innocuous self-care behaviours such as GP attendance.)

Moreover, an understanding of the way that our professional identities are an amalgam of our own perspectives and values, the implicit expectations of medical culture, and formal regulations invites junior doctors to take a critical stance regarding our professional development and nascent professional self-concept. Medical students express their desire to be good doctors at every possible juncture, but what that might mean in practice can be woefully unclear. As I discussed in my essay, doctors will often go to considerable lengths to rationalise behaviours they know to be wrong! If we want to be the best doctors we can be, we have a duty to actively interrogate our perspectives and how they contribute to our medical identities.

Next year is a big year in your career,  as you take on a placement, what are your personal plans for managing your own well-being given how busy you will be?

Strategies like effective scheduling and workflow optimisation can go some way towards maintaining well-being even as workloads ramp up, but time management can only manage time, not create it ex nihilo. Increased working hours don’t only cause stress in and of themselves; by reducing the free time available for spending with loved ones, practicing hobbies, or simply doing nothing, they predispose us to further stress and increase the potential for burnout. I think that junior doctors, with our hectic workloads, have to have a level of realism about what we can and cannot do, and recognise that even with “Dr.” prepended to our names, we are deeply fallible and still only human. Setting unrealistic standards for ourselves as doctors is also an aspect of the “magic white cloak” I discussed in my essay. We should be very careful (especially as younger doctors) to make a conscious effort to reject such values.

From that point of view, while I expect to press pause on some of my hobbies in the short term to give myself more breathing room to get up to speed with my new duties as an intern, beyond that it will be important to find a reasonable balance between my personal and professional lives, and the time allocated to each.

What would your message be to medical students and the profession about having your own doctor?

While the medical profession is regarded with considerable respect by the Australian public, there is also increasing recognition that issues such as bullying and burnout are prevalent among doctors. We are the next generation of Australian doctors, and over the course of our gradual ascent to consultancy we will have the choice whether to accept (implicitly or explicitly) or reject aspects of the medical culture of which we will eventually be representatives. Discussing (or writing essays about!) how we think Australian doctors should practice as they preach is easy: those of us in the graduating class now have the opportunity to prove to ourselves and our peers that we’re willing to effectuate positive cultural change through our actions.

Read Callum's winning essay.

If we want to be the best doctors we can be, we have a duty to actively interrogate our perspectives and how they contribute to our medical identities.