theDoctor
ONE ON ONE WITH DR. WAFULA NALWA, THE CARDIOLOGIST

Friday evening, the making of a Doctor.

I have been planning to write on the plight of medical students for a long time but I never had the right words, I still don’t but I will try and paint the picture. I’m not sure how it happens in other universities but in Maseno university where I trained; it is tradition that every year, for at least 6 years, trainee doctors are tortured for an entire day – tactically, on a Friday, in the name of examination results.

fresh from high school we had no idea what the future held for us. first year

For those in the field, you know what end of year exam results mean when you are in medical school. For those who have no idea, well, it is a matter of life and death, not literally, but that is what it feels like every time you come to the end of another academic year.

Arguably, the biggest goal, while in medical school, is to finish. With the current curriculum, that should, in an ideal setup, take a minimum of six years. Any other number between six and twelve years is still acceptable as long as you finish. It is for this reason that the most annoying question asked to medical students by relatives and their friends from the north pole is,” utamaliza lini?” (when are you finishing school?). It is annoying not only because they ask it too many times but also because you have no idea when you will actually finish.

Yes! I know the academic calendar says 6 years, so when you enroll in 2014 you should finish in 2019. But that’s just a calendar, as the Swahili saying goes, ya kuku ni mayai, ya med school ni mengi. Anything can happen along the way and 6 could turn into 7 and 7 into 8 or even worse. Even more painful, your years of hard work and academic struggle could be written off altogether. Just like that.

almost everything changed within the six years

To go six years without redoing a year is a blessing, to go all the six years without a supplementary to me is a miracle. But whether you go through smoothly or you encounter one or two bumps along the way the emotional torture that you face when waiting for the result on the typical Friday evening is the same.

It is that brief glance at the pass list in search of your name that determines how your next year would be. It determines if you will be at a club celebrating that night or if you will be drawing up a study timetable to prepare for the dreaded supplementary exam in a few weeks’ time. It determines whether you will have to be in the same class you had been that year and relive the experience or if you will move to the next class and count a year down. It is that quick glance that may give you the ultimate scare of being discontinued. As quick and brief as it is, it is the climax of every academic year in medical school.

the wait was long and tedious but we always had each other

I am part of a great class of doctors from Maseno university, the class of 2020. I was admitted into medical school on the 6th January 2014, on a Monday. And that marked the beginning of what would be nothing short of drama, learning, growing, falling to the ground and rising again even stronger. Medical school builds character and resilience it hardens you, maybe just to prepare you for what lies ahead. It’s like a war of swords; where all the soldiers start in one line and charge towards the enemy. As the enemy fights back, some are injured and take longer to get to the end and some who had been on the frontline fall back and charge again, renewed. But eventually, the war is won; muddy and bloody, but won. The same happened to the class of 2020, the class at admission is only a semblance of the class at finish line.

Typically, the EYE (end of year exam) would end earlier in the week leading to the Friday of reckon. Probably on a Tuesday or Wednesday. Now these few days leading up to the said Friday are usually filled with anxiety and artificial humility. These are the days of the year that you least want to offend God. You don’t want to get into fights with anyone lest they jinx your results (talk about superstition). So, in an attempt to kill the anxiety, these days were mainly marked by watching movies going for hikes and visiting the less privileged in society probably in an attempt to tell God, “deep down you know I am a nice person.”

the anxiety was unbearable, distractions were key

Those two or three days would be long and tedious. It was hard to do anything well. All means of distraction somehow weren’t good enough. You would remember a wrong answer you gave during viva exam and your heart would almost jump out of your chest. You would be playing FIFA and some uncultured guy would say how a certain diagnosis was Infective Endocarditis and not Rheumatic Heart fever and your armpits would start sweating profusely. It was a long wait.  

Now when Friday finally comes you, tactfully, want to wake up late just so the day can go a little faster. You will be having sinus tachycardia from the time you wake up until Friday Evening is over. You should be sleepy because on the previous night you simply couldn’t sleep. You spent the night imagining all the possibilities and praying to the Almighty. You would take time and analyze every unit, what you had in the CATs and what you need to get in the main exam to ‘be safe’. You try and convince yourself that you’d be fine but deep down you know it can go whichever way. This is worse if you have a” debt” in any of the units -if you didn’t meet the threshold of 50 plus 1. So, you wait.

beauty with brains and resilience

Personally, I preferred to spend that Friday with friends. We would tell stories, play some games and mock each other for looking too anxious. Most guys used to get diarrhea. People were only a shadow of themselves. Putting on calm faces while almost dying inside. Those Fridays were terribly long. We would take a walk and for a moment forget what was awaiting but the minute we pass by the boardroom, and see all those vehicles parked around the meeting point, my insides would go nuts again. Butterflies in my stomach, palpitations, nausea and strange headaches. Dr. Owino would be hiding his tension trying to talk about which lecturer just bought which car, or who was still driving a poor mans car despite being a successful doctor. But we weren’t even listening. It was torture!

being with friends who had become family made it all better

And the meeting would drag, by design, it was meant to end late just to prolong the torture. These are the times we would make next years resolutions. “I am not going through this again, next year, if God willing, I am on that pass list, I will read. I swear I will be going to the library; I will not wait for last minute to start preparing. And I will not even be reading for exams I will just read to know, for my patients.” We would make all sorts of very hard to keep promises.

change, growth everything was different

Then the rumors would start to come. This was even worse than just waiting. Dr. Murunga would post something on the group of how she had been told by a source close to a board member that it was not looking good. That a certain number of people had direct repeats or only 20 people were on the pass list. You try to count the top 20, those who were sure they would pass and you are not even in the top 30. It was hell on earth.

a good number of pass lists later, almost doctors

Then finally the damn thing would arrive. Late in the evening. Sometimes too late you need a torch to see it. Back in preclinical training, they would hang it from the inside of a window pane and we would all crowd around to see our names. During the clinical years it was a photo on your phone. This was the climax of all anxiety. You don’t waste precious time reading titles or the powerful statement, “the following X students have satisfied the board…” that didn’t matter, what mattered was your name being on the list. As soon as you saw your name, everything would change hell would become heaven. Your heart would finally calm and the hair on your body would finally go back to normal. It was over.

But it wouldn’t end so instantly for everyone. Sometimes your name is not on the list, not even on the second list showing those with supplementary. You had no idea what had just happened. To make matters worse, its late Friday evening. All the offices are closed. You have no one to ask what just happened. That is known as the ‘long weekend’. As your colleagues take to social media posting how they made it. As Dr. Munenge posts selfies and thanks God for yet another year without blemish, those not on the list continue with the torture, knowing that whatever news awaits them on Monday, they have to face strong and live to fight again.

Its tormenting enough to have to go through all that Friday evening feeling once or twice but to make a doctor in Kenya you go through that at least six times. It is not easy. I take this opportunity to acknowledge the struggle that is making of a doctor. To all those who have gone through the system, and finally appeared on all the six pass lists, theDoctor says congratulations. May we go ahead and be great doctors.

congratulations doctors,

By Nyadimu

Nyadimu Festo MD

Medical Doctor. MBChB with IT (Maseno university). Passionate about medicine, writing and leadership. Voice of the Kenyan doctor.

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