Tying Up
TYING UP
A few months before, I left a whole bunch of loose ends hanging in the air: the MRCEM SBA result, the departmental exam, the possibility of BST 3 or moving on. Whether all that studying, stressing and sacrificing had actually been worth it.
At the time, I genuinely had no idea which way things would go. I’d spent so much of BST 2 watching carefully laid plans fall apart that I had almost stopped trusting plans altogether. So, I did the only thing I really could do: I sat the exams, packed my bags and carried on with my life while everything else sorted itself out in the background.
And, somehow, it did. After failing my first attempt at the MRCEM SBA, I sat down, did the work and passed the exam with flying colours. Next came the departmental exam. Against all odds, and despite the laughable amount of preparation I had managed to squeeze in around work, I passed that too. With my portfolio completed, my audit submitted and both exams passed, I had cleared the major hurdles standing between me and progression to HST. On paper, at least.
Becoming an HST
Becoming an HST wouldn’t be all that simple though. There was still the interview, of course. Medicine would never be kind enough to let one finish line simply remain a finish line.
There would always another form to submit, another box to tick and another person sitting across a table deciding whether you were ready for the next stage. For the first time in a while, however, the uncertainty felt different. Previously, I had been waiting to find out whether I was going backwards. Now, I was waiting to discover how far forward I could go. And I think I was ready.
The idea of becoming an HST was intimidating, sure. It would involve more responsibility, more expectations and more people turning towards me when something went wrong. Different shifts, different pressures and, most likely, a whole new collection of reasons to question whether I knew what on earth I was doing. Somewhere over the previous couple of years, however, that had stopped sounding purely terrifying and started sounding exciting too.
Mostly cause BST 2 had humbled me in more ways than one. It had shown me how much I still didn’t know and how quickly confidence could be knocked sideways. Yet it had also shown me that I could handle far more than I gave myself credit for. I had become more comfortable making decisions and admitting when I didn’t know something, and I was also far less obsessed with trying to look like the smartest person in the room. Maybe that was the whole point. I didn’t feel ready because I suddenly knew everything. I felt ready because I finally understood that I never would.
Reality Keeps Losing
Medicine apart, coming back from Ecuador, I found myself at yet another checkpoint in my life. And, as I always tend to do at such moments, I took a step back to gain some perspective.
Looking back, it’s funny how harshly I judged the previous year while I was living through it. In my head, BST 2 had become defined by the exam I failed, the injuries I sustained, the workouts I skipped, the cigarettes I started smoking again and all the goals that fell through the cracks. I kept comparing the year I was actually having with the perfectly organised version I had planned. Needless to say, reality kept losing.
But reality had actually been pretty incredible. I completed my portfolio. I submitted my audit. I failed an exam, picked myself back up and passed it the second time. I passed the departmental exam too. I travelled through countries I had never visited before, learnt how to ski, crossed mountains, deserts and canyons, pushed myself physically in ways I hadn’t expected and somehow still managed to become a better doctor along the way. And, I also got to see a humpback whale and a whale shark up close!
Sure, it wasn’t the year I had planned. But, in more ways than one, it went way better than expected. I had done everything I had set out to do and then some. Reality had definitely exceeded my plans.
The Exhaustion After the Finish Line
That said, achieving everything I had planned didn’t magically fix all the exhaustion that had accumulated over the year. If anything, once the pressure finally eased, I realised just how badly I needed to stop for a while.
I was exhausted and tired. Tired of constantly measuring myself against the next requirement. Tired of feeling guilty whenever I wasn’t doing something productive. Tired of promising myself that I would get back into shape next week, quit smoking next month, start running again, read more, dive more and travel more. It was always about more, more and more.
There was always something, and I didn’t want my next training programme to begin with me already running on fumes. I needed a reset. Not some dramatic reinvention in which I suddenly woke up at 5AM, meditated for an hour, ran ten kilometres, meal-prepped for the week and transformed into the most disciplined human being alive like one of those influencers who seem to have it all figured out. I simply wanted to feel like myself again.
I wanted to train because I enjoyed feeling strong rather than because I was chasing some arbitrary target. To run and cycle because being outside cleared my head. To get back into the water. To quit smoking because I was finally bored of everything it took away from me. I wanted to read things that had absolutely nothing to do with medicine, learn something completely useless simply because it interested me and travel without spending half the trip mentally calculating how much extra shifts I’d have to work to make up for my holiday.
Most of all, I wanted to stop being so hard on myself. Coming back from gap year. I swore I wouldn’t let medicine take over the rest of my life. And, in so doing, I had worked so hard to have a life outside of medicine that I got burnt out trying to prove to myself that I could do the impossible. And, in truth, I managed. But was it worth it? They say “all work and no play makes Jack a dull boy”. True enough, I guess, but as I figured, all work and all play makes Jack an exhausted one.
And so, most of the loose ends I had left behind finally been tied – the medical ones at least. HST was suddenly within reach, provided I could make it through the interview. But the rest? The rest I’d figure out along the way.