Coffee and Life in the Med School

CEBU, Philippines - I grew up in a house of coffee lovers. Breakfast wouldn’t be complete without a hot mug of coffee into which family members would dip their pandesal. Little did I know that coffee would not simply be part of my trove of family memories—but would instead become a valuable companion when I entered college.

When I got accepted into the INTARMED program of UP. INTARMED (or iMed, the 7-year accelerated medicine program of UP), I was among the top 40 interested UPCAT qualifiers. The first two years in iMed are spent taking general education subjects while medicine proper comprises the remaining five years. So technically I’ll be in 6th year this June, and if everything goes according to plan, I’d be an MD at the age of 23.

During the first two years of iMed, we were taking classes with students from other courses. The pressure to excel and prove ourselves worthy of being iMed was immense, and our professors’ expectations were always higher compared to the others. Thus, we had to work extra hard to perform well and achieve. Coffee was there to perk us up when we had to study for exams or get reports done.

We were then joined by 120 new students (who already had their pre-med degrees) when we entered med proper. Third year was all about the normal human anatomy and physiology, while fourth year was about the pathologic or abnormal.

Our schedule for those two years was 8 am – 5pm from Mondays to Fridays; most of which we spent inside a classroom, listening to a boring lecture. Every morning, I relied on coffee to give me a kickstart and another cup after lunch to keep me from taking a siesta in the afternoon sessions. In addition, the current medical curriculum of UP was designed in such a way that evaluation is done right after each module. That meant having to take exams almost every Friday (the reason why I started dreading Fridays)!

We were supposed to study pages upon pages of lecture transcriptions and suggested readings in books that were as heavy as our heads every week. Being a born procrastinator, I could not finish all the recommended study materials in one or two nights. During this period, I learned how to budget my time and start studying at least 3 days before the exam – that is, if there’s only one exam for that particular week.

It became another story when there was a biochemistry exam sandwiched on a Wednesday, or a paper due also the morning of the exam. Throughout those two years, coffee never failed to rouse me when I needed that extra jolt of energy.

Fifth year marked the start of our exposure to the clinics. During this year, we were expected to be able to accurately diagnose common ailments of patients in the ambulatory setting. Supposedly, the first two years were enough to prepare us to deal with actual patients and be all Dr. House-ish in determining what their diseases were.

Turns out, nothing prepares you for the real thing. We had to review everything we were taught and correlate them with what we saw in the out-patient department. Nevertheless, this made it easier to remember things as we could apply our theoretical knowledge in actual situations.

It was also during fifth year that we started having 12- and 24-hour duties. Although we only had them in two departments (Pediatrics and OB-GYN), it still made an impact on us students. It primed us for the lives we were to have for the rest of our med life and beyond.

When it was our turn to take our duty posts, my duty-mates and I made sure we had instant coffee with us in the callroom for “emergency purposes”. Coffee gave us the boost we needed to endure the grueling 24 hours alert and coherent. Whenever one of us would show signs of fatigue or drowsiness, we’d keep each other conscious by constantly talking and laughing over cups of coffee during breaktime.

By this June, we’ll already be clinical clerks. We’d be spending an exponentially longer amount of time in the hospital, particularly in the wards. Duties would come every three days, and there’s no post-duty status for most departments. That means we’d still have to stay and/or go to class the day after, extending our waking hours to 30 and more. There’d be times when exams or graded small group discussions would be scheduled right after duty and there would genuinely be no time to prepare for them.

At the wards, we take orders from everyone and perform duties which they refuse to do – paperwork, procedures such as blood extraction and IV lining, and patient history taking and physical examination. Imagine having to concentrate when you’ve been up and about, working for 20 hours straight. Next to impossible, right?

When you’re a clerk, you’re expected to know everything during the grand rounds when a consultant asks you about your patient and his/her disease condition. It’s almost certain that you’d get reprimanded if you are unable to answer – not to mention that there are some who thrive on the fear and embarrassment of students.

Most importantly, there is never a room for error. Just a minor mistake in drug administration can mean either toxicity due to overdosing or lack of therapeutic effect due to underdosing; a mix-up of laboratory results might mean dispensing the wrong treatment regimen to different patients.

An innocent and unintentional error may prove to be fatal; that is why hospital duty requires an extremely high level of focus – one thing that coffee can help provide.

Coffee increases the capacity of the human body for physical and mental labor. It enables one’s thoughts to flow smoothly and quickly, and improves general body coordination. The most important things at stake here are not the grades we would be getting, but the kind of medical care our patients would be receiving.

Aside from this, coffee also keeps us sane. My friends from upper batches said that in order to maintain a balanced life in medicine, you have to forego a couple of your sleeping hours to redeem your social life post-duty.

Coffee can serve as an energizer that we can turn to in case we need to escape and spend much needed leisurely time in the outside world. After all, there is more to life than what is inside the four walls of the hospital. Being a slave to our profession is not an option, at least for me. Eventually, I still would want to settle down and start a family of my own before it’s too late.

As I am writing this, I’m beginning to get anxious about the upcoming schoolyear. This is actually my last summer break before I get into the meat of my medical education. What did I get myself into?

Well, if this is what it would take for me to realize my dream – if this is what it would take for me to become a great doctor – then sign me up. If I could just have another cup of coffee, please – the one I drank three hours ago just wore off.