Arbitrary Requirements

Graduation is looming. Only slightly less scary than before since I was offered a residency position last week. I've made arrangements to leave an hour early next Thursday to pick up my mom at the airport and I've gotten a substitute so I can take Friday off to spend time with her. Then I second guessed myself and accepted another shift for Friday - same time, same clinic, different supervising physician. Seems silly, but I really don't want to go back to clinic as a student after graduation.

It's CYA time and I'm Santa-Clausing my list (that is, checking them twice and again) of requirements religiously. I was about to say that I don't know of any religion that requires piotous practice so frequently as I consult my lists, but then I remembered the five daily prayers of Islam and consider that they may actually have one up on me. The requirements for graduating from medical school are vast. Besides passing many exams that show that you know better than to make stupid decisions that will kill your patient, graduates from my program are required to:

• Do 2 new patient intakes - easy!
• perform 5 complete gynecologic exams - I don't know how people don't get this requirement done - it's practically all I did for the first year!
• examine male genitalia twice - done
• perform 2 digital rectal exams - whew, that was easier than expected
  perform 2 "male prostate exams" - I'm glad they didn't expect me to do female prostate exams!
• do a complete physical on 5 patients - piece of cake
• do a physical on 2 babies - fumbled through - don't ever trust me with your children!
• do a physical on 1 elder - did I really never see a person over the age of 60?
• 3 of each manipulation - cervical, thoracic, thorax/ribs, lumbar, sacral - check!
• show competency applying electricity to patients using various devises - wow
• etc. (I actually wanted to list them all, but there are so many! The remaining areas of requirements are minor surgery, homeopathy, nutrition and botanical medicine.)

I currently still have 11 of the above (although most of them fall under the etc. category) to complete. They do seem somewhat arbitrary, though. Why 5 gyn exams, but only 2 male genitalia? Is the female genitalia really that much more complicated?

The number of hours we are required to complete fall under the jurisdiction of the accreditation boards, but here's a look back at what I've completed in terms of recorded hours (my class time is not recorded - these are hours specified under our accreditation):

• Community Service 24
• Hydrotherapy Technician 73.5
• Intro to Clinic 12
• Clinic Education 15
• Lab Practicum 24
• Lab Post 12
• Xray Post 24
• ND Medicinary Practicum 24
• Secondary 292
• Primary 668
• Chinese Medicine Observation 264.5
• Chinese Medicine Internship 629 (projected)
• Chinese Medicine Medicinary 24
• Preceptorship (observing NDs, MDs, DCs etc) 232
• Seminars 48 (attended more, but they only credit us 48)
• Grand Rounds 120
• Grand TOTAL: 2216

In all those hours, I will have seen a minimum of 1100 patients. Wow, I guess I really have done a lot in the last 7 years. It's funny to think I've done all that and still managed to write my blog during my clinic shifts. I am, in fact, on shift now, but since this clinic was flooded over the weekend, we don't have many patients today and I'm leaving momentarily for the final show of strength as I win the wrestling match with the thesis. Prepare to see my fist raised as I defend my title on Tuesday afternoon. Revisions Wednesday and Thursday then turn it in on Friday for a guilt-free graduation on Monday. Oh yes, graduation is looming.