Before Medicine (The WAPT)

With the 2017 WAPT (Wits Additional Placement Test) just a few days away and having interacted with some many applicants over the last few weeks, I found myself reminiscing a lot about my own personal experience.

Most people talk and blog about their medical school or working experience but it’s quite rare to have someone share their ‘before medical school’ part of the journey. The waiting, the stressing, the doubts and just everything building up to that response letter. So I thought I’d start a new series of entries going back about 3 years or so sharing my thought processes, my fears and my emotions at different points of that journey. What I’m hoping for is that it may resonate with some of you and maybe even inspire and motivate you a little.

I was a late bloomer, even though I had grown up wanting to be and dreaming about becoming a doctor, it was only in my third year of my B.Sc that I decided to pursue the dream. To be honest I don’t know why it had taken me so long to go after it, but the one thing I know for sure is that fear of being rejected was a really big part of that.

After I completed my B.Sc in 2013, I was forced into taking a gap year. I still owed the university quite a substantial amount so 2014 was really the year to work that off and take a step back to reflect on what it is I really wanted to do with the rest of my life. That was the year I decided that I was going to see this medicine thing through. Around May, I had finally gathered the courage to send my application through. I had one option; it was GEMP and nothing else. A few weeks after that I started reading on the WAPT. I didn’t really know anyone who had had a successful GEMP story but I remember having to continuously tell myself, that wasn’t my portion. I printed out the objective list and downloaded the prescribed textbooks. I spent about a month or so compiling summaries and study materials I’d use closer to the test date. I’d work from 9am to 7pm or 11am to 9pm depending on the shift about 5 or 6 times a week so I was always really tired but I’d come home every night and spend at least 3 or 4 hours trying to teach myself anatomy and molecular medicine, which I had no background in.

On the 7th of July I woke up to my invitation to write the WAPT, I was over the moon excited. It all of a sudden felt so real. I had found that motivation to keep going longer every night. Unfortunately this all lasted about this long; it was really hard staying motivated. I wasn’t in school which meant that I was the only person in my circle studying, I didn’t have anyone to explain certain concepts I was struggling with so I eventually just stopped studying all together. Life started happening, I got busy, I got tired and before I knew it, the study leave that I had requested months in advance was about to start which meant WAPT was 9 days away and I had not been studying.

Reality sunk in as I realized how much I had to study and how little time I had. I was anxious, scared but more than anything I was mad. I was annoyed at myself for having been so careless with my future but I knew somewhere somehow I had to make this work, I had to find the beast from within me to make it happen. So as I got home that evening; I changed my alarm to from 6:30 AM to 3:30 AM, I laid out my notes on the table, ate, watch series and went to bed. The next day I was up at my desk by 3:45 AM; I started with molecular medicine, it was the lightest component so finishing it was going to be good for my confidence and motivation. I studied till 12 AM the following day, only taking three 30 minutes breaks in between to eat. That was my routine for a good 5 days. I felt as though I still wasn’t moving fast enough so I started waking up 30 minutes earlier and sleeping 30 minutes later. There was a day where I pulled a 26 hour study marathon. I had lost weight, I had the biggest headache, I looked homeless and sickly but I had a goal and I needed to reach it.

October 2nd, the day before the WAPT. I finished studying at 9 PM. I hadn’t covered all the objectives but I had covered most of it. I went to sleep early, so I could wake up early. I was too nervous to eat in the morning, I woke up to a note from my baby sister reminding me to pray with my mother and wishing me luck.

The venue and time had changed and I had only seen that the previous night so my plans had been disturbed but I tried to stay composed, I hopped on the first taxi I could see and headed out to campus. There was a ridiculous amount of traffic and the taxi was really slow so now a new set of panic started kicking in as I thought I wouldn’t make it on time. I got so anxious that I forgot about the stress of how difficult that test could be, or how ready I was and now I just wanted to have the opportunity to write it. We eventually got to campus 4 minutes before registrations closed and I sprinted down to the venue, that was the first time in years I had ran so I was convinced I was about to die. I made it just as the last lady at the table who just happened to be in charge of last names starting with L was packing up.

She allowed me to register and as I walked into Hall 29, seeing at least a thousand people, still trying to catch my breath. I realized that this was it. Everything I had put myself through over the last couple of months was for this moment. I had never studied like that before, I had never pushed myself like that before, I had never wanted anything the way I wanted this before.

I found the last available seat, I said one final prayer and started the exam. Let me tell you this, the most difficult thing about the WAPT is preparing for it, once I had stopped worrying about how difficult it could be, once I had realized just how much I wanted it, once I had felt just how ready I was for it; it automatically became the most pleasant and easiest exam (experience) of my life.

FIN

Advertisements

my pain is no more

You won’t understand why, you’ll think I was selfish. You’ll say I had so much to live for. You’ll say you never knew but the signs were there. I didn’t become withdrawn because I was mad at you, I didn’t start covering myself because I was cold. I didn’t stop eating because I was on a diet, I didn’t stop talking because I had nothing to say. I just got tired of not being heard, I got tired of screaming but feeling as though I was simultaneously put on mute. I got tired hurting, I got tired of crying myself to sleep every night. I got tired of pretending I was coping. I got tired of trying and that I did, I tried, I really did but I’m sorry I failed. You won’t know how to mourn me because you’re hurting and you’re angry but you’re also confused. It was never my intentions to cause you any hurt and I’m sorry that my liberation has become the source of your pain. Maybe now you’ll understand why I hugged you longer and tighter than usual the last time I saw you, maybe now you’ll understand why I felt the need to keep telling you that “I loved you” over the last few days. Maybe now you’ll understand.

My name is Yannick Leyka*, I’m 25 years old and I’ve suffered with depression for as long as I can remember. It was my secret and I guarded it with my life, the very life it has now taken. I guarded it because depression is weak and how dare I as a black man ever portray weakness. It was my secret until it wasn’t, it became too big to keep. I thought that maybe if I spoke about it, it would make a difference but no one understood. So often it was brushed off with comments like “it’s just a phase, you’ll be fine”  or “stop mopping around and be a man about it.” You just didn’t understand but I don’t blame you. From the outside looking in, I had no reasons to be sad, to be demotivated or to feel broken or empty. My life showed so much promise and being unhappy always made me feel as though I was being ungrateful. It didn’t help that I just never learnt how to express myself effectively so I shut the world out because words always escaped me, in a similar way to how they’re escaping you right now. It isn’t your fault and I don’t ever want you to think that it was.

I tried, I really did but to feel sadness without cause and to try fill the void to a black hole created a paralyzing frustration. I remember sitting alone in my room staring at the wall for hours on end, wondering what life would be like for you if I was no longer around. I cried everyday because I was in pain. Sleep was my only escape and even that was taken away from me, as I’d lay in bed for hours before eventually dozing off, sometimes dawn would come without me shutting my eyes at all and wondering off to my perfect world; to the world where my pain was null and void, the world where I didn’t have to hide myself, the world where I was free. Maybe if the sleep was permanent, I’d finally know peace, I’d finally know happiness.

Every 1 in 10 persons you meet are suffering from depression, you may have missed it with me, you may have overlooked the signs with me but now I need you to learn to pay attention, it may just be what saves a life.

FIN

The King who was also a Doctor (I hate pathology but I loved the pathologist).


Many had heard of him, but few had ever set their sight on him. He was a legend, the greatest who had ever lived. He barely ever left his dark castle but whenever he did crowds from all over the land would come to hear him speak, many young men and women hoping to gain favor in his eye. Many had come before us and many will come after us, all in the hope to make his rankings. A dark cloud covered up the sun and this darkness came with it. The silence was deafening. There he was; white crips shirt, red bow-tie and a wooden stick, he had a blunt look on his face and hoarse voice.

We struggled to hear him but no one dared to complain or ask him to repeat himself. He spoke of foreign concepts, told us of stories of strange deaths, laughed at his own jokes and coughed a lot. He spoke in great length of what he had planned for us, all the activities and trials we had to perform to gain his favor and commented on how many had fail him in the past with the spirit to frighten us. He was the king, no one dared to defy him, he wanted you to learn as he taught, speak and understand as he did, if you didn’t, you’d be struck with the red sword and forced to come back in the next season to try again.

As he finished talking and slowly walked away, the cloud disappeared and the sun was again visible. The timing could not be ignored. There we stood terrified by the images he painted to us, most of us were overwhelmed by the confusion, wondering what he meant by inflammation, the different types of necrotic tissue and why polymorphs were so important.

Yes, He was King, not by tittle or profession but by name. He was the adorable pathologist from the third floor, Dr King.

A letter to 2017


It’s that time of the year again; resolutions, reflections, new journeys etc. A new year is on the horizon and once again we’ve been given an opportunity to try, to do better and achieve more. It means so many different things to me.

Emotionally – it doesn’t erase whatever hurt, worry or other negative feelings I may be experiencing at the moment but it definitely redirects my attention towards hope, peace, happiness and optimism. There’s also a sense of accomplishment in having survived a year many people deemed to be worse in a long while. I’m ready for what’s coming ahead.

Physically – I’m all for a year of gym, healthy living and and fitness. Definitely going back to basketball, I’ve even gotten myself a new ball. I’m also really looking forward to having to smarten out my everyday look. Smart shirts, ties, chinos and smart shoes. It’s time to be a grown up.

Mentally and spiritually – it understanding how difficult this new year is going to be. It’s really going to challenge many of my core values, my priorities and my ability to cope with it all. I know school will be a thousand times harder. My sense of responsibility as a man is also developing quite drastically so that’s pretty exciting.

Academically – it’s goodbye blocks and hello rotations, hospital time, finally. To be honest I don’t know how to feel about fifth year yet. It’s nerve racking, but it’s also exciting. It’s a chance to finally see what being a doctor is all about. I think the thing I’m looking forward to the most is cancelling out on plans because I’m on ‘call’, it just sounds so Grey’s Anatomy. I love it.

2017 will be a great year, I’ll make sure of it.

Wishing Everyone a Happy New Year.

Medical School in South Africa (Interview with a matric pupil).


How far along are you in your studies?

  • I’ve just completed my fourth year.

Why did you choose to study medicine at Wits?

  • Medicine has been my passion since I was yay high, I did an entry on  why medicine a few weeks ago. My choosing of Wits was based on personal preference and it made the most logistical sense, I live in Johannesburg, they offered what I wanted to study, and it’s a great university.

How many university offer medicine in South Africa?

  • There’s 9 in total; University of the Witwatersrand, University of Cape Town, Stellenbosch university, University of KwaZulu-Natal, Sefako Makgatho Health Sciences University (previously known as Medunsa), University of Pretoria, University of the Free State, Walter Sisulu University and University of Limpopo.

Are all the courses identical?

  • No there’s no standardization in the curriculum, every university teaches it differently. The amount of time spent on core subjects, clinical exposure and even labs differ. We are however expected to know more or less the same things by the time we graduate.

How are the years broken down?

  • First year is devoted to basic sciences (Biology, chemistry, physics). There’s also Psychology, sociology, and Medical Thoughts and Practice (MTP).
  • Second year is an introduction to medical sciences; Anatomy, physiology, molecular medicine and MTP II.
  • Third and fourth year is integrated basic medical and human sciences. Each blocks focuses on a specific system. It introduces clinical concepts such as pathology, pharmacology, immunology, bioethics, microbiology, anatomy and physiology.
  • Fifth and sixth year introduces clinical rotations, most of your time is spent in the hospital, you get to play doctor and interact with patients. You’re expected to go through the following rotation; Internal medicine, OBGYN, surgery, Paediatrics, family medicine, urology, ENT, psychiatry, ophthalmology, forensic medicine, Trauma, emergency medicine, anesthetics and community medicine.

Which university offers the best medical degree?

  • I’d say Wits, we have the biggest teaching hospital on the continent as our classroom so we have a broader exposure spectrum. We’re also the only MBBCh in the country (although I think that’s just Wits way of being spicy). I’m obviously extremely bias because I’m a product of Wits. However I’ve heard that Tuks, UCT, SU and SMU have really good programs too. It’s very hard to compare because the teaching styles, the academic hospitals, exposure and resources all differ between universities. For example, Wits focuses more on theoretical training whilst Tuks focuses more on practical training, which of the two produces the better doctor is based on the students themselves (this is a non-ending debate between very bias parties, one you should stay away from.) In the end it’s really the reputation of the university that counts.

Do I need to be very smart to succeed in medicine? 

  • A certain level of intelligence is required to understand tricky concepts and reason your way to diagnoses but in my opinion resilience and disciplines are qualities that will take you further.

What are the pre-requisite coursework to get accepted in medicine?

  • From a high school level; physical sciences & pure maths. However doing life sciences is also quite helpful. From a tertiary level, most schools would ask that you have completed physics, chemistry and biology at least on a first year level.

How long is a medical degree? 

  • A medical degree in South Africa is 6 years (5 years at the UFS, I stand to be corrected). Wits offers a 4 year program but you need to be a degree holder to qualify for that.

Tell me more about the 4 year program at Wits.

  • Basically there’s an entry point into 3rd year. You get to skip the first two years but you will need to have completed a degree first. There’s quite a complex selection process and entrance exam. Details on the course can be acquired here.

What is your average day like?

  • as a fourth year student, my mornings would comprise mostly of lectures or labs, it was quite rare to have afternoon lectures but they did happen every now and then, especially towards the end of a block. I’d be at Varsity Mondays, Wednesdays, Thursdays and Fridays. On Tuesdays I’d be in the hospital so it would be morning rounds, clerking patients, presenting to the registrar in charge then going to clinical skills in the afternoon.

Is medicine difficult?

  • Yes and no, There’s a lot of work to learn in a very short period of time. Each block is different, so you need to adapt really quickly. It’s a really taxing degree and requires a lot of strength. You will need to be disciplined and work hard. You’re studying to save a life one day, that is not something one should take lightly.

Do you have a social life?

  • What’s that? I’m kidding, yes I still have a social life, mostly with my classmates though because of the similar schedule and location of residence. I rarely ever see my other friends though, after your third year most of them graduate from their respective degrees, start working etc so dynamics change. It’s important to live a well-balanced life so having a hobby, playing sport and hanging out with friends is very therapeutic.

What happens after 6th year?

  • You become a medical doctor. You have to go through 2 years of internships at a public hospital (which you apply for in your final year). You’re the most junior doctor in a team of doctors, you go through different rotations and teach medical students if you’re at a teaching hospital. You then have to do a year of community service, usually at a clinic where you’re now considered a senior doctor. Once that’s completed you can choose to either specialize as a registrar or become a general practitioner.


This is based on my personal experience and conversations that I have shared with friends at different university.

FIN

It was an ordinary Tuesday morning.

9:15 AM on a Tuesday morning, a man in his mid 30’s is brought into casualties on a stretcher by 4 paramedics. Victim of a mob attack, he’s unconscious, has multiple laceration to the face and torso, possible damage to his cervical spine and a fracture on his right leg. There’s no registra on duty, she left 5 hours after her shift last night because of the evening patients influx after an accident on the M1. The other registra has been called off to another hospital for the week. There’s only two doctors in the wards; one is a second year intern who is now 3 hours post-call and the other is first year intern who started her rotation two weeks ago. A third intern has been called in from the surgical unit but he hasn’t arrived yet. There are too many casualties coming in that no one notices the 10 year old child who’s having a seizure in the corner or the crying mother with the 3 months old baby who has now become unresponsive. Sounds like the introduction to a Code Black episode right? sadly this is more or less an ordinary morning in the trauma and emergency unit at any large public hospital in South Africa. The lack of resources and the shortage in medical staff in comparison to the patients that require help becomes a reality you experience upon the early days of clinical exposure. It’s not a story that is told to scare us, it’s a reality. There aren’t enough healthcare professionals in the country.

But back to this ordinary Tuesday morning, a sigh of relief as the Nurse in charge notices us, “students, great.” She quickly calls us over, “Hi guys, as you can see we’re having a busy morning” she said before she started instructing us on what to do, “Can the two of you go help in administration and triage patients, can you follow this doctor and assist her” she instructed my friends. She then turns to me, “bad day to wear a white shirt my boy, follow those paramedics and assist the doctor with that man they’re carrying.”

Now I’m also thinking that it was a really bad day to wear a white shirt. I run off after the paramedics. “Here help us get him on the bed on the count of 3. Careful with his neck. Hi sir, can you hear me?” said the doctor in charge, let’s call him Dr. X. “What’s your name?” He says, looking at me, “okay, Yannick I need you to get me two bags of Balsol, ask the nurse over there to show you where to get morphine.” I did not completely understanding what he said, it was hard to concentrate; there was a lot of blood, I had never seen so much blood before. I run off to the nurse who helps me find the Balsol and morphine. As I return, Dr. X says, “pupils are reactive to light, he opens his eyes to and flexes away from pain stimulus, his speech is slurred and inappropriate. What’s his GCS score?” before he goes on to insert the drip. “GCS score, uhm I should probably say a number, any number” I thought to myself before guessing 7/15. “He saw right through that, he knows I guessed”, still thinking to myself. “No, it’s actually a 9/15, you need to revise your notes. A fifth year student should know these things” he says, looking rather disappointed. “I’m actually in fourth year Dr.” I corrected him, but deep inside I still felt as though I should have answered that right. He pauses for a second then says “Oh my bad, well today we’re going to treat you like you’re in fifth year. I’m gonna need you to draw blood, syringes are in the orange basket, after that you’re going to need to put a cast on his right leg, I think he might have fractured his tibia. I’ll suture his face while you put the cast on. I’ll talk you through it.” Now my mind is racing and my heart is pounding, I’m feeling dizzy and a little nauseous but I can’t  differentiate between a hypoglycemic attack because I had skipped breakfast or a panic attack. I’ve drawn blood maybe a handful of times, I have sweaty hands now, what if I puncture right through the vein, what if I get a needle stick injury, what if I precipitate the formation of a thrombus and kill the patient. Seeing the look on my face he says “You’ll be fine, I’m right here to help now get going, this man needs your help doctor”
I had been called doctor by my family members and friends, since before I had ever filled out my application form to med school. Somehow it felt different having this tired intern call me that. I followed his instructions, spoke out when I needed help and the rest is history.

I had learned two important lessons on that ordinary Tuesday morning; never ever wear a white shirt to a Trauma/emergency unit (I mean why would you?) and to always be prepared. That ordinary Tuesday was my first day of fourth year, I didn’t even know the ward we had been assigned to and while I was still on holiday mode, the patients I was suppose to serve that day needed the best version of me. There’s no days off, there’s no excuses, you can’t be slacking off; if you’re going to show up, you’ve gotta be ready, you never know when you’ll be the deciding factor between life and death.

FIN

Why medicine?

Why medicine? It’s the ultimate question and the simple and rather expected answer is that “I want to help people.” It can’t be the money, I mean we really don’t make that much for the work we do; but then again I don’t understand why there would be a simple or expected answer to such a question.

I was a sickly child, so I spent a lot of time in hospital surrounded by sick people, many of were often alone and scared. I remember going from bed to bed chatting to people and telling them that they’d get better and that everything would be okay. I kept getting in trouble with my grandmother because she kept telling me to stay in bed but I couldn’t help myself. From that grew an overwhelming passion to want to help people, even it meant that I got yelled at for it. As a child I remember being asked what it is I wanted to do when I grew up. My answer each time was that I wanted to make the world a better place, helping one sick person at a time. If people felt better than the world would be better too.

I was cute and innocent, but that sentiment remains true till today. Truth is that medicine is the perfect combination of all my passions. It’s where science meets art, facts meets faith. it highlights the imperfections of humans and yet promotes and teaches to never give up on them, it is the best representation of humanity. It’s a practice that encompasses my passion for people, my love for God, my understanding of nature and it excites my being. Let’s face it, medicine is awesome. I remember the first time I stood in the dissection hall, that first incision, that paralyzing moment, how could one feel so alive in the presence of death. How could one be so much, so complex and yet so simple. The human anatomy, I don’t understand how you could not fall more in love with what it is to be a human being. I remember my first interaction with a patient, I didn’t know enough to diagnose, let alone help her, but just talking to her and making her smile. I’ve never felt more in the right place. How could I ever do anything else. I want to be use as a tool by God to aid others heal, to bring life into the world, to guard and to serve that very life. I’d practice medicine even if I wasn’t getting paid for it.

So when you ask why medicine? It’s really simple but it’s not; I am medicine, Medicine is me. It is an extension of me, in as much as I am an extension of it. We’re in a love hate marriage, a complicated relationship but we’re definitely soulmates. We fused when we met and became one being; it’s my thoughts, my heart, my passion, my dream and my calling. So that’s why medicine.

FIN