My Master’s in Medicine: A Post-Mortem

I came up with the idea for my Master’s thesis myself. I would do an audit of the patient volumes in the trauma unit in the hospital where I worked, and see if the numbers of patients per shift actually matched up to our Month-End-Weekend-With-Soccer-Is-A-Stab-Fest beliefs. Originally, I thought this would be a fun little audit to do, ‘just quickly’, as ‘practice’ for my MMed. The consultant I pitched it to (and who became my supervisor)however, pointed out that doing the project would meet all the requirements for an MMed thesis — going through the ethics approval process, collecting data, writing a literature review, interpreting results, writing up results — so why not just do it, call it my MMed, and move on with my life. Awesome idea.

I would just like to get it out of the way now that there was only one awesome thing about my MMed: my supervisor. The rest of it was nothing but the most frustrating, sisyphean slog, that felt largely pointless when looked at in the greater scheme of things. Sure, on the list of immense tasks one must perform in order to become a paediatric surgeon in this country, ‘complete MMed’ is quite a big one, so it’s nice to have that box ticked. But that’s about it. Probably the only people who will ever read the thesis are my supervisor, and the unfortunates who were tasked with marking it. There’s no ‘Gosh that’s interesting’ moment in the results section, because every single healthcare-type person who has ever dabbled even briefly in the state sector in this country knows that month-end weekends are stab fests. Nobody needed me to spend almost four years labouring over trauma logs and statistics software and mountains of other mind-numbing articles in barely-read journals to tell them what their own bloodshot eyes and blood-soaked hands already knew.

I realise that perhaps I have some kind of mental block, some kind of personal built-in research glitch that made the whole process particularly hard for me. I know people who churn out research faster than Kim Kardashian churns out selfies. I know people who wake up with an idea one day and have an acceptance letter from a peer-reviewed journal in their inbox a month later. I know people my age whose publication lists hit higher on a Google search than their Facebook or LinkedIn profiles. I look at these people and am amazed and awed by them. How do they do it? They look regular. They look like they drink wine and watch Netflix and have children and do the groceries and all those other things that I believe distract me from vomiting up research. I do not know what their secret is. I salute them.

Anyway, in the interests of closure, I would like to share a few things about my MMed journey. This is not a How-To. It’s a rant.

1. Time: None Of It

Maybe you work in the kind of department that will allocate you a few weeks or months to do nothing but work on your MMed, and if so, that’s awesome. My department was, at the time of me doing the MMed, not one of those. Everything I needed to do had to be squashed in between everything else I simply had to do: calls, paying attention to my husband, outpatient clinics, operations, giving birth, preparing theatre slates, making dinner, preparing presentations — you get the idea.

The MMed has many steps, and each of them takes a significant amount of time, and each of these steps is kind of difficult and requires a certain amount of undivided attention. So when you’re trying to squeeze it in between all these other things — 10 minutes here while the anaesthetist gets the patient to sleep, an hour or two there after the kids are asleep — it’s just impossible. For example, I can’t do a thorough literature search, read the literature, and then write a review thereof in segments spread over weeks. Maybe you can, and then congratulations, you’re one of the people I was saluting previously.

Ultimately, when I changed from general surgery to paediatric surgery, a sympathetic consultant agreed to allow me a two week stretch just for finishing up. I would never have been able to do it without that.

2. The Stats

Once again, I acknowledge my own shortcomings here. I have friends who ‘taught [themselves] how to do The Stats from YouTube’. You people are incredible. I did not manage to teach myself how to do The Stats from YouTube. I did go to a man tasked with helping imbeciles like me with The Stats Problem. I thought I would give him all my painstakingly collected data, and he would give me Results. He didn’t. He wanted me to empower myself by learning how to do my own statistical analyses — this included learning to code in the program that does the analysis. I know. Lots of you can code in this program, and good for you. At the time, though, I was learning many other things: how to use a laparoscope, how to place an intra-ventricular drain (don’t ask), how to survive vascular surgery whilst pregnant without killing myself, and so forth. Learning to code just seemed too much at the time.

So I never went back to that man. I did what any reasonable person would do in this situation: I made an impassioned plea on Facebook for help. This plea worked, and I was referred to people who did not expect you to learn to code, and would give you some printed out results for a small fee. Unfortunately, quite a number of suffering MMed students had discovered these people before me, and I made the mistake of telling them my deadline was ‘very far away’. These people work better with an immediate deadline. My data languished with them for months and months, until finally my deadline was no longer so far away, and I was forced to go sit in the office of the statistician while she actually did The Stats. The worst part of this was pretending that I understood Poisson Regression and that I just needed her to do the coding for me. In retrospect, though, I’m sure she wasn’t actually fooled.

3. The Paperwork

The only time that I truly thought I wasn’t going to be able to finish my MMed was when I was grappling with The Paperwork. As you may have gathered, it took me several years to complete my thesis. During that time, the University changed its procedure quite a lot, and also invented multiple forms that had to be completed and signed by multiple people. Some of these forms have to be re-completed and re-signed every year from the time you start your MMed to the time you finish. I only discovered most of the forms in the last few weeks of the project, as I was preparing to hand in.

Despite the fact that I went to great lengths to identify all the forms I needed to fill in, so that I could get them all signed and handed in at once, there were always more forms. The very act of completing a form seemed to generate new forms. It was like a game of Plants vs Zombies: you mow one row of paperwork down, and three new, ever more complex rows appear. I had friends dropping and fetching forms. I was giving colleagues gifts in exchange for collecting signatures on my behalf. I was crying over dinner while my husband rolled his eyes. Pathetic, it’s true, but an ordeal nevertheless.

4. The End

And then, one day, my thesis was complete. My supervisor told me that it had gone from ‘unreadable’ (my eyes, they still burn every time I think about that email), to ‘satisfactory’. I did the weird online submission thing. I didn’t have a wild, celebratory night out because I was (once again) pregnant. I actually sort of forgot about it, until one day, a week or so after my second child was born, I got an email informing me I had passed with distinction.

I read the examiners’ reports over and over again, and couldn’t believe that they had such nice things to say about something I had come to find so boring and hateful. There were a few corrections to do. My supervisor signed them off. And it was over.

Ultimately, I am pretty proud of my thesis. Sadly it’s not because I think the research is very important (although plenty of people find it vaguely interesting), but because it was this really difficult thing that was once just a question in my head, and that I pushed and pushed at, until it was a long and well-explained answer. On the day my library copy was accepted, I drank some good champagne. Here’s to me.

My MMed in (rough) numbers

Patient visits recorded: 16 706

Words in thesis: 26 328

Forms submitted: 15

Signatures collected: 22

Emails sent and received: 161

Direct messages sent and received from person on Twitter who helped me with paperwork even though we’ve never met IRL: 32

Messages of support/commiseration on Facebook posts detailing MMed anguish: 44

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