The world is full of websites and books about what your doctor doesn’t tell you. This familiar anxiety masks a truth, which is that there are likely to be some things that your doctor doesn’t actually know. Medical school tries to cover everything, from the life cycle of the anopheles mosquito to the names of the 27 bones in the hand to the emergency treatment of a haemorrhage. While it is just about possible to retain this information for exams – the corridors beforehand are full of sweating students chanting mnemonics – it is inevitable that some of the knowledge will go missing later on.
Once you start in hospital you find that you simply don’t need it; your days and nights consist of treating the same four illnesses. Meanwhile, the theoretical foundations of medicine – the Krebs cycle, the aetiology of scleroderma – are replaced by a new mountain of uselessly specific yet essential facts. Now you must memorise the codes for three hundred different doors, the whereabouts of the ultrasound department and which form you need to use when requesting an MRI scan of the brain (Not the same form as for a CT scan of the brain! “Go away and come back when you’ve found the right one!”; “But my patient needs an MRI urgently ... ”; “I’m sure he does, but I cannot accept a lilac form!”).
British medical training requires you to spend the first two years after graduation working in a variety of different specialities, and then many more years doing jobs tailored towards a particular career. At the beginning you see a wide variety of medical conditions but you’re too new to feel confident about any of them. As you progress your knowledge grows, but it’s increasingly focused within a specific field. As a result, some of the less commonly encountered organs and illnesses start to acquire a mystique.