Once upon a time, I was classified as the lowest animal in the hospital. That is I was a medical clerk.

For those who don't know, here in my place, fourth year medical students (graduating medical students) are called medical clerks. Medical clerks go through a year of rotations in different departments of the hospitals (mostly government hospitals) as hands-on skills training after three years of medical theory bombardment. After going through the 1 year training, you take a "revalida" or an exam, which is divided into 2: oral and written. Completion of clerkship and passing of revalida entitles you the salutation "Dr" or an attachment of initials "MD" at the end of your surname. Afte that you go into another 1-year government internship. Then you take the boards. And voila, you are now a licensed physician.

But that's getting too far ahead of the story.

Let's go back to the introduction that I was the lowest animal in the hospital.

As the team scud, you bear the burden of most menial responsibilities as ordered by your senior team mates. Tasks that are too beyond them to perform. Your seniors (residents, consultants), nurses, orderlies, and other people in white (with the exception of patients in white hospital gowns) address you as "Dr" while they shove you soiled latex gloves from a rectal exam (you throw the damn thing, doctor). That would be an example of worse-case duties. Typically, you insert things, including your gloved fingers, to any available orifice as needed in a patient as ordered in the chart. If you're new at it, you fumble and you tend to insert things somewhere else. (In that case, you call a fellow scud, who's got "experience"). Sometimes, you puncture holes to draw out blood or push drugs. If you're new, you end up puncturing your own finger and drawing your own blood. Hopefully, if that ever happens, that needle was not used on the patient first. You interview a patient for every single important detail of their life (heck, if you could extract the childhood history of an 88-year-old patient with dementia, YOUR RESIDENT will lauded by his/her consultant for doing excellent history-taking), or you stand there at their bedside and get drilled by questions by over-anxious relatives ON why on earth you think this is the diagnosis, why IS this the test, or that drug, while you manually pump the comatose patient's ambubag (since the people with the mechanical ventilator got stuck in the stairway traffic for 4 hours now). If you can't come up with an answer in support of your senior's judgment, you might as well shut up. On a 24 hour duty, you take hourly or 4-hourly vitals of every single patient in your ward. By the time you're done with the last patient, you have to go back because the time has passed and it's time for the hourly or 4-hourly vitals of the first patient you checked in the ward (nice to see you again, sir?). Meanwhile, if you've managed to pass that task to one of your fellow scuds, you end up interviewing every single admission. You study their cases, and you read your books if you have time. If there are no arrests or code blue (emergency/flatliners) that night, you're lucky to get at least an hour's nap. Otherwise, you "exercise" by performing the SOP 30-minute chest compressions until you stabilize the patient. After a night's workout, you show up at the 7 am endorsement panel, with Panda-like eyebags, while they drill you with questions not related to every single admission you've had (told you, reading that book is useless). After that, the bedside "firing squad" rounds on the ward. You personally endorse each patient to the next duty team. Down to the last detail of farts and bowel movement, if your patient did or did not do so (oh aren't we so close already?). You get to be drilled and insulted in front of your patient today. The next day, hopefully, the other team would do a payback for you, since they are the ones who are on duty today. If you think you could leave at 10 a.m., you must be dreaming. You leave 5 p.m. because post-duty is an 8-hour regular time. You find some other thing to do or else if a wandering resident finds you doing nothing, he/she will find work for you to do (usually it's not enjoyable). After 32 hours in the hospital, scuds usually fall asleep with their scrubs on when they hit the sack. They wake up around midnight, roused by their stomachs and call up fellow scuds to ask if they have a copy of Dr. Quack's lecture (more like the exact copy of a page of your Harrison's Internal Medicine book, only with bigger fonts and diagrams). After reading (turning each page for the sake of turning it), you sleep some more and hope you wake up early so you won't get extra hours demerit for being late. Remember, you'll be living in the previous hospital for a week to make up for those other extra hours given by an OB Gyne resident with a pathological case of PMS.

Now, that's just a summary of activities of what typically happens to a clerk (or to every new clerk). But fortunately, I learned quickly, and I learned how important this animal actually was in the healthcare team.

I guess, I've always had this problem with "authority" and I've always been a rebel. Only I was just passive. The beauty of being passively aggressive is that they (some irresponsible seniors, nasty nurses, uncouth orderlies/lab techs) don't see you coming. Being overlooked and underestimated, they forget you actually earned a Science degree as pre-med and you actually have IQ points that got you into med school in the first place.

So, while I (or we) went through the notions of having that title stamped on my name plate as I went through every duty, me and my pals made a pact earlier on to make sure that we take that year as an adventure instead of "a year psychological hazing."

We refuse that title, and we made sure we got the respect we deserve.

We animals did bite. The stories in the future blogs will be of this moments in time, where we had our adventures and misadventures in our journey of doctorhood.

Hopefully, for those who are undergoing the same thing now, you will find some tips, humor, and hopefully, wisdom with what I've written and what I will write in the future.

As for the rest, well, you get to feel what it is to be who I was before.