Going through the motions

I love medicine. The intricacies of each system of the body, the complexity of patients as people and not diseases, the little surge of smile I get when I make a correct diagnosis, or when I find a vein that no one else did ...I even have a favourite bacteria (it's really very clever).

I am good at what I do. I am not the best, I don't get straight As, I can't name all the bones in the hand or remember more than 3 causes of finger clubbing at any one time, I'm not ground-breaking, I'm nothing special, noone's going to name something after me any time soon, but I am good at what I do. I can get a 4 year old to giggle the whole way through an examination, and muster a good enough my-mum-was-a-ward-sister voice to hush the mouthiest of drunks. I have laughed and cried and sung with patients, I have chased a naked patient making a break for freedom, I have watched patients die. I have made tea, and changed nappies, and taken blood. I am often the first face people will see on a new ward.

I love what I do, and I care about my patients. It has cost the NHS hundreds of thousands of pounds to train me to be a doctor, but there is no guarantee that when I graduate I will be able to work. This might sound like an over-dramatic statement, but it is in fact quite realistic. I am certain that I will not manage to complete the foundation programme on a fulltime basis. It is technically possible to complete it on a less-than-fulltime basis, but it means more hoops to jump through (providing evidence etc), and it is on a pro rata basis (as in, I would still need to be fit to do nights and on calls, which remains to be seen).

Medicine is seeming less and less of a viable career path for me. Even if I become a doctor, my career will not be the career that I had expected. This has been a gradual realisation for me over this last year, and I don't think it's really sunk in. Every time I find myself having a conversation about what the future might look like I get really upset. I feel like I have no other marketable skills - or at least no other marketable qualifications - and that anything else will always feel like second best.

I feel like I've withdrawn a bit from medicine - I'm not excited about placements these days, or wanting to go and spend time on the wards. I feel like I'm just doing what I have to and no more, which isn't like me. It's like I can't bear to get excited about it anymore, because it might not be.

It would be worse if I felt myself physically incapable of practising medicine, but I don't. I'm just not able to work within the training programme as it is - but semantics make no difference. Either way I am shut out of my profession.

I feel numb.