I've Got A Bad Case Of Medical-Student-Itis

It's easy to think you have a disease when you spend so much time learning about it.

13/09/2016 9:54 AM AEST | Updated 13/09/2016 11:00 AM AEST
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"I should go get this cough checked out, I’m pretty sure it’s lupus."

Medical-student-itis is the tongue-in-cheek term used to describe the tendency for medical students to think they have the diseases they're learning about.

This isn't surprising considering the way medical students are taught. We learn about disease processes and the symptoms they present with. But unlike doctors who see patients every day, we don't have enough experience to know what diseases are common or uncommon; likely or unlikely, in any particular patient. We simply know that a particular symptom might be a sign of a serious disease.

For instance, a medical student friend of mine recently had a constant headache and blurry vision for just under a week. If a layperson (i.e. the average non-medical person) had a bad headache, they would probably put up with it; maybe pop a paracetamol tablet or see their General Practitioner. This friend was convinced that her pain was the first symptom of a brain tumour and tried to talk her GP into ordering an MRI scan.

Then, in the hospital, we sometimes meet patients who describe non-specific symptoms but are eventually diagnosed with quite serious diseases. An inevitable extension of this is a tendency to turn our budding knowledge of medical conditions and symptomology to ourselves.

Another friend recently travelled to Malta. A few days into the trip, he developed severe abdominal pain and constipation. Instead of putting it down to eating different foods or a new environment, he diagnosed himself with a large bowel obstruction which is a surgical emergency. Needless to say, neither of these friends came back with positive tests.

Overall, medical students are known to be a fairly anxious group of people. With a limitless amount of knowledge to absorb in a mere five to six years at university, our baseline anxiety is quite high. It follows then that medical students could be at risk of health anxiety, just like anyone else.

However medical students don't always cry wolf. I remember back in my second year of medical school, we were studying endocrinology and were given a case study about a young lady with symptoms that seemed more than coincidentally similar to some medical problems that I was suffering at the time. By the time I finished reading about the pathophysiology of the disease, the symptoms, and how common it was in young women, I was convinced that this was the explanation for my symptoms.

I went to see my GP and confidently asked him to diagnose me with polycystic ovarian syndrome (PCOS). However there was a problem with my "perfect" self diagnosis: patients with PCOS are often obese, but I was not.

The GP acted on his clinical experience and explained that since I was studying the disease at the time and some of my described problems didn't quite fit into the typical pattern of PCOS, I was probably fine. He sent me for some simple blood tests and when these came back normal, I was sent home with the diagnosis of "medical-student-itis".

A common saying is that the best medical investigation, in some cases, is time. A few years later, I was studying endocrinology again for my final exams and came across a list of criteria to diagnose polycystic ovarian syndrome. I noticed that having a normal result on the blood tests did not definitively rule out the disease, and that PCOS could also be diagnosed with an ultrasound. I went to a different GP and asked for an ovarian ultrasound.

Like the previous doctor, this GP noted that I wasn't obese. I explained how some of my other symptoms seemed quite typical of the disease and that I really thought I should have the test. She reluctantly referred me for the ultrasound, where I had the exact same discussion with the sonographer.

Funnily enough, the diagnosis came back as polycystic ovaries. I was so proud of my first correct (self) diagnosis that I barely felt upset about having the condition!

I don't blame my doctors at all and I respect their clinical reasoning. It's very important to consider the likelihood of a disease when trying to diagnose a patient who has already diagnosed themselves, whether the patient is a medical student studying the disease in their textbooks or a layperson having a go at self diagnosis with Dr Google.

Medical-student-itis is an interesting phenomenon which I suspect disappears as one's clinical knowledge improves. I'm entering internship next year, and am happy that my medical-student-itis days are behind me. But I should go get this cough checked out, I'm pretty sure it's lupus.

Lana is a guest on tonight's episode of Insight at 8.30pm on SBS, which asks: how much power do our brains have over our bodies?

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