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The generosity of patients shines through

The past few years have been challenging for many practising clinicians, for a multitude of reasons: staff shortages, endless COVID-19 guideline changes, hospitals working at and, in many cases, beyond capacity, managing patients’ frustration with disruption and uncertainty, and endless discussions regarding vaccination, to name a few. With these stressors added to the already often taxing nature of our work, it can be easy to lose track of why we embarked on a career as a physician. Over the past 6 months, I have been one of the many chief medical residents across the nation tasked with organising trial exams in preparation for the Royal Australasian College of Physicians Clinical Examinations. Most of the patients recruited for longand short-case examinations are medically complex and often immunosuppressed. Understandably, with the advent of COVID19, there has been a reluctance from such patients to participate in close-contact, personal interaction at a time when they are being encouraged to isolate. This has made organising what has always been a logistically challenging exam even more difficult. Despite this, I have been struck by the generosity of patients in volunteering their time to help physicians in training develop their skills. Patients attend hospitals at early hours on weekends to be practice subjects; these are the very same hospitals where they already spend countless hours on outpatient appointments, investigations and inpatient admissions, often within the same week. Some of the patients we have on our trial roster have been volunteering for more than 20 years. Not infrequently, patients will volunteer their time when called in desperation on a Friday afternoon as yet another trial patient has tested positive for COVID-19. When I ask patients why they choose to volunteer for clinical exams (and show such dedication), most reply that their reason is to give back to clinicians that have helped them along the way. The patient-physician relationship that develops due to the longitudinal and considered management of complex chronic conditions is formidable. Another common reason is that patients want to assist junior doctors to become well rounded and, in doing so, ensure the healthcare they have received can be replicated for other patients. Whatever the reasons for these patients’ seemingly endless generosity, we rely on it, and without it we would be deprived of the crucial training opportunities needed not only to pass our Clinical Examinations but grow as doctors. Despite numerous medical and technological advances, the relationships we develop with patients continue to be a driving force behind why we become physicians. This warrants reflection, especially in today’s often bleak and challenging times.