Med student struggles to preserve her idealism

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combatmedic

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Emily Breidbart, a second-year student in the New York University School of Medicine, was an intern with CNN Medical News this summer.

(CNN) -- "Two minutes!" yells our course coordinator.
art.emily.lab.jpg


Her voice startles me as I try to concentrate on Mrs. Chin's account of her recent asthma attacks.

I have already used eight of 10 allotted minutes, and now have to wrap up my "Objective Structured Clinical Examination."

During our four years as medical students, we will do dozens of these OSCEs -- imaginary, but realistic doctor-patient scenarios.

My professor praises that I structured my 10 minutes well. I'm pleased. In our first year, we simply take a medical history. But next year, I'll add a physical examination, and in my third year, I'll be adding counseling and treatment into the "patient visit." And all we get is five more minutes added onto our OSCE time. How can I get all of this done in just 15 minutes?

Learning how to practice medicine on this sort of a time-scale is stressful. But it's totally necessary in order to properly train us for a world of health care in which the average physician visit is six minutes! When our professors went to medical school, they were taught the art of healing; we are taught how to diagnose and treat patients in a limited timeframe. I can't help but think, is this what I signed up for?

My father is a pulmonologist and the head of an eight-doctor practice on Long Island. When I tell people this, many say, "Oh, he must have really wanted you to follow in his footsteps!" But actually, he made me very wary of medicine. He is tired of spending half of his energy dealing with insurance companies. Energy and time, he says, that would be better spent on his patients, time he had when he first started practicing in a health-care era in which doctors didn't need to justify prescriptions and tests to insurance companies. He still insists on giving ample time to his patients, but now has to work incredibly long hours to do so.

At my dad's 50th birthday party, when I was 19, his colleagues interrogated me about my recent decision to pursue medicine.

Are you sure you really want to do this?

Why put yourself through all the years of stress? You're a smart girl -- how about journalism, law, business...?

Your dad couldn't convince you not to do this? I'll have to have a talk with him!

How is it that my classmates and I are going into medicine if this is what people who have lived our future are saying?

We start out in medical school as idealists. We thirst for clinical experience. We want to explore all of our options, and help those who can't afford health care. But somewhere along the line, we start taking off our rose-colored glasses. I've seen it happen already with some classmates after only one year of school. We know that it is surgeries and procedures that are financially rewarded. Insurance companies reimburse very little for routine examinations. So although we might really be interested in primary care or pediatrics, after hundreds of thousands of dollars of debt (my school estimates that each year, tuition, housing and expenses will cost about $55,000), many of us feel pressured to go into a specialty field that will ensure we can pay back our loans. Our dreams and good intentions have to be put aside.

And then there are fields like OB-GYN, which a lot of my colleagues have already ruled out because of the high cost of malpractice insurance.

http://www.cnn.com/2007/HEALTH/08/16/med.student.essay/index.html

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Emily Breidbart, a second-year student in the New York University School of Medicine, was an intern with CNN Medical News this summer.

(CNN) -- "Two minutes!" yells our course coordinator.
art.emily.lab.jpg


Her voice startles me as I try to concentrate on Mrs. Chin's account of her recent asthma attacks.

I have already used eight of 10 allotted minutes, and now have to wrap up my "Objective Structured Clinical Examination."

During our four years as medical students, we will do dozens of these OSCEs -- imaginary, but realistic doctor-patient scenarios.

My professor praises that I structured my 10 minutes well. I'm pleased. In our first year, we simply take a medical history. But next year, I'll add a physical examination, and in my third year, I'll be adding counseling and treatment into the "patient visit." And all we get is five more minutes added onto our OSCE time. How can I get all of this done in just 15 minutes?

Learning how to practice medicine on this sort of a time-scale is stressful. But it's totally necessary in order to properly train us for a world of health care in which the average physician visit is six minutes! When our professors went to medical school, they were taught the art of healing; we are taught how to diagnose and treat patients in a limited timeframe. I can't help but think, is this what I signed up for?

My father is a pulmonologist and the head of an eight-doctor practice on Long Island. When I tell people this, many say, "Oh, he must have really wanted you to follow in his footsteps!" But actually, he made me very wary of medicine. He is tired of spending half of his energy dealing with insurance companies. Energy and time, he says, that would be better spent on his patients, time he had when he first started practicing in a health-care era in which doctors didn't need to justify prescriptions and tests to insurance companies. He still insists on giving ample time to his patients, but now has to work incredibly long hours to do so.

At my dad's 50th birthday party, when I was 19, his colleagues interrogated me about my recent decision to pursue medicine.

Are you sure you really want to do this?

Why put yourself through all the years of stress? You're a smart girl -- how about journalism, law, business...?

Your dad couldn't convince you not to do this? I'll have to have a talk with him!

How is it that my classmates and I are going into medicine if this is what people who have lived our future are saying?

We start out in medical school as idealists. We thirst for clinical experience. We want to explore all of our options, and help those who can't afford health care. But somewhere along the line, we start taking off our rose-colored glasses. I've seen it happen already with some classmates after only one year of school. We know that it is surgeries and procedures that are financially rewarded. Insurance companies reimburse very little for routine examinations. So although we might really be interested in primary care or pediatrics, after hundreds of thousands of dollars of debt (my school estimates that each year, tuition, housing and expenses will cost about $55,000), many of us feel pressured to go into a specialty field that will ensure we can pay back our loans. Our dreams and good intentions have to be put aside.

And then there are fields like OB-GYN, which a lot of my colleagues have already ruled out because of the high cost of malpractice insurance.

http://www.cnn.com/2007/HEALTH/08/16/med.student.essay/index.html

her mistake was coming in with idealism in the first place.
 
About 60 minutes with any resident would have taught her better about medicine.
 
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i think she was aware of everything, i actually know this girl so i think she just wanted to make her writing sound nice by talking about idealism.
 
all people do is bitch about dealing with the insurance companies, but if someone suggests single-payer insurance they bite his head off.
 
Bitter much, guys? I see a halfway-decent and well-intentioned article written by a bona fide medical student.
 
all people do is bitch about dealing with the insurance companies, but if someone suggests single-payer insurance they bite his head off.

Yeah, wrestling with a government beaucracy is SO much easier.
 
the point is that MEDICINE the way it is practiced in the usa SUCKS. IF you have half a brain, and drive thats required to finish medical school and channel it elsewhere you would be very very successful elsewhere.. medicine is very unsatisfying the way its practiced here
 
the point is that MEDICINE the way it is practiced in the usa SUCKS. IF you have half a brain, and drive thats required to finish medical school and channel it elsewhere you would be very very successful elsewhere.. medicine is very unsatisfying the way its practiced here

Sure, but in law school we saw the same articles -- folks who came to law school to "save the world" and quickly learned that they needed to get a real job to service their debt. I suspect other career paths have their loss of idealism too. Idealism is really just a nice way of saying naivity.
 
The girl in the original article is too young and inexperienced to have ideals, at least those of a kind to which she needs to cling for her whole life. Why is "saving the world" a legitimate ideal while, "keeping my wife in the style which she deserves" is not?

There is nothing more ridiculous than an 18-year-old who has it all figured out.
 
The girl in the original article is too young and inexperienced to have ideals, at least those of a kind to which she needs to cling for her whole life. Why is "saving the world" a legitimate ideal while, "keeping my wife in the style which she deserves" is not?

There is nothing more ridiculous than an 18-year-old who has it all figured out.

If she's a second year in medical school, she's at least 22 or 23.
 
Idealism is really just a nice way of saying naivity.

I disagree. You can still be idealistic and at the same time worldly. It depends on your outlook on life. Too many people become embittered and jaded by their experiences, and it is up to each person to sort through all the crap and find what makes life worth living. You can still be idealistic in medicine if you know were you can still make a difference and enjoy what you do on a day to day basis.
 
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Too many people become embittered and jaded by their experiences,

I don't think it's the experiences that make them embittered and jaded, it's the misaligned expectations they started with. When you expect X and the reality is Y, it upsets your belief system with the result that you are jaded. That is idealism aka naivity. If you expect Y and the reality is Y you never get jaded. That is realism aka cynicism. We are talking about the same "experiences", but a difference in how they are interpreted. The world is always better than you expect as a cynic and worse than you think as an idealist. I prefer to have the world always surprise me in a positive way. :)
 
Yeah, wrestling with a government beaucracy is SO much easier.
what the hell do you know about wrestling with beuracracy? i've never heard of doctors having to fight to get paid by medicare (maybe about the reimbursment rates, but not about actually getting paid)

anyway it's sickening to me that so many people going into medicine are whiny, hoitey-toitey idiots like the ugly ass unibrow above who spent her summer interning for sanjey gupta
 
what the hell do you know about wrestling with beuracracy?

Absolutely nothing, because fighting with insurance is the only kind of beaucracy in the entire world.

anyway it's sickening to me that so many people going into medicine are whiny, hoitey-toitey idiots like the ugly ass unibrow above who spent her summer interning for sanjey gupta

Id make some sort of witty response, but your comment really makes no sense.
 
So a million people will read this and think "how sad that the medical student has to struggle to preserve her optimism." Then they'll keep trying to figure out how to get awesome health care without paying a dime.
 
Absolutely nothing, because fighting with insurance is the only kind of beaucracy in the entire world.



Id make some sort of witty response, but your comment really makes no sense.
Wow, you're a real idiot. Not an average, run of the mill regular idiot, but a once in lifetime *****.

Since you don't seem to have a brain, I'll spell it out for you: the idealistic med student above is ugly and has a unibrow. She whines about how medical education is corrupted by *gasp* the real world experiences of doctors. And she spent summer interning for CNN, for which Sanjey Gupta is the chief medical correspondant (he's the smug arrogant neurosurgeon prick who you see on cnn arguing with michael moore)

Anyway, are you the guy on mdapplicants.com that scored 4 touchdowns for Polk High School? I wanted to say congratulations on you mcat score
 
The girl in the original article is too young and inexperienced to have ideals, at least those of a kind to which she needs to cling for her whole life. Why is "saving the world" a legitimate ideal while, "keeping my wife in the style which she deserves" is not?

There is nothing more ridiculous than an 18-year-old who has it all figured out.

o_O

Oh wait... I don't claim to have it "all figured out". I was about to open up a can of the ol' "whoop-ass" on you Panda Bear!

Seriously though, the assumption that as you get older you get wiser makes little sense. I'm sure you know a few 25-year olds who think it's fun to play with homemade fireworks and end up blowing some fingers off. I wouldn't really call them mature either. :p
 
Wow, you're a real idiot. Not an average, run of the mill regular idiot, but a once in lifetime *****.

Since you don't seem to have a brain, I'll spell it out for you: the idealistic med student above is ugly and has a unibrow. She whines about how medical education is corrupted by *gasp* the real world experiences of doctors. And she spent summer interning for CNN, for which Sanjey Gupta is the chief medical correspondant (he's the smug arrogant neurosurgeon prick who you see on cnn arguing with michael moore)

Anyway, are you the guy on mdapplicants.com that scored 4 touchdowns for Polk High School? I wanted to say congratulations on you mcat score


That prick(Sanjay Gupta) you speak of performed a complex neurosugery on one of our troops and a 9 year old boy while he was on a journalism tour in Iraq.

I suggest you take a chill pill and pop open an ice chilled beer.
 
o_O

Oh wait... I don't claim to have it "all figured out". I was about to open up a can of the ol' "whoop-ass" on you Panda Bear!

Seriously though, the assumption that as you get older you get wiser makes little sense. I'm sure you know a few 25-year olds who think it's fun to play with homemade fireworks and end up blowing some fingers off. I wouldn't really call them mature either. :p


Come on now, all other things being equal, you do gain a little wisdom, or maybe we should call it "perspective," the older you get.

I hate to sound like yer' dad but when you are thirty, you will look back at the things you thought were so important at 18 and laugh that you ever got worked up over such trivial things.
 
The article made for good writing material. HENCE it was published.
I find it hard to believe that her father's colleges discouraged her. Um, if they are still doctors, then don't they think their career has more ups than downs. Doctor friends of mine tell me the difficulties of medicine but they also tell me some rewards, all in all, many rewards don't need words to have them expressed.
I love medicine and know one should be cautios of idealism in perhaps any field.
Any med school looking for students wouldn't want an idealistic one.
 
The article made for good writing material. HENCE it was published.
I find it hard to believe that her father's colleges discouraged her. Um, if they are still doctors, then don't they think their career has more ups than downs. Doctor friends of mine tell me the difficulties of medicine but they also tell me some rewards, all in all, many rewards don't need words to have them expressed.
I love medicine and know one should be cautios of idealism in perhaps any field.
Any med school looking for students wouldn't want an idealistic one.

I wouldn't want my daughters to be doctors. And while I may not actively discourage them, I certainly won't encourage them either.
 
The article made for good writing material. HENCE it was published.
I find it hard to believe that her father's colleges discouraged her. Um, if they are still doctors, then don't they think their career has more ups than downs. Doctor friends of mine tell me the difficulties of medicine but they also tell me some rewards, all in all, many rewards don't need words to have them expressed.
I love medicine and know one should be cautios of idealism in perhaps any field.
Any med school looking for students wouldn't want an idealistic one.

Sure, now you do. How about when you are an intern or a resident? How about in ten years? What if you discover that you don't like it that much? Although shadowing and other activities are extremely useful, there is a big difference between that and practicing medcine. For myself, I like it well enough but there are many days when, if I had the financial resources, I'd drop the mother****er like a hot rock.
 
I find it hard to believe that her father's colleges discouraged her. Um, if they are still doctors, then don't they think their career has more ups than downs.

This has to be the most naive statement on this thread. How many people do you know that don't like their jobs, but still do them because they pay the bills? Or because keeping your current job is easier than going back to school and making a career change once you already have a career (which took you 4 years of undergrad + 4 years of medical school + 3-7 years of training)? Or, especially in the case of medicine, because they still have so much debt to pay off that they can't afford not to work in medicine, which, despite everyone's protests, DOES allow most physicians to pull in a significantly larger salary than most professions, and is one of the few professions you can work in when you have that much money to pay back? Plenty of doctors tell pre-meds not to go into medicine. I've heard it myself, and if you read these boards, you will find many, MANY others who have had similar experiences.
 
That prick(Sanjay Gupta) you speak of performed a complex neurosugery on one of our troops and a 9 year old boy while he was on a journalism tour in Iraq.

I suggest you take a chill pill and pop open an ice chilled beer.
I never said he was a bad doctor, just that he comes off as an arrogant prick on tv. Performing complex surgery doesn't negate the fact that you're a prick, just like being a prick doesn't mean that you can't be a good doctor.

Plus, I'd avoid popping "chill pills" and drinking at the same time, that's a recipe for waking up in jail
 
I never said he was a bad doctor, just that he comes off as an arrogant prick on tv. Performing complex surgery doesn't negate the fact that you're a prick, just like being a prick doesn't mean that you can't be a good doctor.

Plus, I'd avoid popping "chill pills" and drinking at the same time, that's a recipe for waking up in jail

and you're coming off as a prick over the internet... shall I judge you too?

:rolleyes:
 
Wow, you're a real idiot. Not an average, run of the mill regular idiot, but a once in lifetime *****.

Since you don't seem to have a brain, I'll spell it out for you: the idealistic med student above is ugly and has a unibrow. She whines about how medical education is corrupted by *gasp* the real world experiences of doctors. And she spent summer interning for CNN, for which Sanjey Gupta is the chief medical correspondant (he's the smug arrogant neurosurgeon prick who you see on cnn arguing with michael moore)

Anyway, are you the guy on mdapplicants.com that scored 4 touchdowns for Polk High School? I wanted to say congratulations on you mcat score

Wow...

I see two distinct eyebrows. And how is her physical appearance relevant to anything?

Please contain your delusional bitterness.
 
While I haven't practiced medicine, something tells me people in general are discontent with their lives; becoming a medical doctor isn't a breach into the plane of enlightenment.
 
i thought the article, which seems to be written with the intent to reach the average reader, does a good job of showing how this person feels about the process to become a doctor.
the public seems to have a concept of how they think that doctors are trained, and this sheds some light on the subject.
the article definitely wasn't aimed at the majority of people on this site, lol.
for what it is, the article's pretty good.

I wouldn't want my daughters to be doctors. And while I may not actively discourage them, I certainly won't encourage them either.

agreed.
 
Wow, you're a real idiot. Not an average, run of the mill regular idiot, but a once in lifetime *****.

You seem to be some sort of pyschic genius. Could you read my palm lines please? (Through the internet, of course. Im sure thats not difficult for someone of your mental power.)

Since you don't seem to have a brain, I'll spell it out for you: the idealistic med student above is ugly and has a unibrow. She whines about how medical education is corrupted by *gasp* the real world experiences of doctors. And she spent summer interning for CNN, for which Sanjey Gupta is the chief medical correspondant (he's the smug arrogant neurosurgeon prick who you see on cnn arguing with michael moore)

Obviously, only pretty people make good doctors. Aristotelian character flaws and all that. In fact, we shouldnt even have an application process for med school. The med schools should just require a photo, and base admissions off that.

Anyway, are you the guy on mdapplicants.com that scored 4 touchdowns for Polk High School? I wanted to say congratulations on you mcat score

Nope, not me. I do feel bad though that you spend your time looking through profiles on mdapplicants.com.
 
I find it hard to believe that her father's colleges discouraged her. Um, if they are still doctors, then don't they think their career has more ups than downs.

Off the top of my head I can think of six of my father's (physician) colleagues who, having found out I'm applying to med schools, asked me point blank: "Are you f-ing crazy?".
 
Off the top of my head I can think of six of my father's (physician) colleagues who, having found out I'm applying to med schools, asked me point blank: "Are you f-ing crazy?".

Yeah, medicine is the worst job ever. It totally sucks. Stop while you still can. I hear investment banking is the way to go. You'll be able to look at yourself in the mirror and say... "Man! I made a real difference today! I'm gonna make six figures this month!" :rolleyes:
 
Yeah, medicine is the worst job ever. It totally sucks. Stop while you still can. I hear investment banking is the way to go. You'll be able to look at yourself in the mirror and say... "Man! I made a real difference today! I'm gonna make six figures this month!" :rolleyes:

even then, going to "make a difference" or "help people" is a ****ty motivation for med school... even your mechanic "helps people"
 
Bitter much, guys? I see a halfway-decent and well-intentioned article written by a bona fide medical student.

I have to agree.

Many of us who are still looking through the glass window from the outside still seem to forget that we have not yet fully experienced the full onslaught that medicine has to offer. While this writer has not yet experienced this completely, either, she can give greater insight into the intricacies of this profession. Once you guys are immersed, you too will experience having your rose-tinted glasses shattered on the other side of that window.
 
I can't see why people are blaming her for false expectations. I am certain we all have false expectations of what medical school will be like and the aftermath.
 
I can't see why people are blaming her for false expectations. I am certain we all have false expectations of what medical school will be like and the aftermath.

there are way too many broken sarcasm meters in this thread. You all really should be careful. we don't let people with poor sarcasm meters into med school.
 
aw poor baby, she's so smart, maybe she should've become a lawyer. puh-****ing-lease.

:rolleyes:

"Idealism" is used by some to express their naivety, and by others to try to discredit differing views as being 'unrealistic' and 'hippistic'. Both groups piss me off. :mad:
 
Yeah, medicine is the worst job ever. It totally sucks. Stop while you still can. I hear investment banking is the way to go. You'll be able to look at yourself in the mirror and say... "Man! I made a real difference today! I'm gonna make six figures this month!" :rolleyes:


Who said anything about investment banking? There are all sorts of professions out there which are interesting and important, and have absolutely nothing to do with healthcare.

While I think I agree with what I think is the point of view underlying your sarcasm (I still can't see myself doing anything other than medicine), it would be silly to ignore the fact that so many physicians are so unhappy with the profession. They are the ones who have lived through it all, not you and certainly not me.
 
Who said anything about investment banking? There are all sorts of professions out there which are interesting and important, and have absolutely nothing to do with healthcare.

While I think I agree with what I think is the point of view underlying your sarcasm (I still can't see myself doing anything other than medicine), it would be silly to ignore the fact that so many physicians are so unhappy with the profession. They are the ones who have lived through it all, not you and certainly not me.

The also got in at a much easier time when med schools didn't make you jump through hoops like a hamster to get in.
 
Wow, talk about thread derail.
 
Who said anything about investment banking? There are all sorts of professions out there which are interesting and important, and have absolutely nothing to do with healthcare.

While I think I agree with what I think is the point of view underlying your sarcasm (I still can't see myself doing anything other than medicine), it would be silly to ignore the fact that so many physicians are so unhappy with the profession. They are the ones who have lived through it all, not you and certainly not me.


Yeah I just wanna know why alot of these physicians point to law as their dream careers.
 
Sure, now you do. How about when you are an intern or a resident? How about in ten years? What if you discover that you don't like it that much? Although shadowing and other activities are extremely useful, there is a big difference between that and practicing medcine. For myself, I like it well enough but there are many days when, if I had the financial resources, I'd drop the mother****er like a hot rock.

I love you. :laugh:
 
This site is full of cynics.

Cynic is just what an optimist calls a realist.

Seriously though, there is cynicism in every field, and I think more so in high stress, high stakes fields like medicine. Its hard to be positive when every day you go to work and deal with people with cancer, or exploding gallbladders, or whatever.
 
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