38yo, VERY non-traditional... your thoughts on my situation?

[RomaniGypsy]

Not sure why people are bothering to respond to this anymore. OP clearly cannot accept that he is wrong about anything and will only respond by posting inappropriately long diatribes about why you are wrong. You’re just wasting your time. There is nothing you can say that he won’t have an answer to.

Do you even read what I write?

Cite one example of how I cannot accept that I'm wrong about something. If you can't, then stop hurling false accusations. ("Thou shalt not bear false witness.")

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[Matthew9Thirtyfive]

Do you even read what I write?

Cite one example of how I cannot accept that I'm wrong about something. If you can't, then stop hurling false accusations. ("Thou shalt not bear false witness.")

The vast majority of your posts on this thread are examples of you completely disregarding what knowledgeable posters have suggested or said. You have argued with physicians and adcoms about getting into med school and being a physician. And now that I am pointing out that you're argumentative and not likely to accept the very good advice many people are giving, you are arguing with me that you don't do that (not to mention by throwing a Bible verse at me that does not apply).

 

[RomaniGypsy]

The vast majority of your posts on this thread are examples of you completely disregarding what knowledgeable posters have suggested or said. You have argued with physicians and adcoms about getting into med school and being a physician. And now that I am pointing out that you're argumentative and not likely to accept the very good advice many people are giving, you are arguing with me that you don't do that (not to mention by throwing a Bible verse at me that does not apply).

"I can't come up with one specific example. Sorry for defaming and attacking you on this thread."

So now instead of me being wrong, I'm merely disregarding what others are saying. You claim I'm arguing with physicians and adcom members about getting into medical school, yet, when requested, you refuse to cite one example of how I took a position in direct opposition to what even one such person said.

And I never said that I'm not argumentative. Clearly I can run with the big dogs in that arena when needed. So, stop lying by saying that I argued that I'm not argumentative. Not only did I never do so, but that'd be a ridiculous assertion for anyone to make because one demonstrates the ability to be argumentative whenever he/she argues.

That Bible verse definitely does apply. You made what I consider to be a false accusation, and then when I challenged you to cite one specific example to demonstrate its veracity, you dodged that by making more generalized accusations that also weren't supported by specific examples. This is becoming really pathetic. If you're going to make strong negative claims about my personality without knowing me, it is not unreasonable to expect that you will cite specific supporting evidence when it is requested. Otherwise, you show that you are making negative and defamatory claims just for your own personal enjoyment... which is sick.

If you want to convince me that my ways are in error, get cracking with citing specific examples. Otherwise, please ride off into the sunset and stop attacking me.

 

[Matthew9Thirtyfive]

"I can't come up with one specific example. Sorry for defaming and attacking you on this thread."

So now instead of me being wrong, I'm merely disregarding what others are saying. You claim I'm arguing with physicians and adcom members about getting into medical school, yet, when requested, you refuse to cite one example of how I took a position in direct opposition to what even one such person said.

And I never said that I'm not argumentative. Clearly I can run with the big dogs in that arena when needed. So, stop lying by saying that I argued that I'm not argumentative. Not only did I never do so, but that'd be a ridiculous assertion for anyone to make because one demonstrates the ability to be argumentative whenever he/she argues.

lmao dude. Case in point. That I choose not to waste my time copy/pasting a bunch of your posts doesn't make it false. When multiple people on this thread is telling you that you're not listening or ignoring good advice, it's probably not everyone else.

That Bible verse definitely does apply. You made what I consider to be a false accusation, and then when I challenged you to cite one specific example to demonstrate its veracity, you dodged that by making more generalized accusations that also weren't supported by specific examples. This is becoming really pathetic. If you're going to make strong negative claims about my personality without knowing me, it is not unreasonable to expect that you will cite specific supporting evidence when it is requested. Otherwise, you show that you are making negative and defamatory claims just for your own personal enjoyment... which is sick.

Ad hominem attacks are generally a sign that you're losing an argument, but in your case I think it's just because you're an dingus who doesn't like being called out on his negative attributes. Have fun not getting into medical school. And no, the Bible verse doesn't apply, since I was merely reporting your actions.

If you want to convince me that my ways are in error, get cracking with citing specific examples. Otherwise, please ride off into the sunset and stop attacking me.

I actually didn't attack you until this post (since if you're going to accuse me of something, I might as well just do it). Pointing out that you disregard what people say and tell them why they are wrong (when they're either not wrong or obviously using hyperbole which you took literally) is not an attack.

 

[JustPlainBill]

lmao dude. Case in point. That I choose not to waste my time copy/pasting a bunch of your posts doesn't make it false. When multiple people on this thread is telling you that you're not listening or ignoring good advice, it's probably not everyone else.



Ad hominem attacks are generally a sign that you're losing an argument, but in your case I think it's just because you're an dingus who doesn't like being called out on his negative attributes. Have fun not getting into medical school. And no, the Bible verse doesn't apply, since I was merely reporting your actions.



I actually didn't attack you until this post (since if you're going to accuse me of something, I might as well just do it). Pointing out that you disregard what people say and tell them why they are wrong (when they're either not wrong or obviously using hyperbole which you took literally) is not an attack.

@Matthew9Thirtyfive -- do not feed the troll....arguing with someone like this is kinda like wrestling in the mud with a pig -- pretty soon you realize the pig enjoys it.....And recall that he's failing the basic test for getting selected for a residency if he gets that far -- is this the kind of person I want to be in a call room with at 0300 waiting on my next admit as a senior? <edited to add> Or will they likely find him duct taped to a chair in a broom closet somewhere in the hospital?

 

[CyrilFiggis]

Hey @RomaniGypsy how many hours of clinical exposure shadowing or volunteering in hospital do you have currently?

 

[Matthew9Thirtyfive]

@Matthew9Thirtyfive -- do not feed the troll....arguing with someone like this is kinda like wrestling in the mud with a pig -- pretty soon you realize the pig enjoys it.....

Good point. Due to his dx, he's unfortunately going to ignore all the good advice here and just assume anyone telling him he has anything to work on is "lying" or "attacking him." Moving on.

 

[ptm33]

I appreciate you accepting my opinions and describing my comments as effective.

I see what you mean about how you are looking out for your family now by reorienting your career.

Good news is, I standby my observation that your attention to detail is extraordinary.. it may be counterproductive in some setting but could make a huge asset for, say, office jobs (and legal jobs as said before and I say office job because it is one of the few types of jobs I've ever had experience in and can comment on ie. there may be other jobs you will be great fit too that I'm not aware).

In some community, through series of unfortunate microevents, your strengths and weaknesses can set off a vicious cycle of negativity..

...but in other setting it can save a company billions..

Or even save lives.

Having shadowed people in healthcare, I have to agree with others that being a physician MAY not be a good fit for you.. ( if this one dimensional computer screen is painting an accurate picture of your persona which I am giving a lot of room for the benefit of the doubt).

Just like how that OB/GYN referred you to a peditrician, doctors are trained to move on quickly and they don't have time to be sensitive.. they have to prioritize and abdicate. They are less concerned with feelings, and more focused on physical healing (I think). They use 3 words sentences in medical notes to describe something you and I might take 4 paragraphs to explain. And they have many patients to get to to help heal in a day (hint: physician shortage) so those 3 words were sufficient. And if they spend too much time with one patient, the other patient might die! (Just a hypothetical extreme case scenario here)

However, I may be dead wrong about this and in fact you will make wonderful doctor.

There's only one way to find out, OP: get out there and get to work! If you really think our assessment of you is unfair, prove us wrong. Not by reflecting and deflecting on everything internet strangers throw at you here.. but by gaining acceptance into a good school or maybe schools outside of @Goro's suggestions. It will take months or years but start working towards that direction NOW.. debating on every single point here will only pull you back, OP.

None of this "you said this then I said that but you said that and I only said this" dialogue from you or anyone here are adding value to your goals.. I don't think.

I understand where you are coming from but I don't think you will find what you are looking for here if I sense it right that you are here to hear some reassurance.. you are garnering a lot of doubts instead and my concern now is you will start doubting yourself in nonproductive ways too. And this is why I decide to engage on this post. It would be such shame if you will in fact make a wonderful doctor someday but got discouraged by internet opinions from people that don't know or understand the whole piece of you.

Instead of exploring thoughts of people in front of computer.. disengage from this virtual reality and go out there and see for yourself if these doubts are valid. The best people to assess whether or not this profession is for you are not internet strangers exchanging opinions via online communication (where tone and personality can be misinterpreted by both sides and opinions are just opinions). The best people to assess your ability and effectively advise are real doctors you can connect with real life!

Good news again about this process is.. Before you start incurring debt and put your family through this.. you are required to shadow and volunteer first. Volunteering isn't just to convince adcoms your service-mindedness but also to explore yourself.

So I recommend you to

- shadow, shadow, shadow as many people at this point... not just physicians but lawyers, too! Not sure if you were just trying to humor me but you sounded interested enough in becoming a lawyer. Some personality (or percieved personality) that is detrimental to some profession can be huge asset to other profession as said. You can have the shadowees and real life mentors be honest with you on this, they will have a more wholesome picture of you knowing you in real life.. have them gauge on your personality, your weakness and strengths.
What you need fixed or what habit, attitude to rethink before embarking on this journey.. and if being a physician won't be a fruitful jouney for you, what other career is there for you. This is for you to find out.

- Start voluteering! Looks like a suicide hotline could he a good start! You can save more lives that way. And I commend you for having saved those two lives.

- Hit those review books and kill the MCAT!

 

[Stagg737]

You're not the only person who has said what I quoted you as saying. I read an article last night which, when boiled down, comes out as "if you don't have a true burning passion for medicine, you will hate being a doctor because it's a crappy job in many ways". Combining all this with what I've heard from some people about how they never wanted to be doctors (though they did become PAs or high-level nurses), I have to ask - if there are so many negatives about being a doctor, and you can still work in medicine by being a PA / NP / nurse / et al., why do people become doctors instead of "stopping short" at the "mid-level" of being a PA / NP, or maybe even a lower level than that by being a non-practitioner nurse?

I'm of a slightly different opinion in the sense that I don't think someone needs to be passionate, but they do need to enjoy it. I enjoy this career path a lot, but I would not consider it a passion, and I don't foresee myself burning out in the path I've chosen anymore than I would in other paths. Only time will tell there though. There are many negatives to being a physician, but many positives as well. You gain a far greater depth of knowledge as a physician than NP or PA, you have more authority and autonomy, better pay potential (no clinical nurse or PA is going to hit 500k/yr, plenty of docs do), wider opportunities outside of the clinical sphere, and other positives as well to go along with all the negatives. Plenty of people go the nursing or PA route first and realize they want more knowledge to be able to provide better care to their patients. Additionally, you can't really operate as a nurse or PA, so if you want to do surgery you've gotta go to med school.

But there are those times when the ambulance comes zooming into the hospital with lights on and sirens blaring... it'd seem that, at those times, a volunteer would likely be in the way.

If you're trying to actually do something, then yea. But most ER volunteers won't get to do any actual hands on work, so you're strictly watching. It's not that hard to just stay towards the back of the room and watch. That's basically what we did as med students on ER rotations during true trauma situations.

I figured that maybe the MCAT is starting to go the way of the GRE.

Not anytime soon. It's the single most consistent measurement of all pre-med students, and one of the two most important factors in selecting who gets an interview.

I hate politics. I wonder if there is any occupation that's free from "work politics".

Start your own business, keep it small, and be your own boss. Or master some skill or trade and do freelance work. Basically work on your own. Anytime you work with other people you'll have to play the game, that's just how life is. If you want to work in almost any aspect of healthcare you're going to have to learn how to play the game, that's just how it works.

That has to be one heck of a situation... going through medical school and residency, amassing all of that debt... and then burning out. I can only imagine what those people must think. But... it's good to know why they burn out.

It is, and it's very common. In some fields over 50% of attending physicians report burnout. It's the reason so many people say don't go into medicine unless you're truly passionate. I think it's less about passion and more about balance though. Even before that though, many people burnout in residency and med school as well. It's a grueling process that can't really be explained unless someone goes through it themselves.

And I don't think I'd be inclined to fire patients when they become non-compliant

Sometimes it's the more ethical thing to do. Example: One of my attendings on my psychiatry rotation saw patients in his private practice. He was so in demand, that if you were a new patients it was a 4+ month wait. His rule of thumb was that if a patient no-showed to an appointment twice without 48 hour notice (non-compliance), then he'd fire them. His reasoning was that he was so in demand and that there area so many patients who will otherwise not be seen, that having patients schedule then cancel without notice not only wasted his time, it wasted an appointment that someone else who really needs the help could have had. There are plenty of other times and reasons for firing patients that are completely justifiable, the point being that sometimes when you try and put too much time and effort into one patient, you're sacrificing time, energy, and resources that could go towards other patients and do far more good.

Are you referring to full-fledged practice, or residency?

Residency. In almost every field 65 hour weeks is pretty normal. In surgical fields you can increase that to minimum 70 hour weeks. Some fields are less than 60 hours, but it is still a significant commitment. After residency there's far more freedom, but some fields are still far more demanding than others. This also depends on whether you choose to work for yourself or become employed and have to follow the rules of a contract.

I read recently that NPs are soon to be required to get the DNP degree in order to be able to "practice"... do you think that the industry is going to shift even further, to the point where PAs and DNPs will be required to complete a residency where they're working insane hours in order to be able to practice to whatever extent they're permitted?

Can't really say. Some PA's have "residencies" which give them better training in a specific field, but overall I don't see mid-level residencies ever becoming a requirement, as that defeats the underlying purpose of mid-levels altogether.

Truthfully, this would probably be a deal-breaker for me. I need to be around for my son. Plus, my wife wants to have at least one more child, and we have no idea if / when that will happen (it took six years of "joy in the journey" to get the first one)... so whether it's one child or more than one, I can't be spending all of my quality time "at work" and arriving home exhausted with no time to spend with my kid(s). I've done 80 hours a week in the past and lived to tell the tale, but I was single.

This is one of the many reasons people regret becoming physicians. They miss large portions of their lives and the lives of their loved ones. I talked to a cardiologist before med school who told me his kids were complete strangers to him and that he was lucky if he got to eat dinner with them more than once or twice a month. That's pretty extreme, but the point is if you pursue medicine it is very likely you will have to make very significant sacrifices. That includes missing part of your family's lives. It wouldn't likely be 80 hour weeks forever, but the sacrifices would still be significant.

Tell me about this "match rate" thing. As I understand thus far, "matching" is where a medical school and a facility such as a hospital come to an agreement to place a student from that school who is soon to graduate or has already graduated, into a residency opportunity available at that hospital. Regardless of the accuracy of that understanding, does a "match rate" of 50% mean that only half of graduating students get placed in a residency? If yes, how would the "unmatched" graduates ever get a residency?

Not quite. 4th year medical students apply for residencies and the residency programs they apply to offer those they deem fit interviews. Once interviews are completed, applicants and programs each submit rank lists and those lists are run through an algorithm which matches applicants to programs and maximizes the number of possible matches along with rank order. Medical schools and hospitals have no agreement whatsoever in terms of residency placement and this is actually illegal as far as I know. Some Caribbean schools end up with less than 60% of the students they accept into medical school going on to enter a residency program, which is basically saying that you're flipping a coin as to whether you'll ever be a physician by going to a Carib school.

The average attrition rate for US medical schools is around 6%. This includes individuals who choose to drop out, leave for medical/family reasons, and those who simply can't cut it and fail. Of those who get to 4th year, somewhere between 93-96% of applicants match into a residency position. Those who don't are either those who apply to too few programs, those who apply to programs that they are not realistic candidates for, or those who have so many red flags that no one wants them. Imo, I'd have no reservations about attending a school with a 95% or higher match rate, as that 5% who don't match can be attributed to the individuals and not a deficiency in the schools. It is common for Carib schools to match less than 80% of their final year students into residency positions, which is not good considering many of their students will have 300k+ in debt along with extreme bias against them.

To the "how would 'unmatched' graduates ever get a residency question: Many don't. You can go through the match as many times as you want, but each time your odds of matching becomes lower. There are threads on here about people who went through the match 7 times before matching. Some people never match and end up with all that debt and no job to show for it. Some take jobs as consultants, in research labs, or working for insurance companies or other organizations because they have to. It's part of the risk of going to those medical schools and the reason most of us adamantly urge people not to attend those schools.

By this do you mean schools that are located in Caribbean countries? And is it student attrition rates (meaning a lot of dropping out) or faculty attrition / turnover rates?

Student attrition rates. Mostly schools in the Carib, but there are some US schools that I won't name outright which I don't believe should be open (other than those Goro named). However, they meet the minimal standards set by COCA/LCME, so what I think doesn't matter.

Not sure why people are bothering to respond to this anymore. OP clearly cannot accept that he is wrong about anything and will only respond by posting inappropriately long diatribes about why you are wrong. You’re just wasting your time. There is nothing you can say that he won’t have an answer to.

I'm responding because regardless of whether OP is getting something out of this, some of his questions are legitimate and apply to many/all applicants. Even if this info can be found elsewhere, it's worth repeating and raising awareness. If OP truly is on the spectrum (which he'd be a pretty good troll if he's not, judging by the composition and content of his posts), then I don't think he's truly rejecting this information as much as people here think he is. People on the spectrum process and absorb information differently than people who aren't and their statements are based completely on their own experiences. Anything that contradicts those experiences is questioned and must be directly addressed and reconciled before being assimilated into their own knowledge and world view. We all do this, but from my experience those on the spectrum are far more up front and blunt with this process when interacting with others.

@Matthew9Thirtyfive -- do not feed the troll....arguing with someone like this is kinda like wrestling in the mud with a pig -- pretty soon you realize the pig enjoys it.....And recall that he's failing the basic test for getting selected for a residency if he gets that far -- is this the kind of person I want to be in a call room with at 0300 waiting on my next admit as a senior? <edited to add> Or will they likely find him duct taped to a chair in a broom closet somewhere in the hospital?

Again, I don't think this is a troll thread, and I don't think OP is intentionally trying to insult or disregard people. I think he has a different method of interpreting information and assimilating information that many people are used to dealing with in such a blunt and seemingly unteachable or even condescending manner. It requires a change in perspective from those educating and a lot of patience in terms of explanation. I get where people are coming from when they're saying OP seems to not listen to anyone, but having worked with individuals on the spectrum far more challenging than OP, I also understand how he is interacting with other posters.

 

[RomaniGypsy]

lmao dude. Case in point. That I choose not to waste my time copy/pasting a bunch of your posts doesn't make it false.

"I don't have to state evidence! I'm right because I say I'm right!"

And they call ME arrogant...

When multiple people on this thread is telling you that you're not listening or ignoring good advice, it's probably not everyone else.

When multiple people is, eh?

Think about the candidate for whom you voted in this last Presidential election. ("Candidate A") Now think about one opposing candidate who received a ton of votes. (There has to be at least one. We'll call this one "Candidate B".) Candidate B had throngs of enthusiastic supporters (all major party candidates do), and if several of them got together, they'd have told you that you're not listening, they probably would've told you you're ignoring good reasoning for supporting their candidate, and you might have been called names.

That doesn't mean that Candidate B was the "right" choice. And just because a bunch of sad, brainwashed human beings who have managed to ascend to a professional rank which accords them the honorific of "Doctor" before their names have spent all too much of their supposedly scant free time attacking me here like a bunch of schoolyard bullies, that doesn't mean that they're right and I'm wrong. If people want to convince me that I'm wrong about something, I've already told them how to do it. They have to do it in a civilized fashion, show me the specific evidence, and present a logical argument therefor. There's a reason why this is how things are proven true in a courtroom. How would you like it if you were a defendant and the prosecuting attorney said "This guy's guilty because multiple people say he is! And I don't have to waste my time showing you evidence to prove that!"..... and then just on the strength of that, the judge said "That's good enough for me. Guilty as charged!"?

I REALLY don't think you would like nor accept that. Yet you tell me I should accept the exact same thing just because this isn't a court of law... if anyone should be "lmao"ing, "dude", it's me. But, unlike many people, I don't get any personal amusement from inflicting needless misery on others... so this sort of thing doesn't make me laugh.

Ad hominem attacks are generally a sign that you're losing an argument, but in your case I think it's just because you're an dingus who doesn't like being called out on his negative attributes. Have fun not getting into medical school. And no, the Bible verse doesn't apply, since I was merely reporting your actions.

An dingus? Name-calling now?

Look, if you're going to attack me, at least use proper grammar. You're not even trying... you're just attacking... talk about evidence that you're losing an argument.

You accuse me of an ad hominem attack, which I never once did because I don't attack people's character / motives / attributes without strong evidence (look, if they're engaging in name-calling or lying, it's not ad hominem to call them out on it), and then you ascribe negative attributes to me without knowing me (ad hominem) and call me names rather than citing evidence to back your claims (ad hominem).

Duuuuuuude.... I totally take back what I said earlier about how I found you to be one of the more pleasant posters here. It just took longer for your truth to be revealed than it did with the others. But it came out... thankfully... and since you pride yourself on your Christian beliefs, I have a couple of verses for you to check out: Galatians 5:22-23.

I actually didn't attack you until this post (since if you're going to accuse me of something, I might as well just do it). Pointing out that you disregard what people say and tell them why they are wrong (when they're either not wrong or obviously using hyperbole which you took literally) is not an attack.

It is when you refuse to back it up with evidence. Without evidence it is a baseless claim, tantamount to a lie, and a lie hurled at a person is an attack.

@Matthew9Thirtyfive -- do not feed the troll....

Ooo, name-calling again. This is not very becoming to a doctor. For your information, I am fully human and there isn't a smidgeon of troll DNA in my genome.

Or will they likely find him duct taped to a chair in a broom closet somewhere in the hospital?

My dear fellow, if anyone tried to duct tape me to a chair, all I can say is that they'd better do it when we're all in a hospital so that their ensuing trip to the ED on a gurney won't take too long. This comment is also not becoming to a doctor. Maybe it's you who would fail my test for residency - is this someone whose attitude I could tolerate for hours on end?

Hey @RomaniGypsy how many hours of clinical exposure shadowing or volunteering in hospital do you have currently?

That is presently a big fat zero.

I'm sure this doesn't look too good, but one would think that I should get a couple of prerequisites out of the way first... one being this upcoming biology class (if I do poorly in it as I did in high school bio, medicine ain't the field for me) and another being a strong narrowing-down of desirable specialties. It'd seem most productive to direct volunteer hours toward locations where I would encounter the practice of those specific medical specialties. (After all, if I have zero desire to go into, for example, urology, why would I want to shadow a urologist or volunteer in a urology clinic?)

Good point. Due to his dx, he's unfortunately going to ignore all the good advice here and just assume anyone telling him he has anything to work on is "lying" or "attacking him." Moving on.

Now we blame the diagnosis. Once again, you're incorrect. (I'm seeing a pattern here.) I have told you how you can convince me that I'm wrong about something, and you have totally rejected that at the altar of "I just feel like assassinating your character; I don't have time to waste reposting things you said which I felt were inappropriate and explaining what specifically was wrong about them".

Duuuuuuude.... I think you and I are done.

I appreciate you accepting my opinions and describing my comments as effective.

Well, do a simple comparison of your style vs. the styles of what seems to be a majority of the repeat posters on this thread. The difference ought to be obvious.

Good news is, I standby my observation that your attention to detail is extraordinary.. it may be counterproductive in some setting but could make a huge asset for, say, office jobs (and legal jobs as said before and I say office job because it is one of the few types of jobs I've ever had experience in and can comment on ie. there may be other jobs you will be great fit too that I'm not aware).

Office jobs bore me. I've had a couple... this is one of the reasons why I never did much with my computer programming training. I worked in programming for a while, and though I did well, I was bored. Some people love sitting in front of a screen... it's just not my bag.

Having shadowed people in healthcare, I have to agree with others that being a physician MAY not be a good fit for you.. ( if this one dimensional computer screen is painting an accurate picture of your persona which I am giving a lot of room for the benefit of the doubt).

Maybe it depends upon specialty. I read an article almost a year ago which talked of a fledgling specialty in the medical field called "social psychiatry" and the article made my pulse quicken noticeably. That excited me. In fact, I started looking into medicine because I was investigating psychology vs. psychiatry and found that a psychiatrist must be an MD or DO. One would think that the practice of psychiatry differs vastly from the practice of other "hospitalist" specialties, if for no other reason than because the hospitals themselves are different. There are general hospitals, and then there are mental hospitals. While a large enough hospital may have a psychiatric ward, it's probably its own little world just as other specialized wards are... and maybe a little more so. I'll have to look into this a bit more. If there were one field of medicine about which I feel I could become passionate, it's mental health. I've spent years working on people's mental health as what might best be described as an "armchair counselor", and the only thing I haven't liked about that is when people ignore what I say (and then wind up no better off, if not worse off, as a result). I've never had anyone who put my suggestions into action and then told me that they didn't work at all.

Just like how that OB/GYN referred you to a peditrician, doctors are trained to move on quickly and they don't have time to be sensitive.. they have to prioritize and abdicate. They are less concerned with feelings, and more focused on physical healing (I think).

That would explain the somewhat standoffish vibes we've gotten from some doctors with whom we've worked in the past... if that's really the way things are, I'm not sure that medicine (or at least the specialties therein which for one reason or another cause their doctors to operate this way) is a good fit for me. I'd feel like I wasn't doing enough if all I did was heal or treat some physical condition. I'd want to make sure the person - the entire person, mind and body - was healing, and that the underlying conditions which caused this physical issue (if any) were addressed. Otherwise, it may easily recur, and what fun is that for the patient or the doctor?

They use 3 words sentences in medical notes to describe something you and I might take 4 paragraphs to explain. And they have many patients to get to to help heal in a day (hint: physician shortage) so those 3 words were sufficient. And if they spend too much time with one patient, the other patient might die! (Just a hypothetical extreme case scenario here)

It could happen. I don't know enough about these emergent life-or-death medical situations to be able to state for certain that were I the doctor, I'd be able to tell Patient A, in all honesty, "I will be back to talk with you at greater length as soon as I can be but for right now you'll have to hold your questions because Patient B is being offloaded from the ambulance as we speak, with a serious problem that I must address immediately!" (or something like that, perhaps more brief). Maybe by the time I'd be able to talk to Patient A, Patient C would have come in and there's where my attention would have to go. (But if an ED only has a small percentage of truly emergent cases, as I believe you suggested earlier, one would think that an inquisitive patient wouldn't have to be blown off for long.)

However, I may be dead wrong about this and in fact you will make wonderful doctor.

There's only one way to find out, OP: get out there and get to work! If you really think our assessment of you is unfair, prove us wrong. Not by reflecting and deflecting on everything internet strangers throw at you here.. but by gaining acceptance into a good school or maybe schools outside of @Goro's suggestions. It will take months or years but start working towards that direction NOW.. debating on every single point here will only pull you back, OP.

The next step starts shortly... perhaps tomorrow when the new semester officially begins. I really don't want to debate points here. All I want is information. I find it sick that I've gotten so many insults. Really, I did expect better from doctors. (But perhaps I have to learn that they're still human, and that I ought not expect better from humans, generally speaking. That'd be a pretty depressing conclusion to draw, though. At the most basic, I'd think "if I don't do unpleasant and unnecessary stuff like that, nobody else needs to".)

None of this "you said this then I said that but you said that and I only said this" dialogue from you or anyone here are adding value to your goals.. I don't think.

Well.... maybe it is, in an unexpected way... by showing me that I might still have to deal with schoolyard-style bullying from colleagues even in the most respected profession in America. Perhaps I ought to see if it really is true that no profession is sacred enough to escape that. If it isn't... then maybe I wouldn't get as much respect for being a doctor as I thought I would. (You know what else has crossed my mind at times? That perhaps their nastiness is all an act, and in fact what's going on is that I'm being "hazed" to see if I want to be a doctor enough to want to stick around this forum even after getting needlessly and irrelevantly attacked a few times. Stranger things have happened!)

I understand where you are coming from but I don't think you will find what you are looking for here if I sense it right that you are here to hear some reassurance..

I swear to you that what I said before about having already gotten reassurance from my primary care doctor is true. I'm not looking for reassurance; I'm looking for information. I already know that I can handle any non-athletic profession and any related training out there, IF the outcomes thereof are desirable to me. I'm trying to figure out if where I would find myself after medical school is a place I'd probably be happy being. When you've tried as many jobs and careers as I have, and in spite of your best efforts have been blindsided by some unexpected significant "negative" that came down the pike, you can do nothing else but redouble your information-gathering efforts for future endeavors.

you are garnering a lot of doubts instead and my concern now is you will start doubting yourself in nonproductive ways too.

I've spent most of the last three days painting a friend's house and I've been thinking about this exact topic quite a bit while so doing. "Does it really reflect on the actual practice and profession of medicine that some of its practitioners have shown themselves on this forum to be such rude jerks? Or is this an aberration which wouldn't be reflected in real life because most of the 'nice' doctors are doing other things with their time which don't involve spending countless hours posting in online forums, and therefore I'm just not encountering many of those 'nice' doctors here?" The only answer to that question will be found in real-life interactions with doctors when they know that I'm investigating the profession. Thus far I'm 1-for-1 on that, which is at least encouraging enough to make me want to increase the sample size.

And this is why I decide to engage on this post. It would be such shame if you will in fact make a wonderful doctor someday but got discouraged by internet opinions from people that don't know or understand the whole piece of you.

Are you a doctor? If you aren't, you should be.

Instead of exploring thoughts of people in front of computer.. disengage from this virtual reality and go out there and see for yourself if these doubts are valid. The best people to assess whether or not this profession is for you are not internet strangers exchanging opinions via online communication (where tone and personality can be misinterpreted by both sides and opinions are just opinions). The best people to assess your ability and effectively advise are real doctors you can connect with real life!

This is true. I just hoped to narrow things down and focus my direction so that I wouldn't waste anyone's time in real life, or (perhaps much worse) put myself or those in the medical profession into dangerous or awkward situations by my presence. I know that if I were a patient, I wouldn't mind there being a person shadowing my doctor or volunteering to help my doctor... but I wouldn't want that person interfering, even if unintentionally, with my care or treatment.

So I recommend you to

- shadow, shadow, shadow as many people at this point... not just physicians but lawyers, too! Not sure if you were just trying to humor me but you sounded interested enough in becoming a lawyer.

It's something I've considered in years past... but it's always struck me like there's a heavy paperwork burden, and that would probably bore me. You have to figure that I'm a rock 'n' roll musician / entertainer. That's part of the baseline personality here. When I speak of things that would bore me, imagine a rock musician doing that job... if you can't see the two being a match, you'll have a fair idea of what won't work for me.

I don't know... it's tempting to go down a road where I and many others along the way have believed I'd do really well... but just because I'd do really well at something doesn't mean I'd like it. They say that being a lawyer isn't all about arguing cases in front of a judge... in fact, that tends to be a rather small part of the job. (I actually knew a lawyer many years ago who was in his 60s and had never once had to go to court. He must've been successful... he lived in a house worth over a million dollars... but he never had to go to court. That boggles my mind, but I never asked him why.)

Interestingly enough, I did as you suggested and investigated the LSAT this morning. I found a website that showed average LSAT scores broken down by college major... the highest was "Mathematics / Physics". Well, there I am... majored in physics, minored in mathematics. But would I enjoy doing the work of a lawyer? Could I travel while doing it? Would it give me a platform from where I could effect true change in the world? I just don't see that... at least not yet. However, my wife's aunt was a lawyer for 20 years, so maybe I could grill her for some information at some point soon.

- Start voluteering! Looks like a suicide hotline could he a good start! You can save more lives that way. And I commend you for having saved those two lives.

I'd be willing to do that. I will admit to responding to random people's posts in my Facebook groups when they talk of suicide or even appear to be talking of suicide. (Sadly, people with Asperger's / "high functioning autism" think about suicide a lot. I am far from the only person who suffers needless bullying on account of this condition and its manifestations.) It does make me tend to "spring into action", as it were. I have also wondered if the local prison would welcome people to come in to talk with inmates who are interested in having people with whom to talk. That prospect scares me more than a bit, because I've never been in a prison and I figure those people have to be more dangerous than average... but the truth is that they are still people, and maybe some are there because they were busted in the act of "acting out" due to having nobody in their lives who listened to them. Won't know until I give it a shot, right? (How about that, I'm talking about prison inmates and I said "give it a shot"... )

- Hit those review books and kill the MCAT!

Even before taking the classes that cover the material tested on the MCAT?

 

[RomaniGypsy]

I'm of a slightly different opinion in the sense that I don't think someone needs to be passionate, but they do need to enjoy it. I enjoy this career path a lot, but I would not consider it a passion, and I don't foresee myself burning out in the path I've chosen anymore than I would in other paths.

What's your specialty?

Only time will tell there though. There are many negatives to being a physician, but many positives as well. You gain a far greater depth of knowledge as a physician than NP or PA, you have more authority and autonomy, better pay potential (no clinical nurse or PA is going to hit 500k/yr, plenty of docs do),

$500,000 per year? I have to ask just how many of them hit that level though... and what they sacrifice to do so... when all of the information I found points to a median salary of about half that, on average, depending upon specialty and location of practice.

I like depth of knowledge. One of the reasons why I seek so much information is because I've made some pretty big mistakes in my life due to having inadequate information. I read an article recently which said that nurses are the limbs, while doctors are the eyes and brains. Doctors figure out the problem, nurses execute the treatment. I like both brain work and "hand work" (or whatever it'd be called), but I've always been drawn to the "brain work" more. If given my choice of only one, that's the one I'd select because to me it'd seem that taking the "hand work" option would mean that I'm always going to be told what to do. That's okay if the person doing the telling is entirely trustworthy and I truly believe he/she has my best interests in mind... but that seems to be the case only very rarely. So... I usually like to be the "brain guy"... and if I'm doing the "hand work", chances are I've already done the "brain work" myself.

wider opportunities outside of the clinical sphere, and other positives as well to go along with all the negatives. Plenty of people go the nursing or PA route first and realize they want more knowledge to be able to provide better care to their patients. Additionally, you can't really operate as a nurse or PA, so if you want to do surgery you've gotta go to med school.

Yeah... well, I guess I have to keep researching to develop a consensus opinion. I have a cousin who's a nurse and he told me recently that he has never known a nurse nor doctor who was dissatisfied with his/her career choice. I've got data points all over the chart here... I guess I need more in order to figure out where, or if, they "clump".

If you're trying to actually do something, then yea. But most ER volunteers won't get to do any actual hands on work, so you're strictly watching. It's not that hard to just stay towards the back of the room and watch. That's basically what we did as med students on ER rotations during true trauma situations.

I could rock with that. I would spend the whole time resisting the desire to get right up into the action so I could see what was happening, though. I learn fairly well by watching. When my wife delivered our son last month, even before she tapped me to assist her, I was right there watching closely as the nurses did their thing, and asking them specific questions about things I saw them do... not because I distrusted them, but because I really wanted to know what was happening and why.

Start your own business, keep it small, and be your own boss. Or master some skill or trade and do freelance work. Basically work on your own. Anytime you work with other people you'll have to play the game, that's just how life is. If you want to work in almost any aspect of healthcare you're going to have to learn how to play the game, that's just how it works.

I don't know if you've ever worked "on your own" like this, but I have, in a few different ways, and though you do avoid the "politics of coworkers" when you have no coworkers, there's no escaping having to "play the game" with other people. There's always a game, even if the occasional rule differs from the "employment" game. For us, it's having to deal with the people who hire us, many times having to hound them and hound them just to get in contact with them. I'm at the point of not being as convinced as once I was that this is substantially better than the garden-variety "employment" situation. At least with employment, when you're hired, you're hired, and you don't have to beg to be hired over and over and over.

It is, and it's very common. In some fields over 50% of attending physicians report burnout.

Am I assuming correctly when I think that "attending" is basically an increase in rank over "resident"? As in, every doctor who completes residency automatically becomes an "attending" just as every "assistant professor" who teaches at a college for some set number of years automatically becomes an "associate professor"?

Sometimes it's the more ethical thing to do. Example: One of my attendings on my psychiatry rotation saw patients in his private practice. He was so in demand, that if you were a new patients it was a 4+ month wait.

Yeah, that might change things a bit, wouldn't it? I was never so in demand as a music teacher that I had that long of a waiting list. If I did, I might just have jettisoned a bit of the dead weight in my student roster and invited new people in to see if they'd fare any better. Heck, my piano teacher did exactly that... she didn't need the money (she did it for fun), so if you didn't practice, she'd simply drop you. So, she never had more than about 20 students, but all of them generally did as she told them to do.

And as you mentioned later on, yes, there's the element of doing the most good for the most people. If firing the occasional patient would enable that, I believe I'd do it too.

This is one of the many reasons people regret becoming physicians. They miss large portions of their lives and the lives of their loved ones. I talked to a cardiologist before med school who told me his kids were complete strangers to him and that he was lucky if he got to eat dinner with them more than once or twice a month. That's pretty extreme, but the point is if you pursue medicine it is very likely you will have to make very significant sacrifices. That includes missing part of your family's lives. It wouldn't likely be 80 hour weeks forever, but the sacrifices would still be significant.

Is it REQUIRED that you work long hours like that after residency? Or is it just that the more hours you work, the more money you make, and that motivates a lot of people to burn the candle at both ends? (Sometimes the question needs to be asked... what price sanity?)

Not quite. 4th year medical students apply for residencies and the residency programs they apply to offer those they deem fit interviews. Once interviews are completed, applicants and programs each submit rank lists and those lists are run through an algorithm which matches applicants to programs and maximizes the number of possible matches along with rank order.

So let's test my understanding here. Medical student does interviews with (let's say) five residency programs, and comes out stating "my #1 choice is program D, #2 is E, #3 is B, #4 is A, and my last choice is C." Residency program interviews (let's say) five students, and comes out stating "our #1 choice is student B, #2 is D, #3 is A, #4 is C, and our last choice is E." Then the algorithm iterates until it creates a match list which gives each student his/her highest program choice possible while also giving the programs their highest student choices possible.

How close does that come to the reality?

Medical schools and hospitals have no agreement whatsoever in terms of residency placement and this is actually illegal as far as I know. Some Caribbean schools end up with less than 60% of the students they accept into medical school going on to enter a residency program, which is basically saying that you're flipping a coin as to whether you'll ever be a physician by going to a Carib school.

This, combined with what you said later, still leaves a question in my mind about how "low prestige" schools fail to match students to residencies. In theory, their 4th year students would also be going through the process you explained above, even if my understanding of it is still not quite perfect. Is the hiccup in the process the whole notion of "those they deem fit", as in, if the student is coming from a school that is accredited though not well regarded, even if the student's grades and everything else look good, still the student may not be "deemed fit" by the residency program?

And for that matter, what is a residency program anyway? I thought that a residency was where you practice as essentially a "junior doctor" under the auspices of other more experienced doctors, in a hospital or other relevant setting, to get what amounts to "on the job training" before you are cut loose to practice medicine independently. If that's true, why would there need to be a "program" serving as the middle man?

Some people never match and end up with all that debt and no job to show for it.

Is there anything a medical student can do after failing to match, to increase his/her chances of matching in the next round?

And is there any option at all for a medical student who repeatedly fails to match into a residency? (Such as, could they practice in another country without having to complete a residency? Or are residencies in certain other countries easier to get even if they're universally required?)

If OP truly is on the spectrum (which he'd be a pretty good troll if he's not, judging by the composition and content of his posts), then I don't think he's truly rejecting this information as much as people here think he is.

Finally someone gets it. And for whatever it's worth, if anyone really doubts my diagnosis, I will scan and post a properly redacted copy (for privacy's sake, of course) of my official diagnosis document. I would prefer to be trusted, though... after all, how is it advantageous for anyone to claim to be autistic when he/she is not? I can't think of one way in which it would be.

People on the spectrum process and absorb information differently than people who aren't and their statements are based completely on their own experiences. Anything that contradicts those experiences is questioned and must be directly addressed and reconciled before being assimilated into their own knowledge and world view. We all do this, but from my experience those on the spectrum are far more up front and blunt with this process when interacting with others.

Yeah, that's a good summary. When I question something, that doesn't mean that I automatically think it's wrong. Maybe many people question things with a hidden agenda of proving the questioned person wrong, and I will admit to having done so occasionally (just so that the person would realize for him/herself that he/she is wrong, for the benefit of everyone including that person), but each and every last time that I have asked anyone a question, I am truly open to hearing the answer and examining it to see if it sounds logical... even if I think there's only a tiny probability that the person is going to provide an answer that would pass muster with me. And in this forum, I really am asking my questions from a standpoint of "my preconceived notions are likely to be adjusted or eradicated, and I hope to learn something". But that won't happen if the answer is vague or insulting. And if I question further after getting the answer, that doesn't mean I thought it was wrong... just that I want to refine my understanding even more. (One would think that doctors would do something like this all the time.)

and I don't think OP is intentionally trying to insult or disregard people.

I never do. In fact, I actively try to avoid doing those as much as possible... unless, of course, a person has pushed my buttons too much. I'm nobody's doormat and I can return fire with the best of 'em if need be. But I never "shoot first".

I think he has a different method of interpreting information and assimilating information that many people are used to dealing with in such a blunt and seemingly unteachable or even condescending manner. It requires a change in perspective from those educating and a lot of patience in terms of explanation. I get where people are coming from when they're saying OP seems to not listen to anyone, but having worked with individuals on the spectrum far more challenging than OP, I also understand how he is interacting with other posters.

I have read and re-read every even marginally informational post on this thread, multiple times. I've taken some of the information and run internet searches based thereupon to go beyond the answer I got. (I don't hold that against anyone. Who is going to waste much time being my Google?) I mean, really, when Goro listed those medical schools, I went and looked them up even though I suspected that my chain was being yanked. Gathering information, right? I do try to turn every stone. But what I always wonder is this: "if these respondents KNEW that I was a good person and that my sole objective for being here is to gather as much relevant information as possible as quickly as possible, would they respond to me differently than they do now?"

This is far from the first time that I've been attacked in a similar manner when it was entirely unwarranted. I can accept that people won't readily understand me due to my being so "different" if they're trying to translate my words into "what would something like this mean if it were coming from a 'normal' person?"... but if I tell them "look, trust me, I'm a good guy without a negative nor unpleasant intention to be found, and you'll understand me best if you take my words exactly as I write them without changing them, ascribing hidden meanings to them, or disbelieving them", I don't see why that's so much to ask. It'd seem that I'm making their lives simple. Just read the words and take them as is. No need to translate. It's like machine code... doesn't get any more basic than this.

 

[CyrilFiggis]

That is presently a big fat zero.

I'm sure this doesn't look too good, but one would think that I should get a couple of prerequisites out of the way first... one being this upcoming biology class (if I do poorly in it as I did in high school bio, medicine ain't the field for me) and another being a strong narrowing-down of desirable specialties. It'd seem most productive to direct volunteer hours toward locations where I would encounter the practice of those specific medical specialties. (After all, if I have zero desire to go into, for example, urology, why would I want to shadow a urologist or volunteer in a urology clinic?)

Stop writing 10,000 character rebuttals to every single post and instead find a hospital to volunteer in. It doesn't matter the specialty right now. A large percentage of medical students switch to different specialties than what they thought when they matriculated. During your third year you'll be exposed to everything from Urology to OB to Psych to ICU. The point of clinical exposure as a pre-med is to have patient encounters and be exposed to the day to day of medical practice.

Please don't respond to this. You have lost many helpful voices on this forum (many of whom helped me, a 30-something medical student) and it's due to the long winded and combative (perceived) nature of your responses. So for now, unless you have specific questions, I suggest: 1) volunteer, it's pointless to spend money on medical education if you have no provider-side exposure 2) do well in your Bio course as well as Gen Chem. These can be weeder courses and anything less than A's should send up red flags 3) Finally, relax. You have a lot of energy and zeal, but I think right now it needs to be focused less on internet validation and more of tangible action.

Good luck.

 

[Stagg737]

What's your specialty?

Psychiatry.

$500,000 per year? I have to ask just how many of them hit that level though... and what they sacrifice to do so... when all of the information I found points to a median salary of about half that, on average, depending upon specialty and location of practice.

A significant amount do. For some fields (ortho, neurosurgery are the two biggies) $500k isn't much above the average. Most fields can hit 500k if you've got a sound business model and are willing to bust your butt. I even worked with a pediatrician who I'm pretty sure cleared 500k as he bought a car at an online auction one day "because he felt like it". This guy also worked 70-80 hour weeks on the regular and had a bit of a different practice set-up. But it's certainly possible.

Am I assuming correctly when I think that "attending" is basically an increase in rank over "resident"? As in, every doctor who completes residency automatically becomes an "attending" just as every "assistant professor" who teaches at a college for some set number of years automatically becomes an "associate professor"?

Yes, an attending is a physician who graduates medical school then completes residency.

Is it REQUIRED that you work long hours like that after residency? Or is it just that the more hours you work, the more money you make, and that motivates a lot of people to burn the candle at both ends? (Sometimes the question needs to be asked... what price sanity?)

You don't have to work at all after residency if you don't want to. I know of an EM doc that spent his first 5 years out of residency working overtime to pay off student loans and build up his nest egg/retirement portfolio then dropped to part-time working around 25 hours a week for the rest of his career. It also depends on how you're being paid. If you're employed you may just get a flat salary. Most places will offer a flat salary + production bonus or pay scaled based on production. If you're in private practice and not employed, the more you work the more you make. Some people are driven that much by cash. Others work ridiculous hours so they can retire in their 40's. Just depends on the person.

So let's test my understanding here. Medical student does interviews with (let's say) five residency programs, and comes out stating "my #1 choice is program D, #2 is E, #3 is B, #4 is A, and my last choice is C." Residency program interviews (let's say) five students, and comes out stating "our #1 choice is student B, #2 is D, #3 is A, #4 is C, and our last choice is E." Then the algorithm iterates until it creates a match list which gives each student his/her highest program choice possible while also giving the programs their highest student choices possible.

How close does that come to the reality?

The algorithm is a bit more complex than that, but that's the general idea.

This, combined with what you said later, still leaves a question in my mind about how "low prestige" schools fail to match students to residencies. In theory, their 4th year students would also be going through the process you explained above, even if my understanding of it is still not quite perfect. Is the hiccup in the process the whole notion of "those they deem fit", as in, if the student is coming from a school that is accredited though not well regarded, even if the student's grades and everything else look good, still the student may not be "deemed fit" by the residency program?

And for that matter, what is a residency program anyway? I thought that a residency was where you practice as essentially a "junior doctor" under the auspices of other more experienced doctors, in a hospital or other relevant setting, to get what amounts to "on the job training" before you are cut loose to practice medicine independently. If that's true, why would there need to be a "program" serving as the middle man?

Even "low prestige" medical schools in the U.S. don't have a difficult time matching applicants. There are many more residency positions than there are US grads, the issue is that there are some residency programs that most people don't want to go to (ie, that rural community hospital's IM program in Middle-of-nowhere Montana). The issue isn't really with medical schools themselves, as prestige doesn't matter that much unless you're coming from a top-tier program. The difference is that lower prestige programs put out statistically worse applicants on paper (as a whole), meaning it's harder for them to match into competitive fields and locations. The issue with Carib schools is that there's a large bias against them for many reasons (search through various threads on here if you want to know why) by residency programs, they have low graduation/match rates, and they're expensive. So you're paying a lot, have a lower chance of matching, and even if you do you're essentially shooting for either worse residency programs or less competitive fields (or both). If a student is a superstar applicant, they'll have a shot at most places and specialties regardless of where they're coming from, it's just harder for them than a USMD and it's harder for the non-superstars in general.

You're not far off on what residency is. You are basically a "junior doctor" (you're actually a full-fledged physician but with less liability working under an attending's supervision). The difference is where medical school is a broader education where you learn about most fields and the whole body, residency is more focused and trains you to be a specific type of physician (Family med doc, psychiatrist, general surgeon, neurosurgeon, etc). Beyond that there are fellowships which can allow you to further specialize but are not needed to be a fully-licensed and certified attending.

The "middle-man" is basically there for efficiency and to make sure no one is getting screwed too bad. It's a lot more complex, but for now I'll just post a link to the wikipedia page. If you have more questions I can try and answer them later, but for now I'll leave it at this: National Resident Matching Program - Wikipedia

Is there anything a medical student can do after failing to match, to increase his/her chances of matching in the next round?

And is there any option at all for a medical student who repeatedly fails to match into a residency? (Such as, could they practice in another country without having to complete a residency? Or are residencies in certain other countries easier to get even if they're universally required?)

Some do a pre-lim year or 'traditional internship' which is basically just the first year of residency and then they apply again as PGY-2s. Some take a year and do research, many take Step 3 (the final required certification exam to be fully-licensed), both help but going unmatched is a huge red flag to overcome. There are options for those who never match. Working for insurance companies, consulting, doing research, some actually become PAs or nurses (less common, but gotta pay the bills somehow). Their lives aren't necessarily over, but they'll likely miss out on their career as clinicians. They could potentially practice in other countries, but that depends on the standards and requirements of the specific country they're trying to practice in and there is a lot of variation.

 

[RomaniGypsy]

Psychiatry.

I knew I liked you. Truthfully, I started investigating medicine when I recognized that to be a psychiatrist, you have to be an MD or DO. I was looking at differences between psychiatrists and psychologists and found that to be one of them. Is there a significant call for "social psychiatrists" these days? If there were one field of medicine that would truly excite my mind, that's it... being able to blend psychiatry and psychology to create a holistic approach to mental illness. (I don't know how many opportunities there are for locum tenens psychiatrists, but that's something I could look up.)

I'm about to say something which may make me seem horribly ignorant, but in many ways I am horribly ignorant... hence my presence here. I do not believe in mental illness the way it is most commonly discussed. It seems that there is so much focus on medicating mental illness away. While I don't deny that medication is indicated in certain severe cases, I find myself thinking on a regular basis that most of the conditions we currently call "mental illness", while legitimate and biologically or chemically measurable at the time, are caused more by a person's social and environmental circumstances than by chemical imbalances in the person's brain which would affect him/her negatively even if he/she were put into the most ideal possible social and environmental conditions. I say this because I've known people in the past who have been diagnosed with mental disorders, and I could cite general aspects of their environments which most uninformed people would probably agree contributed to their mental disorders.

So, in short, were I to go into psychiatry, I'd want to know that I could integrate psychology and sociology into the approach to mental illness without there being any implicit pressure to solely medicate people into some appearance of normalcy. Is that something that could fly in real life or do psychiatrists mostly diagnose and medicate for mental conditions as it has always seemed to me that family medicine and internal medicine doctors do for physical conditions?

One more kind of side-note question: Is it dangerous to be a psychiatrist, given that they work with mentally ill people, some of whom are probably quite unpredictable and violent in their tendencies? (The only experience I have with the mentally malfunctioning is my encounters with elderly people who have dementia... and some of them can be violent, though probably not as dangerous as younger people whose conditions may give rise to more "malice aforethought".)

Even "low prestige" medical schools in the U.S. don't have a difficult time matching applicants. There are many more residency positions than there are US grads, the issue is that there are some residency programs that most people don't want to go to (ie, that rural community hospital's IM program in Middle-of-nowhere Montana).

Are you saying, then, that if a person wants the highest possible chance of matching, he/she should apply to the less desirable residency programs such as the uber-rural type you mentioned?

(See, that wouldn't bother me at all. I LOVE rural areas. My only question would become - is there anything ELSE that is undesirable or potentially hazardous to a doctor's career prospects about residencies like this? Or is it JUST that you're living out in the middle of nowhere? Because, if that's the only thing, I don't think I'd mind. In my experience, any town large enough to have its own hospital, even a small one, is going to be large enough to have whatever I'd need for living. It'll probably have a grocery store or two, a gas station, a general store of some kind, a post office with reasonable hours, a library, a park or two, a fast food place, and at least one hole-in-the-wall restaurant. I wouldn't need anything more than that on a regular basis. The town in which I live right now has a small hospital - one that doesn't even have a labor and delivery department - and the town is big enough for me.)

The issue isn't really with medical schools themselves, as prestige doesn't matter that much unless you're coming from a top-tier program. The difference is that lower prestige programs put out statistically worse applicants on paper (as a whole), meaning it's harder for them to match into competitive fields and locations.

I look at this and wonder about confounding factors, and whether or not we're dealing with a self-perpetuating cycle here. To wit: Let's say that school A is considered prestigious and school B is considered bottom-of-the-barrel for prestige, though both are accredited. The best medical school candidates will likely apply to school A and not school B (they'd apply to school B just as a "safety school" and wouldn't really be intending to go there unless they failed to gain acceptance to the schools they really wanted), so the end result is that school A will probably get a stronger crop of incoming students compared to school B. Those stronger students will perform better, so as graduates they will look stronger on paper than the students at school B do... BUT... it has less to do with the schools themselves than it does with the self-selected cohort of students at each one. Meaning - if those strong students had gone to school B and the weaker students went to school A, then school B would pump out the stronger graduates and the ones graduating from school A wouldn't look as good on paper.

Does this match reality or is there more to it?

(Because one would think that if it does, the self-perpetuating cycle would continue, where each year's incoming class at school B is not as strong because school B is not as prestigious... and then it'd be plenty logical to ask - exactly why did school B end up not as prestigious as school A? What is the empirical gauge of prestige, apart from the caliber of students who choose to matriculate to that school?)

Also, what's the downside of matching into less competitive fields and locations? I don't quite understand the idea of matching into a less competitive field - I figured you'd try to match into the field in which you intend to specialize. By the time medical students are in their 4th year and looking at residencies, don't they all have their specialties pretty much chosen after having experienced clinical rotations? I was under the impression that the purpose of clinical rotations is to give students some hard experience in what it's like to be that type of doctor so that by the time they reach the point of choosing a residency, they'll know where they want to go. To my perspective it would seem a bit silly, unproductive, and indicative of a lack of focus if some 4th year medical student applied to residencies in psychiatry, otolaryngology, obstetrics/gynecology, and radiology. While all medical fields, they are vastly different, each from the others.

Or am I completely mistaken, such that it is entirely normal for a 4th year medical student not to have narrowed his/her preferred specialties down to three at the most? (If yes, just how common is it for students to apply to a wide variety of residencies, and how is a student picked for one when they're basically throwing a bunch of darts at a wall and hoping one will stick? Even when you apply for a "regular job", the company wants to see that you know about the job, you know about the company, and your skill set and end goals are a good match for the position... it tends to work against you if you come off as naught but a resume blaster, hoping to land just any job.)

Some do a pre-lim year or 'traditional internship' which is basically just the first year of residency and then they apply again as PGY-2s. Some take a year and do research, many take Step 3 (the final required certification exam to be fully-licensed), both help but going unmatched is a huge red flag to overcome. There are options for those who never match. Working for insurance companies, consulting, doing research, some actually become PAs or nurses (less common, but gotta pay the bills somehow). Their lives aren't necessarily over, but they'll likely miss out on their career as clinicians. They could potentially practice in other countries, but that depends on the standards and requirements of the specific country they're trying to practice in and there is a lot of variation.

To put it bluntly, that seems to suck royally... to go into medical school, amass all of that debt (assuming you don't land one of the full scholarships available), and then not be able to become a doctor because residency programs didn't choose you. Is it possible for a good student, who truly did try his/her best in medical school and got at least above-average grades, never to match into a residency assuming that he/she is willing to take residencies in less-desirable geographic locations as long as they won't harm his/her long-term career prospects? I suppose I wouldn't be bothered by the whole thing as long as it's as close to a certainty as anything could be that the people who don't get a residency after graduation are either the bottom-of-the-barrel medical students who barely graduated, or the ones who are extremely picky about the geographic locations where they'd have residency.

 

[CyrilFiggis]

I knew I liked you. Truthfully, I started investigating medicine when I recognized that to be a psychiatrist, you have to be an MD or DO. I was looking at differences between psychiatrists and psychologists and found that to be one of them. Is there a significant call for "social psychiatrists" these days? If there were one field of medicine that would truly excite my mind, that's it... being able to blend psychiatry and psychology to create a holistic approach to mental illness. (I don't know how many opportunities there are for locum tenens psychiatrists, but that's something I could look up.)

I'm about to say something which may make me seem horribly ignorant, but in many ways I am horribly ignorant... hence my presence here. I do not believe in mental illness the way it is most commonly discussed. It seems that there is so much focus on medicating mental illness away. While I don't deny that medication is indicated in certain severe cases, I find myself thinking on a regular basis that most of the conditions we currently call "mental illness", while legitimate and biologically or chemically measurable at the time, are caused more by a person's social and environmental circumstances than by chemical imbalances in the person's brain which would affect him/her negatively even if he/she were put into the most ideal possible social and environmental conditions. I say this because I've known people in the past who have been diagnosed with mental disorders, and I could cite general aspects of their environments which most uninformed people would probably agree contributed to their mental disorders.

So, in short, were I to go into psychiatry, I'd want to know that I could integrate psychology and sociology into the approach to mental illness without there being any implicit pressure to solely medicate people into some appearance of normalcy. Is that something that could fly in real life or do psychiatrists mostly diagnose and medicate for mental conditions as it has always seemed to me that family medicine and internal medicine doctors do for physical conditions?

One more kind of side-note question: Is it dangerous to be a psychiatrist, given that they work with mentally ill people, some of whom are probably quite unpredictable and violent in their tendencies? (The only experience I have with the mentally malfunctioning is my encounters with elderly people who have dementia... and some of them can be violent, though probably not as dangerous as younger people whose conditions may give rise to more "malice aforethought".)



Are you saying, then, that if a person wants the highest possible chance of matching, he/she should apply to the less desirable residency programs such as the uber-rural type you mentioned?

(See, that wouldn't bother me at all. I LOVE rural areas. My only question would become - is there anything ELSE that is undesirable or potentially hazardous to a doctor's career prospects about residencies like this? Or is it JUST that you're living out in the middle of nowhere? Because, if that's the only thing, I don't think I'd mind. In my experience, any town large enough to have its own hospital, even a small one, is going to be large enough to have whatever I'd need for living. It'll probably have a grocery store or two, a gas station, a general store of some kind, a post office with reasonable hours, a library, a park or two, a fast food place, and at least one hole-in-the-wall restaurant. I wouldn't need anything more than that on a regular basis. The town in which I live right now has a small hospital - one that doesn't even have a labor and delivery department - and the town is big enough for me.)



I look at this and wonder about confounding factors, and whether or not we're dealing with a self-perpetuating cycle here. To wit: Let's say that school A is considered prestigious and school B is considered bottom-of-the-barrel for prestige, though both are accredited. The best medical school candidates will likely apply to school A and not school B (they'd apply to school B just as a "safety school" and wouldn't really be intending to go there unless they failed to gain acceptance to the schools they really wanted), so the end result is that school A will probably get a stronger crop of incoming students compared to school B. Those stronger students will perform better, so as graduates they will look stronger on paper than the students at school B do... BUT... it has less to do with the schools themselves than it does with the self-selected cohort of students at each one. Meaning - if those strong students had gone to school B and the weaker students went to school A, then school B would pump out the stronger graduates and the ones graduating from school A wouldn't look as good on paper.

Does this match reality or is there more to it?

(Because one would think that if it does, the self-perpetuating cycle would continue, where each year's incoming class at school B is not as strong because school B is not as prestigious... and then it'd be plenty logical to ask - exactly why did school B end up not as prestigious as school A? What is the empirical gauge of prestige, apart from the caliber of students who choose to matriculate to that school?)

Also, what's the downside of matching into less competitive fields and locations? I don't quite understand the idea of matching into a less competitive field - I figured you'd try to match into the field in which you intend to specialize. By the time medical students are in their 4th year and looking at residencies, don't they all have their specialties pretty much chosen after having experienced clinical rotations? I was under the impression that the purpose of clinical rotations is to give students some hard experience in what it's like to be that type of doctor so that by the time they reach the point of choosing a residency, they'll know where they want to go. To my perspective it would seem a bit silly, unproductive, and indicative of a lack of focus if some 4th year medical student applied to residencies in psychiatry, otolaryngology, obstetrics/gynecology, and radiology. While all medical fields, they are vastly different, each from the others.

Or am I completely mistaken, such that it is entirely normal for a 4th year medical student not to have narrowed his/her preferred specialties down to three at the most? (If yes, just how common is it for students to apply to a wide variety of residencies, and how is a student picked for one when they're basically throwing a bunch of darts at a wall and hoping one will stick? Even when you apply for a "regular job", the company wants to see that you know about the job, you know about the company, and your skill set and end goals are a good match for the position... it tends to work against you if you come off as naught but a resume blaster, hoping to land just any job.)



To put it bluntly, that seems to suck royally... to go into medical school, amass all of that debt (assuming you don't land one of the full scholarships available), and then not be able to become a doctor because residency programs didn't choose you. Is it possible for a good student, who truly did try his/her best in medical school and got at least above-average grades, never to match into a residency assuming that he/she is willing to take residencies in less-desirable geographic locations as long as they won't harm his/her long-term career prospects? I suppose I wouldn't be bothered by the whole thing as long as it's as close to a certainty as anything could be that the people who don't get a residency after graduation are either the bottom-of-the-barrel medical students who barely graduated, or the ones who are extremely picky about the geographic locations where they'd have residency.

Have you found a volunteer program yet?

 

[Forever Geebs]

This made my Sunday evening. Thank you.

 

[Robin-jay]

For those that don't want to read the thread, here's the short story.

1.) OP claims to be a genius, which honestly doesn't appear to be true based on his posts. Mostly just unfounded arrogance for some reason.

2.) OP think volunteering, shadowing, clinical experience, and helping others are not important in the application process.

3.) OP thinks that they somehow understand the daily life of a physician without shadowing, volunteering or working clinically.

4.) I don't mind cheering for the underdogs of the forums. In fact, that's why I even come here. But the thing I cannot stand is "unfounded" arrogance. OP doesn't have a 40 MCAT and amazing ECs, or anything like that. OP is just currently a guy that thinks he almost too smart to be a physician just because.

 

[tkim]

Not going to get into med school. Bye.

 

[RomaniGypsy]

Have you found a volunteer program yet?

No, unless you count that I've spent the last few days painting the interior of a house, in which dwell two elderly friends of mine who aren't in much condition to be precariously balanced on a ladder holding a paintbrush.

However, that doesn't mean that I never will. It's on the "to do" list... along with a whole bunch of other things.

For those that don't want to read the thread, here's the short story.

1.) OP claims to be a genius, which honestly doesn't appear to be true based on his posts. Mostly just unfounded arrogance for some reason.

2.) OP think volunteering, shadowing, clinical experience, and helping others are not important important in the application process.

3.) OP thinks that they somehow understand the daily life of a physician without shadowing, volunteering or working clinically.

4.) I don't mind cheering for the underdogs of the forums. In fact, that's why I even come here. But the thing I cannot stand is "unfounded" arrogance. OP doesn't have a 40 MCAT and amazing ECs, or anything like that. OP is just currently a guy that thinks he almost too smart to be a physicians just because.

Go back to bed. It appears that you need your sleep.

 

[CyrilFiggis]

No, unless you count that I've spent the last few days painting the interior of a house, in which dwell two elderly friends of mine who aren't in much condition to be precariously balanced on a ladder holding a paintbrush.

First off, no one talks like this. This isn't Dickensian England.

Second, you've spent thousands of words commenting and typing rebuttals to everyone who has tried to help or enlighten you. Yet when push comes to shove, for all your bluster, you haven't even taken the simplest step towards your goal. It's been over a week and you haven't spent the 2 hours needed to find a volunteer program. So that begs the question, do you actually want to be a physician or just argue with those of us who have/are putting in the effort?

 

[Robin-jay]

No, unless you count that I've spent the last few days painting the interior of a house, in which dwell two elderly friends of mine who aren't in much condition to be precariously balanced on a ladder holding a paintbrush.

However, that doesn't mean that I never will. It's on the "to do" list... along with a whole bunch of other things.



Go back to bed. It appears that you need your sleep.

Have you found that volunteering program yet?

 

[CheusChrist]

OP, you appear to be unteachable. Multiple people offer you reasonable advice (and some tough love heads-up) and your response is to write a Supreme Court brief refuting everyone's comments and concerns. You state you have multiple noble intentions, yet the very first things you write about your motivations for a career in Medicine are either naive, starry-eyed, or dripping with hubris and ego.

I and others have interviewed candidates like you and they got rejected outright. Not accepted; not wait-listed, but rejected. That's no mean feat.

These are my last comments in this thread: I think the following schools would be perfect for you: LUCOM, Touro-NY, CNU, SABA, Ross, AUA or SGU.

Ouch... I've met some pretty amazing students from these schools- earnest and outright hardworking and willing to power through the reputations of their schools to prove their sincerity and dedication to be a physician.

 

[Goro]

Ouch... I've met some pretty amazing students from these schools- earnest and outright hardworking and willing to power through the reputations of their schools to prove their sincerity and dedication to be a physician.

I am in no way knocking the students, only the schools. Do a search as to why.

 

[CheusChrist]

You certainly have expectations for what you hope the experience of being a physician will be like- I certainly had my own, but once you gain hands on patient care experience... you'll see the disconnect, and understand what all these commenters are trying to tell you. I recommend gaining exposure to patient care in a large hospital- you'll see the dynamics of team work on full display, and being as outspoken as you are- it will be a bit twilight zone to watch and listen. Cultivating an attitude that supports collaboration is an invaluable skill in medicine- medical schools, residency programs look for those soft skills during interviews. With the patient care exposure, you'll see being a physician is a thankless job, and if you talk to a solo practitioner (family medicine), they'll tell you there isnt alot of money in medicine- so - your motivation matters to your success and sustainability in this profession.

AdCom people read thousands of essays and meet thousands of students each cycle, they can spot uncooperative phonies a few sentences in a personal statement, keep your unpopular truths in a locker and pull every fiber of your will together to shut up and simply be receptive to criticism. good luck?

 

[RomaniGypsy]

First off, no one talks like this. This isn't Dickensian England.

That sentence was grammatically correct and it conveyed my intended meaning. That is how I tend to speak, when I have the time to make sure I am using proper grammar. How would you have worded the sentence so that it is still grammatically correct and identical in meaning to what I said?

Second, you've spent thousands of words commenting and typing rebuttals to everyone who has tried to help or enlighten you. Yet when push comes to shove, for all your bluster, you haven't even taken the simplest step towards your goal. It's been over a week and you haven't spent the 2 hours needed to find a volunteer program. So that begs the question, do you actually want to be a physician or just argue with those of us who have/are putting in the effort?

You just don't get it, do you? Getting into a volunteer program is not the simplest step toward the goal, nor is it as simple as spending two hours to find such a program. The journey of a thousand miles may begin with a single step, but no wise person takes even the first step toward an undesirable goal. Therefore, what must be accomplished first is the determination of whether or not the goal is desirable. That's what I'm doing right now. Though many a past medical student may have decided on a whim that he/she wanted to be a doctor, and then just went for it, that isn't how I work. I imagine that such a cavalier attitude toward the profession is what has caused the rate of suicide among doctors to be as high as it is - people go into it with inadequate knowledge of what it's all about.

"So get out there and volunteer!" - okay, how many hospitals can field a phone call at 11:00 PM and give me thorough information on their volunteer opportunities? Even if I could find one, or if I were fortunate enough to be able to call one during normal business hours, I'd be a fool to pursue volunteer opportunities in a field that wouldn't be of interest to me in the end. For example, I wouldn't job-shadow a garbage collector. I have nothing against them; it is simply not a field which interests me. So why waste what scant "normal business hours" time I have, driving who knows what ungodly distance one way in Snow Belt winter weather to get to a hospital which houses the practice of a certain specialty of medicine, if I can figure out beforehand that I won't want to be involved with the practice of that specialty? I'd do better to spend my late-night hours when nobody will answer the phone in the hospital's volunteer office trying to figure out which specialties would be worth my pursuit.

If y'all wouldn't attack me like a pride of hungry lions, I wouldn't have to spend so much time and so many words explaining and defending myself. This has gone far beyond "tough love"; it vaulted the bar for "schoolyard bullying" long ago. I am, frankly, horrified by the behavior of some of the people on this forum. Yes, some have been quite helpful and informative without being insulting... but the mere fact that any of y'all crossed the line into being insulting is appalling. All of that education, all of that volunteer philanthropy (obviously since the doctors here managed to get into medical school), all of that intellectual ability to handle one of the most rigorous professions out there... and it still didn't make "good people" out of them. Good people don't attack other people. At most, they defend, and only when personally attacked.

(You should know that I have posted a copied-and-pasted version of my "original post", tweaked only as much as was minimally necessary to make it relevant to the other branches of medicine that I have considered, in other forums relevant to those other branches as this one is to being an MD or DO. Not once has anyone "there" attacked me the way they have "here". If this, along with drastically increasing the risk of mental ailments that often lead to suicide, is what being a medical doctor tends to do a person, I don't want it... and there would go any related reason to volunteer.)

 

[Robin-jay]

That sentence was grammatically correct and it conveyed my intended meaning. That is how I tend to speak, when I have the time to make sure I am using proper grammar. How would you have worded the sentence so that it is still grammatically correct and identical in meaning to what I said?



You just don't get it, do you? Getting into a volunteer program is not the simplest step toward the goal, nor is it as simple as spending two hours to find such a program. The journey of a thousand miles may begin with a single step, but no wise person takes even the first step toward an undesirable goal. Therefore, what must be accomplished first is the determination of whether or not the goal is desirable. That's what I'm doing right now. Though many a past medical student may have decided on a whim that he/she wanted to be a doctor, and then just went for it, that isn't how I work. I imagine that such a cavalier attitude toward the profession is what has caused the rate of suicide among doctors to be as high as it is - people go into it with inadequate knowledge of what it's all about.

"So get out there and volunteer!" - okay, how many hospitals can field a phone call at 11:00 PM and give me thorough information on their volunteer opportunities? Even if I could find one, or if I were fortunate enough to be able to call one during normal business hours, I'd be a fool to pursue volunteer opportunities in a field that wouldn't be of interest to me in the end. For example, I wouldn't job-shadow a garbage collector. I have nothing against them; it is simply not a field which interests me. So why waste what scant "normal business hours" time I have, driving who knows what ungodly distance one way in Snow Belt winter weather to get to a hospital which houses the practice of a certain specialty of medicine, if I can figure out beforehand that I won't want to be involved with the practice of that specialty? I'd do better to spend my late-night hours when nobody will answer the phone in the hospital's volunteer office trying to figure out which specialties would be worth my pursuit.

If y'all wouldn't attack me like a pride of hungry lions, I wouldn't have to spend so much time and so many words explaining and defending myself. This has gone far beyond "tough love"; it vaulted the bar for "schoolyard bullying" long ago. I am, frankly, horrified by the behavior of some of the people on this forum. Yes, some have been quite helpful and informative without being insulting... but the mere fact that any of y'all crossed the line into being insulting is appalling. All of that education, all of that volunteer philanthropy (obviously since the doctors here managed to get into medical school), all of that intellectual ability to handle one of the most rigorous professions out there... and it still didn't make "good people" out of them. Good people don't attack other people. At most, they defend, and only when personally attacked.

(You should know that I have posted a copied-and-pasted version of my "original post", tweaked only as much as was minimally necessary to make it relevant to the other branches of medicine that I have considered, in other forums relevant to those other branches as this one is to being an MD or DO. Not once has anyone "there" attacked me the way they have "here". If this, along with drastically increasing the risk of mental ailments that often lead to suicide, is what being a medical doctor tends to do a person, I don't want it... and there would go any related reason to volunteer.)

Rambling skill: 10/10
Productivity skill: 0/10

 

[RNthenDoc]

Imagine reading a 35 page soap note.

 

[CheusChrist]

I imagine that such a cavalier attitude toward the profession is what has caused the rate of suicide among doctors to be as high as it is - people go into it with inadequate knowledge of what it's all about.

Terrible imagination... This is a deeply sad reality and to say "cavalier attitude", "inadequate knowledge" of what the profession is about is very insensitive and ignorant. Suffice to say- if you had actual exposure to this profession, you wouldn't imagine- it's complex. This isn't the 80's, you can email hospital's volunteer department and email applications for volunteer positions- once you start your search, you'll see "opportunity" there if you want it.

If you think this forum's comments are ugly- look up what getting "pimped" in residency means. IF you think this is an attack- wait til you hear the **** that comes out of patients and angry family members threatening to sue you to hell. Oh, and you can't rebuttal or respond the way you do on this forum.

If you are dead serious about pursuing this goal- I invite you to look several steps ahead- look at MSAR (on AAMC website) on acceptance rates and requirements, service and shadowing are all expected of competitive candidates. Past applicants can not decide on a whim they want to be doctors- its more involved than you think- even for a traditional college student following a path. Some schools will receive upwards of 9K to 12K (hight for state school) applications, and they interview less than 5-8% of this pool. Everyone will have comparable scores, test grades, and volunteer and shadowing experiences- how and what each applicant evaluates and discusses in their volunteer/shadowing experiences sets a tone for Adcom to understand if said applicant will be a fit in their program. MSAR will also show you % of accepted students who volunteer, shadowed, done research, etc... and those values are close in the 95% range (minus research). All this push for you to volunteer is not a hoax to waste your time.

 

[CheusChrist]

(You should know that I have posted a copied-and-pasted version of my "original post", tweaked only as much as was minimally necessary to make it relevant to the other branches of medicine that I have considered, in other forums relevant to those other branches as this one is to being an MD or DO. Not once has anyone "there" attacked me the way they have "here". If this, along with drastically increasing the risk of mental ailments that often lead to suicide, is what being a medical doctor tends to do a person, I don't want it... and there would go any related reason to volunteer.)

This reminds me of a segment Dave Chapelle did on his new Netflix comedy special, he'd say that's a "brittle spirit". It's actually relevant here but minus the inappropriate context of the segment. Please go watch the special if you have time to spear and follow up.

 

[RomaniGypsy]

Respectfully, I think that people are suggesting that you volunteer in order to figure out whether medicine is a field that will interest you.

And there is indeed logic in that. I may even find something else that interests me through such volunteering, even if medicine doesn't turn out to be it (in any of its specialties).

And you never see all the "behind-the-scenes" stuff - the paperwork and fighting with insurance companies that make up >50 percent of the job, the stress, the long hours. That all happens behind closed doors.

I guess this could be a whole additional thread in and of itself... and I just might make one if I can't find one by searching for it... but I'll pose the question anyway: Do doctors generally feel controlled, restricted, or reduced to mere pawns in a game, on account of a system over which they have no control, which is headed up by non-physicians?

For example: when I taught high school, I felt that way. There were people in administrative positions whose sole activity during the day appeared to be justifying the existence of their jobs by walking around with their noses up in the air, "observing" how we operated and making sure to point out every last little error they found. I was made to teach a bunch of stuff that I knew my students would never use in real life, because the government said I had to do so. The people who made those laws were not educators; they were politicians. Now, could this be unique to that district, that period of time (ten years ago), that state, etc? Yes... but this is what I mean. If people asked me what I disliked most about teaching high school, this would be it. I'm sure I wouldn't like similar conditions any more as a doctor or other medical professional.

For another example, we have what happened to my wife today at her OBGYN appointment. This was her "6 weeks postpartum" appointment, which actually happened at 7+ weeks because they couldn't (or refused to) schedule her for anything workable around the 6 week mark. The technician told us that because we were at 7 weeks, the doctor couldn't do the uterine exam because insurance won't cover it. (It would've been nice for the scheduler to tell us this, but the tech said that the people in the front end really don't understand obstetrics and gynecology enough to know to tell us those things right off the bat.) She told us that we could do a birth control consultation and insurance would pay for that, so either way, we were seeing the doctor. So I got thinking: "if I were the doctor in this situation, and this procedure would take only a few minutes like every other procedure she's ever done on my wife has taken, I would just do it anyway even if I wouldn't get paid for it". I asked if the doctor would be able to do the procedure anyway since we were already there, and the tech said that the doctor absolutely must bill for everything she does. I asked her to explain the law or the reason why that is absolutely necessary and she couldn't. She said that it's insurance fraud to bill for procedures that aren't done, and when I asked if it is insurance fraud NOT to bill for procedures that ARE done, she didn't know.

Any insight?

And here's one more question: can a doctor reduce all of this paperwork and stress by simply going "cash only" and refusing to accept insurance? (If yes, what's the downside to that? Anything other than "reduced income"?)

It doesn't even have to be hospital volunteering - it could be a free clinic, a hospice center, the nursing home where you already work, and as little as two hours a week while you're taking your classes.

I looked up volunteering for a suicide hotline last night and it turns out that you have to take so many hours of classes and training before you can do that. They definitely don't make it easy to work for nothing. But... even if for some reason I can't do that... there are other opportunities...

Perhaps you could get certified as a CNA or EMT and get clinical experience and supplemental income at the same time.

Would that qualify though? I never really wanted to be a CNA (or, "STNA" in this state)... but with my wife gunning for nursing school, especially if that means she has to attend classes or clinicals in person during daytime hours, it'd be logical for me to become able to make money during "second shift" so that someone is always around to watch our son... and I do suppose that I would get experience with the medical profession in so doing. However, it isn't "volunteer" experience... though the pay is stinko, it's still paid work.

And no need to choose a specialty now - you will get exposure to all the major specialties in medical school if you choose to go, and make your decision at the end of your third year of medical school. The first question, as you've accurately identified, is whether medicine itself is the right fit - and getting experience in healthcare will help you answer that question.

I'm finally going to admit that I find this strange. Maybe you or some other (kind, informative) soul frequenting this forum can clear this up for me. People seriously go into medicine essentially thinking "I want to be a doctor, but I don't know what kind of doctor I want to be"? I don't get it. If you go into teaching, you select your major in the beginning of your undergrad training and you'd better be dead-set on it no later than the beginning of your 2nd year or else you won't be graduating on time. You want to be a math teacher? You'd better be majoring in math. You want to be a kindergarten teacher? You'd better be majoring in early childhood education. A large number of your classes are geared toward your "specialty". If medical students go through three out of four years without yet having chosen a specialty, it would seem as though that attests to a shocking lack of focus, given how widely varied are the specialties in medicine. Can I get some light shed onto why it's basically okay for a medical student to tell an admissions committee "I want to be a doctor, but I'm not sure what type of doctor I want to be"?

I would also suggest that even if you end up not going into medicine, volunteering with the sick, the disabled, the dying, etc. will be an intrinsically valuable experience outside of your goal of getting into medical school.

*sigh* Maybe... the only problem is that based upon everything I've read, I meet all of the criteria for being an empath. (Today I read an article which said that a narcissist is the diametric opposite of an empath. So much for the opinions of the unkind among the posters here.) It's really rough on me to be around the dying. I first realized this when I first worked at the nursing home. I'd see people in their rooms, surrounded by pictures of them in their younger years. They'd look so vivacious, so alive... and now here they are, lying in hospital beds, mouths agape, surrounded by machines chugging away just to keep them alive... it's really sad to me. I look at that and think that I would never want it for myself. Though I doubt she'd do this, I've instructed my wife to shoot me right between the eyes with the most powerful gun we own if I ever become that physically or mentally decrepit before dying naturally. Apparently, I'm not alone either... I read a study recently which showed that doctors have a much higher than average percentage of "do not resuscitate" orders when they become old. (The psychologists who authored the study guessed that the reason for this is because doctors have acute knowledge of what happens in the end of someone's life and they don't want to be that decrepit person wasting away in a hospital bed.)

I could feasibly work with the disabled and the non-transmissibly sick... but as for the dying... I've never liked death.

This reminds me of a segment Dave Chapelle did on his new Netflix comedy special, he'd say that's a "brittle spirit". It's actually relevant here but minus the inappropriate context of the segment. Please go watch the special if you have time to spear and follow up.

Since it's relevant to the conversation, I'm going to post the message you sent after posting this, and respond to the whole thing.

that comment on "brittle spirit" did not come out the way I intended. The comparison I drew from you saying "maybe you don't want this" .. bc of A,B,C and negativity from some of the commenters - sounded like defeat. And I hate, hate for you to quit before you even started exploring. I read an amazing book titled, How we Die, By Sherwin Nuland- it's shaped how I think about medicine and the role of a physician. And I hope it helps you find beauty in this sort of service. The Dave Chapelle segment mocked a Louie CK accuser of having a brittle spirit, for quitting comedy because of this harassment, and he said imagine if MLK quit his civil rights dreams because of BS.

I personally think healthcare could use old farts like us who have lived whole other lives before making a decision to be a physician. I also think the stubborness in your character could be invaluable in patient care/advisement- but less productive working with other know-it-all physicians. I could also see you exploring frontier medicine- stuff that big pharma lobbies against- you are teachable, because you dare question the convention. You'll find so many reasons to want this the deeper you explore. That's all, I just wanted to clarify the comment, it was eating me inside. Don't quit- not yet- not until you've seen the ugly stuff for yourself.

I've seen a lot of ugly stuff on this forum. I looked up what you mentioned about being "pimped" in residency... and again, for me, it would be all about attitude. If the person firing questions at me really does have my best interests in mind and is merely trying to hone my knowledge without the slightest overtone of attempting to humiliate me in front of other people, I would be fine with it. I have been known to do similar things with students of mine, because then they get to recognizing what they have to work on. Of course, that's always in a one-on-one situation, so there's no chance of being embarrassed.

I'm going to continue exploring, and I do enjoy reading, so perhaps I'll be able to find time to read that book you suggested.

Honestly, I think I do just fine working with people who know more than I do. The situation that pops out in my mind was when I was a 19-year-old intern at a telecom company during the "internet boom" era. As the sole intern, all of my co-workers were full-strength employees, many of whom held master's degrees. Yet, nobody ever disrespected me. I was part of the team. I didn't know as much as they did, and I had far more to learn from them than they did from me, but I had a few surprises for them anyway. If that were my situation as a junior doctor, I'd be fine with it. I've been a teacher since age 6 (really) and my attitude has always been "If I know more than you do, that doesn't make me better than you. I'm offering my knowledge to you so that your knowledge can increase, so take advantage of it." - - if I got that, I'd be fine.

What was your career before becoming a doctor? How old were you when you started medical school? What is your medical specialty?

 

[CyrilFiggis]

That sentence was grammatically correct and it conveyed my intended meaning. That is how I tend to speak, when I have the time to make sure I am using proper grammar. How would you have worded the sentence so that it is still grammatically correct and identical in meaning to what I said?

I never said it wasn't grammatically correct. It's verbose and unnecessary. "Unfortunately, the last few days I was helping some elderly friends paint their house." FULL STOP. Wait until you are
rounding and you have to present a patient, you get maybe 5 sentences max - more likely 2-3.

You just don't get it, do you? Getting into a volunteer program is not the simplest step toward the goal, nor is it as simple as spending two hours to find such a program. The journey of a thousand miles may begin with a single step, but no wise person takes even the first step toward an undesirable goal. Therefore, what must be accomplished first is the determination of whether or not the goal is desirable. That's what I'm doing right now. Though many a past medical student may have decided on a whim that he/she wanted to be a doctor, and then just went for it, that isn't how I work. I imagine that such a cavalier attitude toward the profession is what has caused the rate of suicide among doctors to be as high as it is - people go into it with inadequate knowledge of what it's all about.

Actually I do get it. I'm a 30-something med student with a wife and family who had a 10 year career prior to pursuing medicine. If anything, I'm the archetype for your career and you should probably listen. I couldn't decide on a whim. You know how I determined if this was the correct goal. I VOLUNTEERED AT A HOSPITAL. I interacted with patients and families and nurses and MDs in the NICU, ED, Cath Lab and OB Suite. I asked residents about the training. I asked physicians about the changing landscape. I watched deliveries and C-Sections, gave compressions as part of the code team and consoled family members after a loved one died. I did that as a volunteer.

If you and I were interviewed at the same time about why we wanted to go into medicine, I could give experiential anecdotes while you would ramble on about being an empath with no genuine knowledge of the day-to-day. I did all this while working middle management with long hours. When I applied to my post-bacc, I had over 300 hours worth of determination. There was nothing flippant or cavalier about it.

Also, you need to watch yourself when talking about physician and medical student suicide. Some of us have lost friends to it. The reasons are multi-factorial and you have NO RIGHT to make such a glib statement about it.

Finally, I saw that you said STNA, which means you may be in a state like Ohio. I googled "medical volunteer ohio" and found in 30 seconds, 7 different websites to apply to volunteer at hospitals throughout the state. I also did a quick count and in your last two responses, you typed 2100 words. If you're a professional typists, that means that took you at least 30 minutes, probably closer to 45 minutes - 1 hour. I took 1/60th of that time and could be volunteering by February.

 

[xd42069]

Well if there's one thing that OP has shown in this thread, it's that he's not lying about being autistic.

He belongs on r/iamverysmart

 

[Magus5454]

Im shocked this thread is still going on. And Goro, you came back to it!

 

[arcus]

Any insight?

What dx and prescriptions have been given to you in the last 24 months and how compliant have you been?

serious question.

 

[deleted103644]

Sorry I missed this before OP got banned.

 

[Rcola23]

I found this thread last night. Fell asleep reading somewhere around the 500,000 word mark, woke up, continued reading during my morning constitutional and stopped at about the 750,000 mark, and I just finished reading tonight.

I read the Supreme Court’s opinion of the “Travel Ban” the other day - from all of the Justices - there’s a fair chance that was shorter.

Kudos to you guys who hung in there. I was giving high fives at the different mile markers.

 

[mjscal]

I for one could not make myself read all of this thread. I think I would find myself grinding my teeth if I ever had the misfortune to interview the OP.

 

[Goro]

I found this thread last night. Fell asleep reading somewhere around the 500,000 word mark, woke up, continued reading during my morning constitutional and stopped at about the 750,000 mark, and I just finished reading tonight.

I read the Supreme Court’s opinion of the “Travel Ban” the other day - from all of the Justices - there’s a fair chance that was shorter.

Kudos to you guys who hung in there. I was giving high fives at the different mile markers.

 

[Gfliptastic]

So why medicine for me?

1) My wife had three major surgeries in 2015 and there were many times when I was not impressed with the "bedside manner" of the doctors. Obviously they were competent, but they seemed somewhat uncaring beyond that. For example, I had a ton of questions and they didn't seem all that interested in answering them. Until payment system changes, it's often due to time constraints. You will also fine similar time pressure if you get to that phase

2) My wife and I have an "end goal" comprising the following, in no particular order:
-ability to travel when we want, and stay put when we want (we've been full time RVers and our next RV is currently parked in our back yard, awaiting transformation from its current incarnation as a school bus)

DO PLEASE SHADOW A FAMILY MEDICINE DOCTOR! Do you know what being a doctor entails??? It's very much "eat what you kill" so unless you also step up to some independently wealthy private practice, no work no $. I ABSOLUTELY enjoy road trips, hiking adventures, but if you even try to have a longer than 1 week vacation, in a group, it's going to take some doing. A month is like a fairy tale in 90% of the situations!
-ability to help people in need (we'd love to be able to do disaster relief, among other things, and I figure that being a doctor will provide not only necessary skills for such, but also enough money to be able to help needy people in other ways even if not medically)
Same as above? Unless a calamity happens in your specific neighborhood or block, do you think we can just get in the car and show up at a disaster and say, "I'm a doctor, I'm here to help." Doctors without Borders is another thing, but going back to previous point, you probably won't find a group that will let you go global.
-establishing a "commune" for the purposes of seeding some real change in the world (that requires money, and also it would be a huge draw if we could tell people "there's a doctor on site")... okay, I'm a hippie, I admit it!
-providing a good childhood for our son and whatever other children we may have in the future

3) I have the intelligence to handle it. Without bragging, let's just say that I recently saw an infographic on IQ distribution for medical doctors and I am significantly above the 90th percentile line. Also, my strength is natural science. (The other sciences, while legitimate, seem too abstract for my brain.) It does take a lot to practice medicine besides smarts, or even different kinds of smarts besides books; so even if you have an IQ that puts you above Stephen Hawking, don't call it a slam dunk

4) I'm a rather "young" 38, and I anticipate living a long life. It seems like everyone in my family, on both sides, who doesn't smoke nor get killed tragically lives a life of above-average length. So, even if I can't practice until I'm in my mid-40s, I'll still have plenty of time. And take it from me, I was 33 when I started medical school. When the hours start adding up, particularly during Intern year of residency, I wished almost nightly I was a little younger

5) Being a doctor seems to provide the ability to travel, especially if you are a family practice doctor willing to serve "underserved" populations. Those are my people. I've always been an "underserved" person myself, in many ways, and yet I grew up in an area that might best be called "overserved". I know the contrast, and I know what I like. Many years ago, I chose to get out of where I grew up and go to more rural places. So when I read that there is a high demand for doctors in rural areas, I realized that I wouldn't be short on work were I to go into this field. (Not to mention, I could do "locum tenens" work. There appears to be no shortage of such opportunities!) This is probably the best response so far. Rural docs are needed. Again though don't get it twisted that you are going to travel and even less so if you are the only doc in 100's of miles. You aren't there, no one sees your patients.

6) I believe I'd prefer family practice. I have nothing against specialists, but I can't see myself going to a hurricane-ravaged area and saying "I can help; I'm a radiologist" or "I can help; I'm a dermatologist". It would seem that "jack of all trades" family doctors would be of the most use at times like that because a wide variety of people are going to have a wide variety of medical needs. (The only specialty I can see being useful to the end goal is emergency medicine, so that's still on the table for now at least.) Since that's an area of "critical need" in the medical profession (at least now), it'd seem that there's room for me.

7) I've always been a bit of a hypochondriac, and my dad is even worse. People generally fear going to the doctor because they think they're going to get bad news. I believe I can deliver bad news in a way that people would be more likely to accept. Does that mean that they'll like getting it? No, but if you want to get better, you need to hear it. Having been the guy who is afraid of going to the doctor, and having known people who are worse, I could treat people accordingly. Look up SPIKES, it can be taught. Some people are better at it than others though, true.

8) I really want to be respected. Yes, there is a bit of vanity in this for me, but how many people go into a career field entirely altruistically? I've always been the type to work hard and become the best at what I do, and if I do that and still don't get respect (which is the way I have felt for years in my current profession), it's going to burn me out. At least when you're a doctor, generally speaking, people come to you because they want you to improve their health... so they're willing to listen to you. Are there some who don't listen? Sure. I've known a few. But they seem the exception rather than the rule. It's not what it cracked up before. Dr. Google will make a minority of your patients be no-it-all's so they will not value your opinion as much as you think because they "respect you".

Bolded the important thought, and I my thoughts which might require further consideration.

 

[akinetopsia]

I feel like I missed out having just found this thread.

I'm doing a re-watch of the Office on Netflix and OP makes Michael Scott look like a paragon of insight and selflessness.

 

[BabyDaddy]

HAHAHAHAHAHAHAHAHAHAHAHAHAHAHAAAAAA This thread!
Why do people who haven't even began this journey insist on making accounts on this site to brag about their genius? Baffling. I think I'll find the answer somewhere in the DSM-V

 

[RNtoMD87]

I just can’t imagine putting the time into making NUMEROUS threads as long as OPs. It’s like a full time job in itself.

 

[GenSurgONLY]

Thank you @Goro for your kind/well written post -- I don't think I'd have been as gentle. Seen more than a few of this type of deal come and go -- if they're fortunate enough to get selected into med school, usually they get dealt with before they hit clinical rotations. Otherwise, they usually get slapped down, hard, in front of their peers during rotations.

And we no longer say "non-compliant" -- we say "non-adherent" or "not adherent with the therapeutic plan" -- less traumatic emotionally for the patient....

I would like to ask, what is wrong with a bad experience with a doctor motivating someone to become a better one? Is that not a good reason to become a doctor? I ask because it definitely played a role in my decision to commit to a 16 year long “marathon” as SDN members like to say. Let me add, I had a C-Section, 3 times: the first was an emergency, the second was awful due to my bad scarring and the last one was the best(had an amazing surgeon, and he also has influenced my decision as well to become a doctor). Now, the first two c-sec(s) bedside manners were subpar and that’s being generous. The attendings came from elite schools and were probably sterling on paper but like Goro said, those come a dime a dozen. How one deals with patients is just as if not more important.

Why? Well, speaking as a patient, I was happier with my “fellow” from Egypt than the sterling attending from Harvard because he genuinely listened to my concerns and got his staff in gear, before the anesthesiologist knocked me out, I could hear my surgeon say,”Are y’all done laughing and joking around, we have a baby we need to deliver.” He said it in such a way, where the OR became dead silent, no pun intended.

So, I say this because for me personally, it left an impact on my life. He showed me that not all ER doctors are buttholes(I’m exaggerating but think you get my point). When I think about him as my doctor, I know that’s how I would like to be when I am a surgeon. I honestly will never forget him. There are some doctors out there that you just don’t forget and he was one of them.

 

[GenSurgONLY]

Not true. Given that you can't see into my mind, this is an assumption, and you know what happens when you assume. As for overcoming my Asperger's, I can no sooner do that than you can overcome your height or any other genetically determined condition you have. So whether you're a doctor or not, how about a little understanding here... this is a genetic condition, I didn't ask for it, and I play the hand I was dealt as well as I can. Yes, I'm going to miss certain things from time to time (usually "salient points" don't escape me), and I am going to state things in ways not commonly seen from neurotypical human beings. That does not mean that I am [insert pejorative term such as "narcissistic" here]. It means that I see things and say things differently. It's inappropriate to get on my case for this unless it can be proven that I am being dishonest. Let's say that you had a genetic condition which made your walking gait odd, though functional and not dangerous. Would you want to be picked on for that? Probably not. So for as much as you may think I need to check my ego, I think you need to check your aggression and insensitivity. (And this goes for a few others posting on this thread as well. By now we all know whom they are... or at least we should.)



Questioning does not equal arguing. Argumentative statements end in periods or exclamation points. If it ends in a question mark, it's an interrogative statement / question.



Funny. My primary care doctor finished our little interview thinking that I was in a fine place to begin medical study. He did ask me some questions.



Maybe it's not the right career path. One never knows without investigation. Another main motivator for the entire medical field, though not necessarily becoming a doctor, is to be there with my wife. She's always been inclined toward the "action" part of medicine while I've always been inclined toward the "knowledge" part of it. So, she's gunning for nursing school, and has stated that she doesn't want to be a doctor. I figure I could go for any spot in the medical field, and I have been investigating all of them. More on this later...



Whew... how to make this brief... well, first of all, you need to know that I believe the process of this change is going to take an amount of time exceeding the years remaining in my life even if I live to be a ripe old age. Therefore, one main motivator is figuring out what I'm going to do with the rest of my working years _before_ such change is completed. The establishment of the commune (which, again, is just a convenient term... one I realize is going to conjure up all kinds of inaccurate mental images in the minds of those who have not yet read my book) is not going to be a hard break from society at first. The break will come gradually over a period of years. Sadly, people will still be tied to the current money system for quite some time, and we all need to eat. So, really, the work in the medical field is still mostly for the "here and now" aspect of providing for the family. How it relates to the commune is that it would be a plus for people who'd be thinking about joining... they wouldn't have to worry so much about how they'd get medical treatment. This is an issue for people who live "unconventional" lives. My wife and I were full-time RVers for a while and they have the same problem... how to get medical care when they're constantly in different places and infrequently (if ever) near their "primary" doctor.



Perhaps... by this do you mean that even someone who completes all prerequisite courses which cover the material tested on the MCAT, receives all "A" grades in those classes, and then takes the MCAT relatively soon after finishing the classes (such that the material doesn't have much of a chance to "go stale" and be forgotten), and has always been a "good test taker", STILL runs such a high risk of performing poorly on the MCAT that it's a wise use of time to begin studying for it even before starting the classes containing the material that the MCAT covers?



Mistake count: 1. My posts do, in fact, end.



Mistake count: 2. If I didn't want help, I wouldn't ask for it because that would be a complete waste of time for myself and everyone who'd respond.



Swing and a miss for strike 3. (Good thing you're not a baseball player.) My ego isn't massive; I speak only the truth with no exaggeration nor diminution thereof. If we all did this, the world would be a much more pleasant and honest place, and nobody would strike anyone else as being either egotistical or lacking in self-esteem. And if all I wanted was someone who thinks I'm a great candidate, my primary care doctor already does... so why would I have to look for another one?



Cracks like this make me feel sorry for your patients. If you're doing this to show me what a terrible attitude people tend to develop after being doctors for a long time, well, you're succeeding wildly. I certainly don't want to get into a field, no matter how well it pays, which would turn me into a cynical, aggressive, mean-spirited, negative individual.



And what do you recommend I say? I'm actually being dead serious with this question - no sarcasm at all. I would like you (and/or anyone else reading this who thinks as you do) to cherry-pick some of what you consider to be my most "narcissistic" / "stubborn" / "arrogant" statements (exact word-for-word quotes please, not paraphrases), and reword them to sound like something that would not do me harm were I to say it to an admissions committee. In so doing, you will show me the kind of person who does well as a doctor, and if I cannot see myself being that person, I will bow out gracefully before making a huge and expensive mistake.



You certainly seem to understand exactly what I was looking for in terms of responses - dispassionate factual answers to my questions. You sound like the kind of person I'd want to be my doctor if I lived in your area... so "keep it up", as they say.

You're not the only person who has said what I quoted you as saying. I read an article last night which, when boiled down, comes out as "if you don't have a true burning passion for medicine, you will hate being a doctor because it's a crappy job in many ways". Combining all this with what I've heard from some people about how they never wanted to be doctors (though they did become PAs or high-level nurses), I have to ask - if there are so many negatives about being a doctor, and you can still work in medicine by being a PA / NP / nurse / et al., why do people become doctors instead of "stopping short" at the "mid-level" of being a PA / NP, or maybe even a lower level than that by being a non-practitioner nurse?



I wouldn't be bothered by unintentional non-compliance. The only thing that ever bothers me is intent. (This is universal for me. If I'm stuck in a traffic jam, I'm mad about the intent of the driver who caused the accident through his/her unsafe driving, or the intent of the person in authority at the department of transportation who thought it would be acceptable to do road work at peak traffic times on a well-traveled road. I get mad about a bunch of things but it always boils down to the intent of the person or people who caused the distasteful situations. When intent is purely honorable, bad stuff usually doesn't happen, but if and when it does, I'm not bothered by it.)

I'd imagine that failure to understand how to take prescribed medication would be due to ignorance of the patient (not intent), failure to ask the pharmacist how to take the medication, failure to ask the doctor all relevant questions, etc. Accidental - I don't blame people for "oops moments" because we all have them.



I guess that measures up closely to my ED experiences. I've been to an ED seven times (once as the patient, six times accompanying the patient) and not once was it for a life-threatening emergency... the worst situation could best be described as "this condition is not getting better, if it gets much worse it could be a real problem, we should get it addressed as soon as possible, but even if it continues for another day or two on its current trajectory, it's not likely to result in death".

But there are those times when the ambulance comes zooming into the hospital with lights on and sirens blaring... it'd seem that, at those times, a volunteer would likely be in the way.



Not surprising. When I asked the admissions counselor why they don't require the MCAT, she said that they did a study recently and determined that their "academic index" was a better predictor of performance in medical school, on the required tests such as the COMLEX, and "on the job", than was an MCAT score. I figured that maybe the MCAT is starting to go the way of the GRE. I once thought that every graduate program required the GRE, but so many of them are saying that GRE scores are not required. I guess I'll have to watch to see what happens over the years... the winds of change have been blowing in education as a whole, for some time now.



I hate politics. I wonder if there is any occupation that's free from "work politics".

Reason #1 - obvious to them, perhaps not to me, hopefully they would give the reason.

Reason #2 - if THEY don't know, I'd have to wonder how they're sure that it's a good thing. Just because someone tells you to do something, doesn't mean it's any good for anyone.

I could accept that #3 reason as long as it came accompanied by a promise to take an honest stab at the real explanation when next we both have the time for it to be given. My mom says that I've been asking "why" since I was one year old... it must be deep within my nature. I may sometimes have to tell my son "because I said so", but I expect that he'll accept that from me a lot better than I ever accepted it from my parents, because he'll know that the full explanation will come at the first possible moment.



Seems a mere semantic difference. To me the "right way" is the "best way", even if there is no truly palatable way for people to receive bad news.



In that case, what can you do? If you're forced to deliver bad news, you do it and if the recipient won't accept it, at least you tried. I have issues with doctors who don't give bad news when there is relevant bad news. For example, last week we found out that my wife's grandmother was diagnosed with metastatic bone cancer after landing herself in the hospital from having fallen at her house. The news hopped along the degrees of separation and got to me, but yet the grandmother herself had not yet been told... and as far as I know, she STILL has not yet been told! (She's experiencing a bit of senescence in her old age, but she'd still understand it in its entirety were it to be told to her.) The way I see it - at SOME point, she'll have to find out... why wait, you know?



By "I get it", what I meant was "I get how bad this news is and how you are likely to feel about its revelation", not that I understand every aspect of the situation. I wouldn't have to tell a woman that she'd been raped... she'd already know, or at least strongly suspect, that that were true if it happened. I wouldn't try to claim that I understand what it's like to have cancer. All I'd aim for is conveying the notion that I understand what a devastating blow it is to anyone, to learn that you have a condition that is as severe as terminal cancer.



Well, to me it appeared obvious, but I've been insulted and accused of all kinds of stuff on this forum for daring to believe obvious things that others find erroneous. Apparently there's a "right way" and a "wrong way" to conduct this research and try to develop this understanding. Far it is from all too many humans to respond to requests for information as you have.



That has to be one heck of a situation... going through medical school and residency, amassing all of that debt... and then burning out. I can only imagine what those people must think. But... it's good to know why they burn out. I don't think I could ever lose my empathy... I'd burn out before that happened. And I don't think I'd be inclined to fire patients when they become non-compliant... I've never fired a music student even for the most egregious non-compliance, because I figure that as long as that student is mine, I have the chance to affect positive change, either in attitude or musical ability, in that student. If I drop him/her, I lose that chance and there's no telling whether or not the person will seek a different teacher, much less one who would do better than I did at getting him/her to practice properly and have the right attitude. Generally, I keep my students because I don't want to lose the income that I get from teaching them... and because teaching even the most non-compliant student who is still willing to sit through a lesson really isn't a taxing experience. I could see operating the same way as a doctor. At least when you're a doctor, there are always more clients out there. Can't really say the same for music teachers. Everyone gets sick; not everyone aspires to learn music.



The information I've gotten on this subject has been so widely varied that I have yet to establish a consensus... hence why I keep looking for more. I'll never forget an adult student I had who was a PA, and he told me that not only did he have no desire to be a doctor, but also that many of the doctors with whom he worked said that they wished they were PAs. I read recently that NPs are soon to be required to get the DNP degree in order to be able to "practice"... do you think that the industry is going to shift even further, to the point where PAs and DNPs will be required to complete a residency where they're working insane hours in order to be able to practice to whatever extent they're permitted?



Yeah, too much of it... hence why I asked about a credible source. Internet searches tend to yield sources of widely varying credibility.



Are you referring to full-fledged practice, or residency?



Truthfully, this would probably be a deal-breaker for me. I need to be around for my son. Plus, my wife wants to have at least one more child, and we have no idea if / when that will happen (it took six years of "joy in the journey" to get the first one)... so whether it's one child or more than one, I can't be spending all of my quality time "at work" and arriving home exhausted with no time to spend with my kid(s). I've done 80 hours a week in the past and lived to tell the tale, but I was single.



By this do you mean schools that are located in Caribbean countries? And is it student attrition rates (meaning a lot of dropping out) or faculty attrition / turnover rates?



Tell me about this "match rate" thing. As I understand thus far, "matching" is where a medical school and a facility such as a hospital come to an agreement to place a student from that school who is soon to graduate or has already graduated, into a residency opportunity available at that hospital. Regardless of the accuracy of that understanding, does a "match rate" of 50% mean that only half of graduating students get placed in a residency? If yes, how would the "unmatched" graduates ever get a residency?



I did read that around the time that it happened. Personally I don't like that change, because people on the autism spectrum have so many different types of abnormal characteristics that it'd seem difficult to know how to treat someone if he had only the label of autism. It strikes me like a person asking for a prescription from a "telemedicine" doctor, and only telling the doctor that he's "sick". Okay, that's a start, but what kind of "sick" are you? What are your symptoms? The label of Asperger's helped people mentally select a subset of autistic characteristics that the person is likely to possess, and treat him/her accordingly. I don't see that term disappearing anytime soon, even if it doesn't get reintroduced when they go to DSM-VI (whenever that may be).

Having a son with Autism, I definitely agree! Each child in his class, is slightly different even though they ALL have been diagnosed. I would think that would make prescribing meds(if a parent chooses to go that route) challenging. He is non-verbal but he definitely does not communicate in such a way that someone who is not familiar with the disorder could understand. For example, “daddy finger, daddy bear” means I want daddy. “Mommy, mommy!” is typically when I am getting him dressed and he doesn’t like it. He loves water and getting into it any way he can. And our townhouse is set up like a luxury prison(baby gates, gas stove covers, outlet covers, cameras inside and out, no toys or tv in his room, bath stoppers removed, door locks and chimes, etc) because he will get into almost everything and is a flight risk. So, thank you Ring and ADT!

I can see why your personality seems to be “as a matter of fact”. Rigid structure is something definitely I can associate with Autism. My son is very “routine driven”; I am sure you are familiar with that.

And from a fellow PCP: he thinks this specialty offers the best work hours(he is also PP[private practice]. Residency is the long haul and the your rite of passage so expect the hours to suck but only for this short time. Honestly, if you make it that far then you can definitely suck it up and get it done.

And I agree with what the others have said, money is nice but can’t sustain your happiness. Now, as a former Accountant at a Big4, the pay was ok; finance is where the money is at but the stress is also high(however, stress is like time, a relative concept).

 

[Goro]

I would like to ask, what is wrong with a bad experience with a doctor motivating someone to become a better one? Is that not a good reason to become a doctor?.

By itself, wanting to be a better doctor than bad Dr X is fine. I've had several interviewees express this type of thinking. In a bigger picture, I've had a fair number of my students who were MD caliber attend my school instead because they weren't happy with the treatment they received from the MDs they saw.

BUT, the case is different with the OP. I'm not going to go back and read through the previous posts, but my recollection was that the OP thought "I'm smarter than this guy...I could do this!"

 

[RNtoMD87]

By itself, wanting to be a better doctor than bad Dr X is fine. I've had several interviewees express this type of thinking. In a bigger picture, I've had a fair number of my students who were MD caliber attend my school instead because they weren't happy with the treatment they received from the MDs they saw.

BUT, the case is different with the OP. I'm not going to go back and read through the previous posts, but my recollection was that the OP thought "I'm smarter than this guy...I could do this!"

And his whole post is him expressing why he’s a super human. Most narcissistic poster I’ve seen.

 

[GenSurgONLY]

By itself, wanting to be a better doctor than bad Dr X is fine. I've had several interviewees express this type of thinking. In a bigger picture, I've had a fair number of my students who were MD caliber attend my school instead because they weren't happy with the treatment they received from the MDs they saw.

BUT, the case is different with the OP. I'm not going to go back and read through the previous posts, but my recollection was that the OP thought "I'm smarter than this guy...I could do this!"

Ah! Thank you because I do feel personal experiences can shape you for the better. For me the unforgettable doctors and their commitment to health service invoke a passion in me. I had a Pediatrician keep working until her final days of life. She had cancer and never told anyone, not even close colleagues. All that time as sh cared for my children, she didn’t gripe. Here I was upset about my son’s possible diagnosis and she was literally dying right before my eyes.

Another great example of what a “good doctor” looks like. I will miss her greatly.

 

[Goro]

Ah! Thank you because I do feel personal experiences can shape you for the better. For me the unforgettable doctors and their commitment to health service invoke a passion in me. I had a Pediatrician keep working until her final days of life. She had cancer and never told anyone, not even close colleagues. All that time as sh cared for my children, she didn’t gripe. Here I was upset about my son’s possible diagnosis and she was literally dying right before my eyes.

Another great example of what a “good doctor” looks like. I will miss her greatly.

Strive to be like her.

 

[herdofturtles]

Holy narcissistic personality disorder batman!

This guy is like r/iamverysmart incarnate

That was certainly a journey I had no desire to go on... why, why did you dig up this thread? (jk, if nothing else it was entertaining)

 

[Astharia]

Who has that much time to actually type those responses?

With all the RV talking, traveling, holistic approach talk, my gut is telling me the OP is into "alternative medicine" and thinks he's smarter than modern medicine so he wants to get into it to prove us all wrong. I can't help but wonder if he vaccinated his LO.