A nasty account of a 3rd year clerkship!

[cholecalciferol]

For all those considering medicine check out this link for a first hand account of clinical clerkship

It is a rather negative account (the burning white coat!) but gives you insight into medical training. At least one should be aware of what one is going to face.
http://upalumni.org/medschool/

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[WishUponAStar]

Hello,

That webpage is well written, as in, it is interesting to read. However, It is written so disparingly that I find it to be a deliberate spin on the truth. Do those things happen? Yes. Do they happen with the complete hopelessness described? No. Reading that was like watching a bad soap opera. Overdramatized.

W.

Don't believe the way it is written.

Originally posted by cholecalciferol:
For all those considering medicine check out this link for a first hand account of clinical clerkship

It is a rather negative account (the burning white coat!) but gives you insight into medical training. At least one should be aware of what one is going to face.
http://upalumni.org/medschool/

 

[pogodo]

I agree it is quite negative, but I do believe it is true. I will be starting in August in medschool and I have worked for three years in PT. I know how most of the doctors acted and treated those under them and it sounded a lot like the stories that were written.

 

[babytrey99]

As a woman I am outraged, as a human being I am scared, as a future Dr. I am saddened. I don't doubt the validity of this site for a moment, which is what makes it so truly terrifying.

 

[wheatfarmer]

This cholecalciferol character simply likes to bash doctors...I think he is a chiropractic student or some "alternative practitionor". I have read his posts before.

 

[guylon07]

That was the most rediculous account I have ever seen. I would love the chance to actually talk to this person. I was a nurse for several years and I am starting med school this fall. If I had ever seen anything like that I would not have even thought about it. Well, as you can see this person did not need to be in medicine in the first place. I can say that the sight was a good fictitious read. I think that this person spent too much time reading about being a doctor than they did practicing being one. Like he said, he was going in with an attitude toward authority. Residents and attendings can see this and they will feed on it. I used to see students like this person every day, too smart for their own good. If this persons past credentials were correct he was brilliant, but I don't think brilliance makes a good doc. Smarts + common sense makes a good doc, and you could clearly tell by the stories that this person had no common sense. The stories were written as to always make this person look like a saint. The asthma kid that died amazed me (if it was true). He was always playing the patient advocate, but he let a child die so that he could take the time not to look stupid. Well, he needed an ass chewing.

All of you out there worrying, don't. This is not real life. However it is going to be very very hard. It is not going to be a cake walk. From my experience I say go in prepared and ready to learn and ready to give up part of your life for a while. That part of the story was acurate. And there are going to be bad days when people will yell at you. However, there are going to be good days where you will learn so much. It is not the everyday hell this author discussed.
Just remember you are going to have authority figures bringing down crap on you no matter what you go into. I worked as a drug rep for a very large drug comany before I went into nursing, and it was awful. I had probably 5-10 bosses and it rained down crap on me every day. It was terrible, I was awakened by calls at 5 am, we need you at this hospital this morning, or your doing this right this wrong, you need to pick up in this area, and then out of the blue "We need you to move to Orlando". I was putting in 10-14 hrs a day including the time I was wining and dining docs. I had no family life. I hated it. But I found that I love medicine.

Just remember it's just a few years, and you can handle anything for that longe, and UTILIZE THE NURSES, make friends with them. Don't ignore them. They can be a great asset for the med student and resident.

I admit I did not read the whole thing I could not take anymore of the drama or qoutes, but to all out there with no hospital or healthcare experience, don't take this as story as factual.

 

[Socceroo4ever]

I read some of the article that the first poster mentions. Primarily, I'm shocked some of this stuff happens, but I took it all with a grain of salt. For one thing, I am not myself even in med school yet, but I somehow can't see ALL of this stuff happening in one person's third-year rotations. For another, I'm wondering the validity of some of the author's statistics on abuse: any rational person would surely suspect that such widespread abuse would be spotted out in at least some areas.

All that aside, though, it seems to me this person has an agenda. I didn't read the whole thing, so I couldn't say if the whole diary seems to reflect this, but the Pediatrics and OB/GYN sections certainly did. My overall impression was that the diary was "created" to mask the agenda, to soften it up, perhaps. I even felt the diary was written AFTER the author decided to publish the agenda.

I may be making some carpet assumptions here, but frankly, the text didn't faze me. Rather, it's one of those things you pick up, read the first few pages of, and discard, muttering under your breath as "crap."

My two cents.

 

[travisco]

I read the whole book in pretty good detail. I don't think facts are being purposefully mis-represented, and I don't think the author has an agenda other then the re-form of what he thinks is a very disfunctional medical education system. That said, I do agree that the author is "thin skinned". As a vegetarian animal rights activist, he is an extremely sensitive emotional person. This isn't an bad thing. However the rotations he was doing were in extremely "embattled" hosptials. We're talking the real front lines of medicine. In this type of setting one has to have a hardened "lets get the job done" attitude. If the attendings took too much time out of their day to prolong patient visits, 10 hour workdays could stretch into 14 hours, or 16 hours. Imagine doing that for 10 or 20 years. Even the most humane doctor will start to burn out and just want to go in, do his job and leave. Those who thrive on patient interaction, and holistic care shouldn't work in a massive end stage disease and hard core trauma hospital. Every medical student may have to rotate through this type of setting. I know I will. I'm simply going to view it as "boot camp for my brain" and try to get through it despite it's unpleasantness. Anyway I thought the book was masterfully written and had some valid criticisms, like the whole pelvic exam issue.

 

[kundun]

I actually would enjoy working in that type of setting with those types of individuals..atleast you know where you stand without any sort of pretense or apprehension on your or their part...and one more thing, I like meat ALOT

[This message has been edited by kundun (edited 08-04-2000).]

 

[Doc Holliday]

Dr. Greger's account is not entirely far off base from the mainstay books on internship and medical school training that are out there (Marion, Klass, Konner, etc). I don't doubt that his account is laced with a lot of truth, it was the context that bothered me. A lot of his defensiveness seemed to resist conservativism in medicine rather than the mechanics of medical training... and it was done with a clearly liberal agenda. This is not a poor approach necessarily, it was just distracting to me. Once the political picture became clear I started skimming rather than reading.

Another book I had a hard time reading was "Her Own Medicine" by Sayantani DasGupta, MD. It's about an Indian American women (daughter of activist parents and feminist mother) going through med school at Johns Hopkins. A lot of the same overtones were present as in Dr. Greger's account.

People are always so genuinely surprised at how difficult and trying medical training is. With as much literature as there is out there, who can have an excuse for never seeing it coming? I really want the chance to treat everyone with respect and do some GREAT teaching when I'm in their shoes, but I fully expect to be emeshed in the militaristic combat zone of medical training. I'm preparing accordingly!

Just my .02!

 

[novadoc]

I haven't experienced rotations yet, but I really think it is dependant on the medical school and the hospital at which one does their rotations.

I just started at Nova Southeastern and I am amazed at the professionalism and humaneness of the faculty I have met. They drill it into you that the pt comes 1st. I have to do a clinical preceptorship at primary care clinics, starting in 2 weeks, so I am already getting my feet wet clinically {as opposed to starting at the 3rd yr, which can be overwhelming}. We even had a 'dissection debriefing' session with the psych staff after our first anatomy lab. I think that is important, since learning medicine can be a very cold experience that starts with the cadaver dissection. So, what I am trying to say is that it really depends on the attitude of the medical school faculty and their overall approach to teaching. So, some med schools have good programs, others lack in teaching 'humane' medicine. This author got the short end of the stick; IMHO, he's also overly sensitive.

------------------
Umee D.
Nova Southeastern Univeristy
College of Osteopathic Medicine
Class of 2004

 

[travisco]

test

 

[travisco]

I am attending Tufts right now. I am a first year student. Overall I am really impressed with the patient centered approach to education. We have a whole class that is centered around getting to know actual patients on the wards. We have a medical ethics course taught and directed by a DO. We have a student run free clinic for those in Boston who lack health insurance. Overall Tufts is very progressive. From what I hear, rotations in Boston's teaching hospitals are demanding. However, one definitely has to take Dr. Gregor's words with a grain of salt.
Dr. Gregor glosses over how Tufts responded to all of his complaints:

a.) The dean at Tufts forced the Surgery director to write Dr. Gregor and apology.

b.) The completely re-organized their OB/GYN department in response to Dr. Gregor's criticisms.

The above two factoids are actually in the book. Here something that I didn't learn until I got to Tufts. The school actually allowed Dr. Gregor to give a lecture to incoing first years about medical student abuse during there orientation. He did this during his fourth year. My source on this is one of those first years who saw his lecture.

I found it amusing that Dr. Gregor didn't mention this in his fourth year epilogue.

Dr. Gregor seems extremely dissatisfied with medicine as an institution. I guess that it didn't meet up to his idealistic expectations. Medicine is a conservative profession. It is folly to think that medical schools will be a liberal as an undergraduate school. For anyone else who has this misconception: UNDERGRAD IS NOT REAL LIFE!!! THE ATTITUDES ON TODAY'S UNDERGRAD CAMPUSES ARE NOT INDICATIVE OF THE REAL WORLD!!! Anyway there goes my public service announcement of the day.

On another note, I agree with Doc Holiday about the book having a political agenda. However I have a hunch that it goes beyond this into some personal issues that Dr. Gregor might have had with some of the attendings.

Example: Take a libratarian hippie medical student activist and a military trained republican surgeon, put them in the same OR, and make them work side by side for 60-80 hours a week. Shake well, stew for 1-2 weeks and presto! Watch the fireworks fly. Wow I think I just got a new sitcom idea!

Advice I have for anyone who cares to listen.
As a professional or future professional, leave your ego, stubornness, and personal philosophical/political baggage at the door.
You'll be working with people at random who could be you diametrically oppossed arch-nemesis outside of work. It's your job to work together and care for patients. Things will go much more smoothly if you stay professional and don't let things get personal.

I still think Dr. Gregor is a beautiful writer even if he isn't the best historian.

 

[drusso]

Many medical educators are simply waiting for the "old guard" to die off. New teaching methods, a greater appreciation of how to apply the principles of cognitive science to medical education, and a greater emphasis on psychosocial correlates of health have been slowly gaining a foothold in medical education. Young attendings and medical educators are aware of these trends---older physicians are resistant to them.

[This message has been edited by drusso (edited 09-18-2000).]