Anyone else not interested in being a great physician?

[southbelle]

Maybe I'm in the minority here, but I can't imagine donating 100% of my life to this profession. A little background first: I'm a traditional female applicant from the southeast. Well I have been working this year since college was over but I'm only 22 so that makes me pretty traditional. I'll be going to a state medical school here in 3 or 4 months. I probably could have gotten into a 'top' school, but just wasn't interested in it. In fact, it was the only school I applied to. I've been thinking about a potential speciality, and anything surgical is out because I don't have any interest in working hard long hours to perfect delicate procedures. I'm also not very good with my hands and don't think I'd be very good at it. Dermatology sounds allright but there is no way I'm going to work hard enough in medical school to be competitive for that. I'm not interested in pursuing research opportunities or 'making connections' in such a field. Radiology sounds allright, but it seems a little too high-tech driven for my tastes, is also somewhat competitive than not anything like derm, and I don't think I'd be a perfect fit for it. IM is out because of the call schedule and the general mediocrity of the lifestyle, along with the fact that it basically seems like geriatric medicine and that's not what I'm interested in.

A few others:
neurology- I think too many people go into this field who are really gung ho about neuroscience and I don't think I would fit into that mold. I like the non-procedural nature of it, but it also seems a little depressing.

Fp- Too much variety. Sometimes the lifestyle is only mediocre. I don't want to be known as the 'good ole doc'. Also the hassle of running a practice would drain me.

gas- a little too procedural for my tastes. plus I don't want to be in the OR.

Pathology- A possibility. I'll have to see how I can deal with handling tissue and spending time in the lab. Good hours, no procedures. But the smells of the autopsy room would probably not be great for me. Perhaps it would be a good fit if I eventually got a job in a community where I didn't have to gross in surgical path much and could just be a slide monkey.

EM- I like the length of the residency, and the shift work hours. However, I would hate being in the ED.

[email protected] another decent possibility. I don't know much about this but it sounds ok.


But occupational medicine.......that seems like the ticket. Pretty noncompetitive so I wouldn't have to work hard coming from a decent american allopathic school to get a spot. Great hours and good lifestyle. No prestige but I don't really care about that. I could see myself doing a lot of physicals and tending to employee/employer health related issues. The money is not good for physicians(150-175k for most) but I'm going to a state school, the residency isn't that long, and I wouldn't have to worry about fellowship training or anything. And 150k still is a nice lifestyle in many communities, especially if I marry a professional man. Basically I would make mid/upper level executive money without all the pressure and competition, and it would be pretty much a guaranteed gig. I could even supplement my income by maybe working as a physician who reviews online prescriptions or something. Or maybe one of the physicians who works for a major HMO company and is on call to decide whether or not certain employees/patients get approval to go to the ER. Basically, I'm not looking for a lot of variety, challenges, or interesting pathology in my career, so occupational medicine seems like a perfect fit.

But I didn't want this post to be about comparing different specialties as that would probably be more appropriate for another forum. Mainly I'm interested to see if anyone else is going into medical school with the attitude that they aren't going to 'give 100%' and try to make AOA. If I did just mediocre in preclinical grades, scored 210 on step1, and then put up a lot of B's and C's(or P's) during my core rotations I wouldn't be dissapointed. I'm not trying to be demeaning to those who are gunners, but I was a semi-gunner in college, by my stats at least, and that's over for me now. My goal is just to do enough to comfortably pass and slide into a benign occupational med(or pathology or pmr) residency. I wake up at 615 now every morning, and I'm tired of it. I think it will be possible to get through medical school, at least years 1 and 2, putting a lot less energy into it and having more time to do stuff I like than my current job allows. In that respect, I'm looking forward to medical school. Sometimes I read this board and it seems like I'm the only one who feels this way. I can't be right ?

 

[Megalofyia]

All I can say is I wish you were in my class. I am sure there are many others like you but probably not alot here on SDN.

 

[MErc44]

i feel the same way, I like surgery, especially orthopedics, its interesting and the money is good but I don't like the idea of the long hours especially in residency. I will have time in med school to decide what I like, that's why I want to do well but there is no way in hell I am giving up my last two summers ever to do f%cking research, I already did two years of that in undergrad. If no research keeps me out of ortho that will be too bad.

 

[SunnyS81]

I wanted to comment on a few things

1) What is mediocre lifestyle? Making less than $200k?
2) Procedures = money.
3) For the most part, procedures = not lifestyle = more time working (surgery, cardiology, etc.)
4) Lifestyle or Money (and especially both) = competitive.
5) Residency lifestyle isn't lifestyle in practice. I know very few IM's who complain about their call schedule.

So if you don't want procedures, and you want lifestyle and an easy field, let everyone know when you find that specialty because i'm sure everyone is dying to know.

Maybe you would prefer to be a P.A. or N.P.?

P.S. I think ortho is cool too, but I've seen my cousin's call.....chaos is all I can say.

 

[exmike]

Noone said doctors have to save the world or discover earthshattering procedures and treatments. Even if you life the lifestyle you want, you'll still be making a contribution as a physician. I think a lot of people on here are very idealistic. Some people just want a comfy lifestyle, and that is perfectly fine.

 

[underAchiever]

Maybe I'm in the minority here, but I can't imagine donating 100% of my life to this profession."
Have you ever considered second grade substitute teaching? Medicine, by nature, seems like an all-or-none affair.

 

[southbelle]

I wanted to comment on a few things

1) What is mediocre lifestyle? Making less than $200k?
2) Procedures = money.
3) For the most part, procedures = not lifestyle = more time working (surgery, cardiology, etc.)
4) Lifestyle or Money (and especially both) = competitive.
5) Residency lifestyle isn't lifestyle in practice. I know very few IM's who complain about their call schedule.

So if you don't want procedures, and you want lifestyle and an easy field, let everyone know when you find that specialty because i'm sure everyone is dying to know.

Maybe you would prefer to be a P.A. or N.P.?

P.S. I think ortho is cool too, but I've seen my cousin's call.....chaos is all I can say.

1) I only consider $$ to be one part of the lifestyle equation. Total # of hours and # of hours on call as well as predictability of shifts and vacation time represent a significant portion of the lifestyle component. I said IM had a mediocre lifestyle not just because of the mediocre salaries but because of the poor residency hours and the mediocre hours after residency.

4) Of course. That's why I won't be going into a field like derm(lifestyle + money). I'll leave derm, radonc, and IM spots at Hopkins to you guys

5) Other people have told me the same thing about IM physicians, but when I've had family members who were sick and I was around the hospital for periods of time I would see plenty of them rounding at 7 and 8 in the evening. At 8 oclock I want to be drinking a glass of wine watching a movie. Or at a restaurant. Or going shopping. Or making sure my child does his homework if I have a kid. I guess it's very physician dependent and whether you do a lot of inpatient care.

As to the last point, of course I want lifestyle and no procedures, but I think we have slightly different algorithims for determining lifestyle. If I could work in occupational medicine working 40 hours a week making 150k this would be a good lifestyle for me, whereas others who place more value on $$ would probably not think so. As for NP and PA, the ones who work in primary care in this area make 65-75k working normal hours in pretty relaxed setting. That's a long way from the average salary for [email protected] and occupational medicine. And to do an NP I would have to take a lot of nursing classes(at least 2 maybe 3 years to get a BS RN), work for a few years as a nurse, and then go to NP school(2 more years?). Since I'm already into the medical school I wanted to go to all along I think it makes much more sense even from a time standpoint to go to medical school.

 

[jlee9531]

Maybe I'm in the minority here, but I can't imagine donating 100% of my life to this profession."
Have you ever considered second grade substitute teaching? Medicine, by nature, seems like an all-or-none affair.

2nd grade substitute teaching is one of the hardest things to do...

 

[(nicedream)]

This is a great thread - kudos to SouthBelle.

 

[Zweihander]

Medicine, by nature, seems like an all-or-none affair.

Depends on what you go in to. There are quite a lot of fields which are not, in fact, "all-or-none."

 

[jlee9531]

haha i better leave this thread since my reasons for medicine clash with your reasons...

farewell.

 

[N1DERL&]

jlee9531: you beat me to the punch, I was just going to say that!! subbing or teaching... both tough!

 

[southbelle]

Maybe I'm in the minority here, but I can't imagine donating 100% of my life to this profession."
Have you ever considered second grade substitute teaching? Medicine, by nature, seems like an all-or-none affair.

How so? And no I haven't considered second grande substitute teaching. I have considered teaching 8th grade language arts and have done so now for 7 months. It's hard work. What's your point?

 

[EvoDevo]

Nice thread. Refreshing to hear that not everyone wants to be a gunner. And I think that you're being very smart about understanding what you want and will be happy with. Too many people will choose a specialty/field for $$ or whatever, and because it conflicts with their personalities/goals, they will be miserable bastards.

Good to go!

 

[DW]

Depends on what you go in to. There are quite a lot of fields which are not, in fact, "all-or-none."

Right on. I'm not even done with my first year and I absolutely guaran-damn-tee I wont be letting medicine engulf my entire life after residency, I dont like anything in this world enough to cut off having fun with my friends and family. If I dont make a ton of money as a result, so be it.

 

[TheRussian]

To the OP: Your lack of passion for medicine is incredible. I guess a majority of people hate their jobs but why would you be willing to jump through so many hoops to end up in a job about which you don't care? There are plenty of other areas of employment that don't require you to work nearly as hard that you can not care about as much as you don't care about medicine.

From what you wrote is sounds like you will not enjoy any of your required rotations considering none of them are occupational medicine. It also doesn't seem like the first two years will be enjoyable either. Why are you planning on spending 4 years in misery so that you can get a job that you won't like? Seriously, go for second grade substitute teaching or if they are too young for you try third grade.

 

[Fumoffu]

There are more important things in life than just career.

I don't particularly want to be a "super" MD either. I just want to get into primary care and make a difference in an underserved community.

I'll leave the research and academic teaching for the gunners.

 

[asdasd12345]

its refreshing when someone comes along with a "who gives a flying fack" attitude, really isnt prepared to even put 100% into the profession while there are countless applicants refused admission who are ready to sweat blood to make other people healthy. its inspiring.

 

[Gleevec]

I'll leave the research and academic teaching for the gunners.

Yeah, and who is going to TEACH you about medicine? A "gunner." Without these "gunners" who are "gun" so much that they sacrifice a higher salary in order to pursue their own intellectual interests (related to pushing the fronts of medicine so that some diseases whose patients unfortunately die now may live in the near future) and to teach the next generation of physicians, medicine would be nowhere.

 

[Zweihander]

its refreshing when someone comes along with a "who gives a flying fack" attitude, really isnt prepared to even put 100% into the profession while there are countless applicants refused admission who are ready to sweat blood to make other people healthy. its inspiring.

It's perfectly alright to not want this field to take up every aspect of your life. However, based on her posts, I think the OP's thread title is poorly chosen -- it seems that rather than not wanting to put the effort into being a "great physician," she doesn't feel the need to be a straight-A student in med school.

I should hope that everyone who is going to be dealing with patients actually wants to do the best job they possibly can (though I know that's not the case), and I didn't understand southbelle as trying to say otherwise.

 

[southbelle]

To the OP: Your lack of passion for medicine is incredible. I guess a majority of people hate their jobs but why would you be willing to jump through so many hoops to end up in a job about which you don't care? There are plenty of other areas of employment that don't require you to work nearly as hard that you can not care about as much as you don't care about medicine.

From what you wrote is sounds like you will not enjoy any of your required rotations considering none of them are occupational medicine. It also doesn't seem like the first two years will be enjoyable either. Why are you planning on spending 4 years in misery so that you can get a job that you won't like? Seriously, go for second grade substitute teaching or if they are too young for you try third grade.

I think a lot of people in medicine assume that other professionals don't jump through a lot of hoops. I've had to jump through a lot of hoops the last 8 months teaching language arts. Most professionals do.

And it's not that I won't care about my occupational med or pm&r job. I'll probably enjoy it and I'm sure I will enjoy it more than many other things.

Will I enjoy any of my rotations? I don't know, but I know I have to get through them, and I know it will be important to learn on them and gain valuable experience. If you read my initial post you will see that I am looking forward to the first two years of medical school because it will give me the opportunity to set my own schedule to a greater degree and have more free time(I absorb information very quickly and am very good at memorizing).

And I don't think a 4 year occupational med residency would be misery. It's a job. I'll be a resident with certain responsibilities and I think I will manage to get them done. But I don't think occ med residents are at the hospital at 8pm most of the time either(Im guessing a pgy1 transitional or IM year is required. That would be unpleasant but oh well)

And this is the second time substitute teaching has been mentioned?? People just don't decide "hmmmm....should I become an MD or make $60/day as a substitute?". C'mon. The lowest paying jobs in medicine pay 140k or so per year. Substitute teachers make about 12-13k/year. ($60/day in my district x 180 days). Lifestyle is important to me, and on 150k or so my lifestyle needs can easily be met. They can't at 13k. Not to mention the fact that I'm a teacher now, so I'm not sure why I would give that up to sub? (Nothing against subs, some are very good)

Thanks to the posters who are being supportive!! I think a few people are misinterpreting my statements. I don't intend to ever be reckless when it comes to patient care. If I do occupational medicine I plan on doing a satisfactory job. My point is that I don't want to be on the front lines of healthcare; I don't want to be placing emergency stents or tending to patients during a GI fellowship at 11pm or smiling at 55 people coming through an fp clinic everyday or doing summer research so I can try to get published to have a shot at derm.

 

[Mr. Rosewater]

i think some pple may take the OP's position negatively b/c some of the wording used here is a little emotive. for instance, if the OP said "i have modest goals that include mantaining a balanced life" pple probably wouldn't have any problem w/it. however, the title of this thread indicates someone who would be happy as a subpar doc. i don't think anyone would really be happy w/ that, and i don't think that's what the op was driving at.

oops, op already clarified her position at the end of the last post.

 

[freaker]

I don't want to sacrifice myself to my career completely, anyway. I want a family. Three kids. Vacation time. A good ole dog and some time to toss a frisbee.

But medicine isn't as bad as some other fields. Try being a lawyer and taking a three week vacation. Or better yet, try disappearing from the office for a week without calling in almost daily, if not doing work in your "spare" time.

Things could be far worse.

And my primary reason for choosing medicine is that I want to be able to use some of that vacation time for the benefit of society. I definitely plan on doing medical mission work in the third-world, even if it's only for a week or two every few years. Bill Frist is totally my role model. To take on the responsibilities that he does, and to weild the power that he does, and yet to also take his time to give back.

That's where you're going to be proud to be a physician--when you step outside the grind and use an amazing skill that you've spent years developping using talents that you've been blessed with in a way that others would if they only were able.

I think it's peds for me. Love kiddos. The money ain't the greatest, but man, sunsets are free and kids are awesome. Just watch out for the parents.

 

[Gleevec]

"Pretty noncompetitive so I wouldn't have to work hard coming from a decent american allopathic school to get a spot. Great hours and good lifestyle. No prestige but I don't really care about that. I could see myself doing a lot of physicals and tending to employee/employer health related issues. The money is not good for physicians(150-175k for most) but I'm going to a state school, the residency isn't that long, and I wouldn't have to worry about fellowship training or anything. And 150k still is a nice lifestyle in many communities, especially if I marry a professional man. Basically I would make mid/upper level executive money without all the pressure and competition, and it would be pretty much a guaranteed gig." -- SouternBelle

So basically you want to do the least amount of work possible, really dont care about the patients, the science, or the field, and you consider 150k a year merely a "nice" lifestyle.

How is this supposed to be commended? You're saying you basically chose medicine because it allows you to slack off and make a ton of guaranteed money. Gimme a "gunner" who actually is interested in helping patients or is intrigued by the field from an academic perspective, or at least wants to teach the next generation of physicians, any day of the week.

 

[midlifecrisis]

Any one who thinks teaching'd be easier is tripin' hard. Unless they spent a bunch of time around some jaded soon to retire bidin their time types....
And substitute teaching, thats like closing your hand in a car door over and over for 50$ a day.

So Southbelle, what about primary care relief work, you name the time, you've gotta be flexible about location, but you focus on work for a given time, and retreat into wine drinking at home for those periods in between. Basically a seasonal type job. You choose the amount of work which determines the $$$. Pretty good lifestyle, extended time for travel or recreation or family. And those breaks leave you psyched for work when you go.

 

[asdasd12345]

yes, i agree lets applaud her for her goal of medicority and hope she manages to "slide" through medical school. I mean we wouldnt want her to actually try hard would we? i mean its not like shes going to be dealing with other peoples health is it? lets hope she can find a "professional man" to marry so she wont have to worry too much about the patients she has, because god help us, it might interfere with the "good lifestyle".

 

[10minutes]

My goal now is to get into the residency program I want. After that, I'll think about what to do. But I definitely care about the life outside of medicine and I do not want to work all the time.

 

[southbelle]

its refreshing when someone comes along with a "who gives a flying fack" attitude, really isnt prepared to even put 100% into the profession while there are countless applicants refused admission who are ready to sweat blood to make other people healthy. its inspiring.

I understand where you are coming from, but I'm not the one who sets admissions criteria to get into medical schools. I only applied and interviewed at one school, so I didn't take many interview spots from the countless applicants who are ready to 'sweat blood'. I do think that academically qualified students who are ready to 'sweat blood'(and have shown this through their activities) do very well in this process and get into medical school.

 

[asdasd12345]

why bother? if a jobs worth doing, its worth doings well. why only put in half the effort? if you really dont think you can be bothered enough to put in 100% then why do it? it boggles the mind.

 

[kikkoman]

I'm going to have to side with gleevec and asdfasdf12345 (nice name btw) pretty adamantly. Not only is SouthernBelle's attitude "not to be commended" it is irresponsible, dangerous, and anthetical to medical ethics. Physicians are entrusted with the lives of everyone else in the community and mistakes can lead to misdiagnoses and irreparable consequences. This isn't rare - I, probably along with many of you, know someone who was misdiagnosed by a poorly trained physician, and really really suffered.

Yeah, mediocrity can be fashionable, especially with the load of obnoxious premed gunners, but it just can't be excused or lauded when you are dealing with peoples lives.

I thought the original post was a joke (especially towards the end), and although taking on a lower patient load or "sacrificing" less of one's life to the pursuit of medicine is understandable - skimping on basic training, and adopting a blase attitude towards gaining essential skills you need to sustain other people's lives is outrageous.

For the love of god, won't more people agree with me here?

 

[Zweihander]

For the love of god, won't more people agree with me here?

You guys are totally ignoring the OP's point that she "doesn't intend to be reckless with patient care." As others have already said, her initial phrasing was poor, but the idea is that she doesn't want to bust her ass in medical school and cut out everything else from her life. And you know what? That's okay.

I don't think anyone here is trying to support the idea that it's fine to be an irresponsible or dangerous physician, but I can tell you right now that perfect preclinical grades don't mean a whole hell of a lot for you professionally. Frankly, if you can't bust out all the steps of the TCA cycle and draw an amino acid on demand, your patient probably isn't going to die.

edit: The impression that I've gotten from talking to older students is that the professional skills you learn and which will be crucial to you are picked up in residency. Presumably, no medical school will let you get that far if the initial phases of building up a base of medical knowledge have not been completed satisfactorily. Point: even a "slacker" has to learn a certain amount of information to make it through medical school. If you get to your residency though, and you start being flippant about your patients' health or about learning the information that you need to treat them appropriately, than you're bad news.

 

[southbelle]

So basically you want to do the least amount of work possible, really dont care about the patients, the science, or the field, and you consider 150k a year merely a "nice" lifestyle.

How is this supposed to be commended? You're saying you basically chose medicine because it allows you to slack off and make a ton of guaranteed money. Gimme a "gunner" who actually is interested in helping patients or is intrigued by the field from an academic perspective, or at least wants to teach the next generation of physicians, any day of the week.

I browse this forum often and having read your posts before would have expected a more reasoned viewpoint. When did I say I didn't care about the patients? Occupational health physicians don't care about the patients they are evaluating for insurance purposes? Maybe some don't, but that's not relevant to me. PM&R physicians don't care about the recovery progress of a stroke victim?

Do I not care about the science? I don't care about advancing the field of any medicine in any way through research. Doesn't mean I'm going to be a horrible physician. I did enough research during undergrad to know it's not for me.

Do I consider 150k a nice lifestyle? Sure. I think most people would. It's nice. Above average for an american family and well above average for individual wage earners. Is it super extravagant? No, and I think most people would agree with that. Which is good because I don't need fancy boats or vacations to tahiti.

Finally, I wasn't really looking to be commended. Just to see if there were other people who feel the same way I do. The 'gimme a gunner' part of your post isn't neccessary. Who says their can't be plenty of room for both? I have absolutely nothing against gunners and/or people who love the science of medicine. I appreciate the work academic physicians and mstp types will continue to do as I understand how important it is. It's just not me and I don't think my desire to work as an occupational medicine physician or something similar should bother academic physicians and people who are really passionate about medicine. I'm not preventing them from doing their thing.....

 

[midlifecrisis]

I'm going to have to side with gleevec and asdfasdf12345 (nice name btw) pretty adamantly. Not only is SouthernBelle's attitude "not to be commended" it is irresponsible, dangerous, and anthetical to medical ethics. Physicians are entrusted with the lives of everyone else in the community and mistakes can lead to misdiagnoses and irreparable consequences. This isn't rare - I, probably along with many of you, know someone who was misdiagnosed by a poorly trained physician, and really really suffered.

Yeah, mediocrity can be fashionable, especially with the load of obnoxious premed gunners, but it just can't be excused or lauded when you are dealing with peoples lives.

I thought the original post was a joke (especially towards the end), and although taking on a lower patient load or "sacrificing" less of one's life to the pursuit of medicine is understandable - skimping on basic training, and adopting a blase attitude towards gaining essential skills you need to sustain other people's lives is outrageous.

For the love of god, won't more people agree with me here?

If it means doing a crappy job at school than residency then work, sure I'll agree with you. But if the thread started as a poorly stated version of, "I want a cool job and a cool life, and to get there with my sanity entact" I think thats ok. Depends on how literal you need to be.
I've been to some pretty lame doctors, and I have no idea whether they once were passionate about what they do. I've been to others that were obviously much more passionate about their paychecks then their patient care. Did they start out idealistic? Who knows. Give the jaded post gunner undergrad a break....maybe her laid back approach will result in less of an elitist attitude toward patients and better patient care. Who knows.......

 

[Lion-O]

I gotta say, I feel a lot of what southbelle is talking about. I think a lot of posters are making this into an "all or nothing" thing. Just because someone doesn't want to devote her entire life into excelling in a field doesn't make her bad, or even weird. Not everyone can be the absolute best; positions are needed at every gradation of rank and skill.

If southbelle simply wants to take lower position that she's happy with, how does that hurt anyone else? All it does is leave one higher ranked spot open for the person that truly wants it. Someone has to be in occupational medicine, why not her? I say better her than the gunner who was delegated to it because he/she couldn't make it higher.

Of course, I am biased because I am basically the same. As I'm sure is true with most people going to medical school, I've worked pretty hard all my life, and have succeeded most all my life. But then I sit in my lab and see my advisor work 100 hours a week with her child at a babysitter; and she is perpetually stressed out. Or I listen to my history professor always talking about her next paper, her next book, or her constant departmental political struggles.

Then I look at my instructor for O chem. Yes, he is a Senior Instructor with a PhD. No research, just teaches. You know what? He's the happiest person I've ever met--genuinely. He always has little anecdotes about life, his family, and all the interesting experiences and reading he gets to do with the other half of his life. He made the choice to forget prestige, and focus on what he thought was important. Does this mean he isn't good at his job? Of course not, he's been one of the best instructors I've had.

I'm not saying one way is right, and the other is wrong. I'm just saying that there are two ways. I don't think it's fair to judge people for choosing one of the other.

 

[kikkoman]

Frankly, if you can't bust out all the steps of the TCA cycle and draw an amino acid on demand, your patient probably isn't going to die.

Well, good, that's true. I see that hyperbole has not escaped you - forgetting the structure of alanine will not, in fact, cause all your patients to die.

What about the student who "slides by" his human disease classes? A couple of rare diseases here and there, that won't make a difference will it? Why learn about diseases of the cornea if you are set on being a dermatologist? Or why learn about skin diseases if you are going to be a radiologist? Does southernbelle have a detector for what information she needs to know so she "won't hurt her patients," while conveniently spending less time on the extraneous information?

I amazed that medical school students feel that they have the authority to determine what they "should" know to become a good physician and what they "don't need to know."

The medical profession is complex, and you will probably encounter some situation in your 40 year (+/-) career that you could have never anticipated. And the more prepared you are, the better you will be able to deal with that situation. It's hard to make the argument that a mastery of the material will hurt your patient, and it's much easier see how a casual approach to medicine will.

 

[southbelle]

I amazed that medical school students feel that they have the authority to determine what they "should" know to become a good physician and what they "don't need to know."
.

I don't feel I have that authority. The authority comes from the usmle steps 1, 2, and 3. It determines what I "need to know" and at what level I need to know it.

If I work for an agency or large corp. examing disability patients or workers comp claims, I'm going to get fired if I perform so far below expectations that they feel they could replace me with someone better. That's the way our system works. I think a few people have this idea that 15 years from now I'm going to go into my office, read the newspaper for an hour, download some tunes for another hour, and then take a 2 hour nap on my office sofa. Then at 12:30 I might get around to putting my signature on a few papers. If you are under that impression then you haven't been following the thread. I'm simply going to find a situation in which I feel comfortable, am not working overly hard(but still working a fair amount), and don't have to see large volumes of patients if I don't want to(I don't know on what level I want to see patients yet). I understand that $$ will be sacrificed.

 

[Zweihander]

Well, good, that's true. I see that hyperbole has not escaped you - forgetting the structure of alanine will not, in fact, cause all your patients to die.

What about the student who "slides by" his human disease classes? A couple of rare diseases here and there, that won't make a difference will it? Why learn about diseases of the cornea if you are set on being a dermatologist? Or why learn about skin diseases if you are going to be a radiologist? Does southernbelle have a detector for what information she needs to know so she "won't hurt her patients," while conveniently spending less time on the extraneous information?

I amazed that medical school students feel that they have the authority to determine what they "should" know to become a good physician and what they "don't need to know."

The medical profession is complex, and you will probably encounter some situation in your 40 year (+/-) career that you could have never anticipated. And the more prepared you are, the better you will be able to deal with that situation. It's hard to make the argument that a mastery of the material will hurt your patient, and it's much easier see how a casual approach to medicine will.

Oh, I agree with you, and ideally I'd like to take everything I learn with me to residency and retain it for life. However (and I am truly saddened by this) most of what I learn in medical school I will forget. Happily, residency exists to impress upon us all of the information that we *really* need to know and remind us of the important things we've forgotten, and years of practice should make all of that become second nature.

Maybe I'm being naive, but I should think that with all of these checkpoints and exams along the way, someone who is dangerously incompetent will not make it through. That's why standards exist, after all.

As far as medical students' ability to discern what they need to learn and don't need to learn, I don't know if you're in medical school but in my experience that's just good study skills. Part of being a successful student is being able to discern the important stuff from the minutiae -- not so you can ignore the minutiae utterly but so you budget your studying appropriately. That, and faculty make a pretty strong effort to highlight what is really important.

 

[TheRussian]

Obviously southbelle does not intend to harm patients and will not (I hope) act in an irresponsible manner towards patients but as she said

"If I do occupational medicine I plan on doing a satisfactory job"

The problem with this philosophy is that you don't try as hard as you should and are satisfied with doing a satisfactory job with your patients. Perhaps you can go through your career without causing any patients any harm but perhaps you'll get a patient that you will treat "satisfactory" and because you are not trying as hard as you should you'll miss something and cause the patient more harm then good (I hope this makes sense)

Why would you want to strive for mediocrity? I mean don't you have self-pride and pride in your work? Even if you end up being mediocre at least you put your best forward and work hard at it.

It seems that you believe that those that strive toward a higher goal sacrifice their personal lives. While this may be true for some, it definetely not true for all. Being the best you can and having a life outside of work are not exclusive. You can have both.

 

[kikkoman]

I don't feel I have that authority. The authority comes from the usmle steps 1, 2, and 3. It determines what I "need to know" and at what level I need to know it.

But you said you just wanted a low score on the boards. So, by your own reasoning, wouldn't you say that you would know less of what you "need to know?"

Additionally, I think confining the material that you need to make the best decisions as a physician to the material that is on the boards is a bit short sighted - a motivated student in medical school hopefully picks up a lot more than that.

Sorry for being so hostile, this one just really struck a nerve.

 

[kikkoman]

Maybe I'm being naive, but I should think that with all of these checkpoints and exams along the way, someone who is dangerously incompetent will not make it through. That's why standards exist, after all.

Agreed, but absolute standards cloud the reality that there are gradients in ability among physicians. The "dangerously incompetent" might be "weeded" out, but the mediocre could still slide by and do significant harm.

 

[Sharkfan]

Guys, this thread was started by an exposed troll. It/he/she might be for real, but it/he/she has been caught in a few whoppers. Do a search.

Interesting topic, but ignore the troll/compulsive liar/flame starter.

 

[Zweihander]

Agreed, but absolute standards cloud the reality that there are gradients in ability among physicians. The "dangerously incompetent" might be "weeded" out, but the mediocre could still slide by and do significant harm.

Fair enough. But I think these are beginning to be separate issues. Wanting a life outside of medicine is not tantamount to gunning for mediocrity.

 

[kikkoman]

Being the best you can and having a life outside of work are not exclusive. You can have both.

Definitely agreed. Cutting patient load seems to be a pretty straightforward way to do that. Compromising one's ability as a physician, not so much.

 

[mellantro]

But you said you just wanted a low score on the boards.

I'm sure she doesn't want a low score, but if she gets like a 210, she's not gonna be devastated like other people would.

I mean she has to work hard in medical school in order to pass, that's a given, she's just not gonna kill herself doing so. I think it is kinda refreshing to actually hear someone post something that alot of people probably think about. Sure, it isn't the PC answer, but it sure beats hearing people go on and on about the field of medicine through rose-colored glasses.

EDIT--ok well redact my post since apparently you are a troll, southbelle. heh but nonetheless you did bring up interesting discussion points. I think there are many people that do have similar thoughts.

 

[TheRussian]

Guys, this thread was started by an exposed troll. It/he/she might be for real, but it/he/she has been caught in a few whoppers. Do a search.

Interesting topic, but ignore the troll/compulsive liar/flame starter.

Yep, this is a troll. Now that we can stop arguing about this foolish notion of mediocrity, may I ask what a troll is?

 

[BigBopper]

Well it is a good thing Southbelle didn't espouse her true views during her interviews. That is all I have to say.

Also if you are thinking about good hours with no procedures consider psych.

 

[Zweihander]

Definitely agreed. Cutting patient load seems to be a pretty straightforward way to do that. Compromising one's ability as a physician, not so much.

Sadly, cutting patient load isn't always an option in the world of managed care, but that's a whole 'nother b!tchfest.

 

[Lion-O]

Well, I don't think her OP was troll worthy. But doing the search (as recommended), I dug up this from southbelle:

"I've been accepted to 7 different schools. Three in the top 10. Three more ranked between #11-20, and an unranked but cheap school, an instate school. I've just been informed that I've recieved a scholarship that will pay for almost 80% of my tutition over 4 years at this state school."

And this:

"Yes I am going to mcg meanderson. It's the only school I applied to. It's not all about stats at MCG. That's just a small part of the picture. At MCG clinical experience means a lot more than stats. They love to see lots of shadowing and lots of work in healthcare. If you have decent stats and didn't get an acceptance letter, it's because your clinical experience and shadowing experience was not impressive."

F---ing lame.

 

[BigBopper]

Well, I don't think her OP was troll worthy. But doing the search (as recommended), I dug up this from southbelle:

"I've been accepted to 7 different schools. Three in the top 10. Three more ranked between #11-20, and an unranked but cheap school, an instate school. I've just been informed that I've recieved a scholarship that will pay for almost 80% of my tutition over 4 years at this state school."

And this:

"Yes I am going to mcg meanderson. It's the only school I applied to. It's not all about stats at MCG. That's just a small part of the picture. At MCG clinical experience means a lot more than stats. They love to see lots of shadowing and lots of work in healthcare. If you have decent stats and didn't get an acceptance letter, it's because your clinical experience and shadowing experience was not impressive."

F---ing lame.

Agreed Lame

 

[underAchiever]

I did not realize "second-grade substitute teaching" was that hard, so I apologize, I spoke without knowing and without meaning disrespect. All professions have their honor and share of hard work, and all I was trying to say was that maybe there is something else she can consider as an occupation. so read that post as "second-grade=something easy" "substitute=part-time" "teaching=any profession other than medicine which is not as demanding or hard work, if there is one"