Originally posted by powermd
I definitely agree with some of the sentiments expressed in this thread. I'm a third year just finishing up clinical rotations, and I've just about had it with this ****. A few of my peaves:
1) Unclear expectations of students: Students don't have any real responsibility for patients (on most rotations). You may have patients that are supposedly 'your own', but the real responsibility falls on the intern or resident. They write the orders and communicate with the attending. Only on my medicine and ER rotations was I able to function more or less like an intern. Your only 'responsibility' is to be at the beck and call of your residents. It's impossible to know when you've done enough and it's okay to relax, read, or go home. It's very rare that a resident tells you when your work is done. This wouldn't be much of a problem if other students were willing to draw a line in the sand at when a certain level of participation is enough- but most students are so paranoid about evaluations, they'll forego sleep and reading time just to feign enthusiasm. On my current rotation- ob/gyn, I've just about surpassed the point at which I am no longer willing to pretend to care. I stand by my hatred of scrubbing into OR cases that include no meaningful participation. I stand by my desire, when I'm tired, to just go to sleep when on call, assuming the sky isn't falling in L&D. The residents get to sleep when there's no work to do, why can't students?
2) Shelf exams: Clinical work must always be balanced with reading time to study for exams. My class is extraordinarily competitive, so you really can't slack off studying for these exams if you want to beat the mean. Because these responsibilities must be balanced, it's hard not to always feel like you're not doing enough of one or the other. In the end, neither are any fun because you're constantly stressed about doing more of the other.
3) Lectures and scheduled activities: I'm sick of being told where and when I have to be somewhere, to do something that invariably wastes my time. This includes most lectures, conferences, morning reports, and sign-out rounds. It really galls me when an attending will make a point of asking where a particular student is, who is not present. Apparently this happened to me yesterday. I'm taking night call for L&D, which starts at 5pm. However, L&D has sign outs from 5-5:45pm. Students on both day and night call are forced to be there, even though they never participate, or learn anything. My clinic finished at 5pm, so I went to quickly eat dinner in the cafeteria, because I might not get to eat otherwise. Of course, I heard later that the program director interrupted sign outs to ask where the on-call student was, and then stared at me as I walked onto the ward (20 minutes late) as if it mattered.
4) Medicine is rapidly losing it's magical appeal. Before I came to medical school, I used to love helping people and connecting with them. I would watch tv shows like trauma: life in the er, and "the operation" and this looked like the coolest job in the world. Now I don't see much difference between being a doctor, and being an auto mechanic. You talk to the patient to figure out what's going on, then you follow whatever diagnostic algorithm fits their symptoms, and then prescribe the current standard of treatment. There's a little creativity mixed in there, but not much. The two experiences in medicine that keep me going are the adrenaline rush from crisis situations, and the connections I make with patients. I'm hoping that will be enough to sustain me through residency.
5) I'm no longer idealistic. Due to all of the above, I've become quite defensive of my free time. I'm also tired of not having an income. It's hard not to let these factors 'pollute' my thinking in picking a specialty.
Thoughts?