As people who have gone though medical training,what do you think of this issue?

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

medguy25

Full Member
10+ Year Member
15+ Year Member
Joined
Jan 30, 2007
Messages
16
Reaction score
0
Sorry for the long post, but I think it's an interesting issue which I wanted to get feedback from people who have been through medical training...

Despite the push for clinical experience in medical admissions, most of my class hasn’t had any real clinical experience at all; many students have told me they’ve never talked to a patient before coming to medical school

Doesn’t this seem odd?? How do you know you want to go to medical school without ever having taken care of patients before? Without seeing sick people, patients who are suffering, taking care of patients who die and helping their families with the death, how can you know you want to be a doctor?

Not only this, but there’s the practical standpoint about having realistic expectations about what you’re getting into. For example, I’ve heard some students complaining about the hours, schedule, and lifestyles that doctors have, now when they are almost done with their 1st year of medical school…
Isn't this a little late for talk like this? Shouldn't this have been something that should have been thought of before going to medical school in the first place?

To be fair, there are also people who have had a lot of clinical experience prior to coming here – several EMT’s, nurses, patient care techs

I’m one of the latter and can’t fathom having made the decision to go to medical school without having any patient care experience (in my case, I worked part time in college and full time 2 years after as a nursing assistant/patient care tech for about 5 years at an academic medical center’s hospital on various inpatient floors (mostly different ICU’s and the OR))

Obviously, I’d be an idiot to suggest this (or the EMT people, or even the nurse) means you know exactly what being a doctor is like, however for me personally, it did accomplish 2 things-

1. Especially in the ICU environment, I saw pts. suffering on a daily basis and had plenty of pts. die (including kids since I worked on the PICU for a while)

2. I saw the lives that doctors worked first hand – I usually worked anywhere from 50-70 hr weeks all shifts of the day and night (12, 16 hr shifts) summers home from college and saw residents at 330 AM who had been awake from 7 AM the prior morning (I worked before the resident work hour restrictions and remember the CT fellows on my floor who were going on 35 hours in the hospital), I remember attendings coming in at 2 AM, could go on...

It’s one thing to know that doctors work long hours, but seeing it first hand gave me a better idea just what kind of lifestyle doctors lead
I believe this stuff at least gave me some knowledge on whether a career in medicine is right for me


My ultimate question is this: Do you think medical schools should start requiring a given number of hours of clinical job experience actually taking care of patients? (I say job, so it wouldn’t be a volunteer paper-pusher)


Before you think it’s a strange idea, consider this – many PA schools have requirements for clinical job experience prior to starting

I found this out when I spoke with a PA student at the hospital I worked at (I went to the program website that they actually require 1000 hrs. of this experience)

Things they suggested ranged from the higher level stuff such as nurse, respiratory therapist, paramedic, physical therapist; these are obviously their own fields which obviously is much more than needed

However, the opposite end of the spectrum included things that require only a HS degree with some short training classes such as nursing assistant/patient care tech, phlebotomist, basic EMT, EKG tech
These only require a HS degree with short training classes (I got hired and then trained for 3 weeks before being out on the ICU I started on taking care of pts.)

So in other words, quite possibly the majority of my class would not have been eligible to apply to PA school, but they are in medical school...:confused:
Doesn't this seem weird?

So being people who have gone though med school and who are now residents, do you feel that a requirement for these latter types of experience should be required in a similar manner to PA programs so people have patient care experience prior to going to medical school?

Or is this something that by the time you finish medical school isn't such a big deal?

Members don't see this ad.
 
So being people who have gone though med school and who are now residents, do you feel that a requirement for these latter types of experience should be required in a similar manner to PA programs so people have patient care experience prior to going to medical school?

Or is this something that by the time you finish medical school isn't such a big deal?

No, and I'll tell you why. As you say, you will never truly get what physicians do simply by shadowing. You will also get zero practical training in medical skills, and you will not really appreciate the impact of the work hours, because you aren't doing them. The major advantage of clinical experience that you cite is ability to empathize with other peoples' suffering, and I agree.

But here's the rub in my mind: Doctors aren't paid to empathize with sick people, they're paid to treat them. Empathy also isn't learned, either you're an empathetic person or you're not. The actual value of "appreciating what patients go through" while nice, is not even particularly a job requirement.

What really matters for physicians (and I think allied health forgets this all the time) is that they have the intellectual ability and practical training to diagnose and treat disease. Clinical experience, to me and many others, is useless for anything beyond getting a flavor of whether or not you will enjoy medicine, and even then I wonder if it can really do that.
 
No, and I'll tell you why. As you say, you will never truly get what physicians do simply by shadowing. You will also get zero practical training in medical skills, and you will not really appreciate the impact of the work hours, because you aren't doing them. The major advantage of clinical experience that you cite is ability to empathize with other peoples' suffering, and I agree.

But here's the rub in my mind: Doctors aren't paid to empathize with sick people, they're paid to treat them. Empathy also isn't learned, either you're an empathetic person or you're not. The actual value of "appreciating what patients go through" while nice, is not even particularly a job requirement.

What really matters for physicians (and I think allied health forgets this all the time) is that they have the intellectual ability and practical training to diagnose and treat disease. Clinical experience, to me and many others, is useless for anything beyond getting a flavor of whether or not you will enjoy medicine, and even then I wonder if it can really do that.

I agree. I was an EMT prior to med school and, personally, I can't imagine starting med school without being interested in medicine by having some type of first-hand experience. But, now that I am done, I realize that no matter how much experience you have, there is no way to really know what being a doctor is like. Plus, there are so many specialties that are so different from one another. And, your perspective changes as you go through medical school. I don't think making students volunteer prior to medical school would make any difference in their futures. Pathologists and most radiologists don't routinely see patients. There are just so many ways to go in medicine that even 3rd year medical students don't get good exposure to many specialties.
 
I agree. I was an EMT prior to med school and, personally, I can't imagine starting med school without being interested in medicine by having some type of first-hand experience. But, now that I am done, I realize that no matter how much experience you have, there is no way to really know what being a doctor is like. Plus, there are so many specialties that are so different from one another. And, your perspective changes as you go through medical school. I don't think making students volunteer prior to medical school would make any difference in their futures. Pathologists and most radiologists don't routinely see patients. There are just so many ways to go in medicine that even 3rd year medical students don't get good exposure to many specialties.


Exactly correct. Plus, I'm sorry, but being an tech or a bed-pusher isn't really "clinical experience." I had a ton of "clinical experience" during UG and even now as a 3rd year I realize I did not and could not have any idea what was really going on.

If I were on an adcom I'd much rather see interesting ECs or maybe a few years work experience than 100 hours as a candystriper.
 
Exactly correct. Plus, I'm sorry, but being an tech or a bed-pusher isn't really "clinical experience." I had a ton of "clinical experience" during UG and even now as a 3rd year I realize I did not and could not have any idea what was really going on.

My three years of experience as a CNA was covered fully (technically, intellectually, and emotionally) in the first eight minutes of MS3.
 
The whole OP post reeks of jealousy and an implicit feeling of "you rich kids don't understand the real world like I do." I can NEVER stomach reading so much self congratulatory crap.

1. Especially in the ICU environment, I saw pts. suffering on a daily basis and had plenty of pts. die (including kids since I worked on the PICU for a while)

2. I saw the lives that doctors worked first hand – I usually worked anywhere from 50-70 hr weeks all shifts of the day and night (12, 16 hr shifts) summers home from college and saw residents at 330 AM who had been awake from 7 AM the prior morning (I worked before the resident work hour restrictions and remember the CT fellows on my floor who were going on 35 hours in the hospital), I remember attendings coming in at 2 AM, could go on...

Wow *insert a real, real, slow clap*

Good. Good for you. I guess we should follow your life plan.:laugh:
 
The whole OP post reeks of jealousy and an implicit feeling of "you rich kids don't understand the real world like I do." I can NEVER stomach reading so much self congratulatory crap.



Wow *insert a real, real, slow clap*

Good. Good for you. I guess we should follow your life plan.:laugh:


right, you figured me out...

I can't stomach people who make judgements based a snip of a post. If I came on a just mentioned what you quoted w/o any context, then it probably would be an arrogant "look at me" type of BS.

I'm only bringing it up in the context of the entire post which was a question about if we should change medical admissions to something similar to PA schools, which require at the very least something like did.

In other words, I was at the bottom of the barrel with the job I had. I'm so pround of myself...
Unfortunately, a big chunk of my job was the physical nursing stuff like cleaning bedpans and bathing people.
I congratulate myself for doing that, look at me, I'm special...:rolleyes: I cleaned bedpans in an ICU, so I obviously know everything!

seriously, lighten up
 
I agree with what most of you are saying, but I think you're missing the point.

I obviously wasn't talking about exactly knowing what the life of a doc is either from a technical or whatever other aspect (lifestyle, etc...)

I would submit to you that people who work with docs on a daily basis such as the allied health fields like nurses, respiratory techs, etc know the best that they don't know what it's like to be a doc.

Consider this example - Whenever we have lectures from people of different specialties, one of the most common questions is the "how many hours a week do you work/what kind of lifestyle do you have" question.

The lowest any attending has given for hours/week worked is 60. They've also said that they often miss family functions and that they aren't guarranteed to be home for dinner and so on.

I've talked with people in my class who have complained that nobody works a normal schedule in medicine where they can do the common things such as be home and play with your kids in the evening, have a family dinner every night, take your kids to their activities, and things along those lines.
People have also complained that there's nodody in medicine who works normal hours 40-50 hours a week only in the weekday daytime.

I'll be honest and maybe I'm putting this out of proportion to what my classmates have said, but I'm concerned that they'll be miserable as doctors and only keep on in medicine and do a residency since they are so far in debt that they feel trapped and cannot switch into a more lifestyle/schedule friendly career like they so desparately want.

Now, here's my question, don't you think that if these people worked in healthcare before coming to medical school and saw firsthand attendings work late into the evening after coming in at 7 AM or coming in in the middle of the night for emergencies and other examples like that, that maybe these people may have said to themselves "Wait a sec, this really isn't what I want out of life. Maybe I should rethink this whole medical career thing before I jump into it."


Someone with healthcare experience wouldn't be in such surprise that an attending has a lifestyle like this too instead of just the residents.

Who knows, maybe I'm wrong, but it seems that it wouldn't hurt and that maybe it would turn off people from going into medicine who probably shouldn't be in medicine due to the above type of reasons.
 
Now, here's my question, don't you think that if these people worked in healthcare before coming to medical school and saw firsthand attendings work late into the evening after coming in at 7 AM or coming in in the middle of the night for emergencies and other examples like that, that maybe these people may have said to themselves "Wait a sec, this really isn't what I want out of life. Maybe I should rethink this whole medical career thing before I jump into it."

You don't have to work in a hospital to figure this out. You just have to read a few books, ask around, and cruise SDN for 5 minutes.
 
Exactly correct. Plus, I'm sorry, but being an tech or a bed-pusher isn't really "clinical experience." I had a ton of "clinical experience" during UG and even now as a 3rd year I realize I did not and could not have any idea what was really going on.

If I were on an adcom I'd much rather see interesting ECs or maybe a few years work experience than 100 hours as a candystriper.


This is my point, I'm specifically NOT talking about volunteering and being a bed pusher. That's useless.

I'm talking about working (as in job) on a unit where you do things such as...

-insert yourself on rounds
-talk with doctors about how and why they are managing patients so you can learn something
-pour over charts and monitor your patients by reading progress notes, lab reports, radiology reports
-bug the docs to tell you how they like their field, why they went into it, if they would go into another field if they could do it over again.

I felt doing these things helped me sure up my decision to go into medicine.

I have a hard time believing these things wouldn't be helpful to someone on whether they should or should not go into medicine.
 
You don't have to work in a hospital to figure this out. You just have to read a few books, ask around, and cruise SDN for 5 minutes.


True, that's a good point.

Everybody knows doctors work a lot, but when I first saw that CT fellow on his way home after 35 hours in the hospital looking like a zombie who could barely think straight, I said to myself "holy s**t, that's crazy" It just seemed more real to see it instead of reading that doctors had to work 35-40 hours at a time.

Oh well, maybe it's just me. Like I said, I really wonder sometimes if some of my classmates are going to be unhappy because of 1 of 2 things...

1. They are going to wind up either going into the specialty they want and not liking it b/c they work too many hours and a bad schedule.

2. Go into a lifestyle specialty and have the schedule and hours they want, but be miserable because they only went into the specialty because of lifestyle when in reality, they hate the specialty.
 
This is my point, I'm specifically NOT talking about volunteering and being a bed pusher. That's useless.

I'm talking about working (as in job) on a unit where you do things such as...

-insert yourself on rounds
-talk with doctors about how and why they are managing patients so you can learn something
-pour over charts and monitor your patients by reading progress notes, lab reports, radiology reports
-bug the docs to tell you how they like their field, why they went into it, if they would go into another field if they could do it over again.

I felt doing these things helped me sure up my decision to go into medicine.

I have a hard time believing these things wouldn't be helpful to someone on whether they should or should not go into medicine.


Basically, you are suggesting that undergrads follow doctors on rounds. Aside from confidentiality issues, looking at charts and patient records is not going to be very educational. And, what kind of doctor should they follow? Not all specialists fit your description of coming in at all hours of the night. Do they follow academicians or private practitioners? There is a big difference in responsibilities and lifestyle when you have residents working for you.

I am going into Pathology because I love diagnosing at the microscope. I didn't choose it for lifestyle. You can be a doctor and have a nice lifestyle without being a sellout. What about Radiology, Endocrinology, Nephrology? The great thing about medicine is that you can find a field and practice situation to meet your individual needs. You can't expect undergrads to understand what being a doctor really means by shaddowing one or two people. And, you can't expect an undergrad in school to sacrifice a ton of time away from studying to do this. They can't do anything meaningful regarding treatment due to liability.

I think the current system of peole getting whatever experience they want prior to med school is fine. I don't think that we should mandate that you follow a certain type of doctor around prior to med school. Even if you get an idea of medicine as an undergrad, your life situation and perspective changes in med school and you mature in different ways so that you are not the same person coming out as going in.
 
I think the real answer is... no, there doesn't need to be a change, because med students exactly like your sheltered classmates have been going through (a mostly identical) medical school experience for many decades. And most seem to have come through as functioning, successful doctors...

... why do you seem to believe your peers are the first class unready for the shock? I have to agree with an earlier poster... I sense a lot of self-importance in your earlier posts.

I think most in medicine would also agree that 'lifestyle' for doctors have only improved over the last two decades. Fewer hours in residency, and growing acceptance of doctors prioritizng family life over practice.
 
This is my point, I'm specifically NOT talking about volunteering and being a bed pusher. That's useless.

I'm talking about working (as in job) on a unit where you do things such as...

-insert yourself on rounds
-talk with doctors about how and why they are managing patients so you can learn something
-pour over charts and monitor your patients by reading progress notes, lab reports, radiology reports
-bug the docs to tell you how they like their field, why they went into it, if they would go into another field if they could do it over again.

I felt doing these things helped me sure up my decision to go into medicine.

I have a hard time believing these things wouldn't be helpful to someone on whether they should or should not go into medicine.


Doctors don't like non-doctors to:

Insert themselves in rounds.
-Answer questions to some 18 year old freshman (not that it is bad to be 18 and a freshman) about their treatment plan. especially since he won't know --what the heck the doctor is talking about.
-Pour over their patients charts.
-BUG the doctor, RIIIIGHT. Even the Residents don't get to do that.

Everything you asked for is possbile. It is called RESIDENCY.

The closest your going to get to finding out if medicine is for you is by doing volunteer work.
 
Flex - technically it's not a confidentiality issue if you're on the job working since you're providing care to the patients in question, so you have access to the info

I think the real answer is... no, there doesn't need to be a change, because med students exactly like your sheltered classmates have been going through (a mostly identical) medical school experience for many decades. And most seem to have come through as functioning, successful doctors...

... why do you seem to believe your peers are the first class unready for the shock? I have to agree with an earlier poster... I sense a lot of self-importance in your earlier posts.


How am I suppose to to know about earlier classes other than mine if I'm an M1? My class is the only one I'm going to know in depth about.

Not you too with the self-importance stuff...I just joined this site and this is my first time posting anything besides a fact type of thread, ie a discussion thread - I guess I won't be doing that anymore since apparently either people misinterpret what I write or I'm not doing a good job saying what I want to say.
I don't need to come on a website and say "wow, look at me!". That's pathetic. And besides, what good is that anyways - it's an anonymous website:rolleyes:

Oh well...


In conclusion (at least on my part since I feel as though I've beaten a dead horse here, but feel free to discuss amongst yourselves),

I do see the if it ain't broke, don't fix it type of philosophy. Like heech said, it's been working with plenty of doctors and things are functioning fine.

However, I also still think it's odd that a career (PA) that's less of a sacrifice in terms of time, both years of training, and hours per year, and money in terms of debt has much higher requirements for experience than medical school does.

And I strongly disagree that there's no experience prior to medical school that can give you even a drop in the bucket idea of what medicine is like.

Take a nurse for example
Does he/she know exactly what it's like to be a doctor? Of course not, that's ridiculous.

But it seems to me equally as ridiculous for anybody to say that a nurse wouldn't have any idea whatsoever what physician does for their career on a daily basis and some small idea about what being a physician would be like.


There was just a thread I looked at in another forum about an M2 not wanting to do a residency and wanted to know of different careers he/she could do after medical school. How awful of a situation to be in, you don't want practice medicine after what will be 4 intense years and 100-200K in debt.

My point is maybe something like this could have been avoided with experience beforehand with the person realizing "hey, I can't stand taking care of patients, this whole deal sucks" (I don't know if that's what they believe, I'm just using it for sake of argument)


Thanks for the debate.
 
Doctors don't like non-doctors to:

Insert themselves in rounds.
-Answer questions to some 18 year old freshman (not that it is bad to be 18 and a freshman) about their treatment plan. especially since he won't know --what the heck the doctor is talking about.
-Pour over their patients charts.
-BUG the doctor, RIIIIGHT. Even the Residents don't get to do that.

Everything you asked for is possbile. It is called RESIDENCY.

The closest your going to get to finding out if medicine is for you is by doing volunteer work.

OK, I guess one more post:D

I meant "bug" the doctor in sense of ask questions about anything I had curiousity about. I would routinely have conversations with attendings about anything I wasn't sure about.

For example, one of the first weeks of my job (19, not 18, but close) I had a conversation with an attending about milrinone and dobutamine, similarities, differences, why a patient would be on two inotropes instead of just 1, on and on.

Next week I had a nice discussion with an intensivist on the pros and cons of different ventilator modes and why you'd use each one (SIMV, PSV, PC, VC) and things like PEEP and PAP

Another time a nephrologist answered my questions about why a pt. would need CRRT dialysis as compared to straight, regular dialysis

These were routine occurances, I don't get why that is such a big deal?
It's only 4-5 minutes here and there out of an attendings day.
Believe it or not, they actually liked it because I showed more interest in the stuff than the medical students who were there.
 
I went to PA school and worked as a PA for a few years before I went to medical school, so I understand what you are asking.

For those who are unfamiliar (and what I think the OP is debating), many if not most PA schools require 1000 or more hours of patient contact hours to be eligible for admission. Candystriping, volunteering, bed-pushing, etc. is NOT considered patient contact hours. To gain these hours, you basicaly have to obtain some sort of certification--EMT/paramedic, RN/LPN and respiratory therapist are the most common I've come across.

I think the reason these are required for PA school is that in such an accelerated (i.e. short--2 year long) program, you need to deal with students who are more familiar and more comfortable dealing with patients on day one and can therefore hit the ground running. Medical school, being four years in length, allows for more time to ease into patient contact.

I agree with the OP that having those years of direct patient care experience was invaluable for me while in medical school. I came in knowing what I wanted to do, and was much more comfortable in many situations that the overwhelming majority of my classmates felt lost or uncomfortable in. However, I don't think that will make me a better physician than any of them--medical school has a pretty steep learning curve which only gets infinitely more steep in residency. Before long my PA experience will be a nice memory and I'll always rely on certain experiences gained in that arena, but won't put me at any significant advantage over my colleages.

The fact is, most medical students are a year or two out of college, and are unable to gain significant real world experience. That is never going to change. On the other hand, adcoms seem to be looking more favorably on those of us from other healthcare careers applying to med school, so there must be something to having previous experience. So while nice for those of us who have it, I don't think that hands-on experience needs to be required to allow for successful or happy medical students.
 
There's also something to be said for how freaking long medical training is already. For a PA student to spend a couple of years as a paramedic or LPN or something similar isn't a huge deal because their PA schooling is only two years long. Then they're out making money, practicing their profession, and not accumulating more debt pretty quickly.

With medical school being 4 years long, maybe a year or two for an MPH or research for a competitve residency, residency of 3-7 years, then possibly a fellowship of 1-3 years, can you really imagine adding a year or two before that of some sort of medical training :eek: Enough is enough! We're already putting our lives on hold for so long as it is--delaying marriage, buying a house, having children, financial stability, etc, etc (I think this affects female students on the whole even more than males because of the biological clock issue). The benefits of having a year or two of clinical experience before medical school school are miniscule compared to the disadvantages of delaying your career so that it becomes impossible to finish training before one's early thirties. I also think that would discourage some non-traditional applicants who are already hesitant about starting their prerequisites late if they knew they had to do such a thing first.

I also can't imagine how hospitals would handle the deluge of premed students, esp. at a university of hospital, who are doing these jobs only as a prerequisite for admission to medical school. If I ran an EMT training program, I'd be pretty upset putting in all this effort to train individuals who aren't genuinely interested in being EMTs and who aren't going to work for me and fill my scheudle for more than a year or two. It just isn't fair to them either.
 
To the OP, I just think that it is unreasonable to require everyone applying to medical school to have previous employment (you would have to be employed to get around the confidentiality issues) in a healthcare field prior to entering medical school.

Also, what if people did find out that they don't want direct patient contact for the rest of their careers? Should they not go to medical school? What about pathologists, radiologists, public health administrators, etc. There are many careers in medicine that can contribute to improving diagnosis and treatment that don't require patient contact. That's why you pick a specialty that fits you and your career goals after 3rd year.
 
I went straight through college and med school, I don't agree with these statement. Those of us who have become good, empathetic clinicians developed those traits fairly quickly. Empathy and listening skills cannot be effectively taught. On the other hand, those students who didn't have these skills to begin with still lack them at the end of medical school, and continue to have terrible bed side manner. So, adding more requirements does not help medical students become better clinicians.

As for the lifestyle issue, I think most pre-meds have an idea that doctors work long hours. There are plenty of specialties that allow you to be home for dinner, and not to miss too many family functions. If you decide that family is more important to you, as many of us have, it does not mean that you shouldn't have gone to med school, and that you will be a terrible physician. It simply means that general surgery is not for you.
 
This is my point, I'm specifically NOT talking about volunteering and being a bed pusher. That's useless.

I'm talking about working (as in job) on a unit where you do things such as...

-insert yourself on rounds
-talk with doctors about how and why they are managing patients so you can learn something
-pour over charts and monitor your patients by reading progress notes, lab reports, radiology reports
-bug the docs to tell you how they like their field, why they went into it, if they would go into another field if they could do it over again.

I felt doing these things helped me sure up my decision to go into medicine.

I have a hard time believing these things wouldn't be helpful to someone on whether they should or should not go into medicine.

Pre-meds who shadow don't decide to do medicine because they start to learn clinical decision making. They decide to do medicine b/c white coats look noble and they imagine how hot they will look in scrubs.

As far as talking to doctors go, everyone suggests you do it, but I don't think it does much. Have you ever met a pre-med student who said, "well, Dr. X talked me out of it." Not very often.

Instead they post their tale of woe on SDN in a post titled "Is Medicine Really This Bad?" and then the cheerleaders tell them stories of happy docs and assure them that as long as they keep a positive attitude everything will be ok.
 
To the OP: You're comng across as very egotistical. There are many ways to figure out if you want to be a doctor or not, and it doesn't have to be direct work experience. If that's what worked for you, great-- I'm glad you've made a good choice. For others, watching a family member go through a serious illness, or getting involved real volunteer work serves the same purpose. For me, it was a combination of volunteer work and good advice from advisors. I love medicine and have absolutely made the right choice, and not by luck alone; I did my research and knew what I was getting into.

You're also misinformed. Radiologists often work 40 hrs per week. Some docs split the practice and each work 30 hrs a week or so for half the money. If you hate stinky patients, you can be a pathologist. If you hate 90 year old demented patients, be a pediatrician. If you hate touching people's bodies, be a psychiatrist. No single work experience is going to show you all of the options.

You shoudn't worry about whether your classmtes will be happy-- they'll find their niche. Worry about yourself, and specifically the idea that everyone you work with appreciates answering your questions. Yes, it's good to ask questions, but in general it irritates attendings when you ask them things you could easily look up (like vent modes), and hold up rounds to do so. It's better to look it up and then say "I was reading about vent settings, and I don't understand XYZ". If you don't use good judgement, you'll be seen as "pimping" your residents and attendings. Just some advice.
 
no undergraduate, medical student, resident and fellow can understand what it is like to have the responsibility of a patient in your hands. that only come when you are finished with training and have no-one looking over your shoulders.

given that, most people tend to volunteer as an undergrad to see what its like. however, you dont need to volunteer to think medicine is right for you. for some, it is the intellectual pursuit. for others, its a career of life-long learning. and for many, its a status symbol or a well-paying job. people become a doctor for many reasons...and you dont need clinical experiences before med school to know that you want to be a doctor.
 
OK, I guess one more post:D

I meant "bug" the doctor in sense of ask questions about anything I had curiousity about. I would routinely have conversations with attendings about anything I wasn't sure about.

For example, one of the first weeks of my job (19, not 18, but close) I had a conversation with an attending about milrinone and dobutamine, similarities, differences, why a patient would be on two inotropes instead of just 1, on and on.

Next week I had a nice discussion with an intensivist on the pros and cons of different ventilator modes and why you'd use each one (SIMV, PSV, PC, VC) and things like PEEP and PAP

Another time a nephrologist answered my questions about why a pt. would need CRRT dialysis as compared to straight, regular dialysis

These were routine occurances, I don't get why that is such a big deal?
It's only 4-5 minutes here and there out of an attendings day.
Believe it or not, they actually liked it because I showed more interest in the stuff than the medical students who were there.

Get over yourself.
 
I'll be honest and maybe I'm putting this out of proportion to what my classmates have said, but I'm concerned that they'll be miserable as doctors and only keep on in medicine and do a residency since they are so far in debt that they feel trapped and cannot switch into a more lifestyle/schedule friendly career like they so desparately want.

Are you really so concerned with the well being of your classmates? Why?

Many of us consider ourselves human beings first, physicians second. Our desire to participate in life doesn't preclude us from practicing good medicine. We will be healers, and we will take care of our own well being. We might even change the culture of medicine in the process. Ultimately, I think we will be happier for it. You don't have to be concerned for us! :thumbup:

If you feel a desire to live your life inside a hospital, then go for it. You do your thing, we'll do ours.
 
Yea .. dont try to make the process of becoming a doctor even longer than it already is. As you will learn getting through the first two years of medical school has nothing to do with pt. interaction but with how well you study and how fast you learn. Most students enter medical school with the desire to help people. And believe me most entering students have a very fantasy like view about caring for sick people. But they soon come to realize what taking care of people truly entails and what sacrifices are required to do so. Even without prior experience dealing with patients and having a true understanding of the lifestyle of a physician most students still tread on because of their own personal desire. Many students dont have the opportunity to spend a whole summer shadowing a doctor for free prior to entering medical school. Therefore to require that experience would be unfair many students.
 
Believe it or not, they actually liked it because I showed more interest in the stuff than the medical students who were there.

Yes, they liked it, but they liked it because you were an outsider who was showing interest in their field, and that doesn't happen very often. If every premed in the country were required to do what you did, they would rapidly get sick of it, and blow you off completely.

The other thing you need to recognize is that doctors operate on an "inside/outside" system. They will be really nice and spend a lot of time explaining things to outsiders, just out of simple courtesy. The same questions, if asked by insiders, are likely to be met with, "You should know that! Go look it up!"

Also, and I'm not trying to be a jerk, but it is not unlikely that after being nice to you and answering your questions, they later sat around laughing at how little you knew, and how annoying it was to have you ask so many simple questions. I see this with nursing all the time.
 
Choosing a career will shape your life. Shape your LIFE, every aspect will be affected. Helping a doctor clean puke off someone and discussing the merits of the different antiemetics doesn't hold a candle to what is really going to happen to you. Maybe instead of getting the experience suggested by the OP, pre-meds would be better served by spending time developing mad coping skills. :D



Besides, if you can really learn what it is like to "BE" something by watching/participating, does that mean that my single friends know what they are talking about when they make suggestions about my toddler because they have nieces/nephews, or have baby sat, or "have alot of friends with kids, so I've seen alot...." ? :laugh: :laugh: :laugh:

It'll rarely be a bad idea to do what the OP is suggesting - but the intended outcome is a reach.
 
I think schools place too much emphasis on shadowing already. Some kids know doctors, have family members who are doctors, etc and this isn't hard at all. I had no connections whatsoever. I put myself out there and asked doctors if I could shadow them and I got blown off- very discouraging. It was the most frustrating part of the application process. Like people have said- privacy issues and what-not.

With that being said, I knew, without ever having shadowed anyone for one minute that medicine is what I wanted to do with my life. Now I am finishing my third year and I was exactly right. Maybe some people need experience, but some people REALLY DON'T. I think it's a case by case thing.
 
Flex - technically it's not a confidentiality issue if you're on the job working since you're providing care to the patients in question, so you have access to the info




How am I suppose to to know about earlier classes other than mine if I'm an M1? My class is the only one I'm going to know in depth about.

Not you too with the self-importance stuff...I just joined this site and this is my first time posting anything besides a fact type of thread, ie a discussion thread - I guess I won't be doing that anymore since apparently either people misinterpret what I write or I'm not doing a good job saying what I want to say.
I don't need to come on a website and say "wow, look at me!". That's pathetic. And besides, what good is that anyways - it's an anonymous website:rolleyes:

Oh well...


In conclusion (at least on my part since I feel as though I've beaten a dead horse here, but feel free to discuss amongst yourselves),

I do see the if it ain't broke, don't fix it type of philosophy. Like heech said, it's been working with plenty of doctors and things are functioning fine.

However, I also still think it's odd that a career (PA) that's less of a sacrifice in terms of time, both years of training, and hours per year, and money in terms of debt has much higher requirements for experience than medical school does.

And I strongly disagree that there's no experience prior to medical school that can give you even a drop in the bucket idea of what medicine is like.

Take a nurse for example
Does he/she know exactly what it's like to be a doctor? Of course not, that's ridiculous.

But it seems to me equally as ridiculous for anybody to say that a nurse wouldn't have any idea whatsoever what physician does for their career on a daily basis and some small idea about what being a physician would be like.

There was just a thread I looked at in another forum about an M2 not wanting to do a residency and wanted to know of different careers he/she could do after medical school. How awful of a situation to be in, you don't want practice medicine after what will be 4 intense years and 100-200K in debt.

My point is maybe something like this could have been avoided with experience beforehand with the person realizing "hey, I can't stand taking care of patients, this whole deal sucks" (I don't know if that's what they believe, I'm just using it for sake of argument)

Thanks for the debate.

You asked for the opinion of people "who have been through medical training." About 15 people responded to your initial post, and for the most part they all disagree with you. I think the people who responded have given some great perspectives on this topic. Obviously you disagree with the responses given to you, and so you're leaving the thread. And so I ask, did you ever really want our opinions in the first place?? Because it sure doesn't seem like it. It seems like you just wanted to find people who agree with you. Most of us here are further along in our medical training than you, so we are going to have a different perspective than you (this is what you wanted, right?) If you're not prepared to interact with our responses, and are going to leave a thread when people disagree with you, then don't ask for our opinion.
 
You asked for the opinion of people "who have been through medical training." About 15 people responded to your initial post, and for the most part they all disagree with you. I think the people who responded have given some great perspectives on this topic. Obviously you disagree with the responses given to you, and so you're leaving the thread. And so I ask, did you ever really want our opinions in the first place?? Because it sure doesn't seem like it. It seems like you just wanted to find people who agree with you. Most of us here are further along in our medical training than you, so we are going to have a different perspective than you (this is what you wanted, right?) If you're not prepared to interact with our responses, and are going to leave a thread when people disagree with you, then don't ask for our opinion.

Well said. OP worry about yourself and less about what others are doing or in your case not doing. If YOU think that YOU are out to help your classmates, do them a favor and bless them with your absence. They will get their share of pompous schmucks in academia. :barf:
 
I'll step up and give medguy some support - jeez, some of the feedback has been harsh!

In general, yeah, I agree, folks coming into med school should have an idea what medicine is about, and working as a tech or whatnot is a great way to get a feel for many aspects of the field. I wiped my share of butts in my former life, and it gave me a great perspevtive not just on the stuff you find out in "the first three minutes of MS3," but also about many elements of the medical world that will sorta closed off to you when you become a med student. Knowing how the grunts do their work isn't, to be fair, necessary to do our jobs, but it provides a fuller view.

That being said, I hardly think it should be an outright requirement for med school application. Nonetheless, if an applicant can use such experiences as subject matter for their essay, interviews, and application, I think it should rate somewhat higher than experience running gels or killing mice in the lab.
 
I'll jump into the fire since I think there are valid points on both sides here.


I think medguy is coming across as arrogant. But he may think that he has to cite his work to get credibility in a way since this is the resident forum.
He's new (less than 10 posts). I remember when I first came on, I felt that I'd automatically be ignored and not have any post of mine actually be thought about in this forum since I was just premed.

However, I can see where med guy is coming from. I did pretty much the same thing as he did as a nursing assistant with the same hours and stuff. (geez man, we're almost exactly the same, are we twins separated at birth??)

Although I have to say, you got onions interrupting rounds as you mentioned. Never would have done that myself. That's a little excessive.
I asked a few attendings here and there questions, but it was when they were by themselves just chilling on the floor. And I only did it with the attendings who were extremely nice people in general. The residents on the hand, I asked them plenty of questions since they were always on the floor (and again, not on rounds, 1 on 1 instead)

Given the pathway involved, I can't think of a career other than medicine where you should be as sure as possible that you want to do it.

However, I would tell you medguy that the only reason I got those jobs was because of total luck with having a family friend who was a nurse at the hospital I worked at who told me about that position.

If I never heard about the job, I'd be one of the people who you are talking about probably having worked in a lab doing bench work and being one of those who "never talked to a patient in their life".

So I would say it's unreasonable to expect most people to have real clinical experience because they may not know where to get it. Like I said, I never would have know there's such a thing as a nursing assistant, phlebotomist, or EKG tech, or any job like that if it wasn't for the luck of the family friend who is a nurse.

Like some other people stated, having a relative go through a sickness and dying is plenty enough reason to want to go into medicine. (just 1 example)

So bottom line is I don't think you classmates should be looked at negatively. (I don't think that's what you think, but threw that in there just in case).






Now, on the other side...

There's no need whatsoever for the chastising that medguy has received from the residents here. That's pathetic and ridiculous.

I totally disagree with the sentiment expressed by most of you that there's no experience that can give you even a drop in the bucket type of knowledge about medicine.
Like medguy brought up, a nurse definitely doesn't know what it's like to be a doctor. BUT, to say that a nurse or paramedic and so on have absolutely no idea (ie on a scale of 0 to 100, literally a 0) of what a doctor's life is like is just downright stupid.
Again, nowhere near knowing what it's like to be a doctor, but at least some kinda of minute idea.

The attitudes expressed here are characteristic of one of my most hated aspects of physicians as a group. It's a trait that physicians, on average, have much much more than, relatively to the general population. That trait is arrogance.

This feeling that in the healthcare system there's

physicians here and -------------------------------------->everybody else in healthcare over here

As if they are on a different planet.

Physicians are the only people who know anything. Everybody else is an idiot who doesn't have a clue about anything.

Think about what some people said. "Non-MD's" That speaks to this arrogance. Lumping everybody in 1 group.

Hello!? There's a diverse array of people in the "Non-MD" group with vast array of skills that keep the healthcare system running.

I cannot tell you how many people have asked me "so now you're going to change and become a know-it all doctor who thinks they know everything and are always right?" when I went off to medical school.

Give me a break.

Physicians need to get over themselves and off their high-horse that thinks they are the only people in the world with any sort of intelligence or who actually work hard in life.
 
Basically the "highschool=>college=>medschool" crowd is mostly arguing against the OP, and the "former NP/LP/PA/EMT" crowd is mostly supporting him. :hardy: No surprises there.

The attitudes expressed here are characteristic of one of my most hated aspects of physicians as a group. It's a trait that physicians, on average, have much much more than, relatively to the general population. That trait is arrogance.

This feeling that in the healthcare system there's

physicians here and -------------------------------------->everybody else in healthcare over here
I agree. Some physicians don't even know what a physical therapist does, or what a nurse educator does. I don't think prior experience in these fields can be replaced by "cruising SDN for 5 minutes".
As far as empathy goes, I think it is a combination of personality and past experience. Empathy implies that you relate their experience to a prior experience of your own. If you haven't lived through some hardship, I think that feeling turns into something more like sympathy.
 
Basically the "highschool=>college=>medschool" crowd is mostly arguing against the OP, and the "former NP/LP/PA/EMT" crowd is mostly supporting him. :hardy: No surprises there.

Yeah, seriously. Who would have thought?:rolleyes:


I agree. Some physicians don't even know what a physical therapist does, or what a nurse educator does. I don't think prior experience in these fields can be replaced by "cruising SDN for 5 minutes".

Exactly. Like paramed2premed said about getting a fuller view. If anything, working these low level, lowest rung of the ladder type of jobs teaches you an appreciation for your fellow co-workers that as a whole, physicians are sorely lacking...

Personally, I think all people going into medicine should wipe their share of butts after a patient with C. diff s**ts all over the place and then have to change them and and give them a bed bath afterwards.

Maybe then, just maybe, physicians will appreciate that they aren't the only ones who have difficult jobs in healthcare and who bust their ass on a daily basis.
 
Personally, I think all people going into medicine should wipe their share of butts after a patient with C. diff s**ts all over the place and then have to change them and and give them a bed bath afterwards.

I just wanted to say for the record: I'm not advocating making this a requirement.

I don't think medical admissions needs to require 1000 hours of cleaning up C. diff. crap for admission into medical school.:eek:
 
I

There's no need whatsoever for the chastising that medguy has received from the residents here. That's pathetic and ridiculous.

Arrogance and an attitude that HE is better prepared for medical school than his classmates because he shadowed or had an home address at a hospital is pathetic and not tolerated. I have known his types and have seen them make fools of themselves when trying to impress their classmates with their astute medical knowledge. I suspect the high degree of negativity coming from the very audience he is addressing is that they know his type as well. Not all people with his type of background are this arrogant of course.

The best medical student in my class worked many years as an EMT and NEVER once did she rub it in anyone's face. She kept it to herself and applied her extra knowledge where necessary and NOT to merely impress others. She remained humble in the basic sciences and during her clinical years where she rocked! She received many awards at the senior banquet and was held in high regard from everyone she worked with from attendings, residents AND FELLOW MEDICAL STUDENTS.

Now, take the OP, there were those in medical school like him who CONSTANTLY made remarks to themselves (so others could hear) or asked questions in class to TRY to impress others with their experience. By the end of the 2nd year, they were pegged and nobody cared what they knew. During third year, they would piss off the residents with their confidence in their own self taught knowledge. In the end, they impressed nobody and OP, you don't impress me. I know your whiney type and can't, can't, CAN'T stomach it! Just don't drive your classmates nuts with stupid lecture questions and a chip on your shoulder.

So a final word, can a medical related experience help you in medical school?? Of course, just don't let your attitude ruin it.

:beat:
 
Arrogance and an attitude that HE is better prepared for medical school than his classmates because he shadowed or had an home address at a hospital is pathetic and not tolerated. I have known his types and have seen them make fools of themselves when trying to impress their classmates with their astute medical knowledge. I suspect the high degree of negativity coming from the very audience he is addressing is that they know his type as well. Not all people with his type of background are this arrogant of course.

The best medical student in my class worked many years as an EMT and NEVER once did she rub it in anyone's face. She kept it to herself and applied her extra knowledge where necessary and NOT to merely impress others. She remained humble in the basic sciences and during her clinical years where she rocked! She received many awards at the senior banquet and was held in high regard from everyone she worked with from attendings, residents AND FELLOW MEDICAL STUDENTS.

Now, take the OP, there were those in medical school like him who CONSTANTLY made remarks to themselves (so others could hear) or asked questions in class to TRY to impress others with their experience. By the end of the 2nd year, they were pegged and nobody cared what they knew. During third year, they would piss off the residents with their confidence in their own self taught knowledge. In the end, they impressed nobody and OP, you don't impress me. I know your whiney type and can't, can't, CAN'T stomach it! Just don't drive your classmates nuts with stupid lecture questions and a chip on your shoulder.

So a final word, can a medical related experience help you in medical school?? Of course, just don't let your attitude ruin it.

:beat:


I agree with everything you've said.

There's some know it alls in my class as there are in every single medical school class in the country and they definitely are annoying.

However, there's a lot worse a person could be than a know it all.
A know it all thinks they know more than they really do, but generally don't treat people badly in any way.

They don't deserve utter hatred for an annoying trait.

At least that's the way I look at it, it's more of an annoying type of trait for me.

I'd rather have a know it all who doesn't treat people badly than somebody else who thinks that others don't know anything and who treats people badly and minimizes their importance (ie like many doctors do with "Non-MD's")
 
I agree with everything you've said.

I'd rather have a know it all who doesn't treat people badly than somebody else who thinks that others don't know anything and who treats people badly and minimizes their importance (ie like many doctors do with "Non-MD's")


:confused: :confused: I don't think this delineation is necessary. Who made it up? I don't think anyone should treat patients badly. I just don't like know-it-all (should I say those that think they do) medical students with a chip on their shoulder like this OP. I mean seriously, so much of his post was to impress us with his experience in health care. This was his big moment to let everyone know how much better HE was compared to the rest us. No matter how they treat patients, they are a pain in the arse to work with and I would rather not have to. If there are those who I sense are like this when they interview, they're done. end of story

It's not about hate. Good grief! :rolleyes: It's a matter of frustration. Its about working with someone comfortably. Maybe he'll change?!?! I actually believe he/she can once they see how smart there classmates are. That was one thing that constantly amazed me in medical school and maybe it is just me, but dang it, my classmates were bright. You go from being in the top 10% in undergrad to being surrounded by that 10%. If that doesn't humble somebody that what can?
 
To the OP:

Not everyone needs the experience of working as a CNA to know they want to become a doctor. I got a pretty good idea that I liked medicine from shadowing doctors. And I still knew, at least in theory, that the hours were going to be long.
 
OP- I don't think most people begrudge you your own personal experience. I'm truly glad you feel that you are prepared, that you know what is coming in medschool and beyond, and that you have already decided you can handle it. It's good to know what to expect! :)

BUT- there is no need to force that on every other premed/med student. We will all figure it out ourselves, one way or another. We have our own paths, our own reasons for being sure we want to be doctors- and I have a feeling there will be surprises for every one of us down the road, including you. We will deal with them and stick with it, and most of us will still wind up good doctors.

You just triggered an automatic feeling of resentment by suggesting that your way is the only way- and that it perhaps should be mandatory! Let us handle our lives- we're big boys and girls too!
 
Top