Cold Feet

[cpain]

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[PlaqueBuster]

1. You have become desensitized but that doesn't mean you are not passionate. Every job will have routine day to day duties. You cannot expect to do something new everyday. That would mean you have a new profession every single day.
2. This is the availbility heuristic. The docs you have contact with do not represent the majority
3. Everything is a business if you are making money from the service
4. You do know yet what you will gain. Different specialities in medicine provide you with different quality of life based on how you shape your career
5. Again limited number of docs you have talked to.

You will probably notice many of these things in dentistry also. So it's time to get your feet soaked in warm water and reapproach this field with an optimistic mindset if you really want to pursue it.

 

[BillrothI]

You have some very valid concerns. Perhaps you should spend some time exploring other career options. You could even take some classes at your school that you might find interesting - engineering, computer science, law. It sounds like you have had limited exposure to other fields and it is certainly possible that you'll fall in love with a profession that has nothing to do with medicine.

Good luck.

-Bill

 

[NeuResurgens]

Your last point is moot. It's a small sample size and a majority of physicians say they would do it again (per medscape physician survey). As far as computers go, you're probably going to see more of that in internal medicine, especially ER and primary care where patient volume is higher and ailments tend to be more routine. As PlaqueBuster mentioned, do you know the rewards of medicine? Because it seems like you mostly have cynical doctor friends anyway (per your last point) which would feed their opinion that "the cost is more than the gain" anyway. Find a couple of providers who obviously are passionate about what they do and shadow them, these people will show you the good sides of medicine. As far as business goes, that's just how it is when money is concerned.

It sounds like you just haven't gotten the right experience in medicine yet to really give you a good snapshot of the profession, so keep shadowing and finding new experiences beyond what you just happen to run into on the job. However, if you do this and still find that you can only focus on the negatives, that's when to pull the plug on going into medicine.

 

[quant_risk]

Maybe you are having too much on your plate at the moment. Have you considered taking a week off for vacation, stepping away from the ER for awhile? When you are fully charged, you might find your passion back.

 

[Salt Salt]

I am just a fellow pre-med, but I have two things to say:

1. The ER is not representative of the rest of medicine. Or rather, it is, but it represents the worst of medicine in a drastic way. It's no coincidence that ER docs have the highest burnout rate of any specialty (this is very consistent across studies). It's one of the hardest specialties not to feel like a "body mechanic" in. This is just the nature of the short-term, in-and-out interactions you get in the ED (not to mention the type of people EDs can attract). I almost decided not to pursue medicine after working in an ED for a year. It was only when I realized that this had more to do with emergency medicine than my personality/interests that I decided to continue my application.

2. Forget the 16 doctors you asked. This is an extremely empirical question and anecdotal evidence is unwarranted.

Just my $0.02. Good luck either way

 

[Just Call Me Doc]

I guess the first question to ask is why did you want to pursue an MD in the first place? Also, what are your ultimate goals that you are trying to reach? I would start from there and work your way back.

From your post, I would say that emergency medicine is most likely out of the picture but there are still other specialties that may fit within what you are looking for. Every career is going to have its pluses and minuses and you have to figure out the right balance for you.

 

[cpain]

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[cyclopes93]

Thank you for your replies. It seems I may need to take a break from the emergency room and evaluate my decision to pursue medicine looking at medicine as a whole rather than one specialty (although when you work in one specialty pretty much your entire working career it seems like the only one that exists =o)
As for why I wanted to choose MD: I liked the idea of being one of the few leaders in the healthcare profession, constantly obtaining new knowledge and actually being able to apply the knowledge you obtain to your patients (rather than gaining all of this knowledge and having to ask for orders to give Tylenol -.-), having the satisfaction of knowing you tried to change someone's life for the better no matter how big or small the change, the challenge of solving different cases, also being able to retire one day is a plus. I would say my ultimate goals were to work as an MD around 40-50hours a week (I don't mind being on call) with something that involves using my hands rather than solely using my mind, have a house where I'll be able to support and raise a healthy family, go on vacation once or twice a year, nothing crazy. Another concern I also have about MD is what if I find something I truly like, say Interventional Cardiology, I get through my 4 years trying as hard as I can, but can't match due to a lower than they want step score. Then I have to match into something I may not even like after 4 years of med school =\ (not saying I couldn't match, but life happens and there is always the possibility).

I say go shadow a dentist. Talk with them about how easy or hard job seeking is. While 16 ppl may not make up a good statistical sample number, it does echoe a concern. However, ER and family are not necessarily a good representation in my opinion. Get a rough idea of what setting you want to work at (not specifically on whether it is medical/dental). Do you want to be a hospitalist because in the near future, you might have to be if you go medical. The computer stuff is really what the government laws and hospital regulations are making doctors do; believe me that doctors really let a third party get away with controlling them and now it's biting them back.

 

[Just Call Me Doc]

Another concern I also have about MD is what if I find something I truly like, say Interventional Cardiology, I get through my 4 years trying as hard as I can, but can't match due to a lower than they want step score. Then I have to match into something I may not even like after 4 years of med school =\ (not saying I couldn't match, but life happens and there is always the possibility).

Life is all about risk management. And doing nothing is sometimes just as much a risk (or sometimes more) as doing something. There is also the risk of finding something you truly LOVE, make it through, and live a great and fulfilling life. There are no guarantees in life but I've always had the philosophy of never letting my fears dictate my decisions. Sure it doesn't always work out, but at least I never regret making a decision (or not making a decision) just because I was afraid of the possibilities.

 

[Vain Brother]

other than the little survey you conducted, i can't really argue with most of your points. it sounds like your heart's not into it -- why put yourself through something so demanding if you're not sure you want to do it?

i'm leaving a field that offers me great pay and a fantastic and flexible lifestyle (pharmacy) for medicine, and yeah of course leaving the lifestyle behind is going to suck as i finish out my 20s in medical school, but ultimately it's a sacrifice i want to make, for the reasons you listed (intellectual stimulation, being the leader of the health care team, etc). if you're worried about lifestyle, sure, go into dentistry, they get paid plenty and it doesn't seem all that stressful. just know what opportunties you're giving up

 

[Psai]

Ems already provided all the medical treatment haha yeah ok

What do you want doctors to do? Sit there for twenty minutes holding the patient's hands as you pray together? Just need enough time to rule out bad things and figure out what's going on. Who do you think interprets the labs that were drawn? Or determines the flow rate of the iv?

Rest of your points are very valid, medicine is a big business and has been turned into money focused ventures by a few greedy doctors and clueless government officials who gave away all the power to large hospitals and corporations. They are doing their best to eradicate any semblance of active thought so that they can fill their pockets which is why they persistently promote the proliferation of non physician "providers"

 

[mimelim]

Hi all, I have been a browser of these threads for a few years now and am making my first post.

I have been a RN/Paramedic for around 5 years now and currently work inside an emergency room. I am also a non-trad student (obviously) studying biochemistry with the intent of pursuing a MD (currently a senior), or at least I thought. Lately, after thinking really hard about my future endeavors, I have began to have cold feet and have even contemplated switching to dentistry. Some of the reasons I have are as follows:
- I don't believe I will be passionate about medicine, or any other career for the matter. I have worked in a variety of medically related settings and after a while it all becomes just a job to me. The 30th bad car wreck that comes in is just as dull as the 500th car wreck that comes in. All of the things I've read say "do not become a physician unless you are passionate" " love patient care" etc. etc., but I don't. I was passionate about it at first, but now I feel like a body mechanic more so than a healthcare provider.
- Most all of the physicians I work with seem to have to treat their computers more so than the patients. For example, a 70 y/o woman comes into the emergency room with shortness of breath. The ER doc glances at her as she rolls by on the stretcher and gets put into a room. He then leaves his computer, comes into the room and introduces himself as Dr.soandso. By this time the patient has already been given medical treatment by EMS so she is no longer having difficulty breathing, an IV is already started, labs have already been drawn, etc. so the ER Doc auscultates, gets a brief history with a "we are going to get you taken care of Mrs. soandso", and back to the computer. I shadowed two family practice doctors as I thought maybe this is just an ER thing, and sure enough 10-15 minutes per patient, and back to the computer. I don't feel like physicians are given the time needed to give compassionate proper care to patients.
- I feel like medicine has become a business, except the doctors aren't running it. Hospital admins, insurance companies, etc. are controlling how long physicians work, how much you will be reimbursed, even write you protocols that YOU as a physician have to follow in order to receive proper payment. I would hate to go through 7+ years of additional schooling, just to be used and abused by a bunch of business junkies.
- The time and stress required (as I've heard from physicians themselves) is far more than what is gained.
Always having the "did I do this procedure right so I don't get sued" lingering over your head followed by 60 hour work weeks seem distasteful. Putting in hours and hours of schooling and residency, just to get out and find patients whom feel entitled to care. They cuss at you, spit on you, fight, bite, and any other "ite" you want to add. Some are brought in by police officers, or EMS etc. that don't even want medical treatment at all, at least in the ER. Not a lot of time to see your kids grow up, have a healthy lifestyle, or strong social life; Time is the most important resource of all is it not?
- I have asked around 16 doctors if they could do it all over again would they, and only 2 of them saying they would. One of those 2 said it's a job and beats working at the Coca Cola factory... 3 of those 16 were orthopedic surgeons (whom I used to be a MA for) who all said they would not do it all over again, one recommending doing PA instead. Obviously I know this is a small sample size, but it still carries some weight.

So these are some big concerns I've had regarding my future. It's not a doom and gloom thread, these are just some things that I have experienced and you may feel differently. I would like to hear some feedback as to whether my reasons to cut medicine out of my future, should actually weigh as strongly as I led on. Medicine has been all I've ever known so it is hard for me to end it all, but I think I would be foolish to ignore all of the signs presented and pursue anyways... help!!!

Thank you for your replies. It seems I may need to take a break from the emergency room and evaluate my decision to pursue medicine looking at medicine as a whole rather than one specialty (although when you work in one specialty pretty much your entire working career it seems like the only one that exists =o)
As for why I wanted to choose MD: I liked the idea of being one of the few leaders in the healthcare profession, constantly obtaining new knowledge and actually being able to apply the knowledge you obtain to your patients (rather than gaining all of this knowledge and having to ask for orders to give Tylenol -.-), having the satisfaction of knowing you tried to change someone's life for the better no matter how big or small the change, the challenge of solving different cases, also being able to retire one day is a plus. I would say my ultimate goals were to work as an MD around 40-50hours a week (I don't mind being on call) with something that involves using my hands rather than solely using my mind, have a house where I'll be able to support and raise a healthy family, go on vacation once or twice a year, nothing crazy. Another concern I also have about MD is what if I find something I truly like, say Interventional Cardiology, I get through my 4 years trying as hard as I can, but can't match due to a lower than they want step score. Then I have to match into something I may not even like after 4 years of med school =\ (not saying I couldn't match, but life happens and there is always the possibility).

I'll start at the end, as described, you have no reason to go into medicine, save yourself the time, energy and hassle and do something else.

Every profession has its ups and downs. Point blank, there are tremendous downsides to medicine. You have highlighted several, but for the sake of completeness, the big ones:

#1 Very long training pathway, from where you are now, 7-13 years between now and when you start clinical practice.
#2 Very expensive schooling with back loaded compensation. 4 years of either negative or minimal cash flow, followed by 3-9 years of 50-60k/year residency, while taking on loan debt if you are the average medical student.
#3 Declining reimbursement, you will see more patients and get paid less than physicians do now and a lot less than physicians did 10 years ago.
#4 It is possible to 'be your own boss', but for the vast majority of physicians, this happens toward the end of their career and deal with hospitals, senior partners, etc for a decade or two.
#5 You will be busy. Anyone who tells you otherwise is lying to you. It is not unusual in medical school and residency to be working or studying 60-100 hours per week. When you are a fresh attending, you can be working just as much, if not more to get your practice off the ground. You WILL miss out on other aspects of life.

Medicine is a calling. Not because of some romantic, "I want to help people!" notion. It is a calling because the only reason to go into medicine is because you know #1-5 and for some reason, doing what a physician does every day somehow makes up for it. Medicine is NOT the pinnacle of professions. It is NOT for everyone. Even if you are a 4.0 GPA /40 MCAT student, medicine MAY not be the right choice for you.

Medicine has some ups that you can rarely find in other fields. Despite the fact that there are always going to be administrative 'bosses', physicians enjoy a near universal role of being the 'captain of the ship'. For people that enjoy leading or having control of their surroundings, this is a plus. A part of most physician's job is going to be some level of management. While there are significant financial problems with medicine, there IS financial security. You will never starve. Unless you are a complete **** up, you are going to be able to get a job when you finish your training. Also, while acknowledging your concern about not getting into the subspecialty that you desire, it is truly not as big of a concern for the people that end up in medicine and SHOULD have ended up in medicine. Interventional cardiology requires medical school (4 years), internal medicine residency (3 years), cardiology fellowship (3-4 years) and then an interventional fellowship (1 year), for a MINIMUM of 11 years of training. Yes, certain aspects of that are competitive, but at every competitive fork, there are lots of other options/backups that most people find pretty palatable. All of that so that you can put in stents and **** up people's groins for me to fix.

Again, in short, based on your post, you should NOT apply to medical school. IF you are still waffling back and forth, the best route is to shadow. Pure and simple. Not volunteering, not working with or for physicians, actually shadow. And for God sake, get out of the emergency room. When you are doing anything besides dedicated shadowing, you have to focus on other things. It is distracting. You may feel more useful (because shadowing provides NOTHING to other people), but this is about YOU and figuring out what YOU are going to do with the next 3-4 decades of YOUR life. You need to answer the fundamental question, "Medicine has a lot of very real negatives, are they worth taking on to be a doctor?" If you are a smart student, you will be successful in something, you don't NEED to be a doctor to find happiness or fulfillment. The earlier you figure this out, the better it will be for you and everyone else around you.




ps. I was kidding about the ****ing up groins.



pps. I wasn't kidding. 3 this week so far and its only Monday...

 

[cpain]

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[MikeSimouns]

Well, Painfully cold feet is an age-old problem for cyclists. In general, it seems to be highly individual. Some riders suffer despite all precautions. Others do fine with minimal protection in glacial conditions.