Critics of the Medical Profession

[8744]

I get accused, along with several other long-time posters, of being overly critical of the medical profession. Our criticism is often greeted with disdain or incredulity and many wonder why the tone of SDN seems to have become more negative over the years.

Consider this. I have been posting on SDN since 2001 and my first year of medical school. SDN has been around longer of course but back then there were far fewer members who had completed medical school, much less started residency. Like travellers to a distant and almost unknown land, we are now returning to tell our fantastic tales and as happens to many explorers, the stories we tell are not always believed.

Just keep that in mind. When I started the only place you could really get any information about medical school, residency, and the realities of the medical profession was to either have an "in" or to read the limited selection of books then available.

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[Koala 33]

To be honest, I'm glad that you are "overly critical." I had a volunteer position at a hospital this summer, and the coordinator only brought people in who were absolutely in love with the medical profession and had nothing bad to say about it. So, it's refreshing to have people involved in the profession letting us know about all aspects of medicine, whether they be positive or negative. I know I'd be extremely pissed off if I got to medical school and had all of the negativity thrown at me without anyone letting me know ahead of time. At least this way I can't blame anyone but myself now if I get there and am shocked about how bad it is since I'm being made aware of it beforehand.

 

[armybound]

not everything is rosy, and people need to hear about the negatives to realize what they're getting themself into.

 

[A Platypus]

along with several other long-time posters

names or it isnt true

 

[xpinchx]

You say what needs to be said. The profession is often over-romanticized and often people need (and like, whether they will admit it or not) a cold slap across the face from reality. I enjoy reading your blog, thanks.

 

[A Platypus]

You, Panda Bear, are the rose in the morning blooming and posting on the internet for all to come and appreciate with words of tribute and praise. Let me linguistically pat you on the back and congratulate you for having the courage to say what needed to be said. Y e s .

 

[Brigade4Radiant]

I understand but why do you so often compare fields out side of healthcare and tell people to go to IB or get a law degree from the top 25 schools?

 

[deuce924]

not everything is rosy, and people need to hear about the negatives to realize what they're getting themself into.

Completely Agree

 

[armybound]

I understand but why do you so often compare fields out side of healthcare and tell people to go to IB or get a law degree from the top 25 schools?

they all require intelligence and pay well, but IB and law school require less of a time commitment for training.

 

[emttim]

Interestingly enough, it seems as if the only aspects of medicine if you would follow all these blogs and comments are negative ones, and that there is no possible reason to get into medicine and no positive aspect if you do.

Don't get me wrong, I'm all for painting a realistic picture of something, not just medicine but anything, because the truth needs to be out there, but the question arises whether there's any logical reason (I don't care about personal anecdotes, this is my calling, blah blah, those are not necessarily rational in most cases) to go into medicine.

The way that you depict it PB, and other bloggers who I've followed a little, is that medicine will continue to be severely threatened by litigation, pay will continue to decline (god knows what will happen if they manage to get enough idiots to vote for socialized health care), work conditions are deplorable and in most cases sound like they are worse than the conditions at a supermax prison, and on top of that, it seems as if once you are finally an attending, nothing really changed and you have to deal with all of that for the rest of your life. Perhaps a realistic portrayal, but not necessarily an encouraging one, even to those who do feel the desire to help others.

I think there's a difference between falling into a pit and climbing out after time and falling in that same pit and then getting buried alive. So as an attending, is live really not that much different, or do you finally climb out of that pit?

 

[IceMan0824]

they all require intelligence and pay well, but IB and law school require less of a time commitment for training.

Investment Banking (IB) may not require less time commitment for training, but it is on par, if nor greater, in terms of sacrifice and time commitment required to dedicate to the career.

To top it off, most people working in IB don't want to stay in IB, and only want to use it to leap into other well-paid or specialty positions, like venture capital or private equity.

I agree with most of what Panda Bear may post but I completely disagree with the notion here on SDN that IB is the professed land of milk and honey. Does IB compensate well? Yes, but it drains the life out of most that work in the profession. This is exactly why it pays so well.

The only reason I would advocate IB is that those who have advanced in the IB realize the commitments and sacrifices that analysts and associates devote. The higher up try to retain these candidates by throwing money at the analyst and associates. Medicine is still yet to learn this secret, instead, those in power would rather berate the new medical student, interns and residents, and politicians would rather decrease their compensation... It may be that the training to become a physician is so time consuming that the exit alternatives are not as lucrative as the exit options of IB. Whatever the reason, IB compensates its workers greatly because it needs to retain the candidates.

Okay, I rambled on enough...If you want to read more of my opinion, read my blog in the upcoming days, I plan to detail why I decided not to attend medical school after all the years I had put into it. Probably not the most exciting reads, but then again, most of you read organic chemisty for fun.

 

[smq123]

Does IB compensate well? Yes, but it drains the life out of most that work in the profession. This is exactly why it pays so well.

Residency drains the life out of most, too. By that reasoning, residency should be extremely lucrative. If you're going to have the life drained out of you, might as well have a bank account that will show for it.

The only reason I would advocate IB is that those who have advanced in the IB realize the commitments and sacrifices that analysts and associates devote. The higher up try to retain these candidates by throwing money at the analyst and associates. Medicine is still yet to learn this secret, instead, those in power would rather berate the new medical student, interns and residents, and politicians would rather decrease their compensation... It may be that the training to become a physician is so time consuming that the exit alternatives are not as lucrative as the exit options of IB. Whatever the reason, IB compensates its workers greatly because it needs to retain the candidates.

Hopefully, medicine will learn this lesson too. Hopefully.

 

[8744]

I understand but why do you so often compare fields out side of healthcare and tell people to go to IB or get a law degree from the top 25 schools?

I have never advocated Investment Banking to anyone (or law school). I don't even really know what investment bankers do except that they are probably some of those people you see in airports obsessing over their laptops and talking continuously into their cell phone "hands free" head sets.

Seriously. I feel like a real slacker when I fly. I don't even own a cell phone.

 

[8744]

...The way that you depict it PB, and other bloggers who I've followed a little, is that medicine will continue to be severely threatened by litigation, pay will continue to decline (god knows what will happen if they manage to get enough idiots to vote for socialized health care), work conditions are deplorable and in most cases sound like they are worse than the conditions at a supermax prison, and on top of that, it seems as if once you are finally an attending, nothing really changed and you have to deal with all of that for the rest of your life. Perhaps a realistic portrayal, but not necessarily an encouraging one, even to those who do feel the desire to help others...

I have never even come close to saying that. The majority of attendings don't work nearly as many hours as the typical resident or pull as much call, nor are they mistreated like residents. Now, there are some attendings in both academic medicine and private practice who work long hours but that is just the fruit of personal choices they have made. If your dream is to be the Chief of Medicine at Duke University Hospital you are going to have to struggle for your entire career.

 

[IceMan0824]

Residency drains the life out of most, too. By that reasoning, residency should be extremely lucrative. If you're going to have the life drained out of you, might as well have a bank account that will show for it.

By that reasoning, if residency is to continue down its current path, it may be forced to be lucrative when there is no more takers of spots, but the invisible hands works all too slowly. It's only because resident see some proverbial "light at the end of the tunnel" that they stick through me. Maybe I'm wrong, after all, I'm not a resident. Let the residents come and tell us what keeps them going through residency.

 

[154465]

So what exactly are you saying Panda? That I won't be able to pick up my 19 year old wife from our mansion in my Porsche? I don't believe you.

 

[IceMan0824]

I have never advocated Investment Banking to anyone (or law school). I don't even really know what investment bankers do except that they are probably some of those people you see in airports obsessing over their laptops and talking continuously into their cell phone "hands free" head sets.

Seriously. I feel like a real slacker when I fly. I don't even own a cell phone.

IB interns work with MS Word
IB analysts work with MS Excel
IB associates work with MS Outlook

There, now you're an expert.

 

[A Platypus]

So what exactly are you saying Panda? That I won't be able to pick up my 19 year old wife (????) from our mansion in my Porsche? I don't believe you.

teh reason for becoming a doctor is to have a 18 yo nsa, not a wife YOU DREAM SMALL

 

[154465]

teh reason for becoming a doctor is to have a 18 yo nsa, not a wife YOU DREAM SMALL

your aspirations humble me...I have much to learn.

 

[8744]

By that reasoning, if residency is to continue down its current path, it may be forced to be lucrative when there is no more takers of spots, but the invisible hands works all too slowly. It's only because resident see some proverbial "light at the end of the tunnel" that they stick through me. Maybe I'm wrong, after all, I'm not a resident. Let the residents come and tell us what keeps them going through residency.

Because we're stuck. If medicine only paid what I made as an engineer, and assuming that I had decided to go into it anyways, I wouldn't have lasted a month in intern year.

"You want me to stay up all night every fourth night and then work a normal work day? Are you crazy? **** you. I quit. Get some other idiot to do that."

Or

"Hey, in case you didn't notice buddy, I'm bigger, older, meaner, and a lot better at hand to hand combat than you so the next time you address me like that you'd better be prepared to throw down."

or

"I don't care if you are a big Attending Surgeon. The next time you talk to me like that in front of other people I will kick your ass."

Seriously, man. The single most annoying moment of my residency was being lectured about the important things in life (total dedicaton to medicine to the exclusion of everything else) by a little slip of girl who had no children, no life, no husband, no social skills, no hobbies, no experience outside of college, medical school, and residency, but was my senior resident.

She was young enough to be my daughter.

 

[pakbabydoll]

I have no life out side of school and work so I don't think I would mind not having a life in medical school and residency or even afterwards. Being a Doctor is one of my goals in life and I am going to do it. I know most of you guys are thinking poor naive pre- med students and perhaps your right and will be proven right and maybe I'll hate it like you do but at this point in my life being a physician is my one goal.

 

[Bartelby]

I have no life out side of school and work so I don't think I would mind not having a life in medical school and residency or even afterwards.

What's with undergrads having no life? It wasn't that hard. I guess if you work enough hours, that might do it. Still, I don't get how so many premedical students have no time for anything else.

 

[Jolie South]

What's with undergrads having no life? It wasn't that hard. I guess if you work enough hours, that might do it. Still, I don't get how so many premedical students have no time for anything else.

I know. I studied/went to class for maybe 20% of my time. The rest was spent hanging out with friends and going to parties and the like.

I ended up with a 3.6

 

[nick_carraway]

What's with undergrads having no life? It wasn't that hard. I guess if you work enough hours, that might do it. Still, I don't get how so many premedical students have no time for anything else.

Only pre-meds can be proud of their lack of a life outside of school & work.

Personally I've never had a fear of calling in sick. Sometimes you really want that three-day weekend.

As for classes, I went to them even less than Jolie and my GPA looks just fi--oh.

 

[8744]

I have no life out side of school and work so I don't think I would mind not having a life in medical school and residency or even afterwards. Being a Doctor is one of my goals in life and I am going to do it. I know most of you guys are thinking poor naive pre- med students and perhaps your right and will be proven right and maybe I'll hate it like you do but at this point in my life being a physician is my one goal.

Who said I hated it? I just observe occasionally that being a resident can blow, big time.

I applaud your dedication...but seriously...don't you have any other interests?

 

[8744]

I have no life out side of school and work so I don't think I would mind not having a life in medical school and residency or even afterwards. Being a Doctor is one of my goals in life and I am going to do it. I know most of you guys are thinking poor naive pre- med students and perhaps your right and will be proven right and maybe I'll hate it like you do but at this point in my life being a physician is my one goal.

What's so hard about undergrad? Now, I probably had a 3.4 GPA as an engineering major but I didn't exactly kill myself either. Undergrad is easy. If you go to class, study, and keep up there is nothing to it.

 

[smq123]

I have no life out side of school and work so I don't think I would mind not having a life in medical school and residency or even afterwards. Being a Doctor is one of my goals in life and I am going to do it. I know most of you guys are thinking poor naive pre- med students and perhaps your right and will be proven right and maybe I'll hate it like you do but at this point in my life being a physician is my one goal.

Well, you think wrong.

Like you, I had a less-than-stellar social life in undergrad. I had to work, I had to keep a house clean, and I decided that it would be "fun" to be pre-med, yet also major in one of the humanities. Let's just say that carrying a packed course load plus a job didn't leave much time for socializing.

By the time you're done 1st year of med school, you're tired of it. You're tired of hearing about medically-related stuff day in and day out. One more word about renal physiology makes you want to rip your own kidneys out. Watching movies and reading books that focus on medical or culturally sensitive topics (that stupid, stupid, poorly-written book about the Hmong, for example) makes you wish you'd never learned to read in the first place. And suddenly, having a family, having a close circle of friends, and getting dressed up to go out somewhere seems really good.

Being a doctor is one of your goals in life. Fantastic. However, hanging around the hospital is only fun for the first 10 hours of your shift. After that, you just want to talk to other people who don't want something, need something, have blood pouring out of somewhere, and are not responsible for evaluating you in some manner.

 

[Bartelby]

but at this point in my life being a physician is my one goal.

Just out of curiosity, why is that? Have you worked in a hospital or shadowed parents or something, or is this coming from abstract notions about what a doctor is and what a doctor does? I have to wonder, if all you really accomplished by the end of your life was being a physician would you regret it on your deathbed? Personally becoming a physician is one of my central goals, but not the only one. And ultimately becoming a physician is one of my goals because I believe it will serve a greater goal of providing me with meaningful and fulfilling work in life.

 

[pakbabydoll]

What's with undergrads having no life? It wasn't that hard. I guess if you work enough hours, that might do it. Still, I don't get how so many premedical students have no time for anything else.

It has little to do with course work. Its more like since I work after school everyday so when I get home after work I study. Its just work/school/home for me.

I know. I studied/went to class for maybe 20% of my time. The rest was spent hanging out with friends and going to parties and the like.

Well that just means that you are very smart. I have to actually study to get "A"s.

Sometimes you really want that three-day weekend.

Oh I have not had a weekend off since my high school graduation in May.

I applaud your dedication...but seriously...don't you have any other interests?

Well I like volunteering at the Betty Griffin house but I started it to get volunteer hours for med school. I am in PTK which started because it would look good on my application. I loved volunteering at the ER but the hospital decided they don't want under 21 people volunteering since we are a "MAGNET" hospital now.

Like you, I had a less-than-stellar social life in undergrad. I had to work, I had to keep a house clean, and I decided that it would be "fun" to be pre-med, yet also major in one of the humanities. Let's just say that carrying a packed course load plus a job didn't leave much time for socializing.

By the time you're done 1st year of med school, you're tired of it. You're tired of hearing about medically-related stuff day in and day out. One more word about renal physiology makes you want to rip your own kidneys out. Watching movies and reading books that focus on medical or culturally sensitive topics (that stupid, stupid, poorly-written book about the Hmong, for example) makes you wish you'd never learned to read in the first place. And suddenly, having a family, having a close circle of friends, and getting dressed up to go out somewhere seems really good.

Being a doctor is one of your goals in life. Fantastic. However, hanging around the hospital is only fun for the first 10 hours of your shift. After that, you just want to talk to other people who don't want something, need something, have blood pouring out of somewhere, and are not responsible for evaluating you in some manner.

You are probably right. I already said that maybe I am being naive about the whole situation. Its not an option for me. I have to prove my self to my parents, my family, to most of all my self. All my life I have been put down by people around me for every thing. I have never been smart enough, compared to my brother. When I got a 75% scholarship in high school my parents said " 75% ? you should have gotten the 100% one who is going to pay 25% tuition."

I work at the hospital, I work 13-14 hours shift depending on the load. However I work in the in house pharmacy so even though I have contact with patients its not that much. The part I hate is that when ever you walk down the hall way every one is always like hello how are you? I am so sick of that.
I used to work in the cafeteria, I started when I was 16. So I know almost everyone. I volunteered at the hospital too over 150 hours and so every one I see has to be Hello who are you? by the end of the day I just want to say I am bad lol.
My point is you are right and I might hate it by the time I get there but I would rather hate it when I get there then never get there in the first place. Maybe thats just crazy me talking but thats how I feel.

 

[brsboarder]

As soon as we stop critiquing, we should be scared. Complacency is a thing that we never want to find ourselves being. While I do not have strong ties to the history of this board, I do believe that whether miniscule, or harsh, a critique is always beneficial. While they can be false in part, they do cause us to think about things more, question more and do more. For that reason, keep your critiquing

 

[collegefootball]

I fit the category of no social life outside of the classroom. That is the way I like it though. I wake up at 5:00 am and drive a shuttle bus from 6am to 8am M-F and from 11:00 pm to noon M-F , and then 3:00pm to 6:00pm M,W,F and get paid 12 dollars per hour.

I work in a booth in a ramp as a student making 7 dollars per hour and work from 8:00 to 10:00 am M-F and 10:00-11:00 M and W.

I also work in a security department at school busting beer parties from 10:00pm to 3:00am on Friday and Saturday.

I shadow at a family crises center from 7pm to 10pm two nights a week and volunteer 3 hours a week at a hospital.

After taxes are taken out, my take home is 1600 dollars a month. I like to work. I have never really had a social life. I don't have any problem getting along with others or connecting with others. I grew up on a farm so I'm use to working from 5:00am to late at night everyday of my life. I can't stand the idea of not working all day long...I feel like a bumb if I don't work.

I lough when I hear how busy the professors are at my college. I have seen most professors not get to school until 9:00am to noon and then a lot of them leave again around 3:00 to 5:30pm. I know this because I work in the both where they drive to park their car. So the next time I hear a professor compain about having to read 40 10 page papers while socializing and drinking coffee I will just role my eyes once I walk away. I could have 40 10 page papers corrected in just a couple of hours. It's all about sitting down and working your ass off. Not going online and drinking a soda and complaining about those papers sitting next to you that need to be graded.

 

[mints of b]

I fit the category of no social life outside of the classroom. That is the way I like it though. I wake up at 5:00 am and drive a shuttle bus from 6am to 8am M-F and from 11:00 pm to noon M-F , and then 3:00pm to 6:00pm M,W,F and get paid 12 dollars per hour.

I work in a booth in a ramp as a student making 7 dollars per hour and work from 8:00 to 10:00 am M-F and 10:00-11:00 M and W.

I also work in a security department at school busting beer parties from 10:00pm to 3:00am on Friday and Saturday.

I shadow at a family crises center from 7pm to 10pm two nights a week and volunteer 3 hours a week at a hospital.

After taxes are taken out, my take home is 1600 dollars a month. I like to work. I have never really had a social life. I don't have any problem getting along with others or connecting with others. I grew up on a farm so I'm use to working from 5:00am to late at night everyday of my life. I can't stand the idea of not working all day long...I feel like a bumb if I don't work.

I lough when I hear how busy the professors are at my college. I have seen most professors not get to school until 9:00am to noon and then a lot of them leave again around 3:00 to 5:30pm. I know this because I work in the both where they drive to park their car. So the next time I hear a professor compain about having to read 40 10 page papers while socializing and drinking coffee I will just role my eyes once I walk away. I could have 40 10 page papers corrected in just a couple of hours. It's all about sitting down and working your ass off. Not going online and drinking a soda and complaining about those papers sitting next to you that need to be graded.

Any thoughts on what you plan on pursuing in medicine?

 

[collegefootball]

Any thoughts on what you plan on pursuing in medicine?

I might become one of the evil mid level health care professionals so I can work full-time doing that job and still be able to teach at a local university (about 2 or 3 classes a semester) and do some international work in my chosen profession. I would like to coach some football on the side as well....at a high school level.

 

[WHR]

I fit the category of no social life outside of the classroom. That is the way I like it though. I wake up at 5:00 am and drive a shuttle bus from 6am to 8am M-F and from 11:00 pm to noon M-F , and then 3:00pm to 6:00pm M,W,F and get paid 12 dollars per hour.

I work in a booth in a ramp as a student making 7 dollars per hour and work from 8:00 to 10:00 am M-F and 10:00-11:00 M and W.

I also work in a security department at school busting beer parties from 10:00pm to 3:00am on Friday and Saturday.

I shadow at a family crises center from 7pm to 10pm two nights a week and volunteer 3 hours a week at a hospital.

Thats pretty impressive - how many hours of classes do you have?

Just one issue: Marking 40x 10pg papers isn't an easy task and should take more than 2 hours. From my experience as a TA, and I am sure other SDN members also know, marking assignments/papers fairly and thoroughly is a time consuming task (source of big headaches in classes of 90+ students). I think you deserve respect for your great work ethic but that doesn't mean that you can look down on (or laugh at) someone who work 9-5 esp since you don't really know what these profs do after they leave the parking lot (may be they work at the hospital as researchers or they value their family life).

 

[mrjbb]

I have been reading your blog for about 2 years now, since before really getting into SDN and at first I was overwhelmed by the "hidden" truths/myths within the medical profession in which you've done a wonderful job exploiting, however as I read more in depth I got hooked.

I realized that we live in a world where ignorance is sometimes unavoidable. Many hopeful doctors believe that from the beginning of their medical professions till the day they retire their always going to be entitled to a life full of blissful joys, and that IMO couldn't be farther from the truth (Not inferring in any way that we as physicians can't accomplish an exultant life).

Panda Bear you've done a great job worthy of being applauded in reference to informing the truth behind the facade many medical practitioners incorporate to "shield" the medical profession.

Many read your blog and become offended, however all you're trying to do is respectively inform the "general" public about the weaknesses, myths, corruptive professionalism and misleading formalities that take place within our medical communities, in which many of us will become a vital part of once we've achieved our goals.

I love medicine and can't see myself happily doing anything else (since I've tried several careers) so reading once in a while about the several detrimental issues that may take place within the medical profession doesn't hurt me but only fuels my passion and interest for medicine.

Who knows maybe we as the "next" generation of physicians can ultimately innovate and drastically improve the medical profession.

However in order to acknowledge and realize what needs to be improved, you need to first be informed of the faults.. My insight...

If you haven't read any of Panda Bears blogs I would suggest you atleast scan through some of his helpful posts.

Your all welcome to discuss this further.

 

[Gut Shot]

Let the residents come and tell us what keeps them going through residency.

It's really pretty simple: I like what I do. It helps that I happen to enjoy pathology, a specialty where I can maintain some sort of life (even in residency). It helps more that my program is pretty non-malignant; there is little in the way of abuse to suffer. There is certainly the light at the end of the tunnel - salaries are reasonable and the opportunities in my area of interest are more than adequate. I have little interaction with patients, which makes what interactions I do have all the more enjoyable. In general, though, I prefer to communicate with other pathologists and physicians. Some of my good fortune is just that, good fortune to have an inherent interest in medicine that makes me happy. And yet, along the way I have made a number of conscious decisions that have led to my life not being a living Hell.

My true Virgil, however, is that for all the ups and downs in residency, it could be worse. Much much worse. In The Paradox of Choice, Barry Schwartz discusses the concept of framing, or how we perceive things based on their context. His example was a comparison of two hypothetical signs at a filling station:

#1:
DISCOUNT FOR PAYING CASH!
CASH - $1.45 a GALLON
CREDIT - $1.55 a GALLON

#2:
Surcharge for paying credit
CASH - $1.45 a GALLON
CREDIT - $1.55 a GALLON

In #1 the "reference price" is the credit price, and if you're paying cash you feel like a winner. In #2 the "reference price" is the cash price, and if you're paying with credit you feel ripped off. The two signs have identical price structures, but they are framed differently, and people will have disparate subjective responses to them. It's all about context.

My context for med school and residency was a comparison to graduate school. Yes, there are some great opportunities in science and research, but for most people it's a hard life. From a monetary perspective, if I went whining to some post-docs about starting below $200,000 right out of fellowship, they'd shiv me. From a job security standpoint there's no comparison. As for the nature of the work, well, that's in the eye of the beholder.

Thus far I'm glad I took the path I did. Even after a long day, all I have to do is imagine myself in a cramped, windowless office, writing grants to cling to my assistant professorship job, and the world seems a cheerier place.

 

[plauto]

It's really pretty simple: I like what I do. It helps that I happen to enjoy pathology, a specialty where I can maintain some sort of life (even in residency). It helps more that my program is pretty non-malignant; there is little in the way of abuse to suffer. There is certainly the light at the end of the tunnel - salaries are reasonable and the opportunities in my area of interest are more than adequate. I have little interaction with patients, which makes what interactions I do have all the more enjoyable. In general, though, I prefer to communicate with other pathologists and physicians. Some of my good fortune is just that, good fortune to have an inherent interest in medicine that makes me happy. And yet, along the way I have made a number of conscious decisions that have led to my life not being a living Hell.

My true Virgil, however, is that for all the ups and downs in residency, it could be worse. Much much worse. In The Paradox of Choice, Barry Schwartz discusses the concept of framing, or how we perceive things based on their context. His example was a comparison of two hypothetical signs at a filling station:

#1:
DISCOUNT FOR PAYING CASH!
CASH - $1.45 a GALLON
CREDIT - $1.55 a GALLON

#2:
Surcharge for paying credit
CASH - $1.45 a GALLON
CREDIT - $1.55 a GALLON

In #1 the "reference price" is the credit price, and if you're paying cash you feel like a winner. In #2 the "reference price" is the cash price, and if you're paying with credit you feel ripped off. The two signs have identical price structures, but they are framed differently, and people will have disparate subjective responses to them. It's all about context.

My context for med school and residency was a comparison to graduate school. Yes, there are some great opportunities in science and research, but for most people it's a hard life. From a monetary perspective, if I went whining to some post-docs about starting below $200,000 right out of fellowship, they'd shiv me. From a job security standpoint there's no comparison. As for the nature of the work, well, that's in the eye of the beholder.

Thus far I'm glad I took the path I did. Even after a long day, all I have to do is imagine myself in a cramped, windowless office, writing grants to cling to my assistant professorship job, and the world seems a cheerier place.

I totally agree with that. I have been teaching in public schools since I graudated 4 yrs ago. Talk about abuse by the stupidest administrators, disrepectful children and idiotic parents, board of educations made up of people not even deserving to clean toilets in a school. No A/C, no decent computer, no outside calls from my classroom, all for $40,000 a year without a retirement plan (and I am lucky to get that much compared to many other teachers), no career development opportunities, and yes...children getting dumber every year (I know as a teacher I shouldn't say that but it's true enough for me to notice the trend in only 4 years). All I'm saying is that in any workplace there are problems and issues, as a teacher, a physician, or a lawyer. At least in medicine we'll have the light at the end of the tunnel and hopefully everybody is going in with a big passion and knowing what it takes to get there. Thanks for the heads-up!

 

[Quix]

I lough when I hear how busy the professors are at my college. I have seen most professors not get to school until 9:00am to noon and then a lot of them leave again around 3:00 to 5:30pm. I know this because I work in the both where they drive to park their car. So the next time I hear a professor compain about having to read 40 10 page papers while socializing and drinking coffee I will just role my eyes once I walk away. I could have 40 10 page papers corrected in just a couple of hours. It's all about sitting down and working your ass off. Not going online and drinking a soda and complaining about those papers sitting next to you that need to be graded.

Hi - college professor here. I teach at two colleges throughout the day (3-4 classes per semester), so it's not uncommon for me to have to drive back and forth between classes (they're about 13 miles apart). I also am leading two studies (currently in the manuscript phase) in critical care medicine, am designing a pilot study (which will probably be turned into a much larger venture once the initial data come in) and a study that will attempt to validate an existent metric for a novel patient-base, am designing a renal replacement educational module for our simulation center, am writing ethics articles, unofficially mentoring several students at a third college, and coaching high school speech and debate - all of these require me to be off-campus. Also, sometimes I like to sleep and eat. There are many like me.

Take home message: You haven't a clue what all your professors do simply because you sit in a booth and watch them drive to and from campus, so don't make assumptions.

 

[MattD]

By the time you're done 1st year of med school, you're tired of it. You're tired of hearing about medically-related stuff day in and day out. One more word about renal physiology makes you want to rip your own kidneys out. Watching movies and reading books that focus on medical or culturally sensitive topics (that stupid, stupid, poorly-written book about the Hmong, for example) makes you wish you'd never learned to read in the first place. And suddenly, having a family, having a close circle of friends, and getting dressed up to go out somewhere seems really good.

Amen.

 

[MattD]

I also work in a security department at school busting beer parties from 10:00pm to 3:00am on Friday and Saturday.

Seriously? Awesome for you, you are officially the worst classmate in history.

So the next time I hear a professor compain about having to read 40 10 page papers while socializing and drinking coffee I will just role my eyes once I walk away. I could have 40 10 page papers corrected in just a couple of hours. It's all about sitting down and working your ass off. Not going online and drinking a soda and complaining about those papers sitting next to you that need to be graded.

No you couldn't. Not if you do your job right. Making a statement like that simply tells everyone you've never had to grade papers before. On behalf of all of us who've ever worked as an educator, F_ off.

 

[emttim]

Seriously? Awesome for you, you are officially the worst classmate in history.



No you couldn't. Not if you do your job right. Making a statement like that simply tells everyone you've never had to grade papers before. On behalf of all of us who've ever worked as an educator, F_ off.

Lmao, well said, haha.

 

[GatorHockeyDoc]

You busted up beer parties at YOUR OWN SCHOOL?

 

[alyssadk]

I've read your blog for a while and most of the doctors I've met are just as if not more jaded than you are about the whole thing. I think it's good for pre-meds, it brings us out of the bubble. I can't lie and say that when I first heard these people and their lack of interest in other people's concerns I thought they were callous. Then I hung around for an hour and heard someone whine because they stubbed their toe.

If you got a job at Abercromie and Fitch and your first day your manager said "I hate high school kids." would you think he was a jerk? I mean really?

 

[smq123]

You are probably right. I already said that maybe I am being naive about the whole situation. Its not an option for me. I have to prove my self to my parents, my family, to most of all my self. All my life I have been put down by people around me for every thing. I have never been smart enough, compared to my brother. When I got a 75% scholarship in high school my parents said " 75% ? you should have gotten the 100% one who is going to pay 25% tuition."

I am really sorry to hear that. I am assuming that you're Asian. (It's not meant to be an insult - I'm Asian too.)

I understand your motivation - trust me, I've been there. But, honestly - you have to be sure that you want to do this. Who is going to be at the hospital at 3 AM, seeing patients in the ER? You, or your parents? They have nothing to do with this, and will never have to go through the **** that you have to go through. They'll never study for the USMLE 1, never have to evaluate a patient who cannot stop throwing up, and never have to take care of a patient who is pouring LITERS of blood out of her vagina because her placenta is prematurely pulling away from the uterus, and will probably die within the next 15 minutes.

My parents always like to talk about how "tough" they are, because they lived in a third world country for the first 20-some years of their lives. Maybe so...but they wouldn't last a full shift in a busy ICU. Your parents will never have a clue, so don't worry so much about bending yourself to their expectations.

And besides, if you keep going after your parents' approval, it'll be a never-ending pursuit. Yes, they'll be proud of you if you're a doctor...but only if you're a surgeon of some type. And only if you win "intern of the year" at your program. And only if you become chief resident. And only if you get published in JAMA. And only if.... Trust me, it doesn't end until you stop it.

 

[8744]

I've read your blog for a while and most of the doctors I've met are just as if not more jaded than you are about the whole thing. I think it's good for pre-meds, it brings us out of the bubble. I can't lie and say that when I first heard these people and their lack of interest in other people's concerns I thought they were callous. Then I hung around for an hour and heard someone whine because they stubbed their toe.

If you got a job at Abercromie and Fitch and your first day your manager said "I hate high school kids." would you think he was a jerk? I mean really?

I hope you're not implying that I'm jaded. You need to look up the definition of jaded if you do. Cynical? Yes. Realistic? Of course. Jaded? No.

As for lack of interest in other people's concerns, I am knee deep in their concerns twelve hours a day, fifty hours a week (yes, EM residency is great from an hours point of view) so I don't see how I could be accused of lack of interest. I am very interested in most of my patients. On the other hand I don't have the time (no physician does) to do anything other than deal with their medical complaints.

 

[Meatwad]

You busted up beer parties at YOUR OWN SCHOOL?

I'm sure when the football team had parties, he "missed," busting those up

 

[LifetimeDoc]

You go into a profession because you want to do that profession. If it turns out that it's more difficult to do that profession, but you still want to be that professional, you suck it up and get through it. Basing your happiness in what you do as a career on the details is a failing IMHO. Overall are you happy? If not, get out. But if you are happy, then sing the praises of your career! Things suck in every career. It's up to you to enjoy life, rather than complaining about every little thing, trying to drive everyone away.

 

[mules05]

By the time you're done 1st year of med school, you're tired of it. You're tired of hearing about medically-related stuff day in and day out. One more word about renal physiology makes you want to rip your own kidneys out. Watching movies and reading books that focus on medical or culturally sensitive topics (that stupid, stupid, poorly-written book about the Hmong, for example) makes you wish you'd never learned to read in the first place. And suddenly, having a family, having a close circle of friends, and getting dressed up to go out somewhere seems really good.

Being a doctor is one of your goals in life. Fantastic. However, hanging around the hospital is only fun for the first 10 hours of your shift. After that, you just want to talk to other people who don't want something, need something, have blood pouring out of somewhere, and are not responsible for evaluating you in some manner.

If you get sick of medicine so quickly, might it stand to reason that this field is not for you? Or maybe I'm the weird one, since I enjoyed learning what I needed to know to get to 3rd year, and I'm loving my time on the wards even on rotations in specialties that I know I'll never consider going into. I'm not saying that one shouldn't have a life outside of medicine, but really...you know that you'll be working 12+ hour days for the rest of your career, plus taking call (in many specialties). Why would you want to continue down that path if you're tired of it after a few hours of the day?

 

[Powdermonkey]

Panda Bear, I stumbled upon your blog by accident, which then pointed me towards SDN so I can blame you for all of the time that I have wasted over the past two months. Thank you oh so much.

As for sounding like you do not enjoy what you are doing, I see the complete other side of the spectrum. I work in an ER and can account word for word what you talk about most times. The majority of people that say you do not have much compassion, dont care for your patients enough, etc., need to come work a few shifts in the ER. Then they will understand why it is so frustrating to deal with all the polybabydadies and just complete wastes of life that always manage to find their way in. Some of these people legitimately need emergent care, but too large of a number dont. And come to the emergency room because its quicker than going to their doctor. Or they dont have a doctor. Or their insurance doesn't pay for a PCP visit, but will pay for an ER visit. Or they dont have insurance and they aren't going to pay.

It is easy to be quickly overwhelmed in the ER from drug seekers, from trivial complaints that are in no way true emergencies and the like. But I can tell from what you write that you are just ridiculously frustrated to no end from these people, and want to simply be able to care for the true emergencies, and the really sick people. But because of JHACO, EMTALA and multiple other assclown organizations that have no idea what it takes to work in an emergency room, things are getting more complicated and time consuming every day.

I for one applaud what you say, maybe because I understand where you are coming from.

For those of you that still dont understand, you need to go work or even volunteer in a local busy ER a few days to understand. Worth every second. You really get to see a lot of medicine, and it really opened my eyes, and I have had the opportunity to speak with so many doctors and have learned volumes.

Write on, Mr. Bear.

-Loyal blog reader

 

[LifetimeDoc]

For those of you that still dont understand, you need to go work or even volunteer in a local busy ER a few days to understand. Worth every second. You really get to see a lot of medicine, and it really opened my eyes, and I have had the opportunity to speak with so many doctors and have learned volumes.

Write on, Mr. Bear.

-Loyal blog reader

I volunteered every friday night for 3 years at an urban, level-1 trauma center with drug-seekers, accidents, violence victims, those milking the system, yada yada yada. I still love medicine. From my readings of Mr. Bear, he says that he wishes that he never went into medicine and has taken on the task of warning everyone away from medicine. Therein lies the difference. He's not complaining about the problems in the system and trying to fix them. He says medicine sucks, get out while you still can.