Critics of the Medical Profession

[armybound]

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.

Hmm, that's not how I take his writings..

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[smq123]

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?

Well, first of all, it wasn't "a few hours a day." I had to study a lot during 1st and 2nd year because the material wasn't intuitive for me. So, it was actually about 10-12 hours a day (because I also went to lecture.) And I still hated that book about the Hmong.

The point was that the conviction that one doesn't need a life outside of medicine is false. And the idea that you can do this for 20 hours a day and still be happy and enthusiastic is not true. After a while the fatigue will get to you. And I didn't realize that until after I finished undergrad.

Trust me, I know about how crappy the hours in medicine can be (I am finishing up my OB/gyn rotation in L&D! - AM rounds started at 5 AM and signout was at 6:30 - 7 PM) and, personally, I still like it. [Really - I actually enjoyed nightfloat, despite the fact that I never saw the sun.] But I was trying to tell pakbabydoll specifically that you have to have a life outside of medicine. Otherwise, you'll burn out fast.

 

[smq123]

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.

Why do so many people interpret his blog as "trying to drive everyone away?" Why is it such a bad thing to warn people about the negative parts of your job, and give people a realistic idea of what to expect? Having people make an informed decision to enter the medical field is a good thing for them AND for medicine. The worst thing is having disillusioned, bitter, and jaded residents. The more they know what to expect, the better they can prepare for it, and the better residents they will be.

 

[Powdermonkey]

I agree smq. I dont think there is a person here that has not complained at one time or another about his job. I mean, seriously, who can be happy at their job 100% of the time? If you dont like what Panda has to say, dont read his blogs.....

I have a bunch of friends that are first and second years right now who always tell me to not come to med school, it sucks. I know they are joking... kinda... but it doesnt bother me. I know that I wont be happy doing many other things, and being a doctor will allow me to live the lifestyle that I want, so I'm doing it. I guess I just dont see what he is saying as "RUN! DONT GO INTO MEDICINE, IT SUCKS!"

Whatever. I'll still read what he writes, its funny . To each his own and Lector Emptor though, eh?

 

[pakbabydoll]

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.

True but thats not the only reason I want to go in medicine. I was suppose to volunteer for 75 hours at the ER last summer and I ended up volunteering over 120+ hours. I love working at the hospital. Even though I kind of called in sick today. lol

 

[Meatwad]

Write on, Mr. Bear.

-Loyal blog reader

I believe that is Dr. Bear.

 

[8744]

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.

That's Doctor Bear. I didn't go to four years of Evil Medical School to be called "Mister."

I challenge you to find one instance of my wishing I had never gone to medical school. I merely point out that residency training blows no matter how you slice it and that if I knew eight years ago what I know now I probably wouldn't have applied to medical school. I have been pretty much sleep deprived for most of the last two for the sake of a highly dysfunctional and often pointless system of training so I think I have a little credibility.

As for trying to fix the problems in the system, uh, to paraphrase Dr. Phil, how can you fix the problems if you don't first acknowledge them? Not meaning to brag but I believe I have a had a fairly significant influence on the internet debate over residency training. I see a lot of my ideas, things that nobody dared write two years ago (for example, how "Patient Care" is used as a tool to shame residents into silence or how sleep deprivation is an evil in of itself whether or not it is harmful to patients) appearing on more and more blogs. It can only be a matter of time before what I am telling you becomes the conventional wisdom, not the current "happy, happy, joy, joy, gee ain't medicine great" paradigm.

 

[8744]

True but thats not the only reason I want to go in medicine. I was suppose to volunteer for 75 hours at the ER last summer and I ended up volunteering over 120+ hours. I love working at the hospital. Even though I kind of called in sick today. lol

Try calling in sick when you're a resident. lol.

 

[8744]

True but thats not the only reason I want to go in medicine. I was suppose to volunteer for 75 hours at the ER last summer and I ended up volunteering over 120+ hours. I love working at the hospital. Even though I kind of called in sick today. lol

Ooh. 120 Hours over three months. Why, that's 40 hours a month! Listen, passing out samiches' and chatting with patients is a lot different than picking up a new chart every twenty minutes for twelve hours and actually doing something. It's like the difference between watching a football game and being down on the field taking some hits.

 

[pakbabydoll]

Try calling in sick when you're a resident. lol.

Well its my first time since I got my job. Only reason I even did it is because my parents are hosting a party. My mom did not tell me till last week when it was too late for me to ask off. Now my dad and brothers are useless so that just leaves my mom. I did not want her to work all day by her self. We stayed up till 4:30 am last night cooking and stuff and have been busy all day today. This is my 2nd break all day since 9am. Not to mention since this is a fast opening party, we are all kind of dehydrated.

Ooh. 120 Hours over three months. Why, that's 40 hours a month! Listen, passing out samiches' and chatting with patients is a lot different than picking up a new chart every twenty minutes for twelve hours and actually doing something. It's like the difference between watching a football game and being down on the field taking some hits.

Actually it was only for one month and 2 weeks, and since my uncle works at the hospital I did not really talk to patients I actually did stuff. I learned how to draw blood, (our P.A actually let me practice on him before he let me do it on patients). I learned how to do EKG. I shadowed the P.A. I got all the minor stuff like cleaning wounds, and most fast track stuff. I worked in triage... It was a good experience. After that starting Jan 2007 I got this internship at the pharmacy (through my high school) and I worked at the hospitals in house pharmacy for 6 months every morning for 2 hours. During that time I worked with our clinical pharmacist and she took me to patients room when ever they asked for pharmaceutical consult. Then after I graduated they gave me a job at the pharmacy. I was in the Health academy while in high school so I have my basic health care certificate and I can get my CNA certificate too.When I was 12 my uncle had to have a by pass surgery I got to watch all of it. I was standing in the OR.
So I have had a lot of exposure to medicine. I admit that I am probably being a little naive that I won't want a life in medical school or that it all gets just way to much. I don't have that experience yet but I will. All I am saying is that it would be worth going through that experience just to get to the end and achieve your goal.


Sorry about the grammar mistakes. I know I must have made like a zillion of them but I am working on it.

 

[8744]

Actually it was only for one month and 2 weeks, and since my uncle works at the hospital I did not really talk to patients I actually did stuff. I learned how to draw blood, (our P.A actually let me practice on him before he let me do it on patients). I learned how to do EKG. I shadowed the P.A. I got all the minor stuff like cleaning wounds, and most fast track stuff. I worked in triage... It was a good experience. After that starting Jan 2007 I got this internship at the pharmacy (through my high school) and I worked at the hospitals in house pharmacy for 6 months every morning for 2 hours. During that time I worked with our clinical pharmacist and she took me to patients room when ever they asked for pharmaceutical consult. Then after I graduated they gave me a job at the pharmacy. I was in the Health academy while in high school so I have my basic health care certificate and I can get my CNA certificate too.When I was 12 my uncle had to have a by pass surgery I got to watch all of it. I was standing in the OR.
So I have had a lot of exposure to medicine. I admit that I am probably being a little naive that I won't want a life in medical school or that it all gets just way to much. I don't have that experience yet but I will. All I am saying is that it would be worth going through that experience just to get to the end and achieve your goal.

Big deal. So you did an ED tech's job for 20 hours a week. Whoopy-dee-doo. I repeat, this is nothing like being a resident.

And I call bull**** on you. No Emergency Department or Urgent Care in America, even if your uncle works there, will let a pre-med college student with no medical experience "get all of the fast track stuff." Young lady, I moonlight in our Emergency Department's "fast track" and simple as the cases are, they are only simple because I am used to much more complicated patients. Are you telling us that your uncle feels comfortable letting you decide which febrile children can go home and which need a lumbar puncture? Are you saying that you are functioning like a PA?

Come on now. I applaud your enthusiasm but really...

 

[8744]

Well its my first time since I got my job. Only reason I even did it is because my parents are hosting a party. My mom did not tell me till last week when it was too late for me to ask off. Now my dad and brothers are useless so that just leaves my mom. I did not want her to work all day by her self. We stayed up till 4:30 am last night cooking and stuff and have been busy all day today. This is my 2nd break all day since 9am. Not to mention since this is a fast opening party, we are all kind of dehydrated.

Try taking a day off as a resident because your parents are hosting a party and your father and brothers are useless. lol.

 

[pakbabydoll]

Well yea because when your a resident you do doctor's job. your basically a physician when you do your residency.

Let me ask you a question: If you could go back in time would you still apply to medical school? Is residency so bad that you would actually give up your dream of being a physician?

Think of all the people your going to help. All the people who would smile because of you.
Your parents being proud of you, your friends everyone.

Try taking a day off as a resident because your parents are hosting a party and your father and brothers are useless. lol.

Dr. Bear give me a break. Its my first day off in 5 months. I work 30 hours a week and go to school full time. I am only 18 and I am not a resident. I think I deserve a day off even if it is just to help my parents.

The issues you have bought up are valid and we should be doing something about it. As you said your self in an earlier reply that we have to acknowledge the problems before we can do something about it. Since you are living the experience I am taking your advice very seriously. I am not opposing you in anyway and I am not trying to disrespect you or anything. All I am saying is that personally even with all the issues with being a resident I would still go through it.

 

[smq123]

I got all the minor stuff like cleaning wounds, and most fast track stuff.

I worked in triage

When I was 12 my uncle had to have a by pass surgery I got to watch all of it. I was standing in the OR.

The hospital let a pre-med clean wounds. The hospital let a pre-med work in triage. The hospital let a 12 year old stand in the OR during a complicated cardiac surgery.

The hospital administration was okay with all this?!

So I have had a lot of exposure to medicine.

Well yea because when your a resident you do doctor's job. your basically a physician when you do your residency.

Think of all the people your going to help. All the people who would smile because of you.
Your parents being proud of you, your friends everyone.

All I am saying is that personally even with all the issues with being a resident I would still go through it.

Well, I would agree that you've had a lot of exposure to health care, but I don't think I would agree that you've had a lot of exposure to medicine.

Residents ARE physicians, not just "basically physicians." They are MDs/DOs, can write prescriptions, can diagnose, etc. Residents essentially run the hospital units and floors, and are usually the first people to see the patients (after the nurses.)

I think that if you had more exposure to medicine, you'd see a wider variety of patients. Not all patients are grateful, and they certainly don't "smile" because of doctors. (Plus, if you had had more exposure to medicine, you'd know that residents ARE physicians! )

This is not directed at you, but at the pre-med education system. Shadowing doctors is f'ing useless, and becoming more of a formality than an actual learning experience. Yeah, you shadow a doctor for 3 hours one afternoon. For starters, people rarely shadow residents, which is a shame - they should. If you DO shadow a resident, you often join him at rounds at 9 AM. Consider that that resident has probably been seeing patients since 5 AM, and will continue to see patients long after you go home. Doctors also sometimes "filter" which patients they let the pre-meds see. So pre-meds and MS1s and MS2s often see the "easy patients" who are nice, easy to talk to, and friendly. They don't see the habitual crack users who are 7 months pregnant and are here for their first prenatal visit. They don't see the wealthy people who have their lawyers on speed dial. They don't see the patients who refuse to say more than one sentence at a time and force the doctor to literally TUG the medical history out of them. It's a shame and a big failing in our pre-med education system. Either make shadowing useful, or don't "recommend" that people do it at all.

And yeah, your parents will be proud of you, until your hospital duties interfere with THEIR plans for your weekend/year/life. ("What do you mean you can't go to your cousin's wedding? Of course you can! Why should it matter if you are on call the night before?)

 

[emttim]

If you DO shadow a resident, you often join him at rounds at 9 AM. Consider that that resident has probably been seeing patients since 5 AM, and will continue to see patients long after you go home. Doctors also sometimes "filter" which patients they let the pre-meds see. So pre-meds and MS1s and MS2s often see the "easy patients" who are nice, easy to talk to, and friendly. They don't see the habitual crack users who are 7 months pregnant and are here for their first prenatal visit. They don't see the wealthy people who have their lawyers on speed dial. They don't see the patients who refuse to say more than one sentence at a time and force the doctor to literally TUG the medical history out of them. It's a shame and a big failing in our pre-med education system. Either make shadowing useful, or don't "recommend" that people do it at all.

Doctors filter the patients you see? Well ****, I need to get in on shadowing then, sounds like it'd be a break from work! I would love to get an actual medical history out of a patient for once instead of having to ask their RN (who usually doesn't know a damn thing anyway since SNF RNs are worthless for the most part) because the patient either has dementia, is an dingus, or both.


Realistically though, most patients aren't that bad, so I don't see what the issue here is; plus it depends a lot on location as well. Out of the 12 patients I've transported in the last month (god bless my call volume at work ), I've had 1 or 2 patients who I'd say were dinguses or otherwise oxygen thieves. Not to mention the fact you deal with scumbags in every job, profession, and walk of life. I challenge anyone to find a job where every customer or person they deal with is nice and thankful; if you find it though, move the hell over because I want it.

 

[nick_carraway]

The hospital let a pre-med clean wounds. The hospital let a pre-med work in triage. The hospital let a 12 year old stand in the OR during a complicated cardiac surgery.

The hospital administration was okay with all this?!

This is not directed at you, but at the pre-med education system. Shadowing doctors is f'ing useless, and becoming more of a formality than an actual learning experience.

Agreed on both points. Hospitals are usually terrible places to do something substantive since the privacy concerns and accountability concerns limit you to clinical research or scut work. As for shadowing, I didn't even know shadowing was a big thing until I joined SDN. Looking over someone's shoulder is a legitimate experience? I thought it was just something you did while doing the rest of your job at a clinic or practice.

At any rate, back to Panda v. Pak, what's "fast track" mean?

 

[Revenant]

During shadowing I was allowed to do open-heart surgery. It's true.

 

[Meatwad]

During shadowing I was allowed to do open-heart surgery. It's true.

Are you in India? I think I read a news article about you a few months ago.

 

[Revenant]

Are you in India? I think I read a news article about you a few months ago.

I'm in hiding. It didn't go well.

"The knee bone's connected to the...something! The something's connected to the...red thing! The red thing's connected to my...wrist watch! Uh oh."

 

[smq123]

Realistically though, most patients aren't that bad, so I don't see what the issue here is; plus it depends a lot on location as well. Out of the 12 patients I've transported in the last month (god bless my call volume at work ), I've had 1 or 2 patients who I'd say were dinguses or otherwise oxygen thieves. Not to mention the fact you deal with scumbags in every job, profession, and walk of life. I challenge anyone to find a job where every customer or person they deal with is nice and thankful; if you find it though, move the hell over because I want it.

You saw TWELVE patients in one MONTH??

:cry: I see twelve patients in one morning. And I'm just the medical student!

Of course there are scumbags in every job. But in other jobs, you rarely have to sweat to save their lives, and you don't have to get up at 4:30 AM to interact with them.

(Before people jump down my throat, I still enjoyed my L&D rotation very, very much. I still like what I do, and many of the patients were really cool to work with. But there are parts that I hate and wish to vent about.)

 

[emttim]

You saw TWELVE patients in one MONTH??

:cry: I see twelve patients in one morning. And I'm just the medical student!

Of course there are scumbags in every job. But in other jobs, you rarely have to sweat to save their lives, and you don't have to get up at 4:30 AM to interact with them.

(Before people jump down my throat, I still enjoyed my L&D rotation very, very much. I still like what I do, and many of the patients were really cool to work with. But there are parts that I hate and wish to vent about.)

Yep, although to be more correctly, 12 patients since I started my job in late July, but I don't want to brag about it or anything because I'm not nearly enough of an dingus to gloat about that knowing how many patients some of the people reading this board see. My ambulance company I work for is a new company so we don't have any hospital contracts yet, hence unless a SNF calls us for a transport to an ER, we don't get any calls.

Granted that yeah, most jobs don't make you get up at 4:30 AM to deal with patients who may be ungrateful SOBs, and you don't have the stress of trying to take care of them, but there's going to be advantages and disadvantages in every job, so it really comes back to whether you want to have a love-hate relationship with medicine or whether you want to have a love-hate relationship with some other job or profession.

Personally, I'd rather have a love-hate relationship with medicine since even if I'm hating it at that point in time, I'm still getting the satisfaction that comes with very high job security and helping others, and once I'm past med school, decent pay since I can't really call what I make as an EMT pay, considering the person taking my order at Carl's Jr. probably makes more than I do.

 

[brianmartin]

The profession is often over-romanticized

And, the negatives are often exaggerated as well, as if medicine is the only profession with problems. Panda will say, "nowhere else do they force you to work 80 hours per week and still tell you you're lazy." OK fine, no other profession necessitates the amount of training you receive in medicine either. I can see why people complain though, and I do hope somebody does something about it before I get there

 

[emttim]

The issue I see (and have) is that it seems as if there is a overwhelming bashing of medicine as a whole, and that some of the residents on this board (or attendings, although I haven't seen any attending denounce medicine on here yet) say that they would not do it again if they knew what they knew now and could do it all over again, and the problem is that sends a blanket statement that it's not just residency, but all of medicine, isn't worthit and people should turn back now.

Now, I realize that nobody who hasn't gone through it yet will have a clue how it really is until they go through it, but there's a difference between warning someone and insinuating that their goals and desires are a pipe dream and they need to just let go. Granted, the downsides are criticized with enough vagueness that this is just my interpretation, and everyone will have a different interpretation of criticism, but it only serves the purpose of educating people up to a certain point.

And it's not as if everyone on this board has never worked a real job before or been exposed to difficult situations, work, etc. I'm sure plenty of people on SDN went straight from high school to college, and plan to go directly from college to medical school without ever having to work for anything in their life or having to suffer, but there's plenty of us who have been in the work force for a number of years before even going to college.

I didn't intend to say residency "isn't that bad" anyway. In fact, I checked my second to last post, and I specifically said "most patient's aren't that bad", which isn't anything close to "residency isn't that bad". I don't think the residency system, or the medical training as a whole, is anything other than inefficient and ****ty...but I honestly don't see what point is being served in misrepresenting what I say or assuming that I (or other people on SDN) have never worked before and therefore have no idea what a "real job" is. Hell, there's a lot more I could say on this, but I already smell enough hypocrisy in this thread that I'm out; I have better ways of enjoying what little time I have to myself right now.

 

[smq123]

the problem is that sends a blanket statement that it's not just residency, but all of medicine, isn't worthit and people should turn back now.

Now, I realize that nobody who hasn't gone through it yet will have a clue how it really is until they go through it, but there's a difference between warning someone and insinuating that their goals and desires are a pipe dream and they need to just let go. Granted, the downsides are criticized with enough vagueness that this is just my interpretation, and everyone will have a different interpretation of criticism, but it only serves the purpose of educating people up to a certain point.

No, you're really not getting it. Sorry for sounding abrupt, but you're not.

NO ONE is insinuating that your goal to become a doctor is a pipe dream, and that you ought to let that desire go. What people are saying is that your vision of what being a doctor will be like is probably a pipe dream, and that you should let that go. If you can still let go of your vision of what life will be like as a doctor, and you STILL want to be a doctor - go ahead! You'll be a better resident because you decided to enter this career with your eyes open. (Probably.)

What's annoying is to tell people the truth, and be told that you're cynical, or jaded, or that your concerns/complaints aren't valid. It's also annoying to be told by a premed that s/he "wants to hear the truth," but then stubbornly refuses to believe a word that you're saying. It's equally annoying to vent about your day, and be told by a hundred super-chipper premeds that "Oh, your life isn't THAT bad," especially when those premeds have nothing with which to measure it by.

(Note: none of these are directed at you specifically, emttim, just in general.)

Hell, there's a lot more I could say on this, but I already smell enough hypocrisy in this thread that I'm out; I have better ways of enjoying what little time I have to myself right now.

Hypocrisy? What hypocrisy?

 

[brianmartin]

And it is hard to hear about how "every profession has negatives" from people who haven't really worked real jobs, much less worked as interns/residents.

Please, I've worked real jobs before. And nobody is trying to accuse you of being cynical and jaded. If anything, that's the image you project to others, so don't get all defensive just because people mention it. We believe you that residency is hard and you work long hours. Again, what were you expecting?

 

[pakbabydoll]

The hospital let a pre-med clean wounds. The hospital let a pre-med work in triage. The hospital let a 12 year old stand in the OR during a complicated cardiac surgery.

The hospital administration was okay with all this?!

Well the surgery happened in Pakistan and my uncles friend who is a cardiologist there said it was ok for me. I was all gowned up and everything, and my parents were watching from the waiting room, they had cameras there and you could basically see the whole thing. But that was Pakistan not here.

The hospital let a pre-med clean wounds. The hospital let a pre-med work in triage.

Pre-med? I was a high school senior back then and our hospital really encourages this type of thing. Well not since we became a magnet hospital now you can't even volunteer unless you are 21 but then again I have been working there for about 2 years and I am good friends with every one. More then half of the doctors are from Pakistan and India and I am from Pakistan so its easy. We are like family friends with the chief of medicine at the hospital. My mom taught his wife how to cook.

I live in Florida most of the patients we get are old and cranky. One time me got this lady with amnesia and she thought that she had killed her sister. OMG. It was a busy day so I was staying with her. She was going nuts and I could not exactly do anything about it till I asked a doctor and he ordered one of the nurses to give her something to calm her down.

Another day we got this 15 year old girl with a baby and the girl was on drugs and the baby looked like it had been beaten up badly.

I have seen drug over dosed patients to a lady lying that she fell off the stairs when clearly we could all see the punch.

And I call bull**** on you. No Emergency Department or Urgent Care in America, even if your uncle works there, will let a pre-med college student with no medical experience "get all of the fast track stuff." Young lady, I moonlight in our Emergency Department's "fast track" and simple as the cases are, they are only simple because I am used to much more complicated patients. Are you telling us that your uncle feels comfortable letting you decide which febrile children can go home and which need a lumbar puncture? Are you saying that you are functioning like a PA?

I am sorry I did not explain... I did not do doctors jobs, when I said fast track, well our fast track usually gets patients with colds, and headaches, and minor cuts and bruises. Even my uncle would never let me do that. I would not know how to do that. I did not even know what an LP was till last semester. We only have one Doctor and one P.A in the fast track.
I am talking more in terms of drawing blood ( I got my certificate for that) and giving them meds ( what doctor ordered) or getting all there labs done.
Assisting with procedures and stuff like that. I did work in triage alone but all we do there is do vitals and write them down on the chart. and there are like 10 questions you ask them. like I said our ER department is not that big. The biggest case we got when I was volunteering was this guy with gun shot and they did not have time to fly him to the other hospital.

And yeah, your parents will be proud of you, until your hospital duties interfere with THEIR plans for your weekend/year/life. ("What do you mean you can't go to your cousin's wedding? Of course you can! Why should it matter if you are on call the night before?)

lol all of my cousins live in Pakistan, I would have to fly here if I wanted to go to there wedding.

 

[brianmartin]

Come on Panda....

Being able to juggle a lot of things at one time is also an essential skill. Every resident in every specialty has to do this to a certain extent but what other residents consider a hectic day is just another routine shift for us. That's the beauty and the curse of Emergency Medicine. The hours are good. Fantastic for residents even by regular job standards. Now that I am working full-time in the department I rarely go over fifty hours a week and some weeks I barely go over forty.

But eventually you get the hang of the mundane things and start to notice that you know what to do and to whom to do it. There is a purpose to residency training and medical school after all. I won't strain my credibility by insisting that everything we learn is necessary and useful but I would cut out a lot less than most of you might imagine.

 

[smq123]

I live in Florida most of the patients we get are old and cranky. One time me got this lady with amnesia and she thought that she had killed her sister. OMG. It was a busy day so I was staying with her. She was going nuts and I could not exactly do anything about it till I asked a doctor and he ordered one of the nurses to give her something to calm her down.

* dementia *, not amnesia.

Pre-med? I was a high school senior back then and our hospital really encourages this type of thing.

So you were a high school student, not a college student? I'm not sure how this makes it better...

Heh - I could be mean and cynical and say that, "Of COURSE your hospital really encourages that type of thing! Free labor, even from unskilled high school students?! What hospital administrator in his right mind would turn that down?"

lol all of my cousins live in Pakistan, I would have to fly here if I wanted to go to there wedding.

It was an example, not a literal situation. The point is, your family will have expectations of you, which are not always easy to fill because you have priorities at your job.

 

[Revenant]

People Who Are Medical Students / Residents / Interns:

Yeah, the profession is over romanticized. It's not a cake walk. You'll most likely regret it

Response from typical premeds:

[YOUTUBE]http://youtube.com/watch?v=Bb3SXGUBdR0&mode=related&search=[/YOUTUBE]

 

[Quix]

I agree with PB and Tired on this one - all of the pre-meds that have worked for me and whom I have taught have maintained an overly idealistic idea about medical practice, what they will do and when they will do it, etc., etc. <insert rosy picture here>, and have greeted my less than enthusiastic support for their fantasies with disdain. These tend to be the people who have never worked a 12-16 hour shift, let alone several back-to-back, who have never had the drunk/druggie attack them, never seen how little reimbursement hospitals get for the care provided, never seen the level of paperwork one patient produces, etc., etc. In short, while these students tend to think that they "know what they're in for" because they've juggled a job and classes (or classes and activities), and this is simply wrong. There is a lot of scut, stress, anger, frustration, confusion, and desperation that goes into it, well beyond anything seen in a classroom or by shadowing. All of this leads to bunker mentalities, dark humor, and sarcasm which is easily mistaken for being jaded and unhappy. Then there are the cases when you actually make a difference in someone's life and they appreciate it. It makes you able to put up with all of the nonsense for a little longer, but it's still taxing, personally, professionally, psychologically, etc., etc.

But it's like anything else that comes with experience - those who know, know, and those who don't think that they do. When I was a plucky undergraduate, I thought I knew what the world outside of academia would be like. Then I went through it and realized that despite my insistance otherwise, I was ridiculously naive as an undergraduate and remarkably arrogant to tell those who had had the experience that they were wrong. I see these same qualities in those students who think that a handful of hours of clinical exposure translates into authority to speak on the hospital experience. It really doesn't, at all, and it's important for relative neophytes to realize that even the most "objective" assessment of clinical work is still rosy by comparison to the real thing. Medicine can break your heart, soul, and body, costing you relationships, friendships, and your physical and emotional health. Sometimes it feels like it's worth it, but many times it does not. The hospital becomes all, and I don't think a lot of pre-meds realize that.

 

[8744]

Come on Panda....

'

Uh, yeah. I'm working fifty-hour weeks now...but that has only been for the last three months of the last 27. For the previous two years I was pretty much q4 call except for a few months here or there. (EM, by the way, is lmited to 72 hours per week when working in the department.)

Much of that time was utterly wasted, I might add, on the usual pointless bureaucratic functions that can only exist in an academic hospital where the bulk of the medical staff is being paid minimum wage. Sleep deprivation had the additional benefit of making me too tired to even think of opening a book once I got home.

One of the many reasons, I might add, for the increasing popularity of Emergency Medicine among medical school graduates is the relative regularity of the hours in residency. You have to be careful however because some programs work more hours than others.

You need to read my whole blog.

No, seriously. You do. It's required reading at 27 medical schools including Drexel, Harvard, and UCSF.

 

[8744]

...Medicine can break your heart, soul, and body, costing you relationships, friendships, and your physical and emotional health. Sometimes it feels like it's worth it, but many times it does not. The hospital becomes all, and I don't think a lot of pre-meds realize that....

Well, let's not get carried away. I have never had that much emotionally invested in medicine to begin with as I went into it because it pays better than engineering and more financially stable, two things that Emergency Medicine definitely is.

I just dislike residency because the hours are terrible, the working conditions are sub-standard (you can't even eat a leisurely lunch but instead have to sit in a conference pretending to be interested in a powerpoint presentation) and the pay, frankly, is laughable. I cannot imagine what would motivate some poor sumbitch to put up with five or six years of it like many do.

Another thing I don't like? This is going to sound funny coming from an EM resident but everything nowadays is a ****ing Emergency, even things that are not. In other words, hospitals have become 24-hour-per-day operations and the operational tempo for every resident is a lot faster than it was when the old-school who defend the current system were residents. Call used to be call I mean, and not just a continuation of the work day where you are actually busier ar midnight than you were at noon. The fact that much of your effort is absolutely wasted on the explosion of bureaucracy that currently bedevils medical practice will kind of make you mad. Nothing like spending fifteen minutes with a patient and an hour on his paperwork.

 

[Quix]

I wasn't trying to get maudlin with the description, but I've worked with some people who have just withered under the hospital's thumb (I avoided at least some of it by starting to write a book about working there; I got about three chapters into it before I quit and had to put the book on the back burner). The more extreme parts of that statement won't be true for everyone, obviously, but I've yet to work with a doc who hasn't felt tethered to the hospital.

 

[KeyzerSoze]

You need to read my whole blog.

No, seriously. You do. It's required reading at 27 medical schools including Drexel, Harvard, and UCSF.

Please help, my pre-med sarcasm meter isn't working right now. Are you serious?

 

[Revenant]

No one even chuckled at my last post?

Damn. It took awhile to track down that clip.

 

[da8s0859q]

Not to sound like a f*ckin' Kool-Aid drinker, but:

For the most part, I've typically always agreed with what Uncle Panda has to say, or read with the assumption that he was probably on to something in those cases where I have zero experience from which to speak myself. Of the dozen or so medical blogs I read via RSS, I usually jump to see what he has to say first on those writers-have-been-busy days where my RSS folder fills up overnight.

Michelle's blog, with the painfully enthusiastic med student, pretty much reminds me of a lot of premedders here.

And I know I have barely any room to say that since I AM a premed student, but at least I'm among the more cynical of the bunch.

Oscar Wilde was right when he said that the cynic knows the price of everything but the value of nothing. I just think that a good dose o' cynicism is warranted for a profession like... this.

 

[da8s0859q]

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.

Oh, and this cracks me up.

 

[pakbabydoll]

Heh - I could be mean and cynical and say that, "Of COURSE your hospital really encourages that type of thing! Free labor, even from unskilled high school students?! What hospital administrator in his right mind would turn that down?"

Hey I don't mind as long as I can put that on my app.

* dementia *, not amnesia.

thats right sorry I don't know what I was thinking.

 

[Revenant]

Hey I don't mind as long as I can put that on my app.

...and herein lies the problem with the application process...

 

[Meatwad]

Hey I don't mind as long as I can put that on my app.

Ugh... let me guess, you are really hoping your parents will let you go on a trip to Africa where you will "help," those poor starving, diseased masses for a couple of weeks? Hey, it looks good on the app!

Please help, my pre-med sarcasm meter isn't working right now. Are you serious?

Haha, way to make yourself look foolish. He's not kidding, it is required reading at a lot of schools. I don't know which ones exactly, but I'll take his word for it on the above three.

 

[pakbabydoll]

Ugh... let me guess, you are really hoping your parents will let you go on a trip to Africa where you will "help," those poor starving, diseased masses for a couple of weeks? Hey, it looks good on the app!

Africa is not my turf, I actually really want to go back to Pakistan...thats where I am from so its better if I give them my time.


Look all of you people who look down upon us pre-med who do stuff just for the sake of putting it on the application should stop because most of you went through the same exact phase. Most of you did stuff just to put on MD application.

where you will "help," those poor starving, diseased masses for a couple of weeks?

Any one who thinks that people actually spend 10+ years in MD school just to help people needs a reality check. We are human and lets face it we are selfish. Its kind of a human nature. No physician of any sort went in to medicine JUST to "help" people. That would be one of the reasons but more often then not they just go with this during interviews...
My motivation? My family!

As Dr. Cox says Chicks, Money, Cars, and Chicks

 

[Revenant]

Africa is not my turf, I actually really want to go back to Pakistan...thats where I am from so its better if I give them my time.


Look all of you people who look down upon us pre-med who do stuff just for the sake of putting it on the application should stop because most of you went through the same exact phase. Most of you did stuff just to put on MD application.



Any one who thinks that people actually spend 10+ years in MD school just to help people needs a reality check. We are human and lets face it we are selfish. Its kind of a human nature. No physician of any sort went in to medicine JUST to "help" people. That would be one of the reasons but more often then not they just go with this during interviews...
My motivation? My family!

As Dr. Cox says Chicks, Money, Cars, and Chicks

Actually. I do things because I enjoy them. There's a reason I avoid trash like the pre-med club and stupid crap like that...

I know....it's crazy.....I genuinely enjoy what I do. I don't do it because I lack the ability to stand up to parental pressure...

 

[Gut Shot]

1) I expected to do my own work, and maybe the work of the residents. I did not expect to do the work of nurses, phlebotomists, xray techs, and secretaries.

2) I expected my learning time and scut work time to be approximately equal.

3) I expected to be treated as a professional colleague, not a worthless sack of crap beholden to everyone in the hospital.

4) I expected that when I wrote orders, they would actually be carried out.

5) I expected that when people screwed up, I would not be held responsible for their mistakes.

6) I expected the people around me to care as much about patients' well-being as I do.

7) I expected that, when unfairly maligned or insulted, that those above me would provide me some support, rather than tell me it was my own fault, or "that's just how it is".

Damn, dude, what were you smoking?

 

[brianmartin]

But isn't the point of residency to turn you into the most responsible person in the hospital? Isn't the best way to do that to have everything fall on your shoulders, at least for a few years...so you become accustomed to constantly being terrified that one little detail has gone missing? It must blow...but is there another way to do that?

You need to read my whole blog.

No, seriously. You do. It's required reading at 27 medical schools including Drexel, Harvard, and UCSF.

Lol. You know, I have read your blog. And while it contains alot of great personal insight into medical training, frankly it is a bit pedantic (perfect for your cadre) and has a conservative slant. I'd love to debate politics some time though...

Actually. I do things because I enjoy them. There's a reason I avoid trash like the pre-med club and stupid crap like that...

I avoided my university premed club...seemd to "pre-meddy" to me. But I avoid cliques in general. And the people in it were pretty cool, some were really smart and genuine, others seemed more flaky and there for the social scene. I can't call it "trash", just a thing to do. The paucity of legitimate pre-medical experiences creates a demand for these groups.

 

[alyssadk]

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.

I was thinking more of the doctors I shadowed

 

[Revenant]

Reagan was not that awesome Panda Bear.

 

[smq123]

But isn't the point of residency to turn you into the most responsible person in the hospital? Isn't the best way to do that to have everything fall on your shoulders, at least for a few years...so you become accustomed to constantly being terrified that one little detail has gone missing? It must blow...but is there another way to do that?

Residency is supposed to teach you to be responsible and capable. It is NOT supposed to turn you into a paper jockey - as my resident says, "Jesus, they have paperwork for their paperwork!!!"

It is not supposed to make you have to do battle with the nursing staff - which is often what happens.

It is not supposed to teach you to take responsibility for other people's carelessness.

It is not supposed to teach you how to do menial tasks like draw blood and run things down to the lab. That's why they have all those phlebotomists and lab techs.

None of these things really teach you how to be responsible and capable. They just make the job unpleasant.

 

[pakbabydoll]

Actually. I do things because I enjoy them. There's a reason I avoid trash like the pre-med club and stupid crap like that...

I know....it's crazy.....I genuinely enjoy what I do. I don't do it because I lack the ability to stand up to parental pressure...

Well then you are one of the only ones.

 

[badasshairday]

Reagan was not that awesome Panda Bear.

I thought he was being sarcastic about that in his blog... Managed care sucks.

 

[8744]

Lol. You know, I have read your blog. And while it contains alot of great personal insight into medical training, frankly it is a bit pedantic (perfect for your cadre) and has a conservative slant. I'd love to debate politics some time though...

Do you even know what that word means? I have been accused of many things but never of having a narrow or ostentatious concern for book learning. It's like the word "jaded." People throw it around incorrectly.

My blog doesn't have a conservative slant, it is full-bore conservative with no apologies and no quarter given. Slant indeed.

And, as you revealed to me in your comments, you don't want to debate politics, you want to insist that everything you believe is true which is not the same thing as a debate, an activity where the possibility of changing someone's mind is implied. You no doubt have an open-mind which has ossified in that position.