D
deleted128562
Consider this your warning.
Told my wife tonight that when I finish residency, I think I'd like to spend a couple years getting an engineering degree and then start a medical device company or something. She pretty much threatened to kill me and why shouldn't she? She's endured quite enough already.
But I am dying from the lack of critical thinking. I am an Intern. I have TONS to learn and would never pretend that medicine isn't an intellectually taxing field. But it is taxing in terms of memorizing huge amounts of information and spitting them back out, not in terms of thinking critically. You need to know the differential diagnosis for weakness (God help you). You need to know Wells criteria. Know that LEMON stands for, "Look externally, Evaluate the 3-3-2 rule, Mallampati classification, Obstruction of the airway, Neck mobility". Know the bones of the wrist. Memorize the classes of Salter-Harris fracture. Memorize the dosages of medications. And so on and so forth for about a million different points of information.
Try thinking critically on the wards and see where it gets you. "Hey you know, this might sound crazy but I was just thinking X, so what if we tried Y?" You will be asked if there is any evidence for that and/or if it is considered standard of care. Assuming you aren't beaten to death first. And hey, that's probably reasonable considering that you don't want a bunch of doctors just coming up with their own ideas and tossing them around as they go. There's a reason for evidence based medicine and standard of care. But it means that your job is to know the anatomy, the factoids, the evidence, and the standards - and to apply them. Not to sit and think critically.
Oh sure there's medical research. If you can get a full time research gig and get enough funding to support your paycheck. And 2 years later after IRB reviews, grant proposals, data gathering, data analysis, spending $1 million in taxpayer money, and so on and so forth, you too can publish ground breaking research showing that "Saltine crakers might in fact have a 1% benefit over Pravagabidalortudastatin for treatment of some disease, except that the study population could have been a little skewed so more research is needed". I got into research during med school because I thought it would finally be an opportunity to do a little critical thinking. Not so much.
So be warned. If you truly like memorizing tons of (sometimes) interesting stuff and helping a few people along the way, then a career in medicine is still a pretty darned good way to go. But if you value critical thinking in a career, then I'm pretty sure medicine isn't it. My dad is an engineer. Loves his job because he is constantly trying to figure out how the heck to do some previously unaccomplished thing, or at the very least how to improve the wheel. No IRB's or a jillion years of often futile research. He thinks through problems, comes up with novel ideas, and then puts them to use and refines them. And engineers help people too. Unless you don't think medical devices, cars, planes, satellites, infrastructure, etc have done anything good for anyone.
And I'm convinced there are many careers besides engineering in which critical thinking is a large component. (Heck my plumber probably does more critical thinking than me, I imagine he has to get creative from time to time).
Sorry for the long post, but just something for you all to consider. Ask yourself, when the novelty of being a doctor (or engineer or plumber) has worn off and you are working a whole ton of hours, what is it that is going to be really important and satisfying for you? Not just "helping people" - you can do that in a whole ton of fields besides medicine - but what is going to make you excited to get up each morning. Premed/ med school/ residency is a long and painful road and I'd really recommend considering this before you commit.
Just my 2.8 cents (and cautionary tale).
Told my wife tonight that when I finish residency, I think I'd like to spend a couple years getting an engineering degree and then start a medical device company or something. She pretty much threatened to kill me and why shouldn't she? She's endured quite enough already.
But I am dying from the lack of critical thinking. I am an Intern. I have TONS to learn and would never pretend that medicine isn't an intellectually taxing field. But it is taxing in terms of memorizing huge amounts of information and spitting them back out, not in terms of thinking critically. You need to know the differential diagnosis for weakness (God help you). You need to know Wells criteria. Know that LEMON stands for, "Look externally, Evaluate the 3-3-2 rule, Mallampati classification, Obstruction of the airway, Neck mobility". Know the bones of the wrist. Memorize the classes of Salter-Harris fracture. Memorize the dosages of medications. And so on and so forth for about a million different points of information.
Try thinking critically on the wards and see where it gets you. "Hey you know, this might sound crazy but I was just thinking X, so what if we tried Y?" You will be asked if there is any evidence for that and/or if it is considered standard of care. Assuming you aren't beaten to death first. And hey, that's probably reasonable considering that you don't want a bunch of doctors just coming up with their own ideas and tossing them around as they go. There's a reason for evidence based medicine and standard of care. But it means that your job is to know the anatomy, the factoids, the evidence, and the standards - and to apply them. Not to sit and think critically.
Oh sure there's medical research. If you can get a full time research gig and get enough funding to support your paycheck. And 2 years later after IRB reviews, grant proposals, data gathering, data analysis, spending $1 million in taxpayer money, and so on and so forth, you too can publish ground breaking research showing that "Saltine crakers might in fact have a 1% benefit over Pravagabidalortudastatin for treatment of some disease, except that the study population could have been a little skewed so more research is needed". I got into research during med school because I thought it would finally be an opportunity to do a little critical thinking. Not so much.
So be warned. If you truly like memorizing tons of (sometimes) interesting stuff and helping a few people along the way, then a career in medicine is still a pretty darned good way to go. But if you value critical thinking in a career, then I'm pretty sure medicine isn't it. My dad is an engineer. Loves his job because he is constantly trying to figure out how the heck to do some previously unaccomplished thing, or at the very least how to improve the wheel. No IRB's or a jillion years of often futile research. He thinks through problems, comes up with novel ideas, and then puts them to use and refines them. And engineers help people too. Unless you don't think medical devices, cars, planes, satellites, infrastructure, etc have done anything good for anyone.
And I'm convinced there are many careers besides engineering in which critical thinking is a large component. (Heck my plumber probably does more critical thinking than me, I imagine he has to get creative from time to time).
Sorry for the long post, but just something for you all to consider. Ask yourself, when the novelty of being a doctor (or engineer or plumber) has worn off and you are working a whole ton of hours, what is it that is going to be really important and satisfying for you? Not just "helping people" - you can do that in a whole ton of fields besides medicine - but what is going to make you excited to get up each morning. Premed/ med school/ residency is a long and painful road and I'd really recommend considering this before you commit.
Just my 2.8 cents (and cautionary tale).
Last edited:
This, too. The vast majority of work is repetitive and devoid of thinking.
