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Don't go into medicine if critical thinking is important to you

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).
 
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Doctor Strange

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Intriguing post nonetheless...
 
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deleted128562

You've been an intern for 16 days. Maybe it gets better?

Well yes.... but I was also a med student for 4 years. I seriously doubt someone is going to come to me in 6 months and say, "Hey Mr. Hat, we'd love for you to apply your critical thinking skills to this patient!". I'll be asked what my differential is, what I'd like to do, and then get pimped on their APACHE score.
 

SN12357

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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).

The grass is always greener.

When you try to get into medical devices and get hit by a patent lawsuit, come back and try and tell us all again how much better and less restricted things are in engineering.

I'm not saying medicine is all sunshine and roses (ha, ha, ha) but it's a bit much to say there's no point in getting a medical degree. Did you go to medical school straight out of undergrad?
 
D

deleted128562

To answer some questions

1) I'm glad I did EM over anything else. At least I get to see and do some interesting stuff.

2) I don't know if it's like this in other specialties but I'd guess so, and maybe worse. At least my patients are undifferentiated. I can't imagine taking consults on headaches all day or something.

3) No I had a few odd jobs and an actual career before med school.
 

circulus vitios

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Does an MD and a bachelors in biomedical engineering qualify you to do real engineering work, though? I thought that MD + bio engineering = clinical trials. I have a feeling that you'll probably be stuck plugging numbers into Excel, speccing out components, drawing stuff in CAD, or dealing with regulatory bull****.
 
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Mt Kilimanjaro

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Well yes.... but I was also a med student for 4 years. I seriously doubt someone is going to come to me in 6 months and say, "Hey Mr. Hat, we'd love for you to apply your critical thinking skills to this patient!". I'll be asked what my differential is, what I'd like to do, and then get pimped on their APACHE score.

You'd probably appreciate the book. Both authors EM docs.

Why not bolt and go IM?

Keep in mind that you can expect about 240k a year when you finish. I'd take that over thinking critically as a plumber any day.
 

Bacchus

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Fellow intern here, training in FM. So far I'm happy with my decision. My schedule hasn't really picked up yet but I will argue that I'm being challenged daily with patient interactions. Critical thinking doesn't necessarily need to be just related to your knowledge. For example, I had a patient today who was noncompliant. I had to think critically of how to approach the issue, express my concerns for the patient and then devise a plan he was both amenable to and also upheld the standard of care.

An assessment and plan is critical thinking and its also memorization. You think a patient has a PE? You're going to get a CT scan. I didn't have to think about that. However, why does the patient have a PE? You can't simply say, "Hmm he had a DVT and now it's broken and embolized to the lung." Does the patient have a coagulopathy? Was he in a dysrhythmia?

You get the point. You can memorize all the algorithms you want, but you do still think critically because there are nuances to every patient whether they be medical, social, or something else.
 

KinesiologyNerd

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Fellow intern here, training in FM. So far I'm happy with my decision. My schedule hasn't really picked up yet but I will argue that I'm being challenged daily with patient interactions. Critical thinking doesn't necessarily need to be just related to your knowledge. For example, I had a patient today who was noncompliant. I had to think critically of how to approach the issue, express my concerns for the patient and then devise a plan he was both amenable to and also upheld the standard of care.

An assessment and plan is critical thinking and its also memorization. You think a patient has a PE? You're going to get a CT scan. I didn't have to think about that. However, why does the patient have a PE? You can't simply say, "Hmm he had a DVT and now it's broken and embolized to the lung." Does the patient have a coagulopathy? Was he in a dysrhythmia?

You get the point. You can memorize all the algorithms you want, but you do still think critically because there are nuances to every patient whether they be medical, social, or something else.

I think that's why a lot of people are questioning if OP just went into the wrong field. You don't really do that deep digging in the ER. After my year of scribing I really think EM the field and EM the lifestyle really fits me. Maybe OP was persuaded by the lifestyle? I don't know.
 

Lya

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Fellow intern here, training in FM. So far I'm happy with my decision. My schedule hasn't really picked up yet but I will argue that I'm being challenged daily with patient interactions. Critical thinking doesn't necessarily need to be just related to your knowledge. For example, I had a patient today who was noncompliant. I had to think critically of how to approach the issue, express my concerns for the patient and then devise a plan he was both amenable to and also upheld the standard of care.

An assessment and plan is critical thinking and its also memorization. You think a patient has a PE? You're going to get a CT scan. I didn't have to think about that. However, why does the patient have a PE? You can't simply say, "Hmm he had a DVT and now it's broken and embolized to the lung." Does the patient have a coagulopathy? Was he in a dysrhythmia?

You get the point. You can memorize all the algorithms you want, but you do still think critically because there are nuances to every patient whether they be medical, social, or something else.


Thank you for sharing your thoughts, the poster above as well as OP.


I am currently interested in primary care for similar reasons, because I would like to incorporate sociocultural factors, among others, into patient care.

I am just curious: In your opinion, is that knowledge and/or experience applicable to developing and implementing health policies? I am also interested in health policy and public health, wondering if it's realistically feasible to "think critically" at the micro (individual patient care) and macro level (health policy).


(As a mathematics major, I see where OP is coming from and share his/her concerns. I also agree with your post as well, however.)
 

OCDOCDOCD

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After I decided I wanted to apply for an MD/PhD I started to be tempted to just go for the MD instead considering the pay and time difference. Then I started shadowing doctors and...yeah, definitely sticking with the MD/PhD. I'd still like to treat patients, but not full time. I need the intellectual fulfillment that research provides, and as luck would have it the dual degree lets me have my cake and eat it too.
 

QofQuimica

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Disagree. You make it sound like there isn't thinking involved when there is.

Also I disagree with the implication that critical thinking is all there is to having a fulfilling job.
Agree.

OP, you've been functioning as a physician for all of two weeks. It's a bit early to say that your job doesn't involve much critical thinking. You also have to understand that right now you're not in a position to do much critical thinking. No one is going to ask you to come up with grand plans and ideas because you don't have the knowledge or experience to manage patients on your own yet. That will come with time; I do a lot more critical thinking as a senior resident than I did as a new intern. Also, being a new intern just sucks. Not that all of residency doesn't suck in its own way, but July of intern year is a special kind of suckiness. It helps if you embrace that suckiness so you can ride it out for the next few months.
 
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Dral

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EM unfortunately has become mostly triage work. Trauma is managed by surgeons, and the medically interesting things are figured out on the floors.

I can see where the OP is coming from.

This seems true.

I'm a derm resident. I know ppl will not believe or they'll laugh at this, but we actually do a decent amount of critical thinking/investigative work.

There are many derm conditions (of course, most are not that common, but we do see them) that do not have standard of care studies. With no studies and patients who are suffering, we do some off label stuff. I had a pt with bad hand ezcema and we were at a dead end on treatment. We started her on Mtx...BAM she is improving a ton. Someone who could not even work with their hands before because they were so bad...now able to do things again.

Especially in the hospital consult settings, we are always putting 2 and 2 together. A lot of times I would think the primary care teams could do this, but again...primary teams and primary providers (kinda what ED has become in a way) don't really have time for this. Got called for a rash in the ED. See the pt...hmm, looks like chicken pox tbh. Ask some questions...some lead to dead ends, but then you get on a trail and it all comes together and makes sense...OH, you are from europe, never were immunized, and you were checking out your visiting grandfathers painful rash on his back. Ok. GIve this guy some Acyclovir, f/u in clinic. Bye. Kinda fun tbh.

This will get laughs and guffaws, I'm sure, but when someone comes in for cosmetics, you have to really analyze: What do they need, what do they want. Which fillers to use, botox too? How much botox goes where based on these things and their muscle structure. Where does this filler go to give the best outcome...each person is different.

We have to learn all the genodermatoses. They are so rare, but we learn them for the reason...they are on our radar and we pick them up. I was seeing a young adult in clinic with my program director...we started putting some things together with the patient, did a few physical exam maneuvers...Hmmm, think this guy actually has an undiagnosed form of Ehlers Danlos Syndrome...pretty satisfying to use your head and make a diagnosis of something we studied the poop out of for step I.

MOHS surgery...same thing. Figuring out how to close wounds, grafts, etc.

Ok, I could go on. People underestimate how much critical thinking can actually go into a field. It's not all doom and gloom. :)

Ok, we do a lot of warts and acne. :smuggrin: Not much critical thinking there. haha. Of course every field's bread and butter doesn't require that much critical thinking.

Anyway, Derm does have a decent amount of critical thinking...not super in depth, but enough to be satisfying for sure. Spectacular field, but then again, I'm biased. :cool:
 
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getdown

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I don't want to beat a dead horse but would like to add my two cents. I'm an anesthesia guy but currently doing a month rotation in the ER. I definitely second the above poster that ER is a lot of triage work as well as being swamped all the time by either nurses, consults, admission teams and tons of patients. This leads to very little time to actually do a lot of critical thinking, at least for those of us who are less experienced. So I see how the OP feels like he's just following formulas.

Anyway, in terms of my field, there's a lot of critical thinking that happens. Each patient will always present differently and each anesthetic approach is going to be slightly different. Is this patient going to require central line for close BP monitoring b/c he has CAD and/or b/c the surgery has a high risk of a lot of blood loss. What are all the potential things that can go wrong if we follow this particular anesthetic management technique and what should we prepare for it. It's actually why I chose to go into this field. We're not constrained by certain algorithms. Yes, we do have some but for the most part we can choose to use an inhaled anesthetic vs MAC depending on the cases. There's also some surgeon preferences but to say outright that medicine totally lacks critical thinking seems a bit ridiculous.
 

gimghoul

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EM unfortunately has become mostly triage work. Trauma is managed by surgeons, and the medically interesting things are figured out on the floors.

I can see where the OP is coming from.

At your hospital, maybe. There's a big difference between the way major academic centers operate versus county and community hospitals.
 

alpinism

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Bro how long have you been an Intern, a few weeks?

Of course it's nearly all memorization at this point, you're there to learn the basics of EM as an intern, much of which revolves around memorizing stuff like the wells criteria, apgar scores, weber classification, etc...

The critical thinking part comes into play as a senior resident and attending when you have more freedom to manage complex and atypical pts using your own judgement and experience. There is a ton of critical thinking in EM (despite what others in this thread say), you're just not going to be doing much of it as an intern. At the same time, you can't just do whatever you want, you still need to practice EBM.

For the premeds: this is why you should get as much clinical experience as you can prior to med school.
 

alpinism

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Agree.

OP, you've been functioning as a physician for all of two weeks. It's a bit early to say that your job doesn't involve much critical thinking. You also have to understand that right now you're not in a position to do much critical thinking. No one is going to ask you to come up with grand plans and ideas because you don't have the knowledge or experience to manage patients on your own yet. That will come with time; I do a lot more critical thinking as a senior resident than I did as a new intern. Also, being a new intern just sucks. Not that all of residency doesn't suck in its own way, but July of intern year is a special kind of suckiness. It helps if you embrace that suckiness so you can ride it out for the next few months.

This.
 
D

deleted307836

I know my opinion doesn't mean anything at this stage (premed) but I feel like anesthesia would be a better fit for the OP given what he wants (critical thinking, no consults) vs a field like EM, that, from my exposure to it, is heavily protocol driven.
 
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KnuxNole

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Bro how long have you been an Intern, a few weeks?

Of course it's nearly all memorization at this point, you're there to learn the basics of EM as an intern, much of which revolves around memorizing stuff like the wells criteria, apgar scores, weber classification, etc...

The critical thinking part comes into play as a senior resident and attending when you have more freedom to manage complex and atypical pts using your own judgement and experience. There is a ton of critical thinking in EM (despite what others in this thread say), you're just not going to be doing much of it as an intern. At the same time, you can't just do whatever you want, you still need to practice EBM.

For the premeds: this is why you should get as much clinical experience as you can prior to med school.

This. As an intern, honing our clinical skills is a top priority and gaining experience, learning + applying that knowledge is key. It may seem frustrating because this is the first time where you feel comfortable to give a solid opinion on your A + P as a real doctor, but like others are saying, the grand ideas will come from the superiors. I would stick it out...remember what made you decide and fall in love with EM and when the dust settles, I'm sure you'll be in good shape :D
 

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After I decided I wanted to apply for an MD/PhD I started to be tempted to just go for the MD instead considering the pay and time difference. Then I started shadowing doctors and...yeah, definitely sticking with the MD/PhD. I'd still like to treat patients, but not full time. I need the intellectual fulfillment that research provides, and as luck would have it the dual degree lets me have my cake and eat it too.

You don't need to have an MD/PhD to be involved with research. You could be doing research 100% of the time with just an MD, the downside is that you have more loans as an MD and you don't make as much in a research setting.
 

Tatastrophy

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Especially in the hospital consult settings, we are always putting 2 and 2 together. A lot of times I would think the primary care teams could do this, but again...primary teams and primary providers (kinda what ED has become in a way) don't really have time for this. Got called for a rash in the ED. See the pt...hmm, looks like chicken pox tbh. Ask some questions...some lead to dead ends, but then you get on a trail and it all comes together and makes sense...OH, you are from europe, never were immunized, and you were checking out your visiting grandfathers painful rash on his back. Ok. GIve this guy some Acyclovir, f/u in clinic. Bye. Kinda fun tbh.
We have to learn all the genodermatoses. They are so rare, but we learn them for the reason...they are on our radar and we pick them up. I was seeing a young adult in clinic with my program director...we started putting some things together with the patient, did a few physical exam maneuvers...Hmmm, think this guy actually has an undiagnosed form of Ehlers Danlos Syndrome...pretty satisfying to use your head and make a diagnosis of something we studied the poop out of for step I.

I have some kind of mystery derm issue but I was basically rebuffed by my PCP for even bringing it up. So now I am too embarassed to try derm and still have not a slightest clue what I could be dealing with. I wish people were as curious as you seem to be. That would really be nice.


OP: give it time, there are tons of things that are going to make you think but first you gotta learn the "automatic" motions of your job....thats how people coming in with MI survive.
 

Pacna

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I understand where the patient is coming from 100%. The ER is all about figuring out who needs to be admitted and who can be sent home. You don't actually end up helping anyone with your critical thinking skills. You just give people pain pills and a strainer most of the time.

You also spend the last 2 hours of your shift doing almost nothing because god forbid you have to sign over your patients.
 

OCDOCDOCD

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You don't need to have an MD/PhD to be involved with research. You could be doing research 100% of the time with just an MD, the downside is that you have more loans as an MD and you don't make as much in a research setting.

Yes, that's true, but there are big downsides to that route:

- Debt (have fun paying off $250k of student loan debt on a researcher's salary)
- Relatively ignorant about how to do research beyond clinical research
- Have to do a lengthy post-doc just to get your foot in the door
- Funding rate for MDs is still abysmal after all that compared to MD/PhDs

MD/PhD gets around all those issues. It also puts you in the best position to do translational research which is what I want to do. Theoretically you could even take a project from the basic science phase all the way to the clinical phase without ever having to surrender control to someone else because you lack the knowledge of the methodology needed for the basic/translational science or because you lack the ability to oversee human studies involving medical procedures.

If you just want to do clinical research though then an MD is the best option, but for basic and/or translational research the MD/PhD is the way to go.
 

TooMuchResearch

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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).

3rd paragraph sounds like you're an EM intern. 4th paragraph sounds non-EM. Yeah, you have tons of clinical decision rules and treatment algorithms, but there are also lots of clinical scenarios without good EBM that require a critical, problem based approach to get through. You're only a month in, friend. Maybe things will get better.
 

EnginrTheFuture

Full Member
Nov 22, 2011
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I could title a post called:

"Don't go into engineering if you actually want to interact with human beings"

The grass is always greener. I worked as an engineer and was completely dissatisfied by how solitary it can be. I spent a vast majority of my time alone, in a cubicle, thinking about the same thing over and over, spending a lot of time learning things just as a non-engineer would, and computer programming in 5+ hour stretches. It was intellectually challenging, and I loved that, but after a year or two you start going a bit mad. Ever hear of the mad scientist... well this is why.

I think getting involved in an interesting research project (maybe 25% of your time) would be ideal for you. You probably won't have time for this until you are a bit older, though. This would give you an outlet for creativity and science. People with your clinical knowledge are badly needed in research. You can be a great contribution to a multitude of projects.

Nothing is stopping you from being a physician and designing things on the side. I know many physicians that do this A LOT. Some of them are engineers, some of them are just very smart people that enjoy learning new things along the way. Where is a better place to come up with ideas for what is needed out there... than in the field? The hardest part of engineering is coming up with the idea. That starting point, that spark is the hardest. Solving the problem can be done by anyone with drive, the internet, and a small network of experienced people. If you are experienced enough to solve an engineering problem without having to learn a lot, it would probably be mundane and void of "critical thinking" all the same. If not, your on a similar footing as a physician as you would be as the inexperienced, unspecialized engineer (granted you have some resources at your disposal).

Next time you are in the ER, start thinking of pet projects you can tackle as an attending or on your own time. Learn the engineering as you go because I am 100% certain getting a degree in it will be nearly useless for what you want. You learn by experience and tacking new projects you have never done before.
 

Urnathok

Boojum tamer
Apr 5, 2013
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I'm not a med student, so this is a one-sided opinion, but I have two things that might could contribute something.

First, the fact that you're in EM may have something to do with it. I've had FM docs, peds, and psychiatrists say that they have to get creative all the time to work with their patients. Someone I shadowed realized that one of her patient's odd symptoms was related to a trip to Japan some thirty years ago where radiation was still a concern, for instance. EM strikes me as something that needs a cut and dry flow chart treatment plan. Then again, I've never spent much time with EM doctors, so I don't know.

Secondly, one of my best friends is an engineer, and he said outright that if money wasn't an issue, he'd have gone into something more creative. His biggest complaint about his education was that he realized he could go into a fantastic engineering program and come out without much of an idea about how to think creatively. He had to kind of burn his free time during college to develop a good bull**** detector in philosophy and lit, and he described it as kind of flying blind.

Spouses not killing you is a preferable option, too, I'd say.
 

TooMuchResearch

i'm goin' to Kathmandu...
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Oct 21, 2008
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  1. Attending Physician
EM strikes me as something that needs a cut and dry flow chart treatment plan. Then again, I've never spent much time with EM doctors, so I don't know.

With some exceptions, most of EM is not flow chartable. There are checklists to remind you not to miss things in certain **** hitting the fan situations, but that is not the same as cut and dry, follow the directions. Also, EM docs do actually need a good history from most patients and do uncover lots of weird illnesses. After all, the acutely ill present to the ED if they can't get into their primary or don't have one.
 

Urnathok

Boojum tamer
Apr 5, 2013
185
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With some exceptions, most of EM is not flow chartable. There are checklists to remind you not to miss things in certain **** hitting the fan situations, but that is not the same as cut and dry, follow the directions. Also, EM docs do actually need a good history from most patients and do uncover lots of weird illnesses. After all, the acutely ill present to the ED if they can't get into their primary or don't have one.

That makes sense, thanks.

Also, part of the feeling might just be burnout from, you know, residency itself. Pressure makes you come up with excuses to jump ship.
 
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