For all the pre-meds

[Elysium]

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I was reading the thread about Tufts on the SDN Boards. Panda gave a url for a website that IMHO should be required reading for ALL pre-meds. I think it's very well done, thought provoking, and accurate.
Please take a minute and read this site.

<a href="http://upalumni.org:8888/medschool/" target="_blank">web page</a>

 

[Papa Smurf]

As jaded as I've become about medicine lately, that dude is just over the top. If I was that disillusioned about medicine, I'd quit practicing. Just my $.02

 

[vyc]

i completely agree with papa smurf.
i couldn't even read through all of it bc it was just too much.
what's he doing in the medical profession anyway?!?!

premeds, don't be disillusioned.

 

[Elysium]

What did you do your residency in?

What was your experience like?

 

[brandonite]

.....

Gulp.

......

 

[Jessica]

The reality is there really are some bad seeds out there, and I have seen more than a few pathetic displays of unempathatic egomania that have made my stomach turn, like this doctor noted. While he may be a little "over the top," I have seen a lot of what he is talking about in the last three years I spent working in a hospital. But, I think that there are also a lot of good, compassionate practitioners out there. Call me naive and idealistic, but I think that physicians have a lot of power (if used collectively) to change the way that medicine is taught and health care is delivered.

 

[Papa Smurf]

I'm not a practicing physician, nor am I currently in residency. Hell, I'm not even a lowly med student yet, but I did stay at a Holiday Inn Express last night. :wink: Anyhow, as someone who's been surrounded by physicians (I use this term loosely) for longer than I care to remember, I'll offer my thoughts. I'm sure others will be able to chime in with their views as well. Essentially, in my opinion, there are two types of people that are really, really miserable in medicine these days. The first one is the extremely naive, innocent, pre-med who many years ago decided that medicine is just this wonderful field that attracts ONLY compassionate, selfless, and intelligent individuals who sacrifice many years of their life for the betterment of humanity without a concern for their personal gain. N.A.I.V.E. Haha. Sorry. When these premeds become med students and get a glimpse of the real world, they're shocked and become disillusioned beyond belief. Yes there are a lot of caring and compassionate physicians out there, but there are an equal amount of pricks. Learn that now, and you'll save yourself a lot of disillusionment later on.

The second is the one who just goes in it solely for reasons such as prestige, respect, and financial gain without any real interest in medicine. Notice that I said "solely." for these reasons. It's definitely possible to have those factors influence your decision and still be happy IF you like medicine as well, and I believe that's the category in which the majority of pre-meds fall. Prestige is decreasing, patients don't respect you like they used to, but you do still get to do what you love and make some bank as well. Yes, you'll always get that one pre-med who says he'd be a physician for free. Sorry, I'm not him. Just being honest there, don't flame me. I'm not gonna be drawn into a debate about people allowing financial reasons to influence their decision to practice medicine, cause those don't really go anywhere. However, for those that say they'd go into medicine for much less than what doctors currently make, I'm just being realistic here: 4 years med school, 3-7 years residency @ 80 hrs/week, 100-200K debt + interest, and say 28K/year salary afterwards (average income in the US). Honestly, how many of you would still be here?

As far as this guy's perspective on the medical field, I'd say some of it is right on, and some of it is thrown in for shock value. In my opinion, the truth lies somewhere in the middle of that idealistic premed's notion of what medicine should be like and this guy's disillusioned view of the state of the medical field. (A broad range I know) After reading his excerpts, I do know one thing however; I know that I'm not going to TUFTS. :wink:

 

[brandonite]

I think I've calmed down now.

I'm in that category you talked about. I wouldn't be in medicine if the average salary was only $30,000 a year. I don't think I'll get flamed for saying that... But money isn't the primary reason I'm in med. But for the amount of work involved in it, there has to be some reward. I like people, I like the idea of working with and helping patiends, I enjoy the science of it, and the money/prestige is nice.

I think a lot of that stuff tends to vary from school to school. Med school is something that I'm more looking to 'survive' rather than enjoy. It's a means to an end. I mean, I have no intention of going into surgery, so I'll be looking to just manage to get through my surgical rotation. 😀

I guess I also know a lot of doctors and med students, and while more than a few of them have told me to avoid medicine at all costs, a lot of them have told me that they love their jobs. Most of them have said that they can't imagine doing anything else. I guess that's where I'm at - med just seems like a fit for me. I don't expect I'll love every single aspect of med school. But I have a pretty thick skin, so I think I'll manage to muddle through the bad parts... 😀 And hopefully at the end of it, I'll be a doctor, and it'll all be worth it...

 

[Elysium]

The thing I think is powerful about his journal (and it IS over the top, I know) is that I don't really think it's a searing indictment of Tufts so much as it is medical training in general. I think that he lists many books that provide evidence of that (some of which I've read).
I know that we've all had experience with doctors (obviously...some are parents, some are personal physcians, some are docs we've seen in the hospitals or in clincs) but I know that NONE of us (except for the residents...of which there are none on this pre-med board) has had actual balls-out medical training.
I was really, really sickened by what he wrote. Especially the stuff about surgeons. And maybe it's not that bad, or maybe these are the bad seeds, but it just felt a little too real for me. I have a feeling that these conversations DO occur in the OR and that patients are depersonalized. I've seen it in friends that are surgery residents. I've seen people that really, really do care about people become disillusioned and sickened (physically and mentally) by their medical training.
My dad told me that he became very, very depressed as a med student during his rotations. He hated peds. Hated watching kids die. Hated being abused and feeling powerless. He's also an incredibly spirtual, upbeat person and an amazingly empathetic physician. But he tells me that was learned in SPITE of his medical training, not because of it.
My point: I know that if we're all here on SDN on a Sat. night we probably all have a real commitment to this profession, warts and all. I guess I just wish the people who go into this blind could have a taste of what might truly prevail despite all of our idealism.

 

[Papa Smurf]

Completely agree with everything that you said brandonite. If the average salary was only 30K, I doubt I'd be here either. Thanks for being honest. Despite all the pessimism surrounding medicine, I still enjoy it. Medicine just fits for me as well. I don't really know what other profession I'd go into though if I couldn't be a physician.

I'm also looking to just survive medical school.
It really is a means to an end. Perhaps I should anticipate really loving it, but I'm too jaded right now to allow that. Guess I've just heard too many stories.

 

[EMDrMoe]

You know, I got to thinking about "surviving" versus "loving" medical school. I'm starting in the fall and am 28 years old. I don't want these crucial years (I guess, though, that we don't really have any life years to be wasted) to be four years I "just get through". I think the fact that my husband and I are going together will make "living through med school" possible. I think it's sort of a happy medium between surviving and loving - that's the goal. Anyone else not want to just get through, but really live it?

 

[darkmatter]

Unless you're a minister, most occupations have a degree of dehumanization. I would tend to agree that HMOs only aggravates this disturbing trend (as presented by the articles). However, the reality is that it is up to the person to make or break his/her profession.

From what I can tell, the doctors who complain are oft those who mask their helplessness and inability to make a difference by blaming the system and its proponents (e.g. older surgeons who depersonalize their patients, etc.). It's one thing to be aware of the bad things happening around you, but it is cowardice to give up. The most potent attack to evil is any benevolent action. Realistically speaking, a blend of morality and safety marks a perfect descriptor of living your profession to its maximum good.

In other words know what you can change, know what you cannot and have the wisdom to know the difference. It's that simple. If your an intern disgusted with the surgeon's practices, perhaps you are not in a position to initiate change immediately. Simply swallow it, do your best, and when you are in such a position, make the change. If the 15,000 or doctors to be this year keep the same ambition, then you have a revolution. But giving up and feeling helpless (hence blaming society) will do nothing.

For now, we can all accept what is reported but let experience be the judge. At this point in time, that is essentially what we are striving for: access to get that exposure and the future possibility of changing what we can.

 

[tulanestudent]

The guy who wrote that is a true pessimist.

I am in the middle of my 3rd year of med school now and have not felt hardly any of the negative views that this author had. In fact, I am really loving that I finally get to enter the real part of medical training and that I've spent the past 8 months working with patients - it makes all the years of studying basic science worth it.

It's true, I have changed through third year, but if anything I've found I've become MORE sympathetic to patients and their conditions. I used to not want to get involved in political debates about health care, but seeing patients who work two jobs and don't have insurance makes me want to find a solution for them. I used to ignore homeless people, but after realizing that most of them have real psychiatric problems, and getting to know some of them, I have a whole new view of them as people really uncapable of helping themselves. These are just a few examples of the positive ways my views of people have changed through 3rd year rotations.

As far as faculty or other doctors, most I have found to be excellent example of how to be compassionate as well as how to be a good teacher. A few, of course, are bad examples, but that's just a few and you find a few bad apples in every profession. Overall I find that students are appreciated on most rotations by both patients, residents, and attendings. So don't get discouraged by one pessimist. Most students out there are still happy we made this decision to go into medicine. Good luck.

 

[darkmatter]

•••quote:••• Completely agree with everything that you said brandonite. If the average salary was only 30K, I doubt I'd be here either. Thanks for being honest. Despite all the pessimism surrounding medicine, I still enjoy it. Medicine just fits for me as well. I don't really know what other profession I'd go into though if I couldn't be a physician. ••••I don't think medicine will be as popular as a career choice without the promise of financial security. Generally, our sense of survival supersedes our sense of purpose. And true physicians borders on the opposite of this statement, the same way saints do.

 

[danjou]

I've only read the first part of this guy's journal, about the pediatric rotation. Interesting.

This was one of the reasons why I didn't go into medicine the first time around. I heard lots of stories like this - the cold, inhumane young docs - from a lot of friends and peers who worked in hospitals and health care.

But moreso, I was disillusioned by the most popular public perception that doctors = god, that doctors will cure all illnesses, take away all pains. It is EXPECTED. And if doctor does not, then the doctor is somehow wrong or bad. I think this notion contributes greatly to the pressures of docs putting on a false front of competence, sureness, confidence in front of patients. There is no room in the ideal for "training" - slip ups, second chances, mistakes.

Not only for the patients is this difficult, but for the med students even more so. How frustrating for that bright, young eager doc to find out that his years of training and hard work hasn't place on him this immortal, all-knowing and all-powerful status of healer. That he might cause a patient even more pain, or god forbid take a life, before he can get better.

In my work at a law firm, I see this same sort of dynamic - these young kids just out of law school, making 6-figure salaries at prestigious law firms, being pressured to bits because they don't know what they're doing, and yet are somehow responsible for their ignorance. They walk out of law school at the top of their class, cocky and arrogant, and within the first 6 months of working, their spirits are broken, their idealism shattered, their negativity takes over, and they quit. The good ones, that is. Some don't quit, but just get used to their bitterness and anger.

Part of me feels sorry for this guy, and for all those others that have their idealism and expectations like this shattered. But then again, another part of me says "Grow the hell up! Welcome to reality!" What did this guy expect?

I should also add that I'm not going back into medicine to treat people, at least not directly. It's not that I don't want to, it's just that I have issues with how they way patients are treated in Western medicine. My compromise is to go into pathology. Can't hurt someone that is no longer alive. Of course I know I'll have to do the same clinical rotations, and for that, well... I'm still trying to figure that out.

 

[danjou]

I should also add that I've been one of those patients that the best doctors couldn't cure. I've had two semi-major illnesses (completely unrelated to eachother). For both I saw a good handful of doctors, and for both I ended up being treated by doctors who were also teachers at one of the top medical school (one of the top three, very well-know, and I'll leave it at that).

For BOTH illnesses, I was no different after being treated by the docs than before, other than a couple of small scars and an abhorance for any pharmeceuticals unless absolutely necessary. They were both incredibly compassionate, very intelligent, explained every detail of their thought process, diagnosis and reason for treatment to me. To this day I still have not been "cured" and am still plagued by both health issues.

 

[fourthwatch96822]

•••quote:•••Originally posted by danjou:
•I've only read the first part of this guy's journal, about the pediatric rotation. Interesting.

This was one of the reasons why I didn't go into medicine the first time around. I heard lots of stories like this - the cold, inhumane young docs - from a lot of friends and peers who worked in hospitals and health care.

But moreso, I was disillusioned by the most popular public perception that doctors = god, that doctors will cure all illnesses, take away all pains. It is EXPECTED. And if doctor does not, then the doctor is somehow wrong or bad. I think this notion contributes greatly to the pressures of docs putting on a false front of competence, sureness, confidence in front of patients. There is no room in the ideal for "training" - slip ups, second chances, mistakes.

Not only for the patients is this difficult, but for the med students even more so. How frustrating for that bright, young eager doc to find out that his years of training and hard work hasn't place on him this immortal, all-knowing and all-powerful status of healer. That he might cause a patient even more pain, or god forbid take a life, before he can get better.

In my work at a law firm, I see this same sort of dynamic - these young kids just out of law school, making 6-figure salaries at prestigious law firms, being pressured to bits because they don't know what they're doing, and yet are somehow responsible for their ignorance. They walk out of law school at the top of their class, cocky and arrogant, and within the first 6 months of working, their spirits are broken, their idealism shattered, their negativity takes over, and they quit. The good ones, that is. Some don't quit, but just get used to their bitterness and anger.

Part of me feels sorry for this guy, and for all those others that have their idealism and expectations like this shattered. But then again, another part of me says "Grow the hell up! Welcome to reality!" What did this guy expect?

I should also add that I'm not going back into medicine to treat people, at least not directly. It's not that I don't want to, it's just that I have issues with how they way patients are treated in Western medicine. My compromise is to go into pathology. Can't hurt someone that is no longer alive. Of course I know I'll have to do the same clinical rotations, and for that, well... I'm still trying to figure that out.•••••I am sorry to hear that your treatments have not worked for you.

People fail to realize that a doctor is not God, but only an expert in medicine. In fact, doctors don't know everything about every specialty of medicine. You would not see a psychiatrist walk into an ob/gyn clinic and start treating patients.