getting back to old self?

[cheetoSnacks]

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hi,

I noticed that a few other posters said how their personalities changed through med school and residency and not necessarily for the better according to them. Question for graduates: if you felt this way, did you change during medical school/residency then once you got out on your own did you/were you able to change back to your original self or like 70% of it? if so how long did it take? thanks

 

[chicamedica]

hi,

I noticed that a few other posters said how their personalities changed through med school and residency and not necessarily for the better according to them. Question for graduates: if you felt this way, did you change during medical school/residency then once you got out on your own did you/were you able to change back to your original self or like 70% of it? if so how long did it take? thanks

I have definitely changed a lot through med school, not necessarily worse or better, just different (i'd say leaning towards better). I've noticed myself becoming more perfectionistic (thought far far away from perfect) and sometimes a bit OCD about certain details, while more impatient with irrelevant things (or just better at judging what's important and what's not). I'm better at recognizing when my time is being wasted, and am a lot more impatient with that than i used to be (which is def a good thing).

As i'm starting out in residency i have also found myself having to make sure to stand up for myself in terms of being taken seriously. I have sometimes felt that, it's either my calm, quiet, soft demeanor, or my being female, that sometimes especially old school male attendings from the outset just dont take one as seriously in the medical field. And if you dont get taken as seriously, you dont get taught as much--that makes me SOOOOO angry (believe me it takes a lot to get me angered). Though i am far away from being an aggressive amazon woman, i've definitely come to realize why women in high powered professions are often very forceful and cutthroat. . .sometimes it's their nature, but i'll bet many have had to become this way to get to where they are now.

 

[beyond all hope]

Med school and residency definately change you, especially residency. You get worked to the bone for several years for minimal wages. The weird thing is that one day you're an underpaid, overworked resident who has to run every decision by an attending and then POOF, you're an attending who makes a decent salary and you're the last word.

The crabbiness and bitterness I had in residency is completely gone. It was gone within the first week of being an attending. POOF! It's good to be da king.

I'm starting to get back to my former self, sans some of the hobbies I had before medicine. I'm trying to get back in but I am indeed a different person, for better or worse.

I'm a lot more confident. I really do make life-or-death decisions daily. I'm also more cynical. I do like helping people but I realize that patients often create their own medical problems with lifestyle choices.

 

[DOtobe]

I've noticed that I've become a lot more cynical in residency. Some days going to clinic is torture. I hate when I see patients with "knee pain," "back pain," etc. on my schedule, because usually that patient is a drug seeker until proven otherwise. Our clinic patients are so snotty and rude sometimes, and throw fits in the clinic when they don't get their Oxycontin that they requested (because it's "the only thing that works..." 🙄 ). They throw fits because they know nothing will happen to them (we don't kick anyone out, because we need NUMBERS, NUMBERS, NUMBERS...numbers make the world go round).

God, I can't wait to be an attending and change my patient population...

 

[billydoc]

I've noticed that I've become a lot more cynical in residency. Some days going to clinic is torture. I hate when I see patients with "knee pain," "back pain," etc. on my schedule, because usually that patient is a drug seeker until proven otherwise. Our clinic patients are so snotty and rude sometimes, and throw fits in the clinic when they don't get their Oxycontin that they requested (because it's "the only thing that works..." 🙄 ). They throw fits because they know nothing will happen to them (we don't kick anyone out, because we need NUMBERS, NUMBERS, NUMBERS...numbers make the world go round).

God, I can't wait to be an attending and change my patient population...

I hear ya, but I don't know if being an attending will get you a better population though. These "dolls" are everywhere where there is anything to be gained. Just like rats outside the fastfood joint kitchen. And if they don't get what they want they'll bring a psychopathic [lowyaa] who'll get them what they want anyway, and you'll be labaled as [heaaaaartlessss, non-compaaaaaaaationaaaaate]doctor evil. Ohhh, I hate this degenerate "victim" game, though I'm not a physician, but work in U.S health system close to 18 years. But hey, if you can't beat them...then join them 😉

 

[BellKicker]

Interesting thread.

I have often thought about it. I think of it as the take-a-nap-when-I-get-home-effect.

In college and med school (and other times), I would wake up in the morning, thinking I was so G-D tired that the first thing I would do when I got home would be to take a nap. You can go into that first morning lecure thinking that but then something changes and when your day is finally gone, you don't take that nap.

Med school and residency is the same thing. The things you thought you would gain from residency or do when you were done..... Most people never do that stuff. Why? Because they have changed.

So we all change, hopefully to someone better and more mature.

 

[TxMed]

the years between ms-1 and pg-5 will be the meanest of you life. i only have two faces now...my mad scowl and my happy scowl. they look about the same.


-tm

 

[Paws]

the years between ms-1 and pg-5 will be the meanest of you life. i only have two faces now...my mad scowl and my happy scowl. they look about the same.


-tm

Holy ****, that is like 9 years you're talking about here. 😡

I feel like the life is being sucked out of me right now and I am just still a third year now. I can see my personality morphing even as we speak ... it is a slow, bitter process. 🙁

 

[Winged Scapula]

I"m definitely more cynical now...probably years of patients with mile-long allergy lists ("morphine makes me nauseated; general anesthesia makes me sleepy, etc."), diagnoses of fibromyalgia or chronic fatigue and obvious doctor shopping will do that to ya.

I don't think the basis of my personality has changed much but all fields have patient types that drive you crazy - the former cancer patient who is 5 or more years out with no evidence of current disease but still wants to keep coming to a cancer center for routine check-up rather than their FP; the teenager with a benign condition which the mother insists on having biopsied because of her OWN fears of cancer; the patients with normal imaging who don't believe the radiologist and want us to read the films, etc. And then there are the angry patients - these are usually scared patients, but after a long day, its hard not to get beaten down by the patient who is yelling at you because some other doctor missed the diagnosis or the patient who tells you about their torn rotator cuff when you are asking about family history of cancer, etc. Somedays I want to walk out the back door for lunch and never come back in...

 

[DOtobe]

I'm so glad to see I'm not the only one who has had an ever-growing sense of cynicism 🙂

And don't get me started on "fibromyalgia" patients... 🙄

And I love when you see allergy lists and the reactions are "diarrhea," "vomiting," "makes me not feel right" (I have seen this one many times), "makes me tired" - I just want to say THOSE ARE NOT ALLERGIES!!!

Oh, and one more rant - our clinic patients ask for a prescription for EVERYTHING. A patient actually asked me for a prescription for peroxide once. I love when people say they can't afford to buy Tylenol or other cheap meds like that over the counter. But they have their two packs of cigarettes in their purse.

 

[raspberry swirl]

im only a 4th year student, so im sure things will get a little worse during residency. however at least one thing for me at least has changed for the BETTER. im actually LESS uptight now than i was before. i think its because i used to be so tense and uptight about things that weren't important (but seemed so at the time since i wasnt exposed to anything really important). now that i've been in the hospital setting for almost two years, i find that when im NOT in the hospital, im more relaxed about things in general. ie i used to hate being late, and i would get really anxious about being late. but now i dont give a **** about being late because what happens if i am? nothing. i know that now. i mean i knew it before, but i can put it in perspective now. not to say that im late all the time. im not, actually, im usually on time. but if i am going to be late, i dont have a stroke about it like i used to. so everyday stuff like that, nothing really stresses me out anymore. because now i know what IS important to stress out about. like your patients in the ICU. you know?

oh and dont hate on the fibromyalgia patients... my psych attending was looking into doing some research on fibromyalgia and early childhood stresses. if you really talk to fibromyalgia patients about growing up, many of them have some really awful stories. part of the reason why many fibromyalgia patients subsequently have psychiatric diagnosis. and if yours dont, maybe you aren't refering them correctly ... just a thought 🙂

 

[Winged Scapula]

And don't get me started on "fibromyalgia" patients... 🙄

And I love when you see allergy lists and the reactions are "diarrhea," "vomiting," "makes me not feel right" (I have seen this one many times), "makes me tired" - I just want to say THOSE ARE NOT ALLERGIES!!!

I have been SOOOOO tempted to do the same. Good GOD in FP I'm sure you see it ALL the time.

At least I can escape it for the most part, or laugh about the "allergy list" with the Anesthesia team while the patient is asleep.

And of course, there is the stock answer, "that's not my area of expertise/I'm not comfortable with that, you'll have to see your family doctor for that." Useful for when patients want some medical problem addressed, or refills on their narcs given to them by their pain mgt team, etc.

 

[Winged Scapula]

i used to hate being late, and i would get really anxious about being late. but now i dont give a **** about being late because what happens if i am? nothing.

Interesting, because now I am much MORE concerned about being late. Perhaps it was the fear of residency that put it into me, although I had plenty of Chiefs when I was a junior resident that didn't care about making us wait. I am more likely to be early now than in my former life when I was always late.

oh and dont hate on the fibromyalgia patients... my psych attending was looking into doing some research on fibromyalgia and early childhood stresses. if you really talk to fibromyalgia patients about growing up, many of them have some really awful stories. part of the reason why many fibromyalgia patients subsequently have psychiatric diagnosis. and if yours dont, maybe you aren't refering them correctly ... just a thought 🙂

I don't disagree that many of them have psych diagnoses, the problem is that most of them don't think they do, or haven't been diagnosed and I end up having to hear about the problems, which really aren't my concern. And don't get me started on whether I really think fibromyalgia really exists outside of a psychiatric diagnosis. It should be a DSM category 🙁

 

[Winged Scapula]

...i used to hate being late, and i would get really anxious about being late. but now i dont give a **** about being late because what happens if i am? nothing.

Interesting, because now I am much MORE concerned about being late. Perhaps it was the fear of residency that put it into me, although I had plenty of Chiefs when I was a junior resident that didn't care about making us wait. I am more likely to be early now than in my former life when I was always late.

oh and dont hate on the fibromyalgia patients... my psych attending was looking into doing some research on fibromyalgia and early childhood stresses. if you really talk to fibromyalgia patients about growing up, many of them have some really awful stories. part of the reason why many fibromyalgia patients subsequently have psychiatric diagnosis. and if yours dont, maybe you aren't refering them correctly ... just a thought 🙂 [/b][/color]

I don't disagree that many of them have psych diagnoses, the problem is that most of them don't think they do, or haven't been diagnosed and I end up having to hear about the problems, which really aren't my concern. If they need to have it looked it, its their FP's problem to refer them, unless they are having an acute psychiatric problem for which then I agree - I'll seek help from my psych colleagues.

But don't get me started on whether I really think fibromyalgia really exists outside of a psychiatric diagnosis. It should be a DSM category 🙁

 

[DOtobe]

But don't get me started on whether I really think fibromyalgia really exists outside of a psychiatric diagnosis. It should be a DSM category 🙁

👍

In my opinion, fibromyalgia is a psych diagnosis.

And as an amusing aside, I spent part of my sports med rotation with a rheumatologist who sees numerous fibromyalgia patients daily. He calls them "BFFs" (which stands for big f*cking fibros).

(disclaimer: those are his words, not mine...so no comments about my insensitivity...😉 )

 

[PainDr]

For all you fibromyalgia haters out there and I know there are lots and lots of you...fibro is probably not a psychiatric condition. While I agree that many of them do have comorbid psych conditions, some of the more recent research indicates that fibro may be a type of central pain syndrome. There are several recent studies looking at NMDA receptors and dopamine releasing neurons within the limbic system. The following treatments will help a large subset of patients, ie. those who aren't too "crazy" and really want to get better: exercise, tricyclics (for pain...not depression), trigger point injections and restorative sleep. Some will also respond to dextramethoraphan (an oral NMDA antagonist) or Ultram (a centrally acting mu receptor agonist). Other types of opioids should NEVER be used, so feel free to ignore their pleas for oxy and send them to PT...stretching and water aerobics are especially effective.

 

[Disciple]

hi,

I noticed that a few other posters said how their personalities changed through med school and residency and not necessarily for the better according to them. Question for graduates: if you felt this way, did you change during medical school/residency then once you got out on your own did you/were you able to change back to your original self or like 70% of it? if so how long did it take? thanks

The pressure and mental exhaustion start during your MS III year. During your 1st 2 years of med school, sure you study alot, but most of the time you can miss lecture if you want, do your studying at home and make time for yourself outside of school. 3rd and 4th year become two years of brown nosing (for me, short clean cut hair, glasses, always trying to think of something intelligent to say, being nervous on whether you should leave the hospital or not, etc.), then crafting carefully thought out answers for your residency interviews.

During intern year, you're always pissed because of the crap you have to put up with, but you always have to have a smile on your face.

When you're a resident you still have to watch yourself because you get evaluated for "professionalism" and have to undergo 360 evals (meaning you get evaluated by non-physician staff). Thank you ACGME for that BS. My last 6 months of residency I got 360 evaluated by the nurses during my last week of home call. Basically the eval was to state whether or I not I was an ***hole and whether or not I answered pages in less than 5 minutes.
At that point in your training you're still worrying about this because of either PD letters for fellowship or your end of residency summary eval used when job hunting.

Now that I've been out for 5 1/2 months, I still try to be as professional as possible, but, the hair's a little more unkempt, I'm not quite clean shaven, I'm more apt to honestly speak my mind, the fear of offending people is diminishing, and I'm just now starting to get back to the activities and life outside the hospital that define who I am.

 

[c diddy]

I have definitely changed a lot through med school, not necessarily worse or better, just different (i'd say leaning towards better). I've noticed myself becoming more perfectionistic (thought far far away from perfect) and sometimes a bit OCD about certain details, while more impatient with irrelevant things (or just better at judging what's important and what's not). I'm better at recognizing when my time is being wasted, and am a lot more impatient with that than i used to be (which is def a good thing).

I feel pretty similarly. Out of curiosity, anyone find themselves feeling more/less compassionate with patients in general? I know I have become more cynical throughout med school and now in residency, and I am still about as mildly compassionate as I was when I started. What stands out in my head is when I was interviewing for med school and everywhere I went the programs would stress that they wanted very compassionate people in addition to being solid academically. I used to think that compassion took a back seat to academic ability, but I wonder with all this talk about declining salaries, stress up the ying-yang, noncompliant patients, etc, whether compassion should be higher up on the list. I figure that those who feel compelled to take care of people regardless of how much they "deserve" it are probably much happier with their work independent of the hassles.