Medical How easy or difficult is it to cultivate values such as humility, empathy, & sincere desire for knowledge through the very arduous journey?

[Goro]

Hello! I wanted to reach out for a more objective opinion on some questions I've been having. How easy or difficult is it to cultivate values such as humility, empathy, and sincere desire for knowledge when one has to go through the very arduous process of medical training? Those are the qualities that I love about myself. I trust the rest of my application, and I have proven to myself that I can be very capable, but right now I am truly questioning whether or not being a doctor is right for me. I have realized that I don't need a medical degree, I just think that I want one, and I may not know enough yet to decide that. My prefrontal cortex still needs some time to develop. Any thoughts? Thank you for your consideration, hope everyone is well, and Happy New Year!

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[TheBoneDoctah]

Kinda confused about exactly what you’re asking...?

Are you asking how do you know you are in it for the right reasons?

 

[TheBoneDoctah]

I think I've basically realized that I've lost sight of my values -- human connection, humility, desire to learn, empathy, etc. -- in trying to prove myself worthy as a med school applicant.

I am a very sensitive person, and I worry that the process of medical training and practice will be difficult for me. I want to try and cultivate healthy levels of detachment, but that is not always an easy process, and I don't want to risk compromising my humility. I am not necessarily proud of my statistics or extracurriculars, I see them as a means to an end. I am proud of my authenticity and my willingness to admit when I don't know something so I can learn.

So yes, I am wondering if this is the right profession for me. I trust my grades, my MCAT score, my extracurriculars, and I put in a lot of work to get to a point where I feel confident in them, but I don't want to become a doctor just because I have already put in the work to be one (essentially the sunk-cost fallacy!). For myself, being a doctor is more about healing more than anything else, and I've now noticed that the people who have healed me haven't always been my doctors, and some of the doctors that I have seen have not healed me.

My apologies if this thought process is a bit confusing to follow -- please let me know how I can clarify, and thank you SO much for your time.

I think that when one goes through medical school, some of that can be lost because you are so focused on testing, studying, stress, etc that you don't have time to focus on the things that you say. Once you get to the end of medical school and become a resident, those things come back because you are then able to focus on your patients and you see the fruits of all that studying when applying what you learned to your patient's situations. It is such a good feeling to have patients literally tell you "thank you for what you do. Thank you for being here. I am lucky YOU were here."

The time will come when you can really show this part of you again, you just have to get there.

 

[TheBoneDoctah]

I see! So there’s a time and place for everything. Thank you so much for your input! I have some time before I need to write the entirety of my application, so I will probably spend some more time exploring other perspectives before I make a final decision. Hope you are safe and well.

Sounds good. Make sure you really think about this before going to medical school.

 

[Mr.Smile12]

Hello! I wanted to reach out for a more objective opinion on some questions I've been having. How easy or difficult is it to cultivate values such as humility, empathy, and sincere desire for knowledge when one has to go through the very arduous process of medical training? Those are the qualities that I love about myself. I trust the rest of my application, and I have proven to myself that I can be very capable, but right now I am truly questioning whether or not being a doctor is right for me. I have realized that I don't need a medical degree, I just think that I want one, and I may not know enough yet to decide that. My prefrontal cortex still needs some time to develop. Any thoughts? Thank you for your consideration, hope everyone is well, and Happy New Year!

I think your question is intriguing because I hope that it is our humanity's innate program to be developing humility, empathy, and desire for knowledge, but environment places values on a specific "recipe" to survive. This includes what is known as workplace culture.

I don't think that medical training in contemporary times has squashed that completely, but I think you will hear from many that they are competing with other values. To that end, many curricula have pushed service with community and a better understanding of the limits of our health care system.

 

[lord999]

Thank you so much for your thoughtful response! It's helpful to know that the curriculum is changing. I have some more thoughts. So sorry for the lengthiness. I appreciate you all taking the time to read and respond!

That's definitely an interesting perspective regarding innate programming -- as I unpack a lot of my preconceived notions, I have realized that what I like about myself, and what I don't like about myself, are things I have internalized from my surroundings at impressionable ages. I definitely feel like I am a product of my environment, regardless of what my innate program is, and realizing that is very humbling.

I am also realizing that I am very frustrated with healthcare and medicine, at least as it stands in the United States. I have read so much about medical racism, medical fatphobia, about both subtle and obvious ways in which the healthcare system has not been created for everyone. I have learned about this from my loved ones, the classes that I took for fun, my own research, and the MCAT. I have also learned not take any information for granted, and nearly everything has some level of bias. One of my past professors just told me that pulse oximeters don't always give accurate readings of Black folks' oxygen levels, because the machines weren't designed with more pigmented skin in mind. This is so deeply entrenched!

I have also been frustrated when reading forums on SDN. I don't remember how far back some of these posts were written, but reading things like "if you mention mental illness, the admissions committee might think you're unstable" and "if you are fat, your interviewer might not take you seriously because clearly you don't care about your health," have been very very disappointing. I have read a lot about how the relationship between body type and health is way too complicated to draw any conclusions just by looking at someone's body. I have also read about the prevalence of mental illness in medical school, and throughout medical training, in general -- it seems to be inevitable that there will be doctors who experience mental illness, so why are we filtering out people who are open about it?

What is especially hurtful is that a lot of this feedback is coming from physicians and faculty members -- and even then, I don't judge them for these viewpoints, because all of the ways in which I judged people negatively in the past have to do with my environment.

Also, COVID has illuminated just how dispensable doctors seem to be in the eyes of many Americans, which is really disappointing as well.

All this to say: I am frustrated with the systems in place, and I am wondering if any of you know to what extent current medical school curricula are trying to rectify this, beyond encouraging service. The MCAT Psych/Soc gave me hope, because it was very obvious that a lot of the passages were trying to unpack a lot of this. I don't know anyone who is currently in their later years of medical school. Is there any way that I can have a better understanding of the curriculum besides just internet searches? Might be easier to talk to a person who is currently or has recently experienced it.

Again, thank you so much!

And the realistic position is that our own cognitive biases do play a latent part in admissions. Ugly and fat people get treated badly by the system and it's no longer very overt, but there is an element of it there. Sexism and racism is still rampant in all the professions and in the administrative ranks. Crusading against the system makes you become a target for everyone.

I deal with some of the professional burnout cases at work on an official basis, and one of the warning signs for me in interns and residents that I pull them aside to intervene is the idea of how much emotional involvement you bring to work. Too little and you desensitize and stop caring about practice, too much and you will either go down with a patient or cross boundaries.

I do have my own negative biases with mental health. There have been too many occasions (at least 12 in my career) where someone makes it too far and visibly proves to everyone concerned that they are a clear and present danger to everyone including patients and staff that I do have it as a criteria where if I interview someone who is depression/anxiety/biopolar prone or exhibits obvious signs of borderline personality, I have had enough negative experiences with dealing with the aftermath of an incident that I do vote against it if I can see it being a problem. I have also dealt with at least two incidents where a mental health episode from a health-care professional permanently harmed a patient, and that sort of lesson stays with you.

My justification is if they are not under clinical treatment to the point that I notice breakthrough symptoms, then I really don't want to see that person under extreme stress or with patient care consequences. So when someone tells me that I have regressive views toward admission or hiring of people with mental health issues, my response has always been that the next time one of these incidents happens, they get to clean it up and I will supervise their cleanup to ensure that the process is followed, but any personnel consequences are theirs to bear (and I recommend them to buy managerial Professional Liability Insurance to cover management of this as it is not covered under standard malpractice claims). Many of my colleagues have been converted to a more conservative position after they clean up their first HR (or worse, patient care) mess from a professional mental health episode.

 

[Goro]

I do have my own negative biases with mental health. There have been too many occasions (at least 12 in my career) where someone makes it too far and visibly proves to everyone concerned that they are a clear and present danger to everyone including patients and staff that I do have it as a criteria where if I interview someone who is depression/anxiety/biopolar prone or exhibits obvious signs of borderline personality, I have had enough negative experiences with dealing with the aftermath of an incident that I do vote against it if I can see it being a problem. I have also dealt with at least two incidents where a mental health episode from a health-care professional permanently harmed a patient, and that sort of lesson stays with you.

My justification is if they are not under clinical treatment to the point that I notice breakthrough symptoms, then I really don't want to see that person under extreme stress or with patient care consequences. So when someone tells me that I have regressive views toward admission or hiring of people with mental health issues, my response has always been that the next time one of these incidents happens, they get to clean it up and I will supervise their cleanup to ensure that the process is followed, but any personnel consequences are theirs to bear (and I recommend them to buy managerial Professional Liability Insurance to cover management of this as it is not covered under standard malpractice claims). Many of my colleagues have been converted to a more conservative position after they clean up their first HR (or worse, patient care) mess from a professional mental health episode.

OP, listen to my colleague wise words. You are on the outside looking in, but we Faculty who know admissions are on the inside looking out. And we all have observed first hand the human wreckage that mental illness can inflict upon medical students.

Medical school is a furnace, and I've seen it break even healthy students. The #1 reason my school loses students to withdrawal, dismissal or LOA is to unresolved mental health issues.

So when I read on SDN someone's WAMC post and they mention their Asperger's, bipolar disorder or episodes of schizophrenia, or some schizoaffective disorder, I involuntarily let out a long, low whistle and caution them that this might not be the right path for them. Like it or not, we're the last thing between them and patients.

At least at my school, we don't seem to have a bias against weight. I've had some students who were merely overweight, but outright morbidly obese. They're practicing physicians now.