Pose

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Sorry that I'm not a former PT, but I think it'd be silly to abandon your full time PT job for research. You gotta eat, and I think there's a lot to be said for being good at and dedicated to your current job, especially if you're a non-trad. Many people get in with no research (I'm one of them), so I personally wouldn't bother unless you're just really interested in doing research prior to medical school. Is there any way you can do some outreach/volunteering as a PT? I think that'd make sense, rather than your typical pre-med volunteer gigs, and make a pretty cohesive application. Can you get some good letters from physician colleagues? I think that might be helpful also.

If you have a good cGPA and sGPA, do well on the MCAT, and can write/articulate why you are leaving PT for medicine, I think you'll do great.
 

Quik

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Not an MD nor a PT, but from the little information provided, it could be your ECs are or were lacking, or maybe you didn't have adequate patient contact during your last application cycle. Are you engaged in meaningful volunteer experiences? Do they stand out? Do they show you care about people and the community? If I were you, I'd look to maximize my MCAT study time and volunteering, and doing what you need to in the meantime to support yourself.

I've heard plenty of anecdotal evidence that suggests research isn't as important as it seems. I've heard few of my peers talk about their research like it mattered much, and hardly if at all came up in interviews. PT school and the practice is a good asset on the application, and be sure you can elaborate why you now want to practice medicine instead of physical therapy.
 

DrMidlife

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What can I do to maximize my chances at med school??
Here's a to do list as you think about moving to medicine:
1. Know your competition. You effectively have to beat a traditional student who has no real experience (thus has made no mistakes) to get a med school seat. Academic stats are the most important thing in admissions, and the averages are around 3.6 undergrad cumulative/science GPA and 31+ MCAT. About 55% of applicants get a seat in a US MD school every year. Find the FACTS page on aamc.org.
2. Describe the job you want, without using the word "doctor". What, exactly, are you wanting that you are not getting as a PT, and what, exactly, do you truly want in terms of responsibility?
3. Research the remaining work you need to do to be ready to apply to med school, before you start the work. Go back and look at your undergrad school website and figure out what the premed coursework is, and whether it differs from the coursework you completed. Do some reading in the MCAT forum here to see the effort level that tends to result in a good score.
4. Find an unhappy old white male ob/gyn who is close to retirement or has just retired, or similar, and get him to freely bitch about why medicine sucks. Drink down that reality and see how you feel about it.

Lots of people here will offer you blanket encouragement or their own personal anecdotes, which is great. But until you do your own homework, you don't know enough to own it.

Best of luck to you.
 

MedWonk

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Here's a to do list as you think about moving to medicine:
1. Know your competition. You effectively have to beat a traditional student who has no real experience (thus has made no mistakes) to get a med school seat. Academic stats are the most important thing in admissions, and the averages are around 3.6 undergrad cumulative/science GPA and 31+ MCAT. About 55% of applicants get a seat in a US MD school every year. Find the FACTS page on aamc.org.
2. Describe the job you want, without using the word "doctor". What, exactly, are you wanting that you are not getting as a PT, and what, exactly, do you truly want in terms of responsibility?
3. Research the remaining work you need to do to be ready to apply to med school, before you start the work. Go back and look at your undergrad school website and figure out what the premed coursework is, and whether it differs from the coursework you completed. Do some reading in the MCAT forum here to see the effort level that tends to result in a good score.
4. Find an unhappy old white male ob/gyn who is close to retirement or has just retired, or similar, and get him to freely bitch about why medicine sucks. Drink down that reality and see how you feel about it.

Lots of people here will offer you blanket encouragement or their own personal anecdotes, which is great. But until you do your own homework, you don't know enough to own it.

Best of luck to you.
Completely agree with 4. There's nothing like an old, cynical doctor to really test your resolve. Especially when they decide to sign up for as many unpleasant patients as possible to see if they can discourage you from going down this path.
 
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chmd

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The most important things you can do are do well on mcat and apply to less competitive schools. I hesitate to list some of these in case others think I'm knocking them or the quality of md they produce because I'm not. Here's a start:

University of Illinois
Rosalind Franklin
Wayne State
University of Toledo

Also consider DO schools. It will make it harder to match into the most competitive residencies but not everyone wants to do ent, plastics etc
 
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Research is in no way mandatory except perhaps at some of the very top tier research institutions. If you like your current PT job keep it and concentrate on doing well on the MCAT, maybe adding in some volunteering (doesn't have to be medical) as well.
 

Darth Doc

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Thanks for the feedback. I'm a PT in a hospital setting and just fell in love with trauma and critical care, I would love to have the knowledge to know what to do when someone arrives crashing, to save their life etc. I know doctors don't always have it easy, but I honestly LOVE being in a hospital and working with patients and I would love my life to be devoted to helping others. Hearing doctors complain makes me so angry, because getting into med is like winning a lottery ticket and I honestly believe it is the greatest career in the world (in terms of having the skill to help others, do ground breaking research, teach students, lecture etc. It's all the things I would ever want out of a career). I full well appreciate the benefit of PT but in terms of knowledge, brain capacity, and responsibility I feel like I truly settled and am capable of giving more of myself for the patients. I feel like I'm working at 50% of my brain capacity and I really crave to know more about disease/pathology and what to do to fix it.
Sounds like you have the passion for medicine. Not all schools require research experience, although some do. Go to the AAMC website and purchase their med school guidebook when you have a good MCAT score and all the pre-reqs under your belt. Lots of people get in, but you have to match your passion with the school. Which school is most likely to want what you have to offer? DO schools are more likely to accept non-trads, but almost every MD school has at least one non-trad in it.

I recommend doing PT full-time. It will enable you to save more money for school and gain more experience. I wouldn't waste your time on research at this point. Your PT experience will make you stand out more than research would.

When you get interview offers, be prepared (see the other student doctor forums) and make sure your passion shows.

I didn't get 30+ MCATs and my GPA wasn't 4.0. But I found the right school for me and am starting at an MD program in the fall.
 
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QofQuimica

Seriously, dude, I think you're overreacting....
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Completely agree with 4. There's nothing like an old, cynical doctor to really test your resolve. Especially when they decide to sign up for as many unpleasant patients as possible to see if they can discourage you from going down this path.
How about a middle-aged, burned out senior resident? Happy to disabuse anyone of any illusions that they care to be disabused of concerning how great it is to be a physician. Hit me up now while the griping is good; I may be liking my job a lot more more next summer when I'm working half as many hours for four times the pay in a better location with nicer people. Though no doubt there will be some new versions of suckiness I have yet to anticipate that I can wax somewhat eloquently about to those that want it.

Hearing doctors complain makes me so angry, because getting into med is like winning a lottery ticket and I honestly believe it is the greatest career in the world (in terms of having the skill to help others, do ground breaking research, teach students, lecture etc. It's all the things I would ever want out of a career).
Don't be angry. If those were the things this job actually consisted of, you'd be right to feel that way. The problem is, I spend a great deal of my time doing tasks like paperwork that someone with a HS education could do. And am often frustrated that the system itself is set up to prevent me from "helping others" the way I should be helping them. The teaching part is certainly grand, and it's one of the few aspects of this job that gives me much satisfaction. If you like to teach, you will be able to find a niche in medicine.
 

MedWonk

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How about a middle-aged, burned out senior resident? Happy to disabuse anyone of any illusions that they care to be disabused of concerning how great it is to be a physician. Hit me up now while the griping is good; I may be liking my job a lot more more next summer when I'm working half as many hours for four times the pay in a better location with nicer people. Though no doubt there will be some new versions of suckiness I have yet to anticipate that I can wax somewhat eloquently about to those that want it.
That would probably work, too. IIRC, though, aren't you still too young for middle age? You still have plenty of youth left.
 

QofQuimica

Seriously, dude, I think you're overreacting....
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That would probably work, too. IIRC, though, aren't you still too young for middle age? You still have plenty of youth left.
I'm getting ready to turn 39, so yes, I guess technically I still have another year to go.
 

Gauss44

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Don't be angry. If those were the things this job actually consisted of, you'd be right to feel that way. The problem is, I spend a great deal of my time doing tasks like paperwork that someone with a HS education could do. And am often frustrated that the system itself is set up to prevent me from "helping others" the way I should be helping them. The teaching part is certainly grand, and it's one of the few aspects of this job that gives me much satisfaction. If you like to teach, you will be able to find a niche in medicine.
Just curious Q: Is there some way that a premed volunteer could help you with paperwork? It seems a shame that so many people would be willing to do free work in exchange for spending time in the ICU and your stuck there doing menial tasks.
 

QofQuimica

Seriously, dude, I think you're overreacting....
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Just curious Q: Is there some way that a premed volunteer could help you with paperwork? It seems a shame that so many people would be willing to do free work in exchange for spending time in the ICU and your stuck there doing menial tasks.
Believe me, if I could hire you on as a scribe, I'd do it in a heartbeat. And write you a LOR for med school too.
 

cabinbuilder

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I agree that the "paperwork" part really sucks in the form of EMR now. Most of my time is spent clicking stupid boxes so the government can track what we do. I have the luxury of refusing to type the full chart note and still am on dictation most places I work as locums since it's too time consuming to teach me all the aspects of a new EMR each time. The grumbling comes from paying a doctor $100/hr to be a typist when you can hire someone at $10/hr to do the same thing at 4 times the speed so the doc can see double the patients. It's not medicine that gets you down, it' s the bull**** reception duties that have been put in place.

I love what I do but sometimes patients really make you crazy. Yesterday I gave abx #1 which is standard for the case present and the patient says, "I won't take that abx it doesn't work, I want amoxil". Okay, but amoxil isn't standard for your diagnosis. He got angry and started telling me how I didn't know him, blah, blah, blah. I switched him to abx #2 he never heard of before that wasn't amoxil. Just irritating to go to school forever and what you do isn't good enough and you end up catering to the public since "the customer is always right" and can complain if they don't get what they want. Sigh.........
 

StBernardsRule

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How about a middle-aged, burned out senior resident? Happy to disabuse anyone of any illusions that they care to be disabused of concerning how great it is to be a physician. Hit me up now while the griping is good; I may be liking my job a lot more more next summer when I'm working half as many hours for four times the pay in a better location with nicer people. Though no doubt there will be some new versions of suckiness I have yet to anticipate that I can wax somewhat eloquently about to those that want it.


Don't be angry. If those were the things this job actually consisted of, you'd be right to feel that way. The problem is, I spend a great deal of my time doing tasks like paperwork that someone with a HS education could do. And am often frustrated that the system itself is set up to prevent me from "helping others" the way I should be helping them. The teaching part is certainly grand, and it's one of the few aspects of this job that gives me much satisfaction. If you like to teach, you will be able to find a niche in medicine.
Can you PLEASE write this rant! I really dislike how often I hear comments like "If you can even consider another career, medicine is not for you" as I think that encourages everyone to only think happy thoughts and not be realistic about what a career in medicine entails. So if you have some free time and want to go into a bit more detail I for one would greatly appreciate it.
 
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NuttyEngDude

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Can you PLEASE write this rant! I really dislike how often I hear comments like "If you can even consider another career, medicine is not for you" as I think that encourages everyone to only think happy thoughts and not be realistic about what a career in medicine entails. So if you have some free time and want to go into a bit more detail I for one would greatly appreciate it.
haha I sent a PM but I also need to hear it, though I suppose I'm not changing my mind at this point.
 

Jewels86

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I agree that the "paperwork" part really sucks in the form of EMR now. Most of my time is spent clicking stupid boxes so the government can track what we do...It's not medicine that gets you down, it' s the bullcrap reception duties that have been put in place.

I love what I do but sometimes patients really make you crazy. Yesterday I gave abx #1 which is standard for the case present and the patient says, "I won't take that abx it doesn't work, I want amoxil". Okay, but amoxil isn't standard for your diagnosis. He got angry and started telling me how I didn't know him, blah, blah, blah. I switched him to abx #2 he never heard of before that wasn't amoxil. Just irritating to go to school forever and what you do isn't good enough and you end up catering to the public since "the customer is always right" and can complain if they don't get what they want. Sigh.........
That's what I go through in the ER, backing up what the Doc's write for prescriptions, explaining, begging, pleading, telling these patients that they NEED to take their antibiotics as prescribed (and this particular one too!!) until they're gone, so they kill off the grandbabies of the P1, F1, F2 and beyond generation or the bacteria will bring back their friends and build an army the size of Texas and, "You'll be back in worse shape". How about the drama for some "vitamin D...". Yes, about the end of my shift a few nights ago, with round two of the flu coming on, my stomach pain was a 10. I had to sit to assess, start an IV, etc., with my patients. BUT...I needed sleep, Gatorade and the weather channel.

And...bring back paper charting!!

BTW: I love the comment of talking with an older doc that's about to retire...those are the ones that tell me to go NP. ALL of them!! Never, "Well...", it's "It's not worth it to put in those many years for this!! Do NP!!". A lot of wisdom there!!
 

QofQuimica

Seriously, dude, I think you're overreacting....
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Can you PLEASE write this rant! I really dislike how often I hear comments like "If you can even consider another career, medicine is not for you" as I think that encourages everyone to only think happy thoughts and not be realistic about what a career in medicine entails. So if you have some free time and want to go into a bit more detail I for one would greatly appreciate it.
It's less of a rant and more of a list of disappointments. A lot of them, you'll already know. Some may surprise you. So here you go:

Unpleasant Surprises in Medical School:
1) Your job for the first two years is to memorize a lot of crap that, after you take Step 1, you will never see again. For those of you who actually like understanding concepts and learning for its own sake, a lot of what you have to pump and dump in med school will consist of boring, irrelevant, and painful rote memorization. You will hate it just like I hated it.
2) After you start your third year rotations, you quickly learn that medicine is not science. No one in medicine has any good basis for much of their practice except anecdotal experience and theoretical rationalizations. Since there's no real evidence one way or the other, everyone does what they want. This is called the art of medicine. What sucks is that Attending A will have you doing one thing, while the next day Attending B will chide you for it and tell you to do the exact opposite. This is also the art of medicine. It is especially painful for those of us who come from a real science background to see how unscientific medicine really is.
3) You're a superfluous human being. You sit around and wait to be noticed, a lot. And you still have to memorize a bunch of crap and take standardized tests each rotation even while working 80 hour weeks. And the notes that you painstakingly spend an hour writing don't count anyway. And patients don't want to see you; they want to see a real doctor.

Unpleasant Surprises in Residency:
1) You are never a more stupid, bigger bumbling idiot than you are in July of your intern year. And people are happy to remind you of this, constantly. It's a mercy that premeds can't know ahead of time how awful the beginning of intern year is, because no one would ever go to med school if they knew what was in store for them. I certainly wouldn't have.
2) By your second year, you know just enough to be dangerous, but you still don't really know much. You just think you do. And the first time you see your cockiness or one of your residency classmate's cockiness injure or kill someone, it's a real b****slap from reality. This is not you playing doctor anymore. This is real. The first patient I helped kill probably would have died anyway. But that doesn't change the fact that I screwed up, and someone who might not have died, is now dead. I still remember his face, his name, that he had a two month old daughter. I think about him every time I see another patient with a similar chief complaint. It also doesn't change the fact that I got to present the case in front of the department and be grilled by a room full of armchair quarterbacks for an hour, while my attending, who was ultimately responsible, didn't even bother showing up. Yeah, I'm still bitter about that one.
3) Speaking of which, you are the bearer of bad news when there is bad news to be borne. People can react to bad news in surprising ways, including attacking the messenger. Sometimes literally. I recommend keeping the door open and not letting the patient or family sit between you and the door any time you're about to tell someone that they or their loved one is terminally ill. I've never been attacked myself, but I know of people who have.
4) More generally, the emotional toll on you can be surprisingly high. You see a lot of really awful things in medicine: violence, trauma, children dying. People don't talk about it much. In fact, instead of supporting you and debriefing you, many people will look down on you as weak if you show much emotion. I confess to being one of those weak people.
5) The health care system sucks. You spend a lot of time in fighting the system to get people what they need. And it's frustrating.
6) People suck. Your colleagues don't appreciate you creating more work for them for some uninsured homeless person. The patient spits in your face to show his "appreciation." My personal favorites are the ones who tell me, "I'm going to sue you." They obviously don't realize that they don't have much to gain financially from a resident anyway, but someone saying that also pushes my buttons where I have to just walk away. Because those are the times when I can understand why some physicians have wished harm upon patients, or have even acted to bring harm down upon them.
7) You still have to study for standardized tests while working 80 hour weeks, just like in med school.
8) You have very limited control over your schedule, and you will spend much of the free time that you do have sleeping, doing chores/errands, and studying. You will miss out on a lot of important life events and family gatherings. You will have some friends and family who won't understand, and some of you will even get divorced. You will also miss out on a lot of meals and a lot of sleep. Ultimately, your needs are not important, and the system is set up to remind you of this over and over again lest you ever forget.
9) Someone you know (hopefully not you) will crack while you're in training. I know one resident who committed suicide, one who developed a drug addiction, and one who had to be psychiatrically hospitalized. Watch out for your friends, because again, these people largely suffer in silence.
10) You will come on SDN and interact with premeds and realize how different of a person you are. Hopefully you figure out a way to be a better person for it rather than turning into a world-class d-bag. But you do lose something of yourself going through this process. And there's no going back to the old you. Ever.
 

StBernardsRule

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Mar 17, 2011
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It's less of a rant and more of a list of disappointments. A lot of them, you'll already know. Some may surprise you. So here you go:

Unpleasant Surprises in Medical School:
1) Your job for the first two years is to memorize a lot of crap that, after you take Step 1, you will never see again. For those of you who actually like understanding concepts and learning for its own sake, a lot of what you have to pump and dump in med school will consist of boring, irrelevant, and painful rote memorization. You will hate it just like I hated it.
2) After you start your third year rotations, you quickly learn that medicine is not science. No one in medicine has any good basis for much of their practice except anecdotal experience and theoretical rationalizations. Since there's no real evidence one way or the other, everyone does what they want. This is called the art of medicine. What sucks is that Attending A will have you doing one thing, while the next day Attending B will chide you for it and tell you to do the exact opposite. This is also the art of medicine. It is especially painful for those of us who come from a real science background to see how unscientific medicine really is.
3) You're a superfluous human being. You sit around and wait to be noticed, a lot. And you still have to memorize a bunch of crap and take standardized tests each rotation even while working 80 hour weeks. And the notes that you painstakingly spend an hour writing don't count anyway. And patients don't want to see you; they want to see a real doctor.

Unpleasant Surprises in Residency:
1) You are never a more stupid, bigger bumbling idiot than you are in July of your intern year. And people are happy to remind you of this, constantly. It's a mercy that premeds can't know ahead of time how awful the beginning of intern year is, because no one would ever go to med school if they knew what was in store for them. I certainly wouldn't have.
2) By your second year, you know just enough to be dangerous, but you still don't really know much. You just think you do. And the first time you see your cockiness or one of your residency classmate's cockiness injure or kill someone, it's a real b****slap from reality. This is not you playing doctor anymore. This is real. The first patient I helped kill probably would have died anyway. But that doesn't change the fact that I screwed up, and someone who might not have died, is now dead. I still remember his face, his name, that he had a two month old daughter. I think about him every time I see another patient with a similar chief complaint. It also doesn't change the fact that I got to present the case in front of the department and be grilled by a room full of armchair quarterbacks for an hour, while my attending, who was ultimately responsible, didn't even bother showing up. Yeah, I'm still bitter about that one.
3) Speaking of which, you are the bearer of bad news when there is bad news to be borne. People can react to bad news in surprising ways, including attacking the messenger. Sometimes literally. I recommend keeping the door open and not letting the patient or family sit between you and the door any time you're about to tell someone that they or their loved one is terminally ill. I've never been attacked myself, but I know of people who have.
4) More generally, the emotional toll on you can be surprisingly high. You see a lot of really awful things in medicine: violence, trauma, children dying. People don't talk about it much. In fact, instead of supporting you and debriefing you, many people will look down on you as weak if you show much emotion. I confess to being one of those weak people.
5) The health care system sucks. You spend a lot of time in fighting the system to get people what they need. And it's frustrating.
6) People suck. Your colleagues don't appreciate you creating more work for them for some uninsured homeless person. The patient spits in your face to show his "appreciation." My personal favorites are the ones who tell me, "I'm going to sue you." They obviously don't realize that they don't have much to gain financially from a resident anyway, but someone saying that also pushes my buttons where I have to just walk away. Because those are the times when I can understand why some physicians have wished harm upon patients, or have even acted to bring harm down upon them.
7) You still have to study for standardized tests while working 80 hour weeks, just like in med school.
8) You have very limited control over your schedule, and you will spend much of the free time that you do have sleeping, doing chores/errands, and studying. You will miss out on a lot of important life events and family gatherings. You will have some friends and family who won't understand, and some of you will even get divorced. You will also miss out on a lot of meals and a lot of sleep. Ultimately, your needs are not important, and the system is set up to remind you of this over and over again lest you ever forget.
9) Someone you know (hopefully not you) will crack while you're in training. I know one resident who committed suicide, one who developed a drug addiction, and one who had to be psychiatrically hospitalized. Watch out for your friends, because again, these people largely suffer in silence.
10) You will come on SDN and interact with premeds and realize how different of a person you are. Hopefully you figure out a way to be a better person for it rather than turning into a world-class d-bag. But you do lose something of yourself going through this process. And there's no going back to the old you. Ever.
Tytytytytytytyty for this. I'm going to think about this a lot as well as talk to some residents/physicians about what you've said. Like hot damn thank you for this it's the exact opposite of what everyone has told me but I'm not sure how honest they're being (my guess is not very).

Do you think if you chose to specialize in something else or done your residency somewhere else you'd still have had a similar experience?
 

Jewels86

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...Like hot damn thank you for this it's the exact opposite of what everyone has told me but I'm not sure how honest they're being (my guess is not very).

Do you think if you chose to specialize in something else or done your residency somewhere else you'd still have had a similar experience?
Since I work hand-in-hand with my docs, everything that QofQuimica said is true...100%. Patient's hate us all; docs, nurses. The attitude we get is we're there to serve the patients and only them. There are times I'm sicker than the patients yet I serve them. Want to see some real drama for "Vitamin D"...go to the ER. The pt's know what to say, how to act with eyes rolling into the back of the head, heavy breathing, name it...and until they get it, we'll be attacked, verbally mostly. Family gets in on it and all hell breaks loose. I've had one family member go straight to my charge because I didn't carry Dilaudid in my back pocket and couldn't just "grab" it out of the pyxis when the patient wanted it.

No wonder the majority of docs tell me to go NP!! Thanks for the wisdom!! I see it the pain the docs (new, old and future) go through...that's why I try and be the best nurse for you docs!!
 

cabinbuilder

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Tytytytytytytyty for this. I'm going to think about this a lot as well as talk to some residents/physicians about what you've said. Like hot damn thank you for this it's the exact opposite of what everyone has told me but I'm not sure how honest they're being (my guess is not very).

Do you think if you chose to specialize in something else or done your residency somewhere else you'd still have had a similar experience?
NO , it's pretty much the same for EVERY residency I would think except pathology since you are dealing with dead tissue anyway. Any residency that deals with live patients pretty much what Q said happens all the time. For me I hang onto the triumphs and am thankful that I know I helped at least one person every day at work.
 
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QofQuimica

Seriously, dude, I think you're overreacting....
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Tytytytytytytyty for this. I'm going to think about this a lot as well as talk to some residents/physicians about what you've said. Like hot damn thank you for this it's the exact opposite of what everyone has told me but I'm not sure how honest they're being (my guess is not very).
I can't imagine you knowing any residents who don't have at least some of the same complaints.

Do you think if you chose to specialize in something else or done your residency somewhere else you'd still have had a similar experience?
Tough to say, and obviously I'll never have the opportunity to conduct such an experiment. But I do think that residency programs have personalities, and yes, this was a fancy high power residency with a hard core kind of culture. I'd say that most of my co-residents haven't enjoyed our time here. But as my sister (who is not a physician, but is married to one) has pointed out, how many doctors will tell you that they loved residency? My BIL went to a community family med residency, the exact opposite of the kind of place I went to, and he hated residency too. So, who knows.
 

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I can't imagine you knowing any residents who don't have at least some of the same complaints.


Tough to say, and obviously I'll never have the opportunity to conduct such an experiment. But I do think that residency programs have personalities, and yes, this was a fancy high power residency with a hard core kind of culture. I'd say that most of my co-residents haven't enjoyed our time here. But as my sister (who is not a physician, but is married to one) has pointed out, how many doctors will tell you that they loved residency? My BIL went to a community family med residency, the exact opposite of the kind of place I went to, and he hated residency too. So, who knows.
For the most part I really liked my residency. It was very family friendly and laid back. We learned a lot and were treated really well. It was very family friendly and I rarely missed one of my kid's events at their school. I was chief resident so I made the schedule and made it fair for everyone. I would say I hated maybe 10% of my residency and those mostly were the call days and call weekend but even those were only twice a month. Can't really complain.
 

jl lin

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It's less of a rant and more of a list of disappointments. A lot of them, you'll already know. Some may surprise you. So here you go:

Unpleasant Surprises in Medical School:
1) Your job for the first two years is to memorize a lot of crap that, after you take Step 1, you will never see again. For those of you who actually like understanding concepts and learning for its own sake, a lot of what you have to pump and dump in med school will consist of boring, irrelevant, and painful rote memorization. You will hate it just like I hated it.
2) After you start your third year rotations, you quickly learn that medicine is not science. No one in medicine has any good basis for much of their practice except anecdotal experience and theoretical rationalizations. Since there's no real evidence one way or the other, everyone does what they want. This is called the art of medicine. What sucks is that Attending A will have you doing one thing, while the next day Attending B will chide you for it and tell you to do the exact opposite. This is also the art of medicine. It is especially painful for those of us who come from a real science background to see how unscientific medicine really is.
3) You're a superfluous human being. You sit around and wait to be noticed, a lot. And you still have to memorize a bunch of crap and take standardized tests each rotation even while working 80 hour weeks. And the notes that you painstakingly spend an hour writing don't count anyway. And patients don't want to see you; they want to see a real doctor.

Unpleasant Surprises in Residency:
1) You are never a more stupid, bigger bumbling idiot than you are in July of your intern year. And people are happy to remind you of this, constantly. It's a mercy that premeds can't know ahead of time how awful the beginning of intern year is, because no one would ever go to med school if they knew what was in store for them. I certainly wouldn't have.
2) By your second year, you know just enough to be dangerous, but you still don't really know much. You just think you do. And the first time you see your cockiness or one of your residency classmate's cockiness injure or kill someone, it's a real b****slap from reality. This is not you playing doctor anymore. This is real. The first patient I helped kill probably would have died anyway. But that doesn't change the fact that I screwed up, and someone who might not have died, is now dead. I still remember his face, his name, that he had a two month old daughter. I think about him every time I see another patient with a similar chief complaint. It also doesn't change the fact that I got to present the case in front of the department and be grilled by a room full of armchair quarterbacks for an hour, while my attending, who was ultimately responsible, didn't even bother showing up. Yeah, I'm still bitter about that one.
3) Speaking of which, you are the bearer of bad news when there is bad news to be borne. People can react to bad news in surprising ways, including attacking the messenger. Sometimes literally. I recommend keeping the door open and not letting the patient or family sit between you and the door any time you're about to tell someone that they or their loved one is terminally ill. I've never been attacked myself, but I know of people who have.
4) More generally, the emotional toll on you can be surprisingly high. You see a lot of really awful things in medicine: violence, trauma, children dying. People don't talk about it much. In fact, instead of supporting you and debriefing you, many people will look down on you as weak if you show much emotion. I confess to being one of those weak people.
5) The health care system sucks. You spend a lot of time in fighting the system to get people what they need. And it's frustrating.
6) People suck. Your colleagues don't appreciate you creating more work for them for some uninsured homeless person. The patient spits in your face to show his "appreciation." My personal favorites are the ones who tell me, "I'm going to sue you." They obviously don't realize that they don't have much to gain financially from a resident anyway, but someone saying that also pushes my buttons where I have to just walk away. Because those are the times when I can understand why some physicians have wished harm upon patients, or have even acted to bring harm down upon them.
7) You still have to study for standardized tests while working 80 hour weeks, just like in med school.
8) You have very limited control over your schedule, and you will spend much of the free time that you do have sleeping, doing chores/errands, and studying. You will miss out on a lot of important life events and family gatherings. You will have some friends and family who won't understand, and some of you will even get divorced. You will also miss out on a lot of meals and a lot of sleep. Ultimately, your needs are not important, and the system is set up to remind you of this over and over again lest you ever forget.
9) Someone you know (hopefully not you) will crack while you're in training. I know one resident who committed suicide, one who developed a drug addiction, and one who had to be psychiatrically hospitalized. Watch out for your friends, because again, these people largely suffer in silence.
10) You will come on SDN and interact with premeds and realize how different of a person you are. Hopefully you figure out a way to be a better person for it rather than turning into a world-class d-bag. But you do lose something of yourself going through this process. And there's no going back to the old you. Ever.
Q, you are highly respected here, and I suspect elsewhere as well. I am NOT trying to take ANYTHING away from your perspective. Your perspectives are your perspectives, period. I just want to reply to what you have said about the "art" of medicine. It is, indeed, an art, as well as an applied science. You obviously know that we cannot control people or even large groups of people the way we can control chemicals or even microorganism we are culturing in the lab. Human beings--People just don't work that way. Striving to approach it that way brings on major ethical issues. Medicine just can't work in the way of a more strictly controlled science.

I am not sure what your area of specialization is or what your residency program is like. I will say that when one works regularly with physicians that truly love merging the art and science of medicine, it is a pleasure to watch and experience. The trouble is that today, the way healthcare costs are overwhelming and the way insurance coverage rolls, for private insurers, Medicaid, DDD, etc., there is just little time to do justice in terms of merging the art and science of medicine. The economics and regulatory systems are the reason for all the ridiculous amounts of paper/computer work--which, you are right, any office clerk could do for $10/hr. In fact, I contend that the mounds of stupid paperwork is part of what is keeping people from learning how to effectively practice the art and science of medicine. This is also what really is holding back a lot of the 'best practices' approach in healthcare as well, IMHO.

I think, if anything, your post shows the absolutely indispensable need for sound amounts of shadowing--or better yet, hands on clinical experience in hospitals and other healthcare arenas prior to application. Sure, keep academic standards high; but no one is doing anyone any favors by not plunging them directly and repeatedly into the real-life arena of healthcare before they apply to medical school. In fact, I say it's downright unfair to overlook a lack of strong and lengthy clinical experiences for pre-meds, while primarily honing in on very high MCAT scores or high-grade academics. I graduated from my undergrad as summa cum laude. Gee, that's nice; but it doesn't really mean a whole of hell of a lot without the real-life exposure to healthcare. Over the years, that exposure has beaten me up somewhat. At the same time, it's made me better in so many ways. The trick is getting in the clinical game in order to know straight-up, through exposure, if this is the right "realm" for the applicant--that is, is real-life medicine truly a good fit for them. After that, it's about finding the experiences and niche where you can excel, and where you will become better and not bitter.
 

Quik

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It's less of a rant and more of a list of disappointments. A lot of them, you'll already know. Some may surprise you. So here you go:


Unpleasant Surprises in Residency:
1) You are never a more stupid, bigger bumbling idiot than you are in July of your intern year. And people are happy to remind you of this, constantly. It's a mercy that premeds can't know ahead of time how awful the beginning of intern year is, because no one would ever go to med school if they knew what was in store for them. I certainly wouldn't have.
I think there are few roles in life that can adequately (somewhat, at least) prepare you for being this kind of neophyte... For some, it's basic training in the military, where you are broken down and rebuilt by drill instructors insisting you are lower than pond scum. For me, it was being a first year guy on an elite hotshot firefighting crew (after four years of leadership experience fighting fire) that humbled me quickly. What I though I knew was worthless, and whether I liked it or not, was going to learn an entirely new system starting from the bottom.

Going in thinking you're a hot **** resident (as I did into the firefighting role) is not the way to do it. Taking it personally and showing it bothers you, also wrong...
Not that I have any experience as a resident to speak from, I believe this is just part of any initiation process, but knowing it's not personal and just part of the deal should help you through the transition faster. Then again, what do I know?
 

jl lin

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I think there are few roles in life that can adequately (somewhat, at least) prepare you for being this kind of neophyte... For some, it's basic training in the military, where you are broken down and rebuilt by drill instructors insisting you are lower than pond scum. For me, it was being a first year guy on an elite hotshot firefighting crew (after four years of leadership experience fighting fire) that humbled me quickly. What I though I knew was worthless, and whether I liked it or not, was going to learn an entirely new system starting from the bottom.

Going in thinking you're a hot **** resident (as I did into the firefighting role) is not the way to do it. Taking it personally and showing it bothers you, also wrong...
Not that I have any experience as a resident to speak from, I believe this is just part of any initiation process, but knowing it's not personal and just part of the deal should help you through the transition faster. Then again, what do I know?

Correct. These kinds of roles beat you down--not necessarily a bad thing. I won't say I am humble, b/c that would be oxymoronic--or something a kin to it. I will say my clinical field experiences have been made up of numerous, on-going cycles of catabolic activity, followed by anabolic experiences, mixed with a overall higher ratio of catabolic experiences. Often valuable learning experiences are painful. These experiences can balance you out--or not--it depends on a number of factors.