Human cost of being a physician

[Instatewaiter]

Prowler won't be happy, our school is usually required 1 month's notice before the start of the clerkship, even if it's a 2 month clerkship (except for unusual circumstances -- death in family or person's own illness).

We were already asked to submit dates we needed to miss for our first rotation and I havent finished second year yet (my last test is tommorrow).

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[Dock-TAH!]

This is in response to the original post and the rest of you who don't know how to just show a little compassion when someone needs it (odd because you will be physicians) can just ignore this.

I completely understand how you feel and have also had similar thoughts this year. It is frustrating to feel like we chose a path where we have to sacrifice so much in order to also get the joys out of something we love to do. No matter how much I researched before coming into medical school and how much I knew that it would be a sacrifice, I could not have planned for the emotions that have come out.

I'm starting to rearrange my thought process and my approach and really make sure that my life is at the top of my priorities. I love medicine but it will have to settle with getting a piece of me and not all of me.

Hang in there and know that a lot of us are feeling the same way. It was comforting for me to read that others feel this too.

 

[mjl1717]

This is in response to the original post and the rest of you who don't know how to just show a little compassion when someone needs it (odd because you will be physicians) can just ignore this.

I completely understand how you feel and have also had similar thoughts this year. It is frustrating to feel like we chose a path where we have to sacrifice so much in order to also get the joys out of something we love to do. No matter how much I researched before coming into medical school and how much I knew that it would be a sacrifice, I could not have planned for the emotions that have come out.

I'm starting to rearrange my thought process and my approach and really make sure that my life is at the top of my priorities. I love medicine but it will have to settle with getting a piece of me and not all of me.

Hang in there and know that a lot of us are feeling the same way. It was comforting for me to read that others feel this too.

Yes, I thought the O.P. exhibited optimal use of SDN... Being able to:

1)Vent (which is probably healthy instead of having stuff FESTER inside of you!)
2)Receiving compassion from folks who are in the field, not neccassarily lawyers.
3) And getting reassurance..

4)A psychologist once told me that the emotions always take over.
5) You could research from now till the cows come home.. but I do not think anything could totally prepare one for the LOAD, emotionaly strife, sacrifice and X factor to actually become even 40% Osler like..

 

[Raidergate]

No offense taken. I understand that it will be more difficult M3/M4 and beyond, but I still know that there are few circumstances that would make me miss one of my best friend's, or one of my sibling's weddings--as other people have mentioned here. Of course, you probably can't go to every wedding you get invited to, but if it is someone you really care about, you will find a way.

Your example proves my point. It was "nerve wracking" for your friend, but she still found a way.

Dude, it's just a wedding. Greater than 50/50 chance it'll fail anyway.

Same for funerals. You already know how it's turned out.

I love SDN, especially the pre-allo and allo forums, where pre-med and med students constantly gripe about the immaturity and unprofessionalism of their classmates, but don't bother looking for a chance to get out of clinic for an afternoon, skip rounds on a bs excuse, or get a golden weekend because some distant friend knocked up his girlfriend and is having to shotgun that super special wedding.

It all comes down to being a mature adult. People with many, many more years of education, experience, and medical training set the curriculums at our schools. But, sure enough, there's the inevitable tide of 1st years trying to push through stupid agendas like the whole "pharm-free" movement, 2nd years fighting to be taught "more to the boards" despite not having taken them yet, and 3rd and 4th years wanting to work less and less, while still thinking they'll be as good or better docs than the residents and attendings they follow.

I, just like anyone else, have had to miss big things, like graduations, weddings, and funerals. Like Law2Doc said, there is no huge agenda to hide that fact from us. I didn't like it then, and I don't like it now, but at the same time it comes with the territory.

The former chairman of my residency department gives a talk simply entitled "What's the right thing?" In that talk he reiterates what an honor it is to care for patients, but it's also hard as hell sometimes to do it, especially when it can seem like your hospital only admits *******s. He says that asking yourself that question, honestly and openly, when making decisions makes a difference in how you view yourself and your medical practice. It sounds really corny and outdated, even to me while I type this, but he's right and I try to do it. Even now, several years after he's stepped down, if we admit one of his former patients, we call him, tell him who it is, run put a tie on, and he shows up to personally see the patient, no matter if he operated on them 30 years prior. That's pretty far out there, but that's how important he views his calling and who am I to argue with someone who has accomplished more in my chosen field than I ever will? (that and the fact that he has an international reputation for being intolerant of poor resident professionalism, which would include arguing with him)

Anyway, I don't know exactly what my post has to do with missing a wedding. However, I do think a bunch of the problems facing American medicine have been born out of this recently evolving idea that being a physician isn't as important as it used to be, either to the individual or society in general. Go be a dentist if you want to avoid self-sacrifice, you'll be happier, and in the long run so will your patients and collegues.

EDIT: I didn't mean for this post to sound quite so mean spirited. SDN is as good place as any to gripe, and I don't want to take that away. In fact, most of my post is griping, too.

 

[brianmartin]

On the topic of "# of cases required to be a good doctor"-

I'd rather do a 5th year of residency than push all those hours into the previous 4. I don't think it makes sense to spread it so thin that you don't get into a groove, but I think 60-70 hours a week, with a few vacations spread throughout the year, is totally enough to learn medicine. More than that and it's diminishing returns. You just don't store/process knowledge very well when you are tired and burnt out.

 

[DrGregoryHouse]

Dude, it's just a wedding. Greater than 50/50 chance it'll fail anyway.

Same for funerals. You already know how it's turned out.

I love SDN, especially the pre-allo and allo forums, where pre-med and med students constantly gripe about the immaturity and unprofessionalism of their classmates, but don't bother looking for a chance to get out of clinic for an afternoon, skip rounds on a bs excuse, or get a golden weekend because some distant friend knocked up his girlfriend and is having to shotgun that super special wedding.

It all comes down to being a mature adult. People with many, many more years of education, experience, and medical training set the curriculums at our schools. But, sure enough, there's the inevitable tide of 1st years trying to push through stupid agendas like the whole "pharm-free" movement, 2nd years fighting to be taught "more to the boards" despite not having taken them yet, and 3rd and 4th years wanting to work less and less, while still thinking they'll be as good or better docs than the residents and attendings they follow.

I, just like anyone else, have had to miss big things, like graduations, weddings, and funerals. Like Law2Doc said, there is no huge agenda to hide that fact from us. I didn't like it then, and I don't like it now, but at the same time it comes with the territory.

The former chairman of my residency department gives a talk simply entitled "What's the right thing?" In that talk he reiterates what an honor it is to care for patients, but it's also hard as hell sometimes to do it, especially when it can seem like your hospital only admits *******s. He says that asking yourself that question, honestly and openly, when making decisions makes a difference in how you view yourself and your medical practice. It sounds really corny and outdated, even to me while I type this, but he's right and I try to do it. Even now, several years after he's stepped down, if we admit one of his former patients, we call him, tell him who it is, run put a tie on, and he shows up to personally see the patient, no matter if he operated on them 30 years prior. That's pretty far out there, but that's how important he views his calling and who am I to argue with someone who has accomplished more in my chosen field than I ever will? (that and the fact that he has an international reputation for being intolerant of poor resident professionalism, which would include arguing with him)

Anyway, I don't know exactly what my post has to do with missing a wedding. However, I do think a bunch of the problems facing American medicine have been born out of this recently evolving idea that being a physician isn't as important as it used to be, either to the individual or society in general. Go be a dentist if you want to avoid self-sacrifice, you'll be happier, and in the long run so will your patients and collegues.

EDIT: I didn't mean for this post to sound quite so mean spirited. SDN is as good place as any to gripe, and I don't want to take that away. In fact, most of my post is griping, too.

good post.

 

[cpants]

Dude, it's just a wedding. Greater than 50/50 chance it'll fail anyway.

Same for funerals. You already know how it's turned out.

I love SDN, especially the pre-allo and allo forums, where pre-med and med students constantly gripe about the immaturity and unprofessionalism of their classmates, but don't bother looking for a chance to get out of clinic for an afternoon, skip rounds on a bs excuse, or get a golden weekend because some distant friend knocked up his girlfriend and is having to shotgun that super special wedding.

It all comes down to being a mature adult. People with many, many more years of education, experience, and medical training set the curriculums at our schools. But, sure enough, there's the inevitable tide of 1st years trying to push through stupid agendas like the whole "pharm-free" movement, 2nd years fighting to be taught "more to the boards" despite not having taken them yet, and 3rd and 4th years wanting to work less and less, while still thinking they'll be as good or better docs than the residents and attendings they follow.

I, just like anyone else, have had to miss big things, like graduations, weddings, and funerals. Like Law2Doc said, there is no huge agenda to hide that fact from us. I didn't like it then, and I don't like it now, but at the same time it comes with the territory.

The former chairman of my residency department gives a talk simply entitled "What's the right thing?" In that talk he reiterates what an honor it is to care for patients, but it's also hard as hell sometimes to do it, especially when it can seem like your hospital only admits *******s. He says that asking yourself that question, honestly and openly, when making decisions makes a difference in how you view yourself and your medical practice. It sounds really corny and outdated, even to me while I type this, but he's right and I try to do it. Even now, several years after he's stepped down, if we admit one of his former patients, we call him, tell him who it is, run put a tie on, and he shows up to personally see the patient, no matter if he operated on them 30 years prior. That's pretty far out there, but that's how important he views his calling and who am I to argue with someone who has accomplished more in my chosen field than I ever will? (that and the fact that he has an international reputation for being intolerant of poor resident professionalism, which would include arguing with him)

Anyway, I don't know exactly what my post has to do with missing a wedding. However, I do think a bunch of the problems facing American medicine have been born out of this recently evolving idea that being a physician isn't as important as it used to be, either to the individual or society in general. Go be a dentist if you want to avoid self-sacrifice, you'll be happier, and in the long run so will your patients and collegues.

EDIT: I didn't mean for this post to sound quite so mean spirited. SDN is as good place as any to gripe, and I don't want to take that away. In fact, most of my post is griping, too.

Dude, I wasn't talking about every third cousin or person that lived on my hall freshman year. I specifically said that I would not miss one of my siblings' or best friends' (maybe 3-4 people) weddings. I would follow your professor's advice and ask myself, "What's the right thing?"--switching my schedule to be my brother's best man, or not bothering or being too scared to ask. I know what my answer is, and I bet your prof would agree with me.

BTW, I am not trying to avoid sacrifice. I'm early on in this and I've already missed dozens of events with family and friends, concerts, trips, and, yes, even weddings. I knew what I was getting into, and I know there is plenty more to come. There are certain things, however, that I am not willing to sacrifice. There is a line, and I'm sure you have one too.

 

[mjl1717]

Dude, it's just a wedding. Greater than 50/50 chance it'll fail anyway.

Same for funerals. You already know how it's turned out.

I love SDN, especially the pre-allo and allo forums, where pre-med and med students constantly gripe about the immaturity and unprofessionalism of their classmates, but don't bother looking for a chance to get out of clinic for an afternoon, skip rounds on a bs excuse, or get a golden weekend because some distant friend knocked up his girlfriend and is having to shotgun that super special wedding.

It all comes down to being a mature adult. People with many, many more years of education, experience, and medical training set the curriculums at our schools. But, sure enough, there's the inevitable tide of 1st years trying to push through stupid agendas like the whole "pharm-free" movement, 2nd years fighting to be taught "more to the boards" despite not having taken them yet, and 3rd and 4th years wanting to work less and less, while still thinking they'll be as good or better docs than the residents and attendings they follow.

I, just like anyone else, have had to miss big things, like graduations, weddings, and funerals. Like Law2Doc said, there is no huge agenda to hide that fact from us. I didn't like it then, and I don't like it now, but at the same time it comes with the territory.

The former chairman of my residency department gives a talk simply entitled "What's the right thing?" In that talk he reiterates what an honor it is to care for patients, but it's also hard as hell sometimes to do it, especially when it can seem like your hospital only admits *******s. He says that asking yourself that question, honestly and openly, when making decisions makes a difference in how you view yourself and your medical practice. It sounds really corny and outdated, even to me while I type this, but he's right and I try to do it. Even now, several years after he's stepped down, if we admit one of his former patients, we call him, tell him who it is, run put a tie on, and he shows up to personally see the patient, no matter if he operated on them 30 years prior. That's pretty far out there, but that's how important he views his calling and who am I to argue with someone who has accomplished more in my chosen field than I ever will? (that and the fact that he has an international reputation for being intolerant of poor resident professionalism, which would include arguing with him)

Anyway, I don't know exactly what my post has to do with missing a wedding. However, I do think a bunch of the problems facing American medicine have been born out of this recently evolving idea that being a physician isn't as important as it used to be, either to the individual or society in general. Go be a dentist if you want to avoid self-sacrifice, you'll be happier, and in the long run so will your patients and collegues.

EDIT: I didn't mean for this post to sound quite so mean spirited. SDN is as good place as any to gripe, and I don't want to take that away. In fact, most of my post is griping, too.

This is great literature!!

Also as far as your chairman sounding corny and out dated..--He DOESNT sound corn and out dated to me ... Because I later on found out the "conscientious level" needed in this arena.. And some may want to argue with me, but I know the passion level in medicine needs to be just about at the same level that one may have for a loved spouse..

As far as medicine not being as important as it use to be..Rough& loaded topic!!
But these items MAY have attempted to discount medicine..

1)Greedy lawyers "stabbing at the heart". -(making us look mistake prone, ignorant and helpless)
2)Sickly alcoholic Insurance monguls..
3)Too many malpractice suits that make us look less desirable..
4)The revolution of the internet gives the patient information real fast..Making us appear slightly less valuable.
5) Info on TV sometimes get to the patient before we even hear about it. Making us look uninformed..
6)Buisness men who see that docs dont go to school for buisness and take advantage. (make us look just a little dumb, lacking solid buisness sense,-no real union)
Just my opinion..

 

[Law2Doc]

This is great literature!!

Also as far as your chairman sounding corny and out dated..--He DOESNT sound corn and out dated to me ... Because I later on found out the "conscientious level" needed in this arena.. And some may want to argue with me, but I know the passion level in medicine needs to be just about at the same level that one may have for a loved spouse..

As far as medicine not being as important as it use to be..Rough& loaded topic!!
But these items MAY have attempted to discount medicine..

1)Greedy lawyers "stabbing at the heart". -(making us look mistake prone, ignorant and helpless)
2)Sickly alcoholic Insurance monguls..
3)Too many malpractice suits that make us look less desirable..
4)The revolution of the internet gives the patient information real fast..Making us appear slightly less valuable.
5) Info on TV sometimes get to the patient before we even hear about it. Making us look uninformed..
6)Buisness men who see that docs dont go to school for buisness and take advantage. (make us look just a little dumb, lacking solid buisness sense,-no real union)
Just my opinion..

Law and medmal are not new things, and so anyone seeing this as a CHANGE in medicine hasn't been aware of the medical for quite a few decades now. The big change in medicine is the grapple hold of insurance companies on medicine. Physicians are the odd man out in a system that forces them to see more patients a day in shorter time intervals - making patients feel slighted and more often likely to sue when things go bad. The days of doctor as advisor/friend are gone because most patients wait a long time to get in to see someone who is desperately trying to limit their visit to 15 minutes or less. That is why physicians have lost their import to the general public. Factor in things like PAs and NPs becoming primary intake person for a lot of patients, and the portrayal of physicians on TV as misanthropes (House) or lewd (Greys, Nip Tuck, or Dr Rey on 90210), and you've got a big public perception problem. All at the same time the public is bombarded with the fact that healthcare costs are skyrocketing out of control and when the public thinks healthcare they think doctors.
The lawyers and businessmen out there are certainly a minor issue, but not the cause of the public's perception.

 

[nogolfinsnow]

There's no way I'd miss one of my sibling's weddings. Period.

This is why I have told both my brother and my wife's brother that once they're engaged I will pick their wedding dates for them.

 

[Law2Doc]

This is why I have told both my brother and my wife's brother that once they're engaged I will pick their wedding dates for them.

You are joking, but some of us certainly gave input on our availability for certain dates for major family member events.

 

[Ashers]

You are joking, but some of us certainly gave input on our availability for certain dates for major family member events.

I told my sister I could make 3 out of the 4 dates she had, she chose the one that I had the hardest time getting to.

 

[TOMFighter]

http://forums.studentdoctor.net/showthread.php?t=524347

 

[soeagerun2or]

While it is understandable people look to the historic record for support of the current state of affairs, the stoicism and reasoning given by supporters is severely lacking in foresight of the way medicine is evolving.

Yes, maybe it was better the way it was. Maybe HOs/Residents should take a sabbatical from family and live in the hospital as residents like they formerly did. Maybe this would weed out the non-devoted people who are entering medical school but not going in to primary care.

Unfortuneately, this is not going to happen and fighting the change will only make it harder for to accept. People want as much as they can get for as little work as possible and doctors/medical students are no different.

 

[45408]

Prowler won't be happy, our school is usually required 1 month's notice before the start of the clerkship, even if it's a 2 month clerkship (except for unusual circumstances -- death in family or person's own illness).

I'm pretty sure I would be more upset at one of my siblings than my school if I had less than 3 months notice for a wedding.

 

[45408]

This is why I have told both my brother and my wife's brother that once they're engaged I will pick their wedding dates for them.

Oh, my brother certainly heard from me when he was picking his wedding date. It's in the middle of my step 1 studying (it's on this Sunday - about 2000 miles awway), but I've got enough days to study that it'll work out. He kind of needed to consider my schedule - I'm the best man.

 

[TerpMD]

I think another issue is women in medicine. Women are more likely to want lifestyle accomodations (or to put it in a less inflammatory way: they want better balance to their lives) than men and are less likely to be the primary breadwinner, thus putting less pressure to maximize their performance and income, and I think when they push for maternity leave, time off for mothering, to be a wife, etc., the men tend to think, "well I'd like that time too..."

I feel like the biggest sacrifice I have to make is waiting to have my kids. If you have them in med school, they are raised by family/nanny/daycare because you have a residency ahead where you will never be around. If you wait you might find yourself in the IVF clinic. It forces you to think about things that I don't know that all men do... like, what if I am pregnant on a cardio fellowship- I need to get out of 9mo of cath lab... I think about my future based on priorties that include a family.

Anyway, my point is that yes, in some ways maybe its us that wants more flexibility but I don't think it's out of line. I totally understand how the OP feels and it is so hard when you are constantly the one who has to say, no I can't come. Non-med school people don't always understand, especially depending on you background.

Did I know what I was getting myself into, yes. Does that mean I should sit here and act like I'm so happy to gamble with my fertility, miss seeing family and friends, and live a sleep deprived rest of my life, no.

 

[nogolfinsnow]

You are joking, but some of us certainly gave input on our availability for certain dates for major family member events.

Only half joking (and maybe less).

 

[EBKame]

Gripe away, but personally there are ways to take care of your mental health. At some point you just need to say "no" to the constant delayed gratification. Have your kids, get married, skip if you need a day for your sanity, and travel when you have the chance. Chances are you'll be a better doctor for the balance you have in your life.

 

[psipsina]

Well, if your friend's weddings are all taking place 3k miles away because you weren't lucky enough to stay near home for school and a trip out and back w/ spouse would run over $1k, the ones you miss start adding up.

Yep I agree with this. I missed a best friends wedding because of this. He happened to plan his wedding for the week before my M1 year started. My husband and I had just moved across the country and had two weeks to set up our home and out lives before school started. We couldn't have afforded to leave any earlier because I had to quit my 1k$/wk job in order to move but there was no way we could drive across the country, set up our house, find pet sitters, fly back across the country for a wedding and back again and not be broke and insane. Sometimes life gets in the way in a myriad of ways.

I have a wedding to get to this September. Its my best friend who actually took the initiative to examine my test schedule when she picked her date! How thoughtful is that? Even though the timing is great I still have to fly across the country and back, get a hotel room, buy a bridesmaid dress/shoes etc, rent a tux for my husband, buy a wedding gift etc which is going to cut into almost all my extra spending money from my loans. Thats alot of $$ and for anyone but her I might not be willing to do it.

 

[farnsworth]

Yep I agree with this. I missed a best friends wedding because of this. He happened to plan his wedding for the week before my M1 year started. My husband and I had just moved across the country and had two weeks to set up our home and out lives before school started. We couldn't have afforded to leave any earlier because I had to quit my 1k$/wk job in order to move but there was no way we could drive across the country, set up our house, find pet sitters, fly back across the country for a wedding and back again and not be broke and insane. Sometimes life gets in the way in a myriad of ways.

I have a wedding to get to this September. Its my best friend who actually took the initiative to examine my test schedule when she picked her date! How thoughtful is that? Even though the timing is great I still have to fly across the country and back, get a hotel room, buy a bridesmaid dress/shoes etc, rent a tux for my husband, buy a wedding gift etc which is going to cut into almost all my extra spending money from my loans. Thats alot of $$ and for anyone but her I might not be willing to do it.

You have a lot of "best" friends.

 

[notdeadyet]

I wonder if folks over-think the importance of hitting weddings. Unless they're in their teens, most couples will understand if you can't make the wedding. Very few people will hold grudges. You can't nail a date that everyone can accommodate.

It's tough having to miss a great friend's wedding, but they will understand. At the end of the day, it's a great party you wish you could be at, but you ain't the host or the one on the pedestal. It'll go on just fine with out you. Send a nice gift and card and the next time you see them, have a bottle of wine and enthusiastically ask to look through their album as pennance.

 

[imagined space]

I wonder if folks over-think the importance of hitting weddings. Unless they're in their teens, most couples will understand if you can't make the wedding. Very few people will hold grudges. You can't nail a date that everyone can accommodate.

It's tough having to miss a great friend's wedding, but they will understand. At the end of the day, it's a great party you wish you could be at, but you ain't the host or the one on the pedestal. It'll go on just fine with out you. Send a nice gift and card and the next time you see them, have a bottle of wine and enthusiastically ask to look through their album as pennance.

An old friend once told me (probably on his third marriage now) that you only need to show at a weeding if you're getting hitched or doing the hitching. The former is also debatable

 

[interstellar]

2) And just to add the icing to the cake .. There is ALWAYS at least one wise guy who will say something like " "Its cake to me" or "Oh before I came into the field I was doing research with Debakey at Baylor"

LOL

OP, i look at the drs all around me and some are bitter and miserable about their profession... others are not ecstatically happy but are content in where they are in life. i just hope to somehow fall into the later category 10+ years from now.

 

[tbo]

I have nothing to add being that I'm starting school next fall but it sounds like there's something to take away from each and every post. Great stuff.

 

[Bravofriendly]

Gripe away, but personally there are ways to take care of your mental health. At some point you just need to say "no" to the constant delayed gratification. Have your kids, get married, skip if you need a day for your sanity, and travel when you have the chance. Chances are you'll be a better doctor for the balance you have in your life.

I worked for an amazing physician for a peroid of time who is an involved mother, wonderful wife, dream employer, loyal and dedicated friend, engaged daughter, active church member, active member of multiple hospital committees, plus takes the time to engage in personally enriching acitivies such as dance lessons, ect. Her secret is setting firm boundaries and empowering herself by saying "no" when someone asks her to make exceptions.

She has earned the loyalty and adoration of her patients through her compassionate and well-executed care. As an OB-Gyn, her patients wish very much for her to be present at their delivery; however, they understand that she refuses to make exceptions to her firm rule of never coming in during the night or on weekends for deliveries when she isn't on call. When she is at the office/hospital, her patients have her undivided attention and when she is at home her family has it, ect.

As a witness to both her professional and personal lives, I know that the struggle to keep such a fantastic balance is both painfully difficult and unimaginably rewarding. As a witness to many other unbalanced physicians, I know the mess that frequently follows in its absence.

I'm just starting out on my journey. I hope that I have the fortitude and wisdom to follow in such well-placed footsteps.