If you could do it over would you

[caldoc44]

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So recently I was talking to a neurologist about this very same question. Before I continue, I'll give some of his background.........

He is of the older generation, and completed his medical education and training in the late 60's or early 70's at Columbia School of Physicians and Surgeons, with residency training primarily being at Bellevue hospital which is used by both Columbia and NYU for clinical training and known for a number of rare cases not seen at your typical hospital. From there he went on to Vermont in a teaching position, then onto USF in a teaching position when the med school was opened in the mid 70's, and a few years after that he decided to go into private practice for 15 years. In the mid 90's he came back to USF COM as an associate professor and now serves as the residency director.

Here were his thoughts on this subject.......

The simple answer he gave to this question is that "Yes" he would do it over again. However, he felt that he truly understood why many physicians would not do it again, and went on to emphasize a point made by Benny earlier......that in this day and age that many physicians are expected 20 minutes and see patients as customers in a checkout line rather then as individuals, and that doctors are being treated as if they should act like robots. In his earlier days he could spend a hour or more with patients getting to know them and not just deal with the medical aspect but the humanistic aspects as well, and he felt a lot of the humanism is leaving medicine with the advent of HMO companies pushing you to see patients in 10-20 minutes. Often times, he went on, HMO company reps take a walk around on rounds with him and go away with the feeling that they really had no idea what really goes on in medicine and being amazed by how much time was really needed. So what it comes down to is that fact that many HMO companies want you to spend such limited time with patients but they don't really understand the fact that more time is needed and understand all the humanistic aspects of medicine much, which causes for a lot of disappointment. He also felt that many older physicians who are disappointed with medicine are not able to adapt to the changes in medicine, but that is a point that refers more to physicians of his generation than to all of you current residents. In medicine, he said a lot of current healthcare issues lie in the fact that they want to treat it like you should be following some protocol rather then thinking, and using your brain to solve the problems whereas in his hay day, he could spent a lot more time with patients to get to understand their problems and think about what really would be the best course of action, rather then being so limited in what he should do. HMO companies wish to treat each patient the same but each patient is different and each case is different, and these things he felt were what brought about problems in medicine. When you say doctors are only spending 20 minutes with a patient, and not doing much, think about this........Is it the physician's fault or the HMO and PPO companies that are running our healthcare systems that are at fault?? I'm going to go with the latter of the two scenarios, after not just listening to this doctor, but also after working in a doctor's office for a month where I heard the nurses and other healthcare workers constantly complaining about similar issues.

As an example of the problems described, he told us a story about a woman who was having some sort of attack. I think it was a stroke or a seizure or something of that nature. But at any rate, he knew they were having the problem they were having and had them go to the ER to get whatever operation or treatment, yet the workers there insisted that they get an MRI in the situation where it wasn't needed because it was blatantly clear what was wrong. And why were they told to get an MRI?? Because HMO companies dictated it like some sort of protocol.

In conclusion, this is just some of the thoughts on medicine from an actual practicing physician at my university, and hence something for other premeds to think about when idealistic perceptions of medicine are being spewed.

Gujudoc you sure do have a lot of time on your hands dont you? If I remember correctly you were complaining about your 14 mcat score a few months ago, maybe you should go study for that?

 

[Diane L. Evans]

Please be professional

 

[gujuDoc]

Gujudoc you sure do have a lot of time on your hands dont you? If I remember correctly you were complaining about your 14 mcat score a few months ago, maybe you should go study for that?

First off, I DID NOT GET a 14 on my MCAT!!!!! I did MUCH HIGHER THEN THAT!!!!!!!!!! So F*** OFF!!!!!!!!!

Secondly, I was posting for the people who wanted to read this thread what an attending I talked to said. I was not posting an opinion of mine, but passing on information from the viewpoint of a well known attending at my university. So back the HELL OFF!!!!!!!!!!!!!!

 

[gujuDoc]

Gujudoc you sure do have a lot of time on your hands dont you? If I remember correctly you were complaining about your 14 mcat score a few months ago, maybe you should go study for that?

Oh and one more thing, you ARE CONFUSING ME with someone else, cuz I NEVER COMPLAINED ABOUT MY SCORE ON SDN!!!!!! I said I was slightly disappointed with doing a 2-3 points less on verbal then what I wanted, but never complained or whined about my scores. That WAS SOMEONE ELSE!!!!!

 

[gujuDoc]

BTW, I don't waste my time, but I saw this attending at a meeting at a premed organization and he was doing a question and answer to give students real world perspective. So don't imply things you don't know anything about. Since this was the obvious place to post these thoughts given by him, I did just that.

 

[Crazy808]

Talk about proving a point by example

 

[monkey7247]

Talk about proving a point by example

 

[CANES2006]

First off, I DID NOT GET a 14 on my MCAT!!!!! I did MUCH HIGHER THEN THAT!!!!!!!!!! So F*** OFF!!!!!!!!!

Secondly, I was posting for the people who wanted to read this thread what an attending I talked to said. I was not posting an opinion of mine, but passing on information from the viewpoint of a well known attending at my university. So back the HELL OFF!!!!!!!!!!!!!!

 

[gujuDoc]

Sorry. Maybe I shouldn't have cursed him out, but he implied things about me that are far be it from the truth for no apparent reason, which kinda upset me.

I apologize, but if someone's gonna insult me they should at least get their facts straight and not confuse me with either someone else or someone from their imagination. I'm not usually like this in real life.

Also, not to stir the pot or anything but just for everyone's information, the only reason I posted what the attending's views were was because a few people a few pages back wanted some more insights from attendings rather then the med students and had said they didn't want to really hear from 2nd year med students as much as they'd want to hear from attendings and residents. Hence, I thought that I'd post what this particular attending said for those people who implied they wanted to hear the perspective of practicing physicians. I just thought this attending's lengthy response brought about a lot to think about and a thorough answer to some of the many problems facing the healthcare systems.

 

[Pharos]

Sorry. Maybe I shouldn't have cursed him out, but he implied things about me that are far be it from the truth for no apparent reason, which kinda upset me.

I apologize, but if someone's gonna insult me they should at least get their facts straight and not confuse me with either someone else or someone from their imagination. I'm not usually like this in real life.

Also, not to stir the pot or anything but just for everyone's information, the only reason I posted what the attending's views were was because a few people a few pages back wanted some more insights from attendings rather then the med students and had said they didn't want to really hear from 2nd year med students as much as they'd want to hear from attendings and residents. Hence, I thought that I'd post what this particular attending said for those people who implied they wanted to hear the perspective of practicing physicians. I just thought this attending's lengthy response brought about a lot to think about and a thorough answer to some of the many problems facing the healthcare systems.

I liked the post. Thanks for taking your time to construct it (i.e. there are people out there who appreciated it).

 

[etudiante04]

I also appreciated the post.

 

[CANES2006]

Sorry. Maybe I shouldn't have cursed him out, but he implied things about me that are far be it from the truth for no apparent reason, which kinda upset me.

I apologize, but if someone's gonna insult me they should at least get their facts straight and not confuse me with either someone else or someone from their imagination. I'm not usually like this in real life.

Also, not to stir the pot or anything but just for everyone's information, the only reason I posted what the attending's views were was because a few people a few pages back wanted some more insights from attendings rather then the med students and had said they didn't want to really hear from 2nd year med students as much as they'd want to hear from attendings and residents. Hence, I thought that I'd post what this particular attending said for those people who implied they wanted to hear the perspective of practicing physicians. I just thought this attending's lengthy response brought about a lot to think about and a thorough answer to some of the many problems facing the healthcare systems.

No harm done. 😀 Just remind me not to get into a fight with you. 😉

 

[gujuDoc]

No harm done. 😀 Just remind me not to get into a fight with you. 😉

hahaha....I've seen some of your posts, and you seem like a nice person who wouldn't instigate such a thing anyways. I don't always fight like this, but some people here on SDN like to take pot shots at others even when they aren't doing anything wrong. That's the only reason I got upset, but I'm not usually like that at all.

 

[billydoc]

Thank You gujuDoc!
Your post is greatly appreciated.
Boy , you sure know how to stick up for the things you believe in 😀
Keep up the good work 👍

 

[NRAI2001]

Lets get back to the OT (did i invent an acronym....original topic).

 

[gujuDoc]

Lets get back to the OT (did i invent an acronym....original topic).

Who knows??? But we'd need more doctors or residents or med students to respond if we want more answers to the original topic.

 

[ssingh0]

As an economist who has spent the last 30 years looking at health care all round the world, may I suggest that frustration and perhaps boredom play a part in the anger of doctors? This is aside from what I accept are genuine conflicts between levels of public funding and clinical aspirations to help patients. Looking at other professionals, they advance through their careers, their work changes, they build teams and grow their businesses. Some stay in single practice but many move into management with changes periodically in their working life.

Similarly, economists like me have a wide range of research, travel as part of our work and manage teams on a diversity of projects. I have no idea what I will be doing in September this year but I am confident it will be interesting. Contrast these professional lives with that of doctors. GPs may have opportunities to develop their management skills but in an environment where the management structures and self-employed status of colleagues make this far from easy. And someone has to see the patients each week. Consultants have more of the variety and team building mentioned but again, their work plans look very much the same, year-in, year-out to the outsider. This leads me to my conclusion.

Is it possible that the calibre of people recruited to medicine is too high for the job - not necessarily for the technical elements but for the pattern of work once GP or consultant status is reached? Is a degree of frustration inevitable given their abilities and the relative consistency of the job beyond the age of 30 or 35? Are many years of clinical practice consistent with the job enrichment that able people may want as their career develops?

??

 

[ssingh0]

"Although I believe that the topic has been comprehensively covered by now, perhaps I could make an attempt to sum up my feelings about why Doctors are unhappy.. The following is based on personal experience and observations in both UK and Australia.. We are.. 1)...by the very nature of the work involved, a "self selected" group of highly motivated, high achievers. 1a)..Possibly MORE likely to suffer from significant clinical depression.. 2)...told from the very first moment in Medical School that we are the "elite" of our generation. 3)...subject to significant social and financial privation in our early under and postgraduate years, with the implicit promise of future "golden rewards". 3a)..often mistreated by those senior to us in our chosen speciality or hospital, for any of many reasons.. 4)...by and large justifiably proud of our achievements and expecting some reasonable recognition for same. 5)...usurped/undermined in our chosen role by any number of semi/poorly/un-trained peripheral persons, all eager to assume some of the kudos that they despise us for achieving. 5a)..occassionaly usurped/undermined in our chosen role by fellow medical practitioners, for various reasons.. 6)...impeded in the discharge of our duties by the devious and doubtful behaviour of legions of "bean counters" and others who act in any thing BUT the best interests of our patient. 7)...working as "biological" (i.e Frail and Fallible) organisms, for the benefit of other "biological" (i.e Frail and Fallible) organisms, under the conditions outlined in (5), (5a) and (6) 8)...expected to be more than mortal in our abilities to cope with the many and varied pressures of (7) above.. For these efforts we are rewarded at a level that is usually considerably less than other "equivalent" professionals. 9)...judged (for financial and status purposes) by those who should know better, for those actions (or inactions) that are inevitable, given the truth of (8) above.. 10)..put under extraordinary pressures by the predatory behaviour of some members of the "legal profession" and the "public" should we be unfortunate enough to fail as in (8) above.. 11)..reviled and discredited should we try to improve the system, point out its problems, redress the mistakes, etc, etc. Not only by "management" and other peripheral personages, but often by members of our own profession who should of course, know better.. Furthermore we are 12)..singularly disorganised when it comes to improving our current standing and conditions. Not withstanding the very real rewards and joys that our work can bring us, the above can so easily contribute to feelings of desperate hopelessness and unhappiness, which can only increase as time passes and no improvement is apparent. Should we be unfortunate enough to suffer from genuine depressive illness as (1a) above, these factors will make our lives increasingly difficult and intolerable. When it all gets too much, we are particularly effective at killing ourselves, because we have the knowledge and the means, readily to hand. The Answer?? Stand together as a body, united with a common goal and ethic, to support each other in our support of our patients. Sounds too idealistic doesn't it?? Unfortunately we are still far too fragmented. Many who should know better are still too immersed in their own interests.. "

 

[ssingh0]

I feel there is one very glaring albeit politically sensitive reason that most doctors privately acknowledge but will not come out with. It is the stranglehold the nursing community has gradually obtained on healthcare in the NHS here in the UK. All this nonsense about their being the patient's advocate has had the effect of the nurse now assuming the mantle of the protector of the patient. Who from..? Well "those doctors" of course. This has brought about an almost adversarial relationship between doctors and nurses treating patients. Nurses questioning treatment plans in front of patients, ignoring orders, and generally flexing their political muscle in the wards are quite familiar to most of us. And now we have talk of nurse consultants in political appeasement gone mad.

The doctor holds all responsibility for his/her patient, but has now been relegated to a second rate role in this NHS. It is the doctor who is the ultimate patient's advocate but in this wierd democracy of numbers he/she will get sued if there is a slip up but the box of chocolates will go to the nurses counter when all is well.

 

[ssingh0]

Burnout as a syndrome is present in many individuals under constant pressure.10 Physicians in particular are frequently overloaded with the demands of caring for sick patients within constraints of fewer organizational resources.11 The symptoms and signs of burnout include emotional exhaustion, cynicism, and perceived clinical ineffectiveness, and a sense of depersonalization in relationships with coworkers, patients, or both. Burnout has been associated with impaired job performance and poor health, including headaches, sleep disturbances, irritability, marital difficulties, fatigue, hypertension, anxiety, depression, myocardial infarction, and may contribute to alcoholism and drug addiction.12-14

Maslach and Leither10 describe burnout as the index of the dislocation between what people are doing vs what they are expected to do. Burnout represents a deterioration of values, dignity, spirit, and will. They describe this constellation as "an erosion of the soul." Burnout spreads gradually and continuously over time, sending people into a downward spiral from which it is hard to recover.10 Deterioration of physician well-being from excessive stress has been described as the silent anguish of the healers.15 The seeds of burnout may be sown in medical school and residency training, where fatigue and emotional exhaustion are often the norm.16-18 By mid-career, the momentum of burnout is maintained by the subtle reinforcement of the esteem and recognition of one's peers for being a hard worker and placing service to others before self-care.

Research on burnout in the workplace reveals several common themes. The risk of burnout increases in individuals who consistently experience work overload and a perceived lack of control over the extent to which the load exceeds their capacity. Workers who are burned out find their work unrewarding, experience a breakdown in community, believe they are treated unfairly, and are confronted with conflicting values.10 These conflicts apply to many medical practice situations and may contribute to the general unrest in physicians worldwide.1, 19-21

 

[ssingh0]

Dr. Zuger mentions that "the recent interest in identifying and preventing medical errors has magnified feelings of insecurity." This is actually the tip of an iceberg: the beating we regularly take from within the medical establishment. Regarding issues such as racial disparities in care, sexual disparities, noncompliance with medications, or adherence to guidelines, our "colleagues" in academe tell us we are racists, sexists, ignoramuses who never read a journal, or lousy communicators. Meanwhile, the "noncompliant patient" is an evil construct born of paternalism. In short, everything that is not ideal is directly our fault, and this in an age when we have less control than ever over patients' behavior. Ergo, patients have authority and no responsibility, whereas we are assigned responsibility and no authority. This is a nightmare straight out of "Dilbert" and a sure recipe for stress and burnout on the part of physicians.

 

[ssingh0]

"Once regulated largely by the conscience of the individual practitioners, many fields are becoming constrained and corporatized by governmental and professional structures, resulting in the professional's loss of autonomy, status, and the respect of the public." The logical response to such constraints is to view medicine as just another job rather than a profession and thus to push for regular hours and better work conditions.

 

[ssingh0]

Kaiser Family foundation national physician survey:

A majority (53%) of doctors say they would recommend the practice of medicine to a young person today – but 45% say they would not.
When those doctors who would not recommend the profession were given a list of possible reasons why, the most frequently cited reasons are
paperwork and administrative hassles (57%) and loss of autonomy (46%). About three in 10 pick excessive professional demands (31%), less
respect for the medical profession (31%), and inadequate financial rewards (31%). Fewer say difficulties in starting or operating a practice (22%),
the educational process being too long, difficult, or expensive (16%), and the profession not being personally satisfying (15%) are the main
reasons for their dissatisfaction.

 

[ssingh0]

Study: Physician Career Satisfaction Across Specialties
(arch Int Med 2002)

Highest % Very satisfied:
geriatric IM
neonatal-perinatal
derm
peds

highest % dissatisfied
otolaryngology
OB/gyn
ophthalmology
orthopedic surgery
IM


(doesn't correlate with incomes at all)

 

[gujuDoc]

SSingh,

What about people in fields like Neurology, other internal med subspecialties, and so forth?? Do you have any data on those other fields?? Thanks in advance.

 

[humuhumu]

Burnout as a syndrome is present in many individuals under constant pressure.10 Physicians in particular are frequently overloaded with the demands of caring for sick patients within constraints of fewer organizational resources.11 The symptoms and signs of burnout include emotional exhaustion, cynicism, and perceived clinical ineffectiveness, and a sense of depersonalization in relationships with coworkers, patients, or both. Burnout has been associated with impaired job performance and poor health, including headaches, sleep disturbances, irritability, marital difficulties, fatigue, hypertension, anxiety, depression, myocardial infarction, and may contribute to alcoholism and drug addiction.12-14

Maslach and Leither10 describe burnout as the index of the dislocation between what people are doing vs what they are expected to do. Burnout represents a deterioration of values, dignity, spirit, and will. They describe this constellation as "an erosion of the soul." Burnout spreads gradually and continuously over time, sending people into a downward spiral from which it is hard to recover.10 Deterioration of physician well-being from excessive stress has been described as the silent anguish of the healers.15 The seeds of burnout may be sown in medical school and residency training, where fatigue and emotional exhaustion are often the norm.16-18 By mid-career, the momentum of burnout is maintained by the subtle reinforcement of the esteem and recognition of one's peers for being a hard worker and placing service to others before self-care.

Research on burnout in the workplace reveals several common themes. The risk of burnout increases in individuals who consistently experience work overload and a perceived lack of control over the extent to which the load exceeds their capacity. Workers who are burned out find their work unrewarding, experience a breakdown in community, believe they are treated unfairly, and are confronted with conflicting values.10 These conflicts apply to many medical practice situations and may contribute to the general unrest in physicians worldwide.1, 19-21

Interesting perspective. Please cite the source if possible.

 

[etudiante04]

Study: Physician Career Satisfaction Across Specialties
(arch Int Med 2002)

Highest % Very satisfied:
geriatric IM
neonatal-perinatal
derm
peds

highest % dissatisfied
otolaryngology
OB/gyn
ophthalmology
orthopedic surgery
IM


(doesn't correlate with incomes at all)

Does this list include those in academic medicine??

 

[ssingh0]

SSingh,

What about people in fields like Neurology, other internal med subspecialties, and so forth?? Do you have any data on those other fields?? Thanks in advance.

Does this list include those in academic medicine??

The main data from the study is published in figure 3.3 in Iserson's Getting a Residency (6th edition).

Notably they state that "Some specialists such as radiologists, anesthesiologists, and pathologists as well as all residents and fellows were excluded from the sample. So two of the ROADE (?) specialties are not represented. But opthalmology is at the bottom for chance of being very satisfied, 3rd for dissatisfied!

Neurology: 40% "very satisfied", 16% somewhat/very dissatisfied.

So the remaining 44% are either "somewhat satisfied" or "neither satisfied nor dissatsified"

The physicians are selected randomly from those who do at least clinical 20 hr/week.

Why is IM a lot more dissatisfied than Family Medicine, Don't they make about the same and do the same stuff?

 

[ssingh0]

Interesting perspective. Please cite the source if possible.

Google scholar is your friend 😛

Just search for the first sentence.

JAMA Sep 25, 2002 vol 288 no12 "mid-career burnout in generalist and specialist physician" Spickard, Gabbe

The sources cited at the end also give more info.

 

[Diane L. Evans]

Dear MS's and premeds. I think until you live the experience you will not understand. MS1/2 with weekly 25 chpt/wk test and an intense learning curve are nothing compared to the residency years. Analogous to a fraternity the heirchary can be depressing, frightening and the work load for an intern enormous. Your first code, pronouning your first death, your first critical patient will scare you and even make you think twice. Sometimes the staff or RNs can be belittling. Sometimes an upper level resident or attending will get frustrated with your lack of knowledge. There will be many times you wish you could quit. It is inevitable you will get reprimanded, made to feel 2 inches tall, but you will go on.... little by little you will change.... and those around you will notice.... and as others here on this site have noticed themselves... in the end you'll probably be happy but I guarantee would not endure 7+ yrs of torture again. Try reading the residency diaries on this sites homepage

Good luck

 

[gujuDoc]

Dear MS's and premeds. I think until you live the experience you will not understand. MS1/2 with weekly 25 chpt/wk test and an intense learning curve are nothing compared to the residency years. Analogous to a fraternity the heirchary can be depressing, frightening and the work load for an intern enormous. Your first code, pronouning your first death, your first critical patient will scare you and even make you think twice. Sometimes the staff or RNs can be belittling. Sometimes an upper level resident or attending will get frustrated with your lack of knowledge. There will be many times you wish you could quit. It is inevitable you will get reprimanded, made to feel 2 inches tall, but you will go on.... little by little you will change.... and those around you will notice.... and as others here on this site have noticed themselves... in the end you'll probably be happy but I guarantee would not endure 7+ yrs of torture again. Try reading the residency diaries on this sites homepage

Good luck

Thanks for the post. 👍 👍

 

[8744]

And I gotta say, as a guy who left a pretty well-paying career to go to medical school, when I look back at the last five years of relative poverty, the three more years of the same I have to look foward to with no real financial payoff on top of being in a specialty which I don't like...well...sometimes in the long watches of the night it's hard to convince myself that it has been worth it.

Having to scramble last year really took the wind out of my sails.

My wife has been a real trouper through all of this and I am fortunate to have a very strong marriage. Still, it has been hard on my lovely wife who probably expected that by this time in our lives we'd be a little more secure both geographically and financially.

The best I can say is that we live in a state of gentile poverty.

My attitude will change if Iam successful in the match this year. Stand by.

 

[TaiShan]

Panda, why do not switch to Anesthesiology or some other field? You had a pretty decent step score...

sorry now I saw you are re-matching this year. Good luck and hope you get in whatever you are applying.

 

[Dr.Wolkower]

would be a slacker and be a parasite on you all


or be another bill gates


or be a politician

most likely would have been a PA

 

[billydoc]

would be a slacker and be a parasite on you all


or be another bill gates


or be a politician

most likely would have been a PA

It's frightening for me to see how many of you guys said you'll never do it again. But this is a real eye opener. At 35 1/2, with less than desirable health, for the med school/residency journey 😱, I'm still kidding myself that I should do it. Pretty much against all odds and a common sense.It's like some kind of maddness tat's pushing me towards it. I'm wondering if anyone formely from alled health professions (RN,NP,PA,PT,OT,SLP,RT etc) would care to post
if it was worthy for you to do the med school. For those of you who will not do it again...what would you rather have done instead?

Thanks

 

[ssingh0]

wow, pandabear your blog is extremeley good, esp for premeds, esp the part "what is it really like" convincing rather than just saying medicine is not glamorous, etc. Thank you like hell

 

[gujuDoc]

And I gotta say, as a guy who left a pretty well-paying career to go to medical school, when I look back at the last five years of relative poverty, the three more years of the same I have to look foward to with no real financial payoff on top of being in a specialty which I don't like...well...sometimes in the long watches of the night it's hard to convince myself that it has been worth it.

Having to scramble last year really took the wind out of my sails.

My wife has been a real trouper through all of this and I am fortunate to have a very strong marriage. Still, it has been hard on my lovely wife who probably expected that by this time in our lives we'd be a little more secure both geographically and financially.

The best I can say is that we live in a state of gentile poverty.

My attitude will change if Iam successful in the match this year. Stand by.

Panda,

Hey I was just reading your blog and was curious what field your current residency position is in, and what field you are trying to get into if the match goes well this year??? Thanks in advance.

BTW: Thanks for your perspectives and your blog posts. It puts things into a lot of perspective.

 

[8744]

Panda,

Hey I was just reading your blog and was curious what field your current residency position is in, and what field you are trying to get into if the match goes well this year??? Thanks in advance.

BTW: Thanks for your perspectives and your blog posts. It puts things into a lot of perspective.

I am in Family Medicine at Duke. I have nothing against family medicine of course but I am not a very good fit for it. I am in the match this year for Emergency Medicine

As my friends on the Everyone Forum know, I scrambled into the position after not matching into Emergency Medicine last year. I should have scrambled into a preliminary medicine or surgery position but not matching kind of threw me for a loop and I plead temporary insanity.

I made a mistake. No question about it. A hard admission to make, especially on SDN where many of the posters have careers and lives which have been on perfect uninterupted arcs from high school to a Derm residency with only a few close calls on exams as complications.

I want to add that I am paying for this mistake in spades. Not only are we going to lose huge amounts of money selling our house and moving again but I have had a fairly rough time scheduling interviews. I would have liked to have gone on more than the nine I managed but it is a lot harder to interview as an intern.

I'm not even sure what my chances are of matching this year.

I also want to add that maybe it's not fair to ask a bunch of interns if medicine was worth it. Intern year, frankly, sucks. Big time. It's even worse for a family medicine intern because we jump around on a variety of very different services and never really get a good handle on any of them, at least when compared to an internal medcine intern, for example, who can pretty much "shut out" pediatrics, obstetrics, gynecology, or surgery.

 

[QofQuimica]

I am in Family Medicine at Duke. I have nothing against family medicine of course but I am not a very good fit for it. I am in the match this year for Emergency Medicine

As my friends on the Everyone Forum know, I scrambled into the position after not matching into Emergency Medicine last year. I should have scrambled into a preliminary medicine or surgery position but not matching kind of threw me for a loop and I plead temporary insanity.

I made a mistake. No question about it. A hard admission to make, especially on SDN where many of the posters have careers and lives which have been on perfect uninterupted arcs from high school to a Derm residency with only a few close calls on exams as complications.

I want to add that I am paying for this mistake in spades. Not only are we going to lose huge amounts of money selling our house and moving again but I have had a fairly rough time scheduling interviews. I would have liked to have gone on more than the nine I managed but it is a lot harder to interview as an intern.

I'm not even sure what my chances are of matching this year.

I also want to add that maybe it's not fair to ask a bunch of interns if medicine was worth it. Intern year, frankly, sucks. Big time. It's even worse for a family medicine intern because we jump around on a variety of very different services and never really get a good handle on any of them, at least when compared to an internal medcine intern, for example, who can pretty much "shut out" pediatrics, obstetrics, gynecology, or surgery.

Good luck to you, Panda. You should find out in a few more weeks, right?

 

[gujuDoc]

Good luck to you, Panda. You should find out in a few more weeks, right?

Yes agreed. Good luck to you Panda. Thanks for your thoughtful realistic portrayal of medicine and taking your time to write in the blogs.

 

[NRAI2001]

Yes Dr. Bear the blogs are very nice.

 

[SlowToLearn]

😡

I'd say "no" 6 days out of the week and "hell no!" twice on Sunday.

I'm still in the game (applying for internal, er, INFERNAL medicine), unfortunately, because of debt and have no other marketable skills that would allow me to find dig myself out of the hole. If my future kids wanted to get into medicine, I'd dis-own them.

I should have followed my heart and gone into pharmacy instead...but I bought into the whole prestige and $$$ that medicine supposedly had to offer. Looking back, I simply did not have enough clinical experience to help prepare myself.

Beware of the program I match at (don't know if that's proper grammar but oh well) because I lack the passion and I have a very poor fund-of-knowledge.

On a serious note, to those of you that read this who are not in med school yet but are thinking about it...make sure you do as much clinical work as you can...and don't make the mistake I made.

-Slow

 

[freshity]

this may sound harsh, as i do have sympathy for people who find themselves feeling obligated to stay with things that they do not want. honestly, however, that's a serious personal problem, and people in that position will face an uphill climb many times over in their lives until they get to the bottom of why they don't treat themselves better and listen to themselves. in the end, you can always make up an excuse for why you've convinced yourself that have to stick with something to which you really aren't committed. it's your life, though, and you're the one making the choice to do things you don't like. you pay the ultimate price for that, and occasionally, those around you have to deal with your bitterness. again, this is where sympathy goes a long way, since we've all met these people in our lives and all we can do hope they find their peace somewhere. but i think i'd have a harder time living with a lie that i tell myself and which costs me my happiness than living with a pile of debt.

 

[bubblegumbezoar]

why not go for the MD/PhD route? that way you won't accumulate a debt and you can go into medical research afterwards and not deal with the people and atmosphere of practicing medicine as much. as a medical researcher thinking up new research ideas, designing how the research will be carried out, performing the research, writing manuscripts for publications, presenting your work at conferences, etc. you won't be doing the same routine thing everyday.

Please take what I am writing with a grain of salt, Dire Straits. I am writing this from the perspective of being married to an MD/PhD student. Okay, please do not do the MD/PhD route unless you are truly interested in doing medical research as well as clinical work. There are many MD/PhD students who only do the program to be paid to go to school and not accumulate any student loans who are miserable. That said, if you were truly interested in what is suggested above, then go for it! It is a 7-8 year program, meaning that when you hit the third year of medical school, some of your formed classmates may be your attending or fellow. My spouse is entirely fulfilled with the MD/PhD program, but at times, the length of the training bogs him down.

 

[kbrown]

YES, YES, YES!!! That being said I completely understand everyone elses perspective. Let's start off with the first two years...they suck. Sitting in a classroom, looking under a microscope, studying the Kreb's Cycle, looking at Reed-Sternberg cells under the scope, trying to grasp medical genetics and transgenic-chimeric mice is...well it's the furthest away from being a doctor I have ever felt. It was a completely demoralizing, dehumanizing, soul sucking experience. BUT...I stuck it out. The one thing that you will learn about medical school once you get in it is that you are not alone. Whatever depression, frustration, hopelessness, isolation, etc that you are feeling so are other people. But people in medicine don't generally like to admit to everyone that they have these doubts...they look at them as weaknesses and are afraid to be perceived as weak. Once you realize that you are not alone, others are going through (or will go through) these same feelings, you can bond together to pull each other through. You can use friends and family, but as we have all said, no one understands until they go through it. So find support in your friends in school.

That was a really dark, depressing paragraph, so let's switch it up. Third year of medical school. Maybe the most terrifying, exhilirating, uncomfortable, satisfying time of medical school. You finally get to go out and "feel" like a doctor. You get to see patients, write in charts, talk about diseases and treatments and see what it's really like to grind day in and day out for the patients. So there is this feeling of "this is why i went to medical school" that permeates and makes it all seem worthwhile. That being said you go through the fear of practicing outside of an area that you feel comfortable. You don't know anything about what lab to order for what disease and how to calculate up what electrolytes need to be in TPN and how to calculate a fluid deficit in a dehydrated kid. So basically, the last two years start to seem like a waste of time. Because you have to relearn every damn thing under the sun about medicine, NOT SCIENCE. So that kind of sums up third year. Its a great year, an exhausting year, a HUGE learning curve and in the end rewarding if you put in the effort.

Fourth year...VACATION, STRESS, ECONOMICALLY IMPOSSIBLE AND SCARY AS HELL. So you finally get to choose what rotations you want to go on. You can start to put together "do I want to be a surgeon, fam doc, ob/gyn, pathologist, etc." You get more responsiblity, you are treated more like a doctor by the residents and attendings and you really feel like you might be able to do this doctor-thing. Then comes applying for residency, getting rejected by programs, getting interviews, going on interviews, discussing "well honey where ARE you willing to move then?" with your s.o., and waiting anxiously for some f'ing computer to tell you where you are going to spend the next XXX years of your life training to be whatever you wanna do. But at some point during this year, it hits you (and this might happen when you are writing orders for a patient and are waiting for the resident to co-sign your orders), it hits you that in a few short months you go from big dog, to low man on totem-pole with one very huge powerful weapon...a degree in medicine. Then you start thinking, what the hell have I gotten into? I'm not ready to sign these orders for XXX, i need to have someone look over this for me. You begin to think about all of the forms that have to be filled out just to see patients, and how if you don't use the right freaking code you might not get paid, or how the insurance companies have a capitation on what they will pay for your patient and you've already spent that amount but your patient needs more tests...who's gonna eat that cost...YOU, the hospital or the practice. In short, reality sinks in. That being a doc isn't glamourous, or glorious. You aren't treated like a celebrity and quite frankly it just doesn't have the same umph in society that it used to.

For me personally, at the end of the day, after I have filled out the forms and fought with social work to get this guy medicaid , and lost that lady in MICU room 12, I still love it. I wouldn't trade those hard years for anything. YOu get to touch lives, saves lives and make a difference. I know that sounds cliche, but it's the truth. Most days you beat your head against the same damn wall, but every so often a patient comes along that reminds you of why you went into medicine. And then it's all worth it. Maybe after I do this for many years I will become as frustrated as some of the people above, but right now I really feel that I made the perfect decision. 👍 👍 👍 👍

 

[NRAI2001]

That was a really dark, depressing paragraph, so let's switch it up. Third year of medical school. Maybe the most terrifying, exhilirating, uncomfortable, satisfying time of medical school. You finally get to go out and "feel" like a doctor. You get to see patients, write in charts, talk about diseases and treatments and see what it's really like to grind day in and day out for the patients. So there is this feeling of "this is why i went to medical school" that permeates and makes it all seem worthwhile. That being said you go through the fear of practicing outside of an area that you feel comfortable. You don't know anything about what lab to order for what disease and how to calculate up what electrolytes need to be in TPN and how to calculate a fluid deficit in a dehydrated kid. So basically, the last two years start to seem like a waste of time. Because you have to relearn every damn thing under the sun about medicine, NOT SCIENCE. So that kind of sums up third year. Its a great year, an exhausting year, a HUGE learning curve and in the end rewarding if you put in the effort.
👍 👍 👍 👍

Really good post 👍 👍

 

[8744]

....For me personally, at the end of the day, after I have filled out the forms and fought with social work to get this guy medicaid... I wouldn't trade those hard years for anything.

Oh Good Lord. I call a day a success when I don't have to get involved in anything remotely smacking of social work.

Dude. That's why they have "case managers" working on the wards. So you don't have to waste your time on that kind of thing.

 

[ericdopt]

Oh Good Lord. I call a day a success when I don't have to get involved in anything remotely smacking of social work.

Dude. That's why they have "case managers" working on the wards. So you don't have to waste your time on that kind of thing.

Agreed! You need to delegate people!!! As a response to a post above: For me, I can have 30 great patients and 1 bad one that will absolutely ruin my mojo. That's when I just grin and think "thank God I'm not going into IM". (No offense, it's just not me).

BTW Panda: Dude, good luck in the match. Let me/us know where you matched.

 

[Gut Shot]

YES, YES, YES!!! That being said I completely understand everyone elses perspective. Let's start off with the first two years...they suck. Sitting in a classroom, looking under a microscope, studying the Kreb's Cycle, looking at Reed-Sternberg cells under the scope, trying to grasp medical genetics and transgenic-chimeric mice is...well it's the furthest away from being a doctor I have ever felt.

I live for that ****. That's why I'm in pathology. Well, that and the (dead) chicks.

 

[NRAI2001]

Agreed! You need to delegate people!!! As a response to a post above: For me, I can have 30 great patients and 1 bad one that will absolutely ruin my mojo. That's when I just grin and think "thank God I'm not going into IM". (No offense, it's just not me).

BTW Panda: Dude, good luck in the match. Let me/us know where you matched.

Whats your specialty?