I'm 5th year undergrad facing a universal question: what career should I go into? For most of my undergraduate experience, the answer has been a career in medicine. I wanted to help people directly, I believed that health of the body necessarily precedes everything we do and therefore its improvement is a noble cause, and I appreciated and anticipated an intellectual challenge.
But as I've become more informed about medical school education and the practice of medicine, I've realized that the education is mostly memorization and regurgitation of facts, while the practice is mostly a narrow-minded intellectual exercise within the confines of bureaucracy and established knowledge, while treating patients for their symptoms but not the greater person or the greater society.
My questions to current medical students are: to your experience, is this true? How often do you find yourself questioning the practice of clinical science itself? How much time do you have to think about the greater ills of society? How much influence do you see yourself acquiring over social policy in the future?
I ask these because my college experience has made me question all of the structures of society. It has made favor abstract thinking over memorization. It has made me supremely idealistic, to the point that I now think a career in medicine will allow me to help too few people, in too narrow a fashion. Have any of you felt this way?
I agree with you. I don't have time to comment extensively, but I have had many of the same concerns previously. Specifically, I've always felt that going into scientific research would result in greater social benefit.
Being a physician is great, but if you really think about it, it IS just "scut work" as another poster mentioned. The same scut work nurses do, except on a "higher" level, requiring higher level knowledge/reasoning. That is to say, the typical physician is completely replaceable. The ER doc goes on his shift, and when he goes off it, someone else as knowledgeable (or slightly less or slightly more) goes on the shift. Sure, there are some individuals who are stellar in that they may be extra conscientious as people, and therefore more responsible as physicians. Over the course of their careers, they may save and impact far more lives than your less conscientious physician who just wants to get through his shift and go home.
But overall, at the end of the day, the average physician is interchangeable with any other physician.
This bothered me for a while, because I felt my creativity would be stifled if I were just a cog in the machine. I felt like I had more to offer and maybe my creativity would be put to better use in research, where having a novel idea might actually make a huge impact and certainly I don't think of research scientists as interchangeable. One might argue that scientific progress is inevitable, regardless of any one individual. But that's still more of a philosophical argument. In practice, and in reality, individuals more matter in the realm of science-- one person can speed up the progress of a new innovation by many years. So that excited me.
My parents wanted me to be a scientist, to be honest. My dad in particular, I felt, never held physicians in the same high esteem as scientists. It was just real interesting to me, because in this culture, physicians seem to get such respect, and saying "I want to be a doctor" in any ordinary crowd of people will inevitably draw "oohs" and plenty of admiration. I always got the feeling my dad simply thought of physicians as regurgitation machines... and it troubled me because I could see his point. At some point, I ended up adopting this mindset as well.
The pre-meds I met (no offense) in class (I was a bio major) were OBNOXIOUS as hell, for the most part. They were the ones in class who were always asking "is this going to be on the test??" And if the professor responded no, you could tell they would just tune out right away. Few of them seemed to display any kind of intrinsic curiosity to the subject matter. Whereas the kids who were into science in these classes would be the ones asking "tangential" questions that clearly probably wouldn't be tested, but were interesting nonetheless, and usually resulted in interesting responses that expanded my knowledge level. I related more to these kids, then the majority of the pre-meds, so I ended up with a sort of disdain towards pre-meds.
But this story is getting a little long, so I'll just skip all the drama and come to the end. Now, I am a pre-med
😀 , and I'm applying for med school for 2009.
The thing I neglected to notice about pre-meds is service. Once I started doing the "typical" pre-med activities (aka volunteering), that was a side of the entire pre-med experience I hadn't paid much attention to. And while my initial impression of pre-meds as unintellectual curious still, in my mind, holds true to some degree, I've come away with a different perspective. That is,
yes a lot of these kids maybe aren't the most intellectual (in the sense of being naturally curious about things)... but they're hard-working, and more importantly, they're motivated to help others. I've discovered more of an altruistic side in myself too through hours of volunteering.
And you know what? It feels good to make immediate, fundamental differences in the lives of others. Research is great and getting useful results is a wonderful feeling. The intellectual challenge is stimulating. But the flip side of it is, many researchers do not end up having a direct impact on people in the immediate future. Don't underestimate how good relieving someone's immediate pain can make you feel.
As for the part about medicine being repetitive/all about memorization... well, being a lowly pre-med, this is just my guess. But my specialty interest is neurology, and certainly I think specialty choice can impact how complex the diagnostic process can get. I like the fact that neurologic disorders are typically not readily apparent the way maybe skin conditions are for a dermatologist. Sure, every specialty has its repetitive handful of diseases... but I think working with stuff like Alzheimer's, Parkinsons, etc. would be very challenging and stimulating. So basically, those are the answers I've found for myself to address the questions of intellectual stimulation and societal contribution.
Your concerns seem more policy-oriented... and in some ways those concerns are easier to address: Go into healthcare policy. I used to work for a healthcare IT firm and one of the executives was a MD who consulted there part-time. If you want to make a difference policy-wise on a large scale, there are plenty of opportunities out there. NOT just in politics, but especially out in the business world. There's a company out there working to manufacture electronic exoskeletons for paralyzed consumers... originally started out as a military project to enhance the strength of soldiers. But I suppose someone sensed a business opportunity and how exciting is it that in the near future, paralyzed folks can buy this product and *walk* again?? The motivations of businesses ($$$) might not be noble, but they can certainly have noble large-scale impacts.
Also, one last thing. Another poster had brought up the example of a drug addict presenting at the ER. No, the one ER doctor can't save this guy's life and make him quit and be clean and get all better. If you want to be a doctor to try to "save" people's lives like that all by yourself, then yeah you're gonna get a cold slap on the face by the real world. BUT. It does take an inter-professional team. If that guy can get family support, maybe counseling from a psychologist, a social worker to check up on him, maybe even a ILS worker to help him readjust to society/find a job, etc. It takes a lot of people... and I think if you really wanted to make social changes on a large level, it really is at the level of policy--- someone has to coordinate the different types of care each patient receives. If a guy like that is getting discharged improperly, and with no follow-up, etc... then yeah, he's likely to fail.
Not everyone has what it takes to start up programs and mobilize other professionals to participate. If you are up to it, then go for it. But having that MD could only help you in the task, I think... not harm you.
