Is being an M.D. just being a walking textbook of medicine?

[MiamiHeat87]

Hi, i've been reading extensively on the forums the past week in considering my career choices. I've come across a post that I am wondering if others would agree with here.

The writer is a Medical Student who says medicine is about memorizing stuff and being able to spit it out when needed.

http://forums.studentdoctor.net/showpost.php?p=9282299&postcount=4

That doesn't sound too bad to me. Basically that is saying your given a complicated problem to solve (like Math) and you have to apply formulated rules to guide you in your process to solve this problem.

Now i'm not saying this is all that being a Doctor is about. In the very same thread I read other replies that I agree with. I believe that different people have different careers they enjoy and even in the same thread, you can read the replies of Doctors who are happy with their choice and ones that say "Run away!".

Pro-Doctor:
http://forums.studentdoctor.net/showpost.php?p=9343711&postcount=11

Anti-Doctor:
http://forums.studentdoctor.net/showpost.php?p=9344049&postcount=12

I also believe there are many things you should enjoy to have a great career. In the very same thread another person tells of how you are invited to the intimate lives of patients, little difficulty getting a job, automony, and get to solve complicated problems. That sounds amazing for me!

http://forums.studentdoctor.net/showpost.php?p=9303873&postcount=10

So I was hoping to get some insight on how a Doctor who is finished with all their medical school, if seeing patients is basically determining what the problem is, apply rules of the universe, and finding a solution using those rules?

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[Morsetlis]

Graduate with an MD and you know nothing. Finish the residency, and you can practice medicine by yourself (unless you're in the army, then you can practice medicine by yourself with only a 1-year internship).

 

[morning]

Graduate with an MD and you know nothing. Finish the residency, and you can practice medicine by yourself (unless you're in the army, then you can practice medicine by yourself with only a 1-year internship).

Even then there will be things that aren't in your scope of practice and you will refer out.

Being an MD means you have an excellent base of medical knowledge. Being a physician means you expanded on that base into a specialty, but you by no means are a dictionary.

 

[boaz]

A textbook is useless unless you can synthesize the contents into a meaningful whole and apply it to a practical situation. If what you mean by "walking textbook" is really "walking flowchart", then that is flat wrong. I would be scared to death to go to a doctor who has a photographic memory but does not understand what he talking about.

To put it in concrete terms for the premed: you can do really well in your prereqs if you can plug-and-chug, but if you don't understand what you're doing, you'll struggle with the MCAT.

 

[Mackey]

I don't know if that is a fair statement.

As was stated to me once by a cardiologist: "sickle cell.. oh god. No, I don't know what goes on with that anymore. I do know how to treat it though."

Some dictionary.

 

[Morsetlis]

(For fun, ask him what the normal force is for a 10kg object sitting on a 45-degree incline.)

 

[Disinence2]

You cannot apply a "Formula" to medicine to solve a problem.

From what I've learned with my limited experience, being a "walking textbook" would be useful for "textbook" cases.

Real like medicine seems rather distant from what the giant textbooks say.

So my opinion... No you can't treat a patient like a math problem.

 

[Mackey]

(For fun, ask him what the normal force is for a 10kg object sitting on a 45-degree incline.)

Does the 10kg object have sickle cell?

 

[Morsetlis]

Does the 10kg object have sickle cell?

Yeah!

 

[Mackey]

I bet the object just wants pain meds. Dirty, lying, frictionless object.

 

[phospho]

People in my school would bitch about how much they've changed from M1-M3, until they saw the kind of change that happened to the X-M4's as they finished their first year of internship... two completely different worlds...

 

[circulus vitios]

I don't know if that is a fair statement.

As was stated to me once by a cardiologist: "sickle cell.. oh god. No, I don't know what goes on with that anymore. I do know how to treat it though."

Some dictionary.

Is that normal for all physicians (not knowing what "goes on" with a disease, but how to treat it)?

 

[phospho]

Is that normal for all physicians (not knowing what "goes on" with a disease, but how to treat it)?

no, it's not normal...

a cardiologist might not know the latest medication that came out, but they will know the basics and will work their way up to wherever they need to be at that moment if they have to. GAG/GTG isn't rocket science (at least for a physician)...

 

[Morsetlis]

That's right. Physicians don't always know everything. There's this nephrologist that's a program director at the hospital I volunteer at. Once, I shadowed him, and we used textbooks, wikipedia, and google to research on possible causes and treatments of gallstone formation in the biliary ducts 10+ years AFTER a cholecystectomy.

 

[Siggy]

(For fun, ask him what the normal force is for a 10kg object sitting on a 45-degree incline.)

African or European?

/You have to know these things when you are king.

 

[wsc2879]

being in the medical field is to deliver humanity. the worst scenario is that the physician becomes a walking medical textbook eventually - science robot

 

[loveoforganic]

the worst scenario is that the physician becomes a walking medical textbook eventually - science robot

This is what rings truest in my mind. The knowledge base is a prerequisite, but what should characterize a physician is the ability to 1) apply that knowledge, 2) convey that knowledge to a lay person, and 3) relate to people.

 

[z31]

I think being a physician is exactly what you choose to make of it.

Do you want to be a flowchart physician? Well, for some of the simplest cases that'll be just fine, and if you can't work it out, refer. You're still doing valuable and noble work.

Do you want to focus on 'delivering humanity', as I think one poster put it? Well that's great too. I shadowed a doc who was as much a teacher and confidante as a doctor. He could whip out a notepad and draw livers and kidneys upside down to diagram for the patient what was going on. The patient was intrigued, and the doctor cared that he/she understood.

Do you want to contribute to the scientific literature? Then be sure to understand the mechanisms of the diseases/treatments you learn about, pay attention to details, be critical of what you observe vs what you're told. You can also make a valuable contribution this way, making sure that medicine is as progressive and evidence-based as it can be.

Or mix and match to the best of your ability! This is both a responsibility and joy of being a physician.

 

[Cleavername]

You cannot apply a "Formula" to medicine to solve a problem.

From what I've learned with my limited experience, being a "walking textbook" would be useful for "textbook" cases.

Real like medicine seems rather distant from what the giant textbooks say.

So my opinion... No you can't treat a patient like a math problem.

ha.

 

[CaptainSSO]

(For fun, ask him what the normal force is for a 10kg object sitting on a 45-degree incline.)

About 70 N.

Rounding acceleration due to gravity to 10 m/s^2. Pretty sure pi/4 is .707.

So .707 x 100 = 70.7 N.

I am so ****ing bored...

 

[Morsetlis]

I knew somebody would do it.

 

[LuciusVorenus]

I imagine being a textbook doesn't come in handy during surgeries
a robot would be more appropriate.

 

[Orbo]

About 70 N.

Rounding acceleration due to gravity to 10 m/s^2. Pretty sure pi/4 is .707.

So .707 x 100 = 70.7 N.

I am so ****ing bored...

Right answer, but pi/4 is soooo not how to do it. sin(pi/4) = cos(pi/4) = .707
pi/4 ~= .785

 

[Mackey]

no, it's not normal...

a cardiologist might not know the latest medication that came out, but they will know the basics and will work their way up to wherever they need to be at that moment if they have to. GAG/GTG isn't rocket science (at least for a physician)...

I disagree. I've encountered this a lot, and it was while I worked at a very high end university hospital...

I've even seen wikipedia being broken out quite a bit.

 

[GoodmanBrown]

Right answer, but pi/4 is soooo not how to do it. sin(pi/4) = cos(pi/4) = .707
pi/4 ~= .785

Props for breaking out the radians!

 

[CaptainSSO]

Right answer, but pi/4 is soooo not how to do it. sin(pi/4) = cos(pi/4) = .707
pi/4 ~= .785

Oh yea I forgot to write cos (pi/4). Good call; mgcos(theta) is the normal force.

 

[circulus vitios]

I disagree. I've encountered this a lot, and it was while I worked at a very high end university hospital...

I've even seen wikipedia being broken out quite a bit.

Haha, really? I figured there would be some sort of continually updated medical journal with treatment guidelines.

 

[LizzyM]

I could see going to wikipedia for a quick review of a rare disease or disorder that might appear in a family history (sister with Wilson's disease, nephew with glucose-6-phosphatase deficiency).

Most physicians know their area of expertise and leave other areas on the back burner. An orthopedic surgeon is not likely to read an ECG and you wouldn't see a cardiologist for a fractured hip.

The front line physicians need a good memory and the ability to synthesize information and elicit more information to make a diagnosis or at least get close enough to determine where to refer, if needed. Depending on the patient's history and physical exam findings, back pain may be treated with physical therapy, analgesics or antibiotics, or referred to a neurologist, rhematologist, urologist, radiation oncologist, or gynecologist.

 

[Mackey]

Haha, really? I figured there would be some sort of continually updated medical journal with treatment guidelines.

Certainly not for any treatment plans, but a few times comes to mind where a patient's history was met by both the resident and attending with a "no idea what that is, lets google it."

I mean.. Have you seen Harrison's Internal Medicine? Its a pretty standard text that provides a decent look into a vast number of diseases an internist would encounter... and its like 3 inchs thick. It makes my bookcase sag. If you find me someone who can recite everything from that book, I'll show you a computer.

 

[Morsetlis]

Certainly not for any treatment plans, but a few times comes to mind where a patient's history was met by both the resident and attending with a "no idea what that is, lets google it."

First-hand experience of this is always funny

Note that doctors will also likely make referrals when they REALLY don't know what's going on--rather than blindly guessing.

 

[FIREitUP]

I'd say the knowledge you get from yoru preclinical years pales in comparison with all that experience you garner through clinicals and residency. textbook knowledge is useless without experience.

 

[MiamiHeat87]

I think being a physician is exactly what you choose to make of it.

Do you want to be a flowchart physician? Well, for some of the simplest cases that'll be just fine, and if you can't work it out, refer. You're still doing valuable and noble work.

Do you want to focus on 'delivering humanity', as I think one poster put it? Well that's great too. I shadowed a doc who was as much a teacher and confidante as a doctor. He could whip out a notepad and draw livers and kidneys upside down to diagram for the patient what was going on. The patient was intrigued, and the doctor cared that he/she understood.

Do you want to contribute to the scientific literature? Then be sure to understand the mechanisms of the diseases/treatments you learn about, pay attention to details, be critical of what you observe vs what you're told. You can also make a valuable contribution this way, making sure that medicine is as progressive and evidence-based as it can be.

Or mix and match to the best of your ability! This is both a responsibility and joy of being a physician.

Thank you Z. I appreciate your response!