http://www.medschoolhell.com/2006/10/26/medical-school-in-a-nutshell/
"Honestly, medicine is just treating patients by cookbook. Once you've been doing it long enough, you memorize all of that bull**** and can start doing things without looking it up. At this point, you are known as a "good doctor." Some mature faster than others.
Sure, you need to be smart to be able to memorize all of that crap in the first place but even those with average IQs can do it with enough repetition. In short, medicine is nothing stellar. It sure isn't rocket science. Space or computer engineers actually have to apply their knowledge to solve a problem. In medicine, those types of illnesses are few and far between."
Being a mediocre doctor is cooking from a cookbook. Its why NPs can "do an MDs job" which few people realize means "can be a primary care physician," because, most of it is checking off boxes on screening and referring to someone else. So, at its BASEST form, Medicine is cooking from a cookbook.
But most of the actual practice of medicine has nothing to do with cooking at all. That's the whole point. Every patient in front of you is not a population statistic, they don't meet public health policies, they may not even obey clinical guidelines. They are themselves, a unique presentation of whatever disease you are dealing with.
Ok... a COPD exacerbation, CHF exacerbation, or cellulitis may be a hospitalist's bread and butter. These do become routine. A general surgeon may be performing their 5000th lap chole of the year. But that repetition just makes you good at your job. You need to do the simple things so you can focus your attention on the hard things.
Guys, if you want a field where you really use your brain in a novel or creative fashion, medicine just simply doesn't provide that.
We in medicine call that "surgery"
I don't get all the kerfuffle about "algorithms". --quote truncated
Me either. Sh
itty doctors think "im good at medicine, Ill follow the algorithm." Thats how I see patients with "CHF" who have been treated at 6 different hospitals, in whom I diagnose the pulmonary embolism (there was no CHF, by the way). That's why I have to change all those patients who have only hypertension who are on 2 Ace-inhibitors and an Arb (thanks VA NPs). If you think they are "few and far between" its because you aren't looking. The problem is that the USMLE step 1 and Step 2 test your basic knowledge, they test the algorithm. There is a "right answer" and it fits in the flow of a case. Students spend
four years learning the basics, the cookbook if you will, the algorithm. Most students don't realize that its just a baseline! Guidelines change every 5 years. And "guidelines" are what you use AFTER you know what's going on. Real life is seldom the algorithm and is riddled with difficulties beyond just the medical workup. You have to know what you're thinking before you know which test to order. Then, when you already know what's going on, how do you handle the varations in patients chronic conditions? How do you handle their psycho-social environment? How do you lead the team?
Collecting the data on how patients do with our established 'cookbooks' and modifying techniques and protocols accordingly is the way to use your brain in modern medicine.
Only true if you want to be a researcher. There are plenty of opportunities to use your brain in other ways (last 3 lines of the last paragraph, above)
How many times are you going to highlight a diagram in the construction of a fuse box or controller as a mechanical engineer. On a 400 hour project, 350 of them are literally standing there, highlighting diagrams,until everything is highlighted. Its called "quality control." Apply your knowledge my ass. If you are the lead researcher of the super colider (we call them Deans or department heads) your equivelant is CEO, Program Director, or Chief of section. If you are the grunt who pushes the red button (called engineers... think Homer Simpson) your equivelant is...well... 3rd year medical student.
I cannot think of a more emotionally and socially rewarding field than medicine. Unfortunately, it doesn't pay very well. Good, but probably not worth the amount of time and sacrifice required to be successful in it. Which is why it is so fulfilling in other ways!
