Med Students start off the most philosophical/sentimental, end up the most cynical

medicine1

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A physician once told me that when medical students first start medical school, they are the most philosophical/sentimental and motivated, compared to the other professional students..and after medical school, end up becoming the most cynical, compared to the other professional graduates. Do most students feel more and more cynical as time passes by? And where does compassion factor in this equation? Is compassion aquired over time, or is it simply something within us from the start? :rolleyes:
 

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medicine1 said:
A physician once told me that when medical students first start medical school, they are the most philosophical/sentimental and motivated, compared to the other professional students..and after medical school, end up becoming the most cynical, compared to the other professional graduates. Do most students feel more and more cynical as time passes by? And where does compassion factor in this equation? Is compassion aquired over time, or is it simply something within us from the start? :rolleyes:
Cynical?????

Nooooooooooooooooooooooo. I could never imagine that,


:rolleyes:
 

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I disagree. While the training can surely create cynics, I think that they are the exception.
 

aphasia

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As far as what the physician said, I learned the same thing in my medical sociology class.
I don't have the statistics handy. I guess it's mostly about how you handle the stress of the training and the everyday situations.
A lot of people don't realize how hard it is to deal w/stressed out people on a daily basis, and that tends to get to people. Also, dealing with a lot of stupid people will do that, too.
I don't know, though. I don't claim to know. I haven't even been to med school yet...just my 2 cents.
 

NotShorty

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True.

Oh, this isn't true/false? :confused: ...shoot, I thought I was going to get that one right.

I think a lot of police officers get in to the job thinking they will be locking up drug dealers and rapists on a daily basis, but then they eventually realize that most of their time is spent doing paperwork on jaywalkers or other "small" stuff. Bit of a shocker when the reality sets in.

We all get into this because we see the lives of doctors from the outside. When they tell us that sometimes it's more guts than glory (no pun intended) it goes in one ear and out the other because we're so fixated on the idea of saving lives and making the world a better place.

There's nothing wrong with that! With the good comes the bad, c'est la vie.

-end ramble-

NS
 

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medicine1 said:
A physician once told me that when medical students first start medical school, they are the most philosophical/sentimental and motivated, compared to the other professional students..and after medical school, end up becoming the most cynical, compared to the other professional graduates. Do most students feel more and more cynical as time passes by? And where does compassion factor in this equation? Is compassion aquired over time, or is it simply something within us from the start? :rolleyes:
I've had a few friends that this has happened to. For me, I just know that I'll be starting med school more than cynical already ...
 
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Several students on the forum have posted questions regarding DOs being more satisfied than MDs in their profession. I have met a lot of MDs that were not satisfied, and had other businesses on the side to make more money. I find this quite sad and pathetic. I suppose it is not MDs vs DOs necessarily, but people agree that DOs are far more personable, and happier with their chosen profession. Then again I know many students who were forced to go to medical school by their parents. I also find this sad and pathetic. Thanks again guys! :rolleyes:
 

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medicine1 said:
Several students on the forum have posted questions regarding DOs being more satisfied than MDs in their profession. I have met a lot of MDs that were not satisfied, and had other businesses on the side to make more money. I find this quite sad and pathetic. I suppose it is not MDs vs DOs necessarily, but people agree that DOs are far more personable, and happier with their chosen profession. Then again I know many students who were forced to go to medical school by their parents. I also find this sad and pathetic. Thanks again guys! :rolleyes:
Believe me, the MDs don't have the market cornered on being cynical and miserable. There really isn't any real difference between MD and DO education, as far as I can tell, save for the 3-6 hours a week we spend doing (to various degrees of resentment) OMM. My boyfriend is an MS III at an MD school and I'm a first year at a DO school (your school, next year, actually). We've had many of the same experiences, similiar frustrations and annoyances, similiar experiences with our classmates. Some of my classmates seem the same from when they started school. Others seem like they've been kicked in the ass one too many times. At some point, everyone has been pissed off and exhausted and stressed to the point of insanity. I think the idea that medicine is some idealized profession that's not going to disappoint you is distinctly niave. Being a doctor is a job, no more or no less. You do what you have to do to survive - and if developing a cynical veneer is something that saves your soul from dying inside, then you do it. Because what you realize is that, at the end of the day, you still have to take care of yourself and your family. Your patients are consumers and they're paying for your skills. You're not god, you're not going to change the world. Hopefully you'll help a few people and you won't get sued. And hopefully you'll take care of and love the people who truly appreciate who you are: your family. Don't ever count on medicine to love you back, because it won't. And if that's cynical, well, then, so be it. I'd rather be a realist.
 
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Elysium said:
Believe me, the MDs don't have the market cornered on being cynical and miserable. There really isn't any real difference between MD and DO education, as far as I can tell, save for the 3-6 hours a week we spend doing (to various degrees of resentment) OMM. My boyfriend is an MS III at an MD school and I'm a first year at a DO school (your school, next year, actually). We've had many of the same experiences, similiar frustrations and annoyances, similiar experiences with our classmates. Some of my classmates seem the same from when they started school. Others seem like they've been kicked in the ass one too many times. At some point, everyone has been pissed off and exhausted and stressed to the point of insanity. I think the idea that medicine is some idealized profession that's not going to disappoint you is distinctly niave. Being a doctor is a job, no more or no less. You do what you have to do to survive - and if developing a cynical veneer is something that saves your soul from dying inside, then you do it. Because what you realize is that, at the end of the day, you still have to take care of yourself and your family. Your patients are consumers and they're paying for your skills. You're not god, you're not going to change the world. Hopefully you'll help a few people and you won't get sued. And hopefully you'll take care of and love the people who truly appreciate who you are: your family. Don't ever count on medicine to love you back, because it won't. And if that's cynical, well, then, so be it. I'd rather be a realist.
Very interesting, thank you for your feedback.
 

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Elysium said:
Believe me, the MDs don't have the market cornered on being cynical and miserable. There really isn't any real difference between MD and DO education, as far as I can tell, save for the 3-6 hours a week we spend doing (to various degrees of resentment) OMM. My boyfriend is an MS III at an MD school and I'm a first year at a DO school (your school, next year, actually). We've had many of the same experiences, similiar frustrations and annoyances, similiar experiences with our classmates. Some of my classmates seem the same from when they started school. Others seem like they've been kicked in the ass one too many times. At some point, everyone has been pissed off and exhausted and stressed to the point of insanity. I think the idea that medicine is some idealized profession that's not going to disappoint you is distinctly niave. Being a doctor is a job, no more or no less. You do what you have to do to survive - and if developing a cynical veneer is something that saves your soul from dying inside, then you do it. Because what you realize is that, at the end of the day, you still have to take care of yourself and your family. Your patients are consumers and they're paying for your skills. You're not god, you're not going to change the world. Hopefully you'll help a few people and you won't get sued. And hopefully you'll take care of and love the people who truly appreciate who you are: your family. Don't ever count on medicine to love you back, because it won't. And if that's cynical, well, then, so be it. I'd rather be a realist.
Very well put. I'm a non-trad who has been working for 8 years out of college. Nothing is really that glamorous.

On happiness, although I don't subscribe to the 'right reason to become a doctor' thing, there are some reasons that will make you more happy in the end. That is, if you want to just make "a ton of money", you may be disappointed. Also, if you're doing this to satisfy familial pressures and not truly for you, then you may struggle.

Perhaps that's why I've seen some truly fullfilled DO's. Perhaps they needed to work harder to get to where they are, or maybe they are non-trads (like myself) that can appreciate the profession from a different perspective, being a bit older.

I know some very happy, and dedicated MD's (a true pro and great woman), and it's not fair to compare like this. However, there just may be some merit to the fact that many DO's are a bit older when they enter med school. Also, DO schools tend to be more non-trad friendly. Have you ever noticed the attitude of the working mom in your biochem class? They're some serious contenders, that are pulling from the heart and overcoming some major obstacles. They're most likely not there because mom and dad where docs. You know? (Not that there's anything wrong with mom and dad being docs. But, it may not be the best reason for that person if there are pressures from mom and dad, while not truly wanting it for themselves.)
 
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It does seem like DOs have this idea that there are many obstacles; that it is harder or tougher to get into a residency/fellowship program, when really it is tough either way you go (MD or DO).
Perhaps DOs work really hard because they want to prove to society, that DOs are just as competent as their MD counterparts. It is true that DO schools tend to prefer non-traditional students. I think non-traditional students are a blessing. Non-traditional students have a lot of great life experiences behind them, and can share their knowledge/wisdom to better themselves and everyone around them.
 

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I was talking to one of my profs at VCOM and she told me that she thinks something happens to med students between the 3rd and 4th year of med school. She said they "cross over to the dark side". She said they start out all gun ho about wanting to help others and wanting to care about their patients and then something happens to them and all they start caring about is money and getting ahead and not worrying anymore about their patients.
 

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I may not have any experience yet to speak on this issue, but it reminds me of the whole "application" process. Most work so hard all 4 years in college just to get those wonderful skinny envelopes in the mail that say "thanks but no thanks". Some drop out after that mailing, others buck up and say "this is what I want, and I am going to get it". Finally, they are accepted and are happy as can be. But, when a fellow medical school applicant asks for advice on the whole application process, a good majority of us are incredibly cynicle. I know I am. The whole process sucked, even though I am exactly where I want to be now, it still sucked. Perhaps this is similar to the majical transisition in medical school. We all just want to be in this pre-planned "place" (be it a specific residency program, grades, sanity, relationships) that we neglect to remember that "hey, this is my dream". And, if medical school truley is your dream, and it comes true, well...how many other people do you know can say they have had a dream come true.

Ok, those are my thoughts. Perhaps it is just the steepest learning curve we have ever experienced! :laugh:
 

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So, good question we have here. Now for my two cents... :D
My philosophy professor would tell you that the definition of Philosophy is "critical, reflective analysis". With that in mind, those of us who feel philisophical about becoming a doctor, I think that it simply means that we have done a great deal of critical analysis and self-reflection and that what we came up with is that 1) the healthcare system in this country is the enemy of both patients and physicians, and 2) we feel passionately that we can make a difference and provide at least small victories for the people we take care of.
It's my opinion that this critical thought about our system, and the self-realization that comes from that- cannot help but make us a little cynical. Like someone said earlier... that's just being a realist, not a cynisist. The difference being: Realist= Know the obstacles and keep pushing on believing that WE ARE doing some good, Cynisist= Know the obstacles and damn the world- giving up the power to do something about it. A cynical person is submitting to the idea that **** is messed up and we are too small and powerless to change it. The realist says I'm gonna learn all I can about these dang HMOs and I am going to fight for my patients to get the care they need.
If anyone gives a hoot, I read a great book called "Man's Search for Meaning" by Dr.Viktor Frankl. The second half of this book is especially powerful in reaffirming that we all have the power to affect those people in our immediate grasp. He argues in his book that if we have a "Why" we can live with any "How". If passion for the human condition is at the heart of your motivation for becoming a doctor, then you will be happy with even the smallest and rarest victories. The Why is your dream and the How is the coping with the healthcare system and the demands of the job.
I assert this:
If I make the life of one and only one person better in my whole career... from all the hardwork I'm going to be embarking on come August and forever, then I will have achieved my dream.
Thats my answer.
Hope we all keep on keeping on, and remember that the patients need doctors who really give a damn. :thumbup:
Momo
 

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momo7430 said:
If anyone gives a hoot, I read a great book called "Man's Search for Meaning" by Dr.Viktor Frankl. The second half of this book is especially powerful in reaffirming that we all have the power to affect those people in our immediate grasp. He argues in his book that if we have a "Why" we can live with any "How".
I give a hoot. I think I may try to pick this up on an audio CD. Those things are cool for when your eyes are about to fall out from studying.

Thanks for the tip.

NS
 
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I appreciate your feedback. There are definitely challenges ahead.
I started another thread, asking about our profession, and what challenges we'll face as future doctors.
:)
 

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aphasia said:
As far as what the physician said, I learned the same thing in my medical sociology class.
I don't have the statistics handy. I guess it's mostly about how you handle the stress of the training and the everyday situations.
A lot of people don't realize how hard it is to deal w/stressed out people on a daily basis, and that tends to get to people. Also, dealing with a lot of stupid people will do that, too.
I don't know, though. I don't claim to know. I haven't even been to med school yet...just my 2 cents.
I also took a medical sociology class in undergrad and studied how medical school can actually change a person for the better or for the worse. I think it does depend on each person though. Med student "A" can enter med school as compassionate and leave just as compassionate or Med Student "B" may just want to get by, see the patients, and make the money.

As for the happiness factor, we make our own happiness. A doctor can be as unhappy or happy as a lawyer, teacher, etc. It's all about the support network, family, and good friends.

I agree that being a physician is not at all glamorous. The long hrs, the debt, blah blah blah...but I disagree w/ the person who said being a doctor is a job. my 2 cents. It's a lifestyle for me-- a lifelong dedication. Is it a job to transplant a kidney and save a patient's life? Do we zone out and do this all for the sake of money? I sure hope not. Medicine is not monotonous like sitting in front of a cubicle (no offense to those that do) and waiting for the paycheck at the end.

I really think compassion can be learned through life experience. For some ppl, it's an innate quality that comes as easy as breathing. The problem with physicians today is that compassion is losing its identity. I read a great book about this too...Bernard Lown is the author. People are SO realistic that they forget that patients are PEOPLE....they aren't a means to a financial end. At least, not for me.

I am a compassionate realist. Medicine is a love-hate relationship. We'll love it one day...we'll dislike it the next. I admit, superficially, medicine is a business but it requires more than providing 'skills'. It requires one to relate to people...tell a father his child has cancer...it pulls upon us to have a heart and humanistic. If we don't have those qualities and love only ourselves and our families, that that makes us selfish when we should be selfless to our patients.
 

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UNE2009LMD said:
I also took a medical sociology class in undergrad and studied how medical school can actually change a person for the better or for the worse. I think it does depend on each person though. Med student "A" can enter med school as compassionate and leave just as compassionate or Med Student "B" may just want to get by, see the patients, and make the money.

As for the happiness factor, we make our own happiness. A doctor can be as unhappy or happy as a lawyer, teacher, etc. It's all about the support network, family, and good friends.

I agree that being a physician is not at all glamorous. The long hrs, the debt, blah blah blah...but I disagree w/ the person who said being a doctor is a job. my 2 cents. It's a lifestyle for me-- a lifelong dedication. Is it a job to transplant a kidney and save a patient's life? Do we zone out and do this all for the sake of money? I sure hope not. Medicine is not monotonous like sitting in front of a cubicle (no offense to those that do) and waiting for the paycheck at the end.

I really think compassion can be learned through life experience. For some ppl, it's an innate quality that comes as easy as breathing. The problem with physicians today is that compassion is losing its identity. I read a great book about this too...Bernard Lown is the author. People are SO realistic that they forget that patients are PEOPLE....they aren't a means to a financial end. At least, not for me.

I am a compassionate realist. Medicine is a love-hate relationship. We'll love it one day...we'll dislike it the next. I admit, superficially, medicine is a business but it requires more than providing 'skills'. It requires one to relate to people...tell a father his child has cancer...it pulls upon us to have a heart and humanistic. If we don't have those qualities and love only ourselves and our families, that that makes us selfish when we should be selfless to our patients.

What I think is a mistake is the notion that we can change the world simply by being doctors. You're not going to change everyone's life, you're not going to save everyone, and some patients aren't really going to care how compassionate you are (or seem to be). I think that patients deserve to be treated with respect and humanity, but I'm not certain if anyone has the capacity to mentally selfless with all our patients all the time. I think it's just too trying, too much mental and physical exhausation, to be constantly "present". My SO is doing his third year medicine rotation and he's simply beyond caring if the drug addict who has insited on giving herself infective pericarditis (from using her jugular IV line to inject heroin) escapes from the hospital or not (true story) and dies on the streets. No amount of compassion in the world is gonna make a damned bit of difference. So, you realize that what's important in life is being good to the people you love (and not abandoning your spouse or kids for what is, really, a job, and not your life ) and still retaining respect for your patients.
 

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By all means, I'm not saying we should abandon our loved ones..our spouse, our family. Of course, they are important. I know doctors can't possibly save the world...and they do have the weight of the world on their shoulders, so to speak. Sure, we'll have a handful of ungrateful patients addicted to morphine, heroine addicts, and the list goes on but that doesn't mean we should become apathetic. The patient who hurts himself shooting up heroine for ex..needs help. We can't do it all as physicians, I know that. And we shouldn't. As a physician, we are part of a medical community..of Drs., nurses, social workers. We should work together. If we think about it, who would you give a liver transplant to? Patient "A" who suddenly contracted a debilitating disease or Patient "B"...an alcoholic? Again, this brings up the age old question that has been debated for years. I'm not saying one person should deserve the liver over another. Regardless of the circumstance, bottom line: both patients are dying and need the liver in order to live. No question about that one.

I realize that we, as future physicians, will have different doctoring styles. It's a given. Do what works best for you. As for me, I want to be the doctor that gives a damn for all my patients, regardless if they are heroine addicts or not.
 

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I think that's a great position to have, and I hope I stay that way as well (caring about all my patients equally and unbiased). But as of right now being close to finishing second year and studying for boards I can tell you first year I was gung-ho and very compasionate, this year patients almost seem more like test questions on a piece of paper. I don't know if all the tests, stress, and crap you have to do to actually see patients changes your mind, if its actually getting out there and seeing everything your told about first and second year that does. I just know I'm tired a lot lately, as are most of my classmates and that we seem to be edgerier (yes I think I may have just invented a word) and react differently now than we would have last year. Hopefully our month off before rotations will be enough of a break to relax us.

sorry for the ramble too, I am highly caffeinated and avoiding studying for our neurology exam tomorrow.
 

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cremaster2007 said:
I think that's a great position to have, and I hope I stay that way as well (caring about all my patients equally and unbiased). But as of right now being close to finishing second year and studying for boards I can tell you first year I was gung-ho and very compasionate, this year patients almost seem more like test questions on a piece of paper. I don't know if all the tests, stress, and crap you have to do to actually see patients changes your mind, if its actually getting out there and seeing everything your told about first and second year that does. I just know I'm tired a lot lately, as are most of my classmates and that we seem to be edgerier (yes I think I may have just invented a word) and react differently now than we would have last year. Hopefully our month off before rotations will be enough of a break to relax us.

sorry for the ramble too, I am highly caffeinated and avoiding studying for our neurology exam tomorrow.
totally feel your pain. neuro sucks ass. plus, we're doing head and neck and renal right now! woohoo.

:oops:
 

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I realize that we, as future physicians, will have different doctoring styles. It's a given. Do what works best for you. As for me, I want to be the doctor that gives a damn for all my patients, regardless if they are heroine addicts or not.

Wow this sounds like me three years ago.

I have def. become more cynical since starting medical school, I'm not sure why that is. I don't think its just the patients that make you cynical but a number of things. The amount of money your spending , the way some of the older doctors behave, the amount of time and effort it takes to suceed, always thinking about what am I going to specialize in, need to score high on my Step I/II so I can land a residency, I don't want to do residency out of NYC, what if I end up in Ohio, when am I going to have kids...

Stress is a big part and its hard to deal with but it does get easier as it goes on def. less stressful after Step I. I also think some medical students just have a sense of entitlement which can create problems with being empatheic.
 

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for the record, i don't think that being cynical per se or caring about making money or having a strong business or practice necessarily means that one does not give a crap about his patients.
 

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Look, whether you go to a MD or DO program, not only you learn how to save patients, you also learn about the bureaucracy and politics in medicine. This will make you bitter at times, given all the sacrifices and the debts you will acquire throughout medical school. But if you are someone who really started compassionate and humble enough to help people, then you shouldn't worry. Truthfully, if you are counting on learning compassion in medical school, then you should start looking for another career. I will however admit that, in general, medical students become little bit more self-oriented throughout their training.
 

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This forum is very funny because I don't think one person mentions the core of the issue. I can only speak for myself...

I can be a very compassionate person coming in for a 30 hr shift at 6am... 24 hrs later, I say "F" compassion and get me out of this dump of a hospital where I can sleep, eat, take care of myself, and call my girlfriend who I've been neglecting and actually have a life... but yet I have to risk my license providing sub par (barely conscious) care in order to "complete transition of care" just to minimize the paperwork the attending has to do.

On teaching rounds post call, after 24 hrs of hard work I get sh!t from attendings for not being able to whip out a diagnostic algorithm for hyponatremia (because of course I was sleeping all night and not actually following up on the 50 patients I'm cross covering.

This is why people lose their compassion in medicine. It's one slap in the face after another. The system bleeds you dry of not only your compassion but your self worth... and your money. Fee after fee after fee... loans collect interest... and for what... to be able to care for people who would sue you at the drop of a hat if they had the chance (and they do get the chance). This is why I became cynical... it has nothing to do with dealing with stress or life and death issues... it has to do with being enveloped by a system who doesn't care for its own members but yet expects its members to care more for the world than for themselves... and provide fake "sleeping/time management/exercise workshops" just because its required by the ACGME.

At this point in my life, I cannot accomplish my own personal goals (marriage, kids, house, etc) because I'm trapped in a system abnormally abusive to its own and in mounds and mounds of debt. PA's, NP's etc don't go through the abuse we have to go through as physicians. How many PA/NP's do you know do 30 hr shifts q4? That's why MD's/DO's become more cynical and pursue a lifestyle specialty. I can be passionate about medicine as much as the next person but purposely sleep depriving clinicians and asking them to play with a person's anatomy/physiology is more than ethically wrong... its BLATANTLY disrespectful to the clinician and the patient... yet medicine does this on a daily basis and no one says boo. But God forbid we should take a pen or free meal from our drug representatives... we don't deserve that perk and its "ethically wrong," at least according to AMSA. We are huge hypocrites as a profession. I am in a constant debate whether or not I should go to law school and sue the medical establishment for providing unsafe working environments and changing the system.

FYI, I'm the happiest person I know in my intern year...

Disclaimer... I'm writing this as an intern... I was once told that if you are not perturbed by mid intern year then you are not being trained well... I'm going into radiology where I hopefully won't work another 30 hr shift ever again. Good luck to all... that's my rant... I'm happier than I sound because I enjoy medicine... but that enjoyment gets pushed to the limit everyday.
 

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Good insight, fred.

It's a shame though, only people in the field (and on SDN) will read your great post. :(
 

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Attending Physician
fred's post hits the issue right on. after jumping through so many hoops, making so many sacrifices, being responsible for so much and being expected to do so much under such unfair working conditions, what normal person would not get a little jaded with the profession or angry with the bureaucracy? and as such, what's wrong to be at least properly compensated for said torture? it's a constant struggle between loving what you do and hating the fact that there are systems and people out there that make you hate what you do on a daily basis.