Non-trad medical students, residents and attendings, Was it worth it?

[ChemMed]

I am asking this question at the beginning of my journey. I'm a M0 at this point. I start in the fall in Oregon. I've seen these types of questions posted on the general doctor forums but not specifically toward non-trads who deal with different life scenarios due to age and other complications when starting the process. So I am wondering not that you have or are in the process:

1) What expectations were met?
2) What expectations were not met?
3) If you have a family, how did they cope with your decision and then the application of that decision?]
4) Do you love what you do?

Thanks for your time.

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[ChemMed]

I don't quite want to let this one die yet. Please answer if you can because I think that this information is valuable.

Adcoms if you think that this should belong elsewhere please pump it to the place you think it should go. Thanks.

 

[mauberley]

I do hope some current folks share their insights. In the meantime, ChemMed, here are some links in the stickied posts to threads that might be of interest:

Threads about Medical School and Physician Life
Nontrads Who Just Finished MS1: posts by current medical students and residents about med school life as a nontrad
Satisfaction with Medicine: posts by med students and residents on how they feel about their decision to go to med school
Do Young Med Students Accept Older Nontrads?: nontrad and trad student thoughts about the generation gap
Keeping a Marriage Together in Medical School: posts by married nontrad med students on the work/family balance
Female Doctor and Family: another discussion about how to achieve the work/family balance in medicine. See this thread also.
Spouse Asks: What Is It Going to Be Like for Me? discussion about what to expect as a spouse of a nontrad medical student
When to Have Kids? discussion about the timing of having children during medical training
Do People Overexaggerate the Difficulty of Medical School? Thread discussing if med school is really as hard as some make it out to be.

 

[ChemMed]

Thanks for the links. I hope I get a few bites to.

 

[QofQuimica]

I don't quite want to let this one die yet. Please answer if you can because I think that this information is valuable.

Adcoms if you think that this should belong elsewhere please pump it to the place you think it should go. Thanks.

Tee hee, I think you meant mods and not adcoms, but in my case, it's all the same.

The thread is fine here, though I don't think it's really necessary to have a special version for nontrads. Several nontrads, including me, have already posted in the general residency forum thread with the same theme. Along with the other threads so nicely linked above, I recommend that those of you who are interested check it out. No point in duplicating efforts, IMO. I will go ahead and link the gen res thread to our sticky so people can find it.

 

[ChemMed]

Tee hee, I think you meant mods and not adcoms, but in my case, it's all the same.

The thread is fine here, though I don't think it's really necessary to have a special version for nontrads. Several nontrads, including me, have already posted in the general residency forum thread with the same theme. Along with the other threads so nicely linked above, I recommend that those of you who are interested check it out. No point in duplicating efforts, IMO. I will go ahead and link the gen res thread to our sticky so people can find it.

To many late nights in the lab watching the lady gaga lab parody wondering if my western blots will end up like those nightmares in the video. I couldn't stop laughing when I watched that.

The links are great. Nice to have them all in one spot. Thanks for your replies.

 

[Trismegistus4]

Also, there was this classic thread. It's closed, but it's positively overflowing with sage advice that will broaden your mind and complete your journey toward enlightenment.

 

[Prncssbuttercup]

You know what... IT BETTER BE WORTH IT!!!!

 

[Prncssbuttercup]

To many late nights in the lab watching the lady gaga lab parody wondering if my western blots will end up like those nightmares in the video. I couldn't stop laughing when I watched that.

The links are great. Nice to have them all in one spot. Thanks for your replies.

Ok, so I had never seen this... I work in Biotech, and this is so funny! I loved her biohazard dress, and the vials with kanji on them, I have that ALL the time at my work! Super funny!

 

[thepoopologist]

Also, there was this classic thread. It's closed, but it's positively overflowing with sage advice that will broaden your mind and complete your journey toward enlightenment.

I've read some of your post history. Did your struggles in medical school affect you in the match? And now that you're in psych, is there time to do other things that you actually like doing.

 

[Trismegistus4]

I've read some of your post history. Did your struggles in medical school affect you in the match?

I would say so. Before starting med school, and early on in med school, I figured I'd go into one of the ROAD specialties, or at least one which, though intense in workload, was high-paying (like cardiology or a surgical field.) I disqualified myself from more competitive specialties, however, by failing Step I on the first try, and not getting honors on any 3rd year rotations. More than those two factors, however, what really hindered me from applying to a competitive field was my own lack of confidence in my knowledge, skills, and abilities. My study habits in MS1 and MS2 were so poor, and my estimation of my knowledge base so low, (which I had some evidence for, as when I'd get pimped during 3rd year I couldn't even begin to answer the most basic questions, ones my classmates could rattle off the answers to in their sleep,) that I felt if I went into medicine or surgery I'd simply be unable to do the job, would wind up killing a patient, and get fired. I suppose I could have matched into anesthesiology somewhere, or applied to medicine and the gunned for a cardiology fellowship, but I felt that despite graduating from medical school and passing Step I, I simply did not have background the job required.

ETA: If you were asking more about how it affected which psych program I matched into, I didn't get interviews at any top programs, no doubt because of the Step I failure. I matched at what I guess would be regarded as a pretty good, mid-tier program.

And now that you're in psych, is there time to do other things that you actually like doing.

Some. There are busy rotations, like IM and night float, when I don't have much time. I've even felt too busy on my last general adult psych rotation, when I just had a lot of complicated patients, wound up having to call multiple families every day, and was stuck there till past 7 half the time. But in general, I do have some time to enjoy life outside of work. Being a medicine or surgery intern would be hell on earth compared to this.

 

[cabinbuilder]

1) What expectations were met? I got to be a doctor and take care of patients. Provide a great life for my kids, always have a job and have excess income to travel and not worry about paying the bills.

2) What expectations were not met? I didn't realize it would be so hard to be someone else's employee when I was the one generating the income but the administrator is never happy and "whipping" me to do more but they get to go home at 5pm and I'm still working at 8pm with no real end in sight.

3) If you have a family, how did they cope with your decision and then the application of that decision?] My husband knows how hard it was for us to get through medical school and struggling for so long without money. My kids were very small when we went through medical school but realize they have a lot more then their friends and understand that we don't have to struggle now because I make plenty of money and they essentially get what they want. My husband has been able to retire and stays home with the kids which works well with his personality.

4) Do you love what you do? Yes, all day, every day. I have been working locums so I get a lot of very random stuff that walks through the door. Makes me think and have compassion towards those who are less fortunate than me. I was told a long time ago that I would never make it into medical school. I proved the naysayers wrong and am grateful every day to do what I do. It's a dream come true.


I love my job every single day.

 

[OneTyme]

I am asking this question at the beginning of my journey. I'm a M0 at this point. I start in the fall in Oregon. I've seen these types of questions posted on the general doctor forums but not specifically toward non-trads who deal with different life scenarios due to age and other complications when starting the process. So I am wondering not that you have or are in the process:

1) What expectations were met?
2) What expectations were not met?
3) If you have a family, how did they cope with your decision and then the application of that decision?]
4) Do you love what you do?

Thanks for your time.

Well, it is kind of hard for me to answer your question about it being worth it. Since I am still in the middle of first year, I haven't reaped many of the rewards of my hard work yet.

As a bit of a back story, I came to medicine after I lost my career in law enforcement due to an injury I received in the line of duty.


1) What expectations were met?

I expected to work hard. However, I didn't realize it was going to be this hard. I worked full time in a pretty stressful career field as a pre-med (often taking ~20 credits), held a good GPA, took the MCAT, and applied just like every other non-trad. I figured that I had been through the fire and I wouldn't be too surprised by medical school.

I was wrong.

Medical school is incredibly hard. I have gotten absolutely rocked in the last couple months of 2nd semester. I have had no less than 14 hours combined of study and lecture EVERYDAY for the last 70+ days straight.(Keep in mind that I am just off of a REALLY rough stint (12 exams in the last 8 weeks!)) Fourteen to eighteen hour days aren't anything that I'm not used to, it is just the voracious nature of effort that I am putting out in that time frame. I am often left in a heap laying with my dogs on the floor at the end of the day.

I can't complain too much though. I did choose this profession. And, I can say I'm really enjoying it.

Now that the last rough patch is over and I made it through relatively unscathed, things are looking brighter. It also helps that today is day 2 of spring break!


2) What expectations were not met?

Besides the nature of the stress/work load, it is exactly what I envisioned.

3) If you have a family, how did they cope with your decision and then the application of that decision?

The medical school process has been pretty emotionally draining for me. At the end of the day it often leaves me emotionally unavailable to my other. It has been hard on us at times and a big adjustment for us both.

4) Do you love what you do?

Um, yes. But not in the whimsical pre-med way that people often talk about. I love that I am successful through the 'blood, sweat, and tears'. All of which I have shed this year many times.

 

[ChemMed]

Well I started this thread over a year ago and was surprised to see it revived. Regardless its good to see the answers. Now that I am in medical school I'm starting to understand them better. It's a little strange to re-visit the me of last year, before I started this process. So in a rhetorical way I guess I can say that so far it has been worth it. Maybe I'll come back next year and hopefully I'll have the same answer

 

[thepoopologist]

I would say so. Before starting med school, and early on in med school, I figured I'd go into one of the ROAD specialties, or at least one which, though intense in workload, was high-paying (like cardiology or a surgical field.) I disqualified myself from more competitive specialties, however, by failing Step I on the first try, and not getting honors on any 3rd year rotations. More than those two factors, however, what really hindered me from applying to a competitive field was my own lack of confidence in my knowledge, skills, and abilities. My study habits in MS1 and MS2 were so poor, and my estimation of my knowledge base so low, (which I had some evidence for, as when I'd get pimped during 3rd year I couldn't even begin to answer the most basic questions, ones my classmates could rattle off the answers to in their sleep,) that I felt if I went into medicine or surgery I'd simply be unable to do the job, would wind up killing a patient, and get fired. I suppose I could have matched into anesthesiology somewhere, or applied to medicine and the gunned for a cardiology fellowship, but I felt that despite graduating from medical school and passing Step I, I simply did not have background the job required.

ETA: If you were asking more about how it affected which psych program I matched into, I didn't get interviews at any top programs, no doubt because of the Step I failure. I matched at what I guess would be regarded as a pretty good, mid-tier program.


Some. There are busy rotations, like IM and night float, when I don't have much time. I've even felt too busy on my last general adult psych rotation, when I just had a lot of complicated patients, wound up having to call multiple families every day, and was stuck there till past 7 half the time. But in general, I do have some time to enjoy life outside of work. Being a medicine or surgery intern would be hell on earth compared to this.

Thanks for the honest reply.

 

[QofQuimica]

I like this thread too. Going to add it to the sticky, as a matter of fact.

 

[Valvool]

I graduate from an MD program next month. Medical school fulfilled my expectations, and other than first year, was academically perhaps a bit easier than I anticipated.

However, now that I am about to begin residency, I am more scared than I was before beginning medschool, and more uncertain about whether I made the right decision to become a doctor than I was four years ago. Perhaps this uncertainly is the result of having had to scramble into a specialty which I had not really considered before the match, and still not being completely adjusted to that reality. But I think too a bit of the idealism and starry-eyedness of the premed/new medstudent has worn off. I have loans to pay off. I'm locked in to this deal. And I'm about to begin residency in a specialty that I did not plan on going into.

I suppose an update at some during residency or after may be a bit more uplifting, once I am settled and things are going well--but at the very moment I am not sure I would do it all over again.

 

[QofQuimica]

I can't say whether I'll ultimately feel that going to med school was worth it once I'm an attending. But if I had known ahead of time what medical *training* would be like, it would be a moot point, because I would not have gone to medical school.

 

[startoverat40]

from my experience, if you ask a resident if it's worth it to apply to medical school, they will say "are you crazy? why would you want to do that?". But if you ask them again 10 years later, they will say "ya sure, go for it!"

 

[dbizzy]

from my experience, if you ask a resident if it's worth it to apply to medical school, they will say "are you crazy? why would you want to do that?". But if you ask them again 10 years later, they will say "ya sure, go for it!"

 

[stolen_biscuit]

I can't say whether I'll ultimately feel that going to med school was worth it once I'm an attending. But if I had known ahead of time what medical *training* would be like, it would be a moot point, because I would not have gone to medical school.

Could you elaborate? I expect it to be difficult, but why not even bother?

Thanks!

 

[QofQuimica]

Could you elaborate? I expect it to be difficult, but why not even bother?

Thanks!

It's not that I hate medicine or don't think anyone should go to medical school. Just that I would have made a different cost-benefit analysis for *myself* if I had known that the costs would be this high.

from my experience, if you ask a resident if it's worth it to apply to medical school, they will say "are you crazy? why would you want to do that?". But if you ask them again 10 years later, they will say "ya sure, go for it!"

From my experience, that's true for some people and not for others. Either way, don't be too quick to be smug. Even if you're right in my case, and I sincerely hope you are, it's easy to blow off the magnitude of the costs when they're being experienced by someone else and not you.

 

[startoverat40]

It's not that I hate medicine or don't think anyone should go to medical school. Just that I would have made a different cost-benefit analysis for *myself* if I had known that the costs would be this high.


From my experience, that's true for some people and not for others. Either way, don't be too quick to be smug. Even if you're right in my case, and I sincerely hope you are, it's easy to blow off the magnitude of the costs when they're being experienced by someone else and not you.

sorry, didn't mean to be smug. My point is that while you're going through the toughest part of the process, your perception is different, and you tend to view it more negatively. Then later on after you've made it out, and your life is on a more normal routine, your stress level is a bit lower, and you tend to give a less bleak outlook to a person considering the same path. I don't know, just my observation based on a few people I know and talked to in the past...

it might be hard to do the cost-benefit analysis, when most of the cost is experienced up-front, and the benefit is delayed. So when you're in the painful part you figure it's all not worth it. Then later when you start to see more of the benefit, then you figure well maybe it wasn't so bad.

anyway, any worthy high accomplishment involves a great deal of pain. Whether you're a concert musician, a dancer, a scientist, an astronaut, or a doctor, you've got to bust your end. no pain no glory.

 

[QofQuimica]

sorry, didn't mean to be smug. My point is that while you're going through the toughest part of the process, your perception is different, and you tend to view it more negatively. Then later on after you've made it out, and your life is on a more normal routine, your stress level is a bit lower, and you tend to give a less bleak outlook to a person considering the same path. I don't know, just my observation based on a few people I know and talked to in the past...

it might be hard to do the cost-benefit analysis, when most of the cost is experienced up-front, and the benefit is delayed. So when you're in the painful part you figure it's all not worth it. Then later when you start to see more of the benefit, then you figure well maybe it wasn't so bad.

anyway, any worthy high accomplishment involves a great deal of pain. Whether you're a concert musician, a dancer, a scientist, an astronaut, or a doctor, you've got to bust your end. no pain no glory.

I understand your point, and I'm not disagreeing with you in general. I'm not even trying to dissuade anyone else from going to medical school, which would probably be pointless in most cases anyway. I only intend to speak for myself, and again, even if I wind up happy as an attending (certainly plausible, maybe even probable), if I could go back and do it again, I would not have gone to medical school. I don't see those two positions as contradictory: what's right for me may not be right for others and vice versa. My perspective on whether *I* should have done it is different now than it was when I was a premed, and it may yet change again. But it may not; many of the things that make me feel this way are related to the system as a whole, not just to my stress level or the fact that I'm paying the price now to hopefully have the glory later. FWIW, cliches don't provide much comfort along the journey, either.

At any rate, figuring out whether others should go to med school or not is far beyond my ken. If someone wants to go to medical school, I can advise them on how to get in and how to get through. I can even give my perspective on the pros and cons of going somewhat tailored to their specific situation if that helps them make a more informed decision. But ultimately everyone has to figure out the "should I do it" part on their own, and it basically winds up being an educated guess. I'm saying that I guessed wrong, and that's an especially painful price to pay.

 

[stolen_biscuit]

I understand your point, and I'm not disagreeing with you in general. I'm not even trying to dissuade anyone else from going to medical school, which would probably be pointless in most cases anyway. I only intend to speak for myself, and again, even if I wind up happy as an attending (certainly plausible, maybe even probable), if I could go back and do it again, I would not have gone to medical school. I don't see those two positions as contradictory: what's right for me may not be right for others and vice versa. My perspective on whether *I* should have done it is different now than it was when I was a premed, and it may yet change again. But it may not; many of the things that make me feel this way are related to the system as a whole, not just to my stress level or the fact that I'm paying the price now to hopefully have the glory later. FWIW, cliches don't provide much comfort along the journey, either.

At any rate, figuring out whether others should go to med school or not is far beyond my ken. If someone wants to go to medical school, I can advise them on how to get in and how to get through. I can even give my perspective on the pros and cons of going somewhat tailored to their specific situation if that helps them make a more informed decision. But ultimately everyone has to figure out the "should I do it" part on their own, and it basically winds up being an educated guess. I'm saying that I guessed wrong, and that's an especially painful price to pay.

Ah, thank you.

I am typically a person who regrets what I have not done, and takes the things I wish I hadn't with a grain of salt. This, in addition to researching related careers and not finding anything I'd like to pursue, is what has ultimately made me decide to go for it.

It's impossible to get a feel for the costs of something you haven't suffered through yet. I am hoping my supportive husband, support network of friends, and very hands-on-parent husband are all able to pull together to get my children and my marriage out with minimal damage. I guess we'll find out on the other side! Thankfully, I expect actual financial costs to be relatively minimal thanks to the great state of Texas.

The system does concern me, especially changes that may be coming. On the other hand, I haven't been very pleased with other systems I've worked with; I think that may just be a part of all major operations.

As for you, could you go back to your previous successful career if you find yourself unhappy in the long run? I know it would be a waste of years, but (pardon the cliche ) hindsight is 20-20.

 

[startoverat40]

maybe the "bright side" is that the system as a whole, as it is right now, is not sustainable, and will sooner or later implode. and maybe that can give you a glimmer of hope, that if you stick with it and stay the course, you'll get a chance to play a part in putting together whatever will replace it. Or you could move to Vermont

 

[QofQuimica]

The system does concern me, especially changes that may be coming. On the other hand, I haven't been very pleased with other systems I've worked with; I think that may just be a part of all major operations.

There *is* something to that. However, medical training is particularly dehumanizing, which is ironic considering how we all clamor for compassionate physicians. For the record, that is the system I'm talking about, not the health care system as a whole (although there is a lot of twisted sickness to that as well).

As for you, could you go back to your previous successful career if you find yourself unhappy in the long run? I know it would be a waste of years, but (pardon the cliche ) hindsight is 20-20.

I don't know. I've been out of chemistry for six years now, and I'm way out of the loop. But there are other avenues I could pursue. I published a book while in medical school, which was an incredibly frustrating but gratifying experience. I'd also consider teaching again. And again, I don't hate medicine, so I wouldn't say there's no likelihood of me practicing. Maybe it will be some combination thereof, or something else entirely. Tough to say.

 

[whatbout2morrow]

There *is* something to that. However, medical training is particularly dehumanizing, which is ironic considering how we all clamor for compassionate physicians. For the record, that is the system I'm talking about, not the health care system as a whole (although there is a lot of twisted sickness to that as well).


I don't know. I've been out of chemistry for six years now, and I'm way out of the loop. But there are other avenues I could pursue. I published a book while in medical school, which was an incredibly frustrating but gratifying experience. I'd also consider teaching again. And again, I don't hate medicine, so I wouldn't say there's no likelihood of me practicing. Maybe it will be some combination thereof, or something else entirely. Tough to say.

 

[EdLongshanks]

There *is* something to that. However, medical training is particularly dehumanizing, which is ironic considering how we all clamor for compassionate physicians. For the record, that is the system I'm talking about, not the health care system as a whole (although there is a lot of twisted sickness to that as well).
.

I'm pretty shocked at Q's sentiments. It sounds like she is on page 100 of "House of God" at the moment - without the cute immoral nurses to make it better.

In the second semester of Medical School, I would certainly do it again, but much sooner. In the first semester I thought that I was going to fail out. If I become embittered later, I'm sure I will say so.

The whole question is not reasonable. We all just do what seems reasonable at that point. There is no way to take a snapshot of myself down the road and receive a "letter from me" that tells me what I should do. Even if we could, the letter would only be a snapshot, not a movie. In general, I have made a whole lot of bad choices that I wish I could undo in life. But, in general, I have been happy, because I'm happy with what I'm doing now and where I am headed now.

 

[QofQuimica]

The nurses are *amoral*, Ed, not immoral. There's a difference.

All kidding aside, that's an abominable book, on many levels. I hated it when I read it. But there's no doubt that the author was drawing on his experiences as a resident.

 

[startoverat40]

Q, the dehumanizing nature of medical training... you mean the long hours, the power hierarchy, both, or something else? still, doesn't this mean that the training part is what is currently making you question your decision to get into medicine, and once you're done with that part, things wouldn't be so bad?

 

[smq123]

(Sorry for the intrusion from a non-nontrad, but I frequently think about whether or not I would do med school again. So, again, bear with me. )

Q, the dehumanizing nature of medical training... you mean the long hours, the power hierarchy, both, or something else? still, doesn't this mean that the training part is what is currently making you question your decision to get into medicine, and once you're done with that part, things wouldn't be so bad?

No.

After training, the money gets better. The hours *might* get better (depending on which clinical setting you go into). The power hierarchy will always be there. And the pressures get much worse.

I'm a few months away from graduating residency. And I am scared out of my mind. I'm scared about missing something potentially serious and hurting someone. There won't be an attending looking over my shoulder, correcting my mistakes before something bad happens. Because of money, we all have to see patients quickly...and I'm scared that I'll be so pressured to see patients fast that I won't have time to think through everything that they have.

And, you always hear that it's not a question of IF you'll be sued, but when. And I know it's coming....but I don't know how, I don't know when. All I can do is act as if each patient will be the one to sue me. Assuming that everyone is out to get you is very tiring and extremely depressing. I try not to dwell on it, but again...it's coming. At some point.

The mental energy that goes into being a doctor is tremendous, and the payoff is becoming less and less each year. Medicare cuts keep looming, to be staved off by a last minute reprieve. Patients don't want to pay you, so if you charge them they take it out on you. The risk of lawsuits is huge, but the malpractice tort reform isn't there. There's less protection of our profession, and less individual protection from being sued, but you're still expected to produce the same high level of care as if those things didn't matter.

If I had to do it all over again, I don't think I would go back to med school, either. Don't get me wrong - I love what I do. I love taking care of patients. But I don't know if I love being a doctor, and I'm even less sure that I love being a doctor enough to make me say that I'd definitely do it again.

Yes, other jobs are strenuous, too. But other jobs don't seem to expect you to be a mix between Mother Theresa and Superman, either.

 

[wholeheartedly]

There *is* something to that. However, medical training is particularly dehumanizing, which is ironic considering how we all clamor for compassionate physicians. For the record, that is the system I'm talking about, not the health care system as a whole (although there is a lot of twisted sickness to that as well).
.

I'm curious about your thoughts on something based on your experiences as a student, adcom member, and resident. As far as perpetuating this dehumanizing system with each generation of physicians, do you think certain personality types are selected for going into the field or do you think that a lot of people have personality changes during training where they become people who "beat down" on trainees. I'm sure there's some of both, but I'm wondering if one is a much bigger factor than the other. While I hate stereotypes and I've met some pretty kind down to earth people in medicine, it still seems like there's a disproportionate number of people on power trips and maybe with some psych pathology in medicine and academics. I kind of wonder if they've just naturally gravitated toward the field because they have those inclinations already.


P.S. I know what you're going to be doing down the road Q. You'll be working for the non-profit I'm going to start when I win the lottery. Don't worry, it'll be cool, promise

 

[ChemMed]

Q what was your book about and where can I find it? I have to say that I am very curious.

 

[QofQuimica]

I'm curious about your thoughts on something based on your experiences as a student, adcom member, and resident. As far as perpetuating this dehumanizing system with each generation of physicians, do you think certain personality types are selected for going into the field or do you think that a lot of people have personality changes during training where they become people who "beat down" on trainees. I'm sure there's some of both, but I'm wondering if one is a much bigger factor than the other. While I hate stereotypes and I've met some pretty kind down to earth people in medicine, it still seems like there's a disproportionate number of people on power trips and maybe with some psych pathology in medicine and academics. I kind of wonder if they've just naturally gravitated toward the field because they have those inclinations already.

I don't know. I do think, though, that if you start out already having those tendencies, being in a career with a strong hierarchy like medicine (or the police, or the armed forces, etc.) will bring those tendencies out in a most undesirable way.

P.S. I know what you're going to be doing down the road Q. You'll be working for the non-profit I'm going to start when I win the lottery. Don't worry, it'll be cool, promise

Deal. I vote for us starting a non-profit drug company. Or working with one like this. Only, we should target impoverished Americans. No need to go looking in Africa or Asia; there are plenty of people right here at home who can't afford their meds.

Q what was your book about and where can I find it? I have to say that I am very curious.

I'll PM you the Amazon link.

 

[wholeheartedly]

Deal. I vote for us starting a non-profit drug company. Or working with one like this. Only, we should target impoverished Americans. No need to go looking in Africa or Asia; there are plenty of people right here at home who can't afford their meds.

Funny you should link that. I was actually daydreaming about what I'd like to do when that big jackpot was going on. I was really thinking of a multi-pronged approach that involved drug development like that and working on more accurate, efficient diagnostics. I'll take the lab test/diagnostics side, you take the drug development. K?

But we have to have a really cool acronym

 

[QofQuimica]

Funny you should link that. I was actually daydreaming about what I'd like to do when that big jackpot was going on. I was really thinking of a multi-pronged approach that involved drug development like that and working on more accurate, efficient diagnostics. I'll take the lab test/diagnostics side, you take the drug development. K?

But we have to have a really cool acronym

I could totally get down with running a clinical chemistry lab. It's a lot of analytical chem, and there's quite a bit of overlap with organic chem since we purified and analyzed all of our own compounds.

How's this for an acronym: LAB US UP (Laboratory Analysis to Benefit the United States Underserved Population)

 

[Northwesterly]

Deal. I vote for us starting a non-profit drug company. Or working with one like this. Only, we should target impoverished Americans. No need to go looking in Africa or Asia; there are plenty of people right here at home who can't afford their meds.

I thought that Montel Williams had solved this?

 

[startoverat40]

Q, smq123,

those of us who are still at the start line should thank you for highlighting the pain-points and fears which we must face one day. Surely we all need to know what we are getting ourselves into, and we must've convinced the adcoms that we did know that, which is why they let us in.

I'm sure the pains and fears are much bigger and more strongly felt at the stage of the game where you are, than at the start line, no matter how much shadowing and volunteering we novices may have done. But I think that we can't let the pains and fears rule us, no matter which stage of it we are at. The fear of making mistakes and killing patients is always there, and it should always be there. As I quoted Dr Rob before, we couldn't be good physicians if we weren't afraid of killing someone by mistake. But this fear should keep us on our toes, and ensure that we are always careful and professional. It shouldn't paralyze us and keep us from entering medicine, or continuing on the path that we have chosen. Do you agree?

There are many other jobs which put the person in the position where making mistakes could cost other people's lives. A bus driver could crash and kill all the passengers. An airline pilot could kill even more people. The operators of nuclear reactors could kill even more. But should they all stop doing these jobs?

As far as the current state of medical training and practice is concerned, I think physicians and med students have a part in perpetuating it as well. we have to pay the big tuition and accumulate the big debt, after which we demand to make the big bucks and have the fancy life-styles. how many of us pick our specialties for sake of maximizing income? As long as all the players in the system demand the big bucks, they will perpetuate the existence of the middle-men and demanding and pushy bosses which get in between the physicians and their patients. Either something/someone has to give, or the whole thing will soon blow up. Maybe it's better we just wait for that to happen, so then we can pickup the pieces and build up something new and better.

 

[ShyRem]

Dehumanizing of medical training. This is a problem... we laugh at those so naive as to tear up when a code is "called", those who cry with the families when they tell them a loved one is dead or comatose with no hope of recovery. We on one hand demand that physicians treat their patients like pieces of meat to carve - stick this needle here, that needle there, well you screwed up, just do it again. Cut this way, hurry up, gee go talk to the family for the code status but you only have 3 minutes to do so. Don't waste so much time on rounds or exam - we have 20 patients to see this morning. But on the other want them to be empathetic, humanistic, caring. But hurry up because while you're telling the 18 year old's mother that he's dead you have another critical patient to see RIGHT NOW.

Clinic? Great. A patient every 15 minutes. And in that 15 minutes you are expected to fill out all the forms for the standards of care for their hypertension, their diabetes, what and when were their last A1c, EKG, CMP, secondary causes of hypertension, last microalbumin, renal function, obesity, smoking, document you talked to them about their diet, their smoking, their exercise, counseled them about their medication, get refills done, examine them, check with your attending, and get them out the door. In 15 minutes. OH, gee, sorry, they really came because they were feeling fatigued and had back pain. What do you mean you are running behind? That's your easiest patient today!

You are expected to care about all those things, answer emails, pages, telephone messages from patients on top of your 70 or 80 hours in the hospital, and there are definitely days your entire goal is to have time to go to the bathroom. In between your patients with STEMI, acute CVA, new onset sz caused by a mass in the brain unknown to the patient you get to go see the drug seeker, the parents who come by because the dog licked their 5 month old's arm (and they are FREAKED OUT by this, mind you), a splinter, or someone who demands a pelvic because they have had vag discharge for 6 months now with pelvic pain but wants to have sex tonight so you need to fix this NOW 'cuz he's really hot. And yes, you are expected to handle them all with grace and compassion.

Now, would I do it all again? Yup. Like smq, tho, I'm about to sign a contract and that scares the absolute crap out of me. I will be expected to know enough, be smart enough, handle my patients alone with no attending backing me up. The money looks awfully nice. The responsibility is terrifying. What if I miss something? I don't know enough..... I likely won't ever feel like I know enough. The field of medicine changes so quickly it is impossible to feel like you know enough. I think a little discomfort is a good thing here though: it keeps you from getting complacent. At least that's my theory and hope.

Now, a good acronym. Nope. All the ones I can think of are dirty or mean. Then again, I wanted my husband's old department to start a Fugutive Apprehension and Recovery Team. Or a Street Hood Intervention Team. I thought it went well with the Biddeford Old Orchard Beach Special Assignment team. (I'm not making that last one up, and yes, those first five initials were on their patches with Assignment Team after them...)

 

[cabinbuilder]

Like you, I was not only terrified the first week of residency and actually hyperventilated during my first call and ran to cry in the bathroom for all those great points you brought up in each post. As you and I know, that residency fear does pass and things get better emotionally and at least you try to pretend that you (we) have a handle on everything.

I was also scared to death to be out on my own on my first post-residency job. I think it helped that I was in the middle of nowhere and the patients were actually grateful to have a doctor available to them. As the weeks pass, the fears also pass. I look everything up and rely on my uptodate page quite often.

We are only human too and you can only do your best. You cannot please everyone and you cannot "fix" everyone. For those who are ungrateful they can move on to the next provider. There will be good days and bad days. Days of hateful stafff and days of that special MA/nurse who you can't live without. I have yet to find an administrator who is humane and worth my time. Just know that no contract is absolute and you do not have to be anyone's slave. It's ok to quit a job you hate and it may take a bit to find that right fit. You will be a good as your confidence lets you be.

 

[ChemMed]

Thanks for the PM Q. I'm also really glad that the spirit of this thread is realistic concerning what I may see in my own future as I progress down this medical education. I don't know how to thank you enough. I think the responsibility of being an attending really does scare me the most.

 

[QofQuimica]

Dehumanizing of medical training. This is a problem... we laugh at those so naive as to tear up when a code is "called", those who cry with the families when they tell them a loved one is dead or comatose with no hope of recovery. We on one hand demand that physicians treat their patients like pieces of meat to carve - stick this needle here, that needle there, well you screwed up, just do it again. Cut this way, hurry up, gee go talk to the family for the code status but you only have 3 minutes to do so. Don't waste so much time on rounds or exam - we have 20 patients to see this morning. But on the other want them to be empathetic, humanistic, caring. But hurry up because while you're telling the 18 year old's mother that he's dead you have another critical patient to see RIGHT NOW.

Clinic? Great. A patient every 15 minutes. And in that 15 minutes you are expected to fill out all the forms for the standards of care for their hypertension, their diabetes, what and when were their last A1c, EKG, CMP, secondary causes of hypertension, last microalbumin, renal function, obesity, smoking, document you talked to them about their diet, their smoking, their exercise, counseled them about their medication, get refills done, examine them, check with your attending, and get them out the door. In 15 minutes. OH, gee, sorry, they really came because they were feeling fatigued and had back pain. What do you mean you are running behind? That's your easiest patient today!

You are expected to care about all those things, answer emails, pages, telephone messages from patients on top of your 70 or 80 hours in the hospital, and there are definitely days your entire goal is to have time to go to the bathroom. In between your patients with STEMI, acute CVA, new onset sz caused by a mass in the brain unknown to the patient you get to go see the drug seeker, the parents who come by because the dog licked their 5 month old's arm (and they are FREAKED OUT by this, mind you), a splinter, or someone who demands a pelvic because they have had vag discharge for 6 months now with pelvic pain but wants to have sex tonight so you need to fix this NOW 'cuz he's really hot. And yes, you are expected to handle them all with grace and compassion.

Yes to all of this. Though I still do tear up whenever I tell families about someone having died, or when I talk to them about making their loved one CMO (comfort measures only). Every time. I can't stop myself from reacting that way no matter how much I try, and I've finally given up and stopped trying. I feel emotional about delivering bad news, and that's just how I am. In a strange way, I think my inability to completely detach myself is a big part of why I'm often successful with those talks. No family member has ever reacted negatively to me getting emotional in front of them. That being said, you can't be the most hysterical person in the room, or you aren't any good to the patient or the family. You can't function that way yourself.

Like you said, I feel heavy pressure to be more efficient, to move the patients through faster and faster, even though interns are supposed to be here to 'learn," not to move the patients through as fast as possible. I've gotten more efficient, and I'm sure I'll continue to get more efficient as I gain more experience. But ultimately, spending time with the patients is one of the few parts of the job that even has the potential of being rewarding. The other part is teaching, which is also inherently inefficient. So I guess I will never be the most efficient resident, or attending, out there. And sometimes I get dinged for that. I'm also a naturally cautious person, and that doesn't help with my efficiency either.

Like you, I was not only terrified the first week of residency and actually hyperventilated during my first call and ran to cry in the bathroom for all those great points you brought up in each post. As you and I know, that residency fear does pass and things get better emotionally and at least you try to pretend that you (we) have a handle on everything.

It does get better, but yeah, there is plenty of posturing going on. One of my classmates has already had two M&Ms.

Thanks for the PM Q. I'm also really glad that the spirit of this thread is realistic concerning what I may see in my own future as I progress down this medical education. I don't know how to thank you enough. I think the responsibility of being an attending really does scare me the most.

You're welcome. I'm happy to talk more about it when we get together if you want.

 

[CremasterFlash]

Hell yes I would do it again. I'm now a third year (sheesh... where did the time go?), about to start my EM sub-i. I worked for 11 years in finance before taking 3.5 years to do a postbacc. Which makes me 40 years old if my math is right. The irony has not been lost on me that my old job was about eliminating inefficiency in the state of human affairs and my new one is about perpetuating it.

I'm having an absolute blast. I have the privilege of witnessing the most important days of people's lives - their births, their deaths, the days they find out the cancer is gone and when it looks like their heart is about a cheeseburger and a shot of vodka away from the edge. I meet people and within minutes I am entrusted with their deepest fears, their happiness, their future, their children. Sometimes they are literally helpless, anesthetized upon a table (apologies to TS Eliot) and they simply trust that we are kind, caring, competent. Many times, my thoughts and actions have significant impact on the well being of another human being. I take the time to look up something that I vaguely remember and it turns out to explain a constellation of symptoms and suggest a solution. I love physiology and find it absolutely amazing that this stuff is actually true - that I can look up the mechanism of a drug and put it together with the pathways I busted my ass to memorize and understand why it works and why it might give you dry mouth or turn your pee brown on the way to keeping you alive.

I love the unrelenting pursuit of a better world and the audacious optimism embedded in the ethos of medicine in the face of overwhelming evidence that we are underappreciated and that ultimately the whole shebang is cosmic rounding error - humanity has been recognizably H Sapiens for about 200k years and we've almost taken ourselves out 3 times in the last 100... i mean, we're not exactly earth's equilibrium state. People are not rational... sometimes they make poor decisions and then we fix them so they can make more bad decisions, perhaps, along the way creating more people with the odds stacked overwhelmingly against them. Our humanism has the seeds of its own end sewn within it. And yet we keep at it because that's just what people do. To not care is quite beyond our capabilities.

Medicine is such a messed up economy because it encapsulates the contradictions and dissonance of what it means to be human. It is a beautiful cacophony, it is a willful refusal to widgetize ourselves. It is economically untenable to the same extent that we will never refuse to treat the poor for fear of encouraging moral hazard.

We know that entropy will win eventually (apologies to Radiohead), that the ideas of efficiency and rational behavior are only in agreement with life writ large in the most specious and temporary senses. In the meantime, we might as well be good to each other.

I think there is something beautiful in that and I feel very lucky to be its daily witness.

 

[LingoLaine]

Hell yes I would do it again. I'm now a third year (sheesh... where did the time go?), about to start my EM sub-i. I worked for 11 years in finance before taking 3.5 years to do a postbacc. Which makes me 40 years old if my math is right. The irony has not been lost on me that my old job was about eliminating inefficiency in the state of human affairs and my new one is about perpetuating it.

I'm having an absolute blast. I have the privilege of witnessing the most important days of people's lives - their births, their deaths, the days they find out the cancer is gone and when it looks like their heart is about a cheeseburger and a shot of vodka away from the edge. I meet people and within minutes I am entrusted with their deepest fears, their happiness, their future, their children. Sometimes they are literally helpless, anesthetized upon a table (apologies to TS Eliot) and they simply trust that we are kind, caring, competent. Many times, my thoughts and actions have significant impact on the well being of another human being. I take the time to look up something that I vaguely remember and it turns out to explain a constellation of symptoms and suggest a solution. I love physiology and find it absolutely amazing that this stuff is actually true - that I can look up the mechanism of a drug and put it together with the pathways I busted my ass to memorize and understand why it works and why it might give you dry mouth or turn your pee brown on the way to keeping you alive.

I love the unrelenting pursuit of a better world and the audacious optimism embedded in the ethos of medicine in the face of overwhelming evidence that we are underappreciated and that ultimately the whole shebang is cosmic rounding error - humanity has been recognizably H Sapiens for about 200k years and we've almost taken ourselves out 3 times in the last 100... i mean, we're not exactly earth's equilibrium state. People are not rational... sometimes they make poor decisions and then we fix them so they can make more bad decisions, perhaps, along the way creating more people with the odds stacked overwhelmingly against them. Our humanism has the seeds of its own end sewn within it. And yet we keep at it because that's just what people do. To not care is quite beyond our capabilities.

Medicine is such a messed up economy because it encapsulates the contradictions and dissonance of what it means to be human. It is a beautiful cacophony, it is a willful refusal to widgetize ourselves. It is economically untenable to the same extent that we will never refuse to treat the poor for fear of encouraging moral hazard.

We know that entropy will win eventually (apologies to Radiohead), that the ideas of efficiency and rational behavior are only in agreement with life writ large in the most specious and temporary senses. In the meantime, we might as well be good to each other.

I think there is something beautiful in that and I feel very lucky to be its daily witness.
__________________
Courage is the price that life exacts for granting peace.
Amelia Earhart

Wow. Just wow. And thank you.

 

[Spurg]

Well put Cremasterflash. Hit the nail right on the head.

 

[smq123]

Hell yes I would do it again. I'm now a third year (sheesh... where did the time go?), about to start my EM sub-i.

If I could be an MS3 all over again, yeah, I'd do it. MS3 was awesome. You show up, you learn a ton, you see a bunch of cool things that most people will never see...it was great.

Being a "real doctor" took some of the fun out of things.

 

[ShyRem]

And put some real fun into other things. I find residency so much more rewarding, challenging, interesting than student years. And yes, Q, I too still have problems not tearing up a little with bad news. I have hugged patients, held them while they cried, celebrated with them during triumphs, spent time discussing options with newly diagnosed cancer patients.

I think if the time comes where I feel so dispassionate about bad news, about patients dying unexpectedly, that is the time to hang it up and retire. When I stop caring it's time to stop practicing. But dang, some of the bs administrative garbage makes the practice of medicine so stinkin hard.

 

[smq123]

But dang, some of the bs administrative garbage makes the practice of medicine so stinkin hard.

Agreed. Completely agree.

I think the question of whether or not someone would do it again is so complex because there're so many aspects to being a doctor.

If I could just take care of patients all day, then I would definitely do it all again, no question. Taking care of patients who truly need your help is awesome. And there are some settings where you can still do this. I'm working at a community health center next year, and I hope that by working with the underserved, that will be the bulk of my day. I hope.

Having to wrestle with insurance companies, do a ton of paperwork everyday, and worry about getting sued when I did nothing wrong, though, make the job kind of suck.

When I was a premed, I worried that I would become jaded and unsympathetic towards patients. I am very grateful that that has not happened. But I never, in a million years, thought that I'd ever yell over the phone at an insurance company.

 

[startoverat40]

But dang, some of the bs administrative garbage makes the practice of medicine so stinkin hard.

But I never, in a million years, thought that I'd ever yell over the phone at an insurance company.

http://www.pnhp.org/