NY Times Article About Med Student Burnout

[pianola]

Nothing you haven't already heard already, I guess (I mean, for the most part).

http://www.nytimes.com/2008/10/31/health/chen10-30.html?_r=1&oref=slogin

What do you think when you read these articles about how hard/depressing/demoralizing med school is? Do you think "this won't be me"? Or do you think "I'll survive...somehow"? Or do you think "It'll be worth it in the end." Some combination?

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[iduwanna]

Nothing you haven't already heard already, I guess (I mean, for the most part).

http://www.nytimes.com/2008/10/31/health/chen10-30.html?_r=1&oref=slogin

What do you think when you read these articles about how hard/depressing/demoralizing med school is? Do you think "this won't be me"? Or do you think "I'll survive...somehow"? Or do you think "It'll be worth it in the end." Some combination?

Pretty much that combination. Usually, when I hear these type of stories they're prefaced the same way as in this case:

"I wanted to become a doctor to help people, but I had given little thought to the process. I was poorly prepared for many things..."

She was naive.

 

[JackInTheBox]

Nothing you haven't already heard already, I guess (I mean, for the most part).

http://www.nytimes.com/2008/10/31/health/chen10-30.html?_r=1&oref=slogin

What do you think when you read these articles about how hard/depressing/demoralizing med school is? Do you think "this won't be me"? Or do you think "I'll survive...somehow"? Or do you think "It'll be worth it in the end." Some combination?

The author of that article has also written a book about her experiences that's a pretty good read.

 

[airplanes]

Hey, I guess PandaBear was on to something!
All I could think about was him when the author mentioned the drop in empathy levels towards patients as school went on..

I think we all have a sense of confidence in our own abilities to overcome adversity and stress. It seems the mighty adcoms know what they're doing though because the vast majority, although they experience burnout, do tend to graduate and move on.

 

[Decicco]

99% graduation rates are always encouraging

 

[Vihsadas]

“We need to change things,” she had said, “because maybe the students who are most vulnerable are the ones who are most empathic.”

This stuck with me...

 

[ButImLETired]

This stuck with me...

Yeah me too. I was at an interview recently where the dean tends to give a very sweeping, intense, dramatic, inspiring (and pretty cheesy) talk instead of the usual "so welcome to our school" speech, and I was sitting next to a girl who started tearing up (I'm not gonna lie, most people were probably feeling similarly, but she was the only one showing it). When I read the article I thought of her. She's first.

 

[unsung]

Yeah me too. I was at an interview recently where the dean tends to give a very sweeping, intense, dramatic, inspiring (and pretty cheesy) talk instead of the usual "so welcome to our school" speech, and I was sitting next to a girl who started tearing up (I'm not gonna lie, most people were probably feeling similarly, but she was the only one showing it). When I read the article I thought of her. She's first.

I don't think this is necessarily the case. I'm pretty much like that girl. I'll even start tearing up at stupid commercials. Otoh, I handle people in crisis (i.e. suicidal, etc.) or rude/out of control patients at the hospital (i.e. psych) far more calmly than a lot of other folks.

It's kind of a weird disconnect, but it makes sense to me. Basically, I just hold patients/whoever I'm helping to a different standard than other people. The person's sick/in distress... why should I take what they're saying/doing in a personal way and get offended or feel less empathic as a result?

I think sensitivity is a good thing... and it hasn't really gotten in the way of how I interact with patients in my job. Actually where it does suck is in dealing with the bureaucracy of working in a hospital. Hospitals are wayy hierarchical. Plus the organization is not always up to par, depending on where one works. So where my sensitivity gets me in trouble is really more with that side of things... really never with patients, themselves.

 

[ButImLETired]

I don't think this is necessarily the case. I'm pretty much like that girl. I'll even start tearing up at stupid commercials. Otoh, I handle people in crisis (i.e. suicidal, etc.) or rude/out of control patients at the hospital (i.e. psych) far more calmly than a lot of other folks.

It's kind of a weird disconnect, but it makes sense to me. Basically, I just hold patients/whoever I'm helping to a different standard than other people. The person's sick/in distress... why should I take what they're saying/doing in a personal way and get offended or feel less empathic as a result?

I think sensitivity is a good thing... and it hasn't really gotten in the way of how I interact with patients in my job. Actually where it does suck is in dealing with the bureaucracy of working in a hospital. Hospitals are wayy hierarchical. Plus the organization is not always up to par, depending on where one works. So where my sensitivity gets me in trouble is really more with that side of things... really never with patients, themselves.

Oh, I absolutely didn't mean to imply that there's anything wrong with being sensitive (trust me, I hid it better but I was also yay close to tearing up). Plus, it was an interview, emotions are running high anyway, lots of tension...

I do think that maintaining a healthy balance between being personally attached to patients and remaining stonily focused on the job is necessary, but that's rather obvious. Let's just hope the author was wrong to suggest that the current process kills the humanity in med students.

 

[pianola]

Yeah. It would be really nice if the higher-ups would somehow respond to the article and make fundamental, necessary changes.

But I guess medical school was never supposed to be 'easy'...it will never be 'easy' to confront issues of pain, suffering or death...

to us all. Class of 2013 (and beyond).

 

[Flushot]

Thanks for posting this. I have her book, so it's nice to see that she's still writing and might do another book in the future.

 

[ConfusedMD2009]

As a 4th year medical student I am F-ing BURN'T OUT !!!!!!!!!!!!!!!!!!!!!!!!!!!!

 

[WannaBePreMed]

As a 4th year medical student I am F-ing BURN'T OUT !!!!!!!!!!!!!!!!!!!!!!!!!!!!

I'm a beast, I'll find a way to manage through it

 

[WannaBePreMed]

“We need to change things,” she had said, “because maybe the students who are most vulnerable are the ones who are most empathic.”

This was a very powerful statement.

 

[beachblonde]

99% graduation rates are always encouraging

Because after the first year you might be up to $80,000 in debt, and what other career path will help pay it off? 25% of a medical degree ain't work jack. Plus most of those M1s have nothing but an undergrad degree, probably in biology or chemistry. Again, worth jack.

Once you enter med school, unless you're very wealthy, you're stuck.

 

[Nanon]

I think that often, avoiding depression and burnout has a lot to do with sleeping enough, eating good food, and maybe most importantly, expectation management.

One of the things said in the article is that perhaps all of the information medical school wants to share with us isn't actually needed to graduate good doctors. In fact, every single one of my friends who went through medical school (and most of them were pretty healthy at the end of it) told me that you have to be comfortable letting information go. Sometimes a lot of it. I think that's a really tall order for people who have been told that they need to be at the top of their class most of the time to be doctors.

I think being older, being comfortable with failure, having a family and having a lot of doctors as friends (and hence not seeing them as anything other than people) will help to protect me. But I think that lack of sleep, anxiety about effectively treating patients, having a family and the lack of time off will make this a really tough four years.

 

[chiz2kul]

That was depressing in itself..

 

[jamestudor]

Reading things like this motivates me even more, I want to test myself, I want to put myself through hell and see what comes out on the other end.

 

[Morozovo]

Didn't Pauline Chen go to Northwestern Med? I thought they prided themselves on having happy students and reducing competitiveness... disturbing... maybe the curriculum has changed since she attended?

 

[Vihsadas]

Didn't Pauline Chen go to Northwestern Med? I thought they prided themselves on having happy students and reducing competitiveness... disturbing... maybe the curriculum has changed since she attended?

I dunno. I'd imagine that no matter where you attend medical school it's going to be unbelievably stressful. That being said, there probably has been a few significant curriculum changes since she's been there.

 

[UVAbme2009]

For me at least, everything will be easier with a solid support system. Being close to home, having good relationships with fellow students, and having my SO with me. I'll sacrifice trying to learn everything (impossible, I know) in order to stay sane.

 

[njbmd]

I am not super intelligent and I am a very normal person. Medical school was a challenge but not miserable, overwhelming or depressing. I had the camaraderie of a great class of supportive classmates and I studied material that was well-presented and very interesting. I had to adjust to the volume of material that was being presented but I made that adjustment.

I can tell you that anyone, medical student, resident or practicing physician has to have balance in life or "burnout" is possible. Your success (or failure) in any endeavor is largely due to your attitude going in. If you go in with the idea that you "can't get it done" or that "this is unbelievably hard" , you will likely encounter an situation that you can't get thorough or something that is unbelievably hard.

In medical school (and in life), if something is not working for you, you make some changes to something that does work. Everything, even just living, can be stressful if that is your first reaction.The vast majority of people who are accepted into medical school, get thorough medical school without dying or becoming emotional cripples.

The person who wrote that article attended medical school more than ten years ago. Today, there are tons of resources out there for medical students here in the U.S. You have to be willing to seek help when you need it and keep yourself balanced overall. Is medical school easy? Not for the vast majority of us but is is doable? Definitely yes.

If you want to worry about something, worry about paying for medical school. In today's climate, the costs are worth the worry.

 

[dr milky]

I personally find Dr Chen's writing depressing and melodramatic. As one who has been successful in a very competitive field, I can tell you, unequivocally, that watering things down is never good. As a patient, I NEVER want to see my doctor cry. In my experience, emotional intrusions rarely improve performance, and in Dr Chen's book, even, her attacks of empathy seemed merely to impede.

 

[pianola]

If you want to worry about something, worry about paying for medical school. In today's climate, the costs are worth the worry.

Oh don't worry -- I think we're all worried about that as well.

The only thing worse than being miserable is being miserable AND being $150K in debt (or $200K or whatever).

---------------

I believe that I WILL be able to make it work somehow, but the article was still very sobering.

 

[indeed]

I can tell you that anyone, medical student, resident or practicing physician has to have balance in life or "burnout" is possible. Your success (or failure) in any endeavor is largely due to your attitude going in. If you go in with the idea that you "can't get it done" or that "this is unbelievably hard" , you will likely encounter an situation that you can't get thorough or something that is unbelievably hard.

In medical school (and in life), if something is not working for you, you make some changes to something that does work. Everything, even just living, can be stressful if that is your first reaction.The vast majority of people who are accepted into medical school, get thorough medical school without dying or becoming emotional cripples.

The person who wrote that article attended medical school more than ten years ago. Today, there are tons of resources out there for medical students here in the U.S. You have to be willing to seek help when you need it and keep yourself balanced overall. Is medical school easy? Not for the vast majority of us but is is doable? Definitely yes.

Good words... I hope you're right. Reading articles like these always make me feel a little nervous about what I'm getting into...

 

[bcat85]

I dunno. I guess I could see how people could burn out, but I actually really like medical school... much more than undergrad. I think that if someone doesn't have an outlet, burn-out is a lot more likely... its about not destroying yourself to try to honor everything I think.

 

[Jolie South]

I dunno. I guess I could see how people could burn out, but I actually really like medical school... much more than undergrad. I think that if someone doesn't have an outlet, burn-out is a lot more likely... its about not destroying yourself to try to honor everything I think.

yea, i feel the same way.

some of my classmates, for example, will spend the week before the test sleeping at school and only going home to shower. this is not me and i hope it never will be.

 

[pianola]

yea, i feel the same way.

some of my classmates, for example, will spend the week before the test sleeping at school and only going home to shower. this is not me and i hope it never will be.

Heh, your words are always encouraging Jolie South. I appreciate it. Baylor sounds like a really great place to be.

 

[Jolie South]

Heh, your words are always encouraging Jolie South. I appreciate it. Baylor sounds like a really great place to be.

yea, i tend to treat med school like a marathon as opposed to a sprint. i think that's the way you have to do it. you'll still work hard, but never feel too stressed or burnt out.

i bust my arse at the beginning of the block, so i'm not like these crazy tools that don't sleep at the end of the block.

 

[Doublecortin]

I personally find Dr Chen's writing depressing and melodramatic. As one who has been successful in a very competitive field, I can tell you, unequivocally, that watering things down is never good. As a patient, I NEVER want to see my doctor cry. In my experience, emotional intrusions rarely improve performance, and in Dr Chen's book, even, her attacks of empathy seemed merely to impede.

I agree, med school is SUPPOSED to be HARD. Otherwise, anyone could do it, right?! You don't want just anyone taking care of your loved one, you only want the very best.


" I knew that I wanted to become a doctor to help people, but I had given little thought to the process. I was poorly prepared for many things: the pressure to excel in ways that seemed so far from caring for people; rapidly mounting debts I signed off on every semester; a roller coaster existence from chronic lack of sleep; hazing from the more experienced students and residents; and the realities of patient suffering despite my best efforts."

Well, gee weez, Dr. Chen, what the hell did you expect med school to be, CLUB MED?

 

[gujuDoc]

I agree, med school is SUPPOSED to be HARD. Otherwise, anyone could do it, right?! You don't want just anyone taking care of your loved one, you only want the very best.


" I knew that I wanted to become a doctor to help people, but I had given little thought to the process. I was poorly prepared for many things: the pressure to excel in ways that seemed so far from caring for people; rapidly mounting debts I signed off on every semester; a roller coaster existence from chronic lack of sleep; hazing from the more experienced students and residents; and the realities of patient suffering despite my best efforts."

Well, gee weez, Dr. Chen, what the hell did you expect med school to be, CLUB MED?

In a way this is why I'm glad I won't be 21 when I start medical school. Being slightly older by a few years has allowed me to really talk to residents and medical students on here and in real life and know what it is I'm getting into. I thinnk it has opened up my mind to a lot of things I didn't understand 4 years ago and so if I get into medical school this year, i don't know how i'll feel after a year for sure but I know at least I won't expecting it to be a breeze and I know it will be tough.

But the real question is whether it is the sleepless nights or the bureacracy (sp?) that is involved in medicine that will change us. That is the one thing I do fear is that cynicism will form due to the disjointed beauracracy (sp??) and running of our medical system.

 

[medaholic]

In a way this is why I'm glad I won't be 21 when I start medical school. Being slightly older by a few years has allowed me to really talk to residents and medical students on here and in real life and know what it is I'm getting into.

That's true, but a number of physicians will make the same argument that undergrad was a waste of their time. But I'm not going to get into the whole age & medical school debate.

For the most part, people have good motives going into medicine. They want to help people. They want to make a difference. They like interacting with patients, they like the science, they're up for a challenge.

What's not advertised is the debt, sleepless nights, calls, rude patients, insurance, paperwork, malpractice and bureacracy.

 

[Jolie South]

That's true, but a number of physicians will make the same argument that undergrad was a waste of their time. But I'm not going to get into the whole age & medical school debate.

For the most part, people have good motives going into medicine. They want to help people. They want to make a difference. They like interacting with patients, they like the science, they're up for a challenge.

What's not advertised is the debt, sleepless nights, calls, rude patients, insurance, paperwork, malpractice and bureacracy.

I think you're missing the point. of course, undergrad is a waste of time. for me, it was the time i spent on my own and abroad AFTER undergrad that was incredibly valuable.

it's hard to settle on a career when you haven't seen all the other alternatives and explored the negatives of your chosen path. now, i'm not saying that people that go straight through undergrad to med school don't do this, but being in the "real" world gives you a lot of time to think about this and lose some of your idealized vision of medicine.

i want to help people as much as the next person, but i realize that medicine isn't all sunshine and rainbows.

 

[gujuDoc]

That's true, but a number of physicians will make the same argument that undergrad was a waste of their time. But I'm not going to get into the whole age & medical school debate.

For the most part, people have good motives going into medicine. They want to help people. They want to make a difference. They like interacting with patients, they like the science, they're up for a challenge.

What's not advertised is the debt, sleepless nights, calls, rude patients, insurance, paperwork, malpractice and bureacracy.

huh??? I don't believe I said anything different then you except that I'll be glad I'm not so uber young when I get into things which makes me more practical towards a lot of things.

 

[nellia]

99% graduation rates are always encouraging

yeah but i think there is also an element of fear of quitting. i mean you've done so much to get where you are once you are in medical school. there is a point of no return where i think a lot of medical students feel they are caged into staying in the profession.

 

[gujuDoc]

That's true, but a number of physicians will make the same argument that undergrad was a waste of their time. But I'm not going to get into the whole age & medical school debate.

For the most part, people have good motives going into medicine. They want to help people. They want to make a difference. They like interacting with patients, they like the science, they're up for a challenge.

What's not advertised is the debt, sleepless nights, calls, rude patients, insurance, paperwork, malpractice and bureacracy.

I think you were missing the point of my post. The point of my post, is precisely the opposite. Because I know a lot of medical students, residents, physicians, etc. personally well, what is not advertised to the general public is stuff I've talked extensively with these people about and they've spoken and I've seen firsthand what some of them have gone through and this other side. That's what I meant by I'm glad I won't be 21 and naive. I know the bad side and know that its not all colorful roses. I'm not sure what you were trying to prove to me.

 

[ButImLETired]

Bureaucracy! It's spelled bureaucracy!!!!


-- now the grammar nazi goes back to bed...

 

[sunset823]

These posts in response to the New York Times article written by Dr. Pauline Chen makes for some interesting reading - especially for the gunners on SDN, you should read through all of these to guage your readiness to handle the pressures of med school

http://well.blogs.nytimes.com/2008/10/30/the-misery-of-the-med-student/?apage=1#comments

 

[dr milky]

Bureaucracy! It's spelled bureaucracy!!!!

Thank you...

Congrats on Vandy!

 

[Dr Roboto]

Med school is hard. No doubt about it. Nothing will ever prepare you for med school. Nowhere has anyone ever tried learning so much information in such short time. The best thing that you guys can do for yourselves now is to remember your enthusiasm and motivation for medicine. It will serve you well when you feel like you hit rock bottom.

 

[MilkmanAl]

Enjoying the material will help, but nothing will save you if you feel like you have to put in 10 hours of studying every day. I'm convinced that a big part of succeeding in med school is finding a way to study efficiently. You'll still have to work harder than you ever have before, but you won't find yourself crushed by the work if you can find a way to get all the day's material down in 4-5 hours. It's also very important to let loose occasionally and just plain stop studying. Staying in full-throttle study mode at all times is going to make med school suck a lot. Hang out with friends as much as you can. It'll make life a lot better.

 

[ar2388]

this is quite... im not sure what

http://www.annals.org/cgi/content/abstract/149/5/334

 

[gujuDoc]

Bureaucracy! It's spelled bureaucracy!!!!


-- now the grammar nazi goes back to bed...

Thank you. Sorry I was too lazy to look up the spelling.

 

[Depakote]

I didn't realize I'm supposed to be miserable. I guess I need to do a better job keeping up with the literature.

 

[smq123]

I agree, med school is SUPPOSED to be HARD. Otherwise, anyone could do it, right?! You don't want just anyone taking care of your loved one, you only want the very best.


" I knew that I wanted to become a doctor to help people, but I had given little thought to the process. I was poorly prepared for many things: the pressure to excel in ways that seemed so far from caring for people; rapidly mounting debts I signed off on every semester; a roller coaster existence from chronic lack of sleep; hazing from the more experienced students and residents; and the realities of patient suffering despite my best efforts."

Well, gee weez, Dr. Chen, what the hell did you expect med school to be, CLUB MED?

WHY are med students so quick to dismiss other students who talk about their struggles in med school and residency? Look on SDN. Anyone who talks about how tough medical school was is greeted with a wave of, "Well, I'm an MS-1, and I LOVE MEDICINE MORE THAN EVER!!!!" Whoop-de-freaking-do, what does that prove? Nothing.

Or someone says, "I had a really tough time emotionally in medical school, which I wasn't prepared for," and then 4 other people (invariably including at least 1 pre-med) jump in with, "Well, what did you expect?!? A Club Med vacation?!?! DUH!"

Ugh.

Why med students are so quick to make snap judgements about their fellow students is beyond me.

Sure, some people are whiners. And some people are just venting.

But some people are GENUINELY struggling. I was one of those (a lot of stuff outside of school wasn't going well, and on top of med school....it was very overwhelming a lot of times), and everytime I reached out for help, I was always told that I should be "grateful" that I was one of the fortunate few to make it into medical school. That's not helpful.

We're warned not to make snap judgements about our patients - not all people who come into the ED with severe pain are drug seekers, and not all young men with chest discomfort have cocaine-chest pain. So why do med students make snap judgements about other med students?

Learn how to help your fellow classmates out. Take 30 seconds and check in with someone who looks more tired than usual. Take 5 minutes and listen to someone vent for a bit. And when someone confides in you that, "maybe medical school was a mistake," just offer sympathy and compassion, and NOT advice or instructions or misguided attempts at motivation.

 

[TRN1983]

These posts in response to the New York Times article written by Dr. Pauline Chen makes for some interesting reading - especially for the gunners on SDN, you should read through all of these to guage your readiness to handle the pressures of med school

http://well.blogs.nytimes.com/2008/10/30/the-misery-of-the-med-student/?apage=1#comments

In regards to some of the posts in that blog:

First, I know there are exceptions to everything. But, in general, I often think that people who complain as much as they do about the way they are treated as medical students and as physicians haven't had very extensive job experience prior to going into medicine. Being abused by superiors and by patients/customers is ubiquitous. Hell, if you think you're treated poorly as a health care provider, try being a waiter/waitress.

I actually was shadowing a physician not long ago for a couple of days, and after the experience a nurse approached me and said: "So, (my name goes here), how was that ONE patient?" I was like... "huh?". She then proceeded to say "Oh man, Dr. (name) told me that while you were shadowing him he had one of the worst patient encounters he'd had in a long time". I was like... "huh?" Then I remembered there was one guy who was giving a little lip b/c he said he was in horrible pain and, in his opinion, he keeps getting the run around. I knew it was the same guy b/c he was the only guy of (insert race/ethnicity here) we had in the clinic that day. IMHO the guy was being pretty reasonable if he actually was in that kind of pain--people get irritable when they're in pain, so what? i understand its not the physicians fault and no he didn't deserve to get lip, but I'd get worse treatment than that from pissed off customers who were mad I accidentally double scanned their soda. That's how some people are.

 

[JKBL4]

i think a little bit of apprehension is a good thing, as it suggests you understand the enormity of what you are getting yourself in to. If you are crying your eyes out at the sarah mclaughlin/humane society commercial, things just might be a bit more challenging emotionally

 

[JKBL4]

Sure, some people are whiners. And some people are just venting.

But some people are GENUINELY struggling. I was one of those (a lot of stuff outside of school wasn't going well, and on top of med school....it was very overwhelming a lot of times), and everytime I reached out for help, I was always told that I should be "grateful" that I was one of the fortunate few to make it into medical school. That's not helpful.

We're warned not to make snap judgements about our patients - not all people who come into the ED with severe pain are drug seekers, and not all young men with chest discomfort have cocaine-chest pain. So why do med students make snap judgements about other med students?

Learn how to help your fellow classmates out. Take 30 seconds and check in with someone who looks more tired than usual. Take 5 minutes and listen to someone vent for a bit. And when someone confides in you that, "maybe medical school was a mistake," just offer sympathy and compassion, and NOT advice or instructions or misguided attempts at motivation.

awesome point

 

[Caesar]

There WERE two threads about this, and now there is one.

(Merging...)

 

[PeepshowJohnny]

I personally find Dr Chen's writing depressing and melodramatic. As one who has been successful in a very competitive field, I can tell you, unequivocally, that watering things down is never good. As a patient, I NEVER want to see my doctor cry. In my experience, emotional intrusions rarely improve performance, and in Dr Chen's book, even, her attacks of empathy seemed merely to impede.

X 100.

Medicine is emotionally and physically grueling in the real world. Med school is painful for a reason. And this is coming from somebody who thinks hazing and initiation stuff is B.S. and hates attendings who complain residents have it "easy" now with the 80 hour work week.