Open letter to new medical students in 2014

[NontradCA]

I'm not talking about only workplace behavior. Very few specialties in Medicine have a clock-in, clock-out behavior mentality - that's part of professionalism - staying longer without being asked. You'll get a whole lecture about medicine being not being "just a job" when you start.

Heard it 100 times in orientation alone. Actually, the OPs entire blogpost read like a-z speaker at orientation. I bet he's in academics, or headed that way.

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[tantacles]

I'm not talking about only workplace behavior. Very few specialties in Medicine have a clock-in, clock-out behavior mentality - that's part of professionalism - staying longer without being asked. You'll get a whole lecture about medicine being not being "just a job" when you start.

I don't think cynicism means not doing your job. And medicine is, in fact, just a job. It just happens to be a job that calls for more from you than other fields. The expectations are high.

Except for many people cynicism and being caustic is more destructive esp. in med education when you go thru premed --> med school --> residency, etc. where it feels like it never ends.

I'm Jewish; cynicism isn't destructive for Jews. We spent 40 years wandering the desert so that we could be this way.

Why do you think physician suicide rate is so high?

Myriad reasons. I don't see a compelling reason to believe cynicism is one of them. Depression? Sure. But not cynicism.

 

[DermViser]

I don't think cynicism means not doing your job. And medicine is, in fact, just a job. It just happens to be a job that calls for more from you than other fields. The expectations are high.



I'm Jewish; cynicism isn't destructive for Jews. We spent 40 years wandering the desert so that we could be this way.



Myriad reasons. I don't see a compelling reason to believe cynicism is one of them. Depression? Sure. But not cynicism.

What does being Jewish have anything to do with cynicism? Not seeing the correlation.

Constant cynicism can very well lead to depression. It's rampant in EM docs.

 

[DermViser]

Heard it 100 times in orientation alone. Actually, the OPs entire blogpost read like a-z speaker at orientation. I bet he's in academics, or headed that way.

That's just the beginning you'll hear it all thru medical school, residency (at the same time you're getting kicked down), attending (when you'll be offering some of your medical services unpaid), etc. I believe the OP works in a private hospital. I don't know what you're getting from him, but I think the only thing he's conveying is that he enjoys his work tremendously due to the relationships he builds with his patients. Sorry, you seem to be reading more into it, than what's there.

 

[tantacles]

What does being Jewish have anything to do with cynicism. Not seeing the correlation.

In the old country, we all sang the same songs, read the same books, spoke in the old language. Oy, these youths. Oy, my back.

Constant cynicism can very well lead to depression. It's rampant in EM docs.

Meh. I'd need an elaborate study better defining the construct of cynicism and correlating it with major depressive disorder to entertain cynicism as a cause of depression. Now, perhaps a change from complete naivete to reality might cause depression, but again, not something I can effectively debate at this point. In any case, I don't see any compelling reason to believe that a cynical baseline should lead to depression.

 

[sinombre]

Heard it 100 times in orientation alone. Actually, the OPs entire blogpost read like a-z speaker at orientation. I bet he's in academics, or headed that way.

Myriad reasons. I don't see a compelling reason to believe cynicism is one of them. Depression? Sure. But not cynicism.

Yes, cynicism is one way to cope with getting through medical school. Drugs and alcohol are also coping mechanisms. I think it's fairly obvious that not all coping mechanisms are good and/or healthy.

It benefits everyone going through this process to find positive ways to deal with stress. Being unnecessarily negative will not benefit anyone.

 

[tantacles]

Yes, cynicism is one way to cope with getting through medical school. Drugs and alcohol are also coping mechanisms. I think it's fairly obvious that not all coping mechanisms are good and/or healthy.

It benefits everyone going through this process to find positive ways to deal with stress. Being unnecessarily negative will not benefit anyone.

Actually, my affect and attitude are quite positive. However, I understand that people who complain of pain don't always have it, that a stray bullet can cost you $50,000 if you're the one hit by it, and that physicians sometimes cut corners in ways that are detrimental to their patients. Being cynical isn't necessarily an emotional coping mechanism; it can also be a way of trying to acknowledge and fix issues that a less observant individual might overlook.

Edit: And not to belabor the point too much, but I actually think it's IMPORTANT to be somewhat cynical in medicine. Are we to believe that there are no physicians who write prescriptions for opiates for their patients for a fee so those patients can resell them illegally? Are we to believe that hospitals never overbill? Skepticism is an important part of evaluating medical care.

 

[NontradCA]

Yes, cynicism is one way to cope with getting through medical school. Drugs and alcohol are also coping mechanisms. I think it's fairly obvious that not all coping mechanisms are good and/or healthy.

It benefits everyone going through this process to find positive ways to deal with stress. Being unnecessarily negative will not benefit anyone.

I'd argue that cynicism can be a good approach to gaining knowledge. It leads to questions, self doubt and challenging the information at hand. Isn't that good medical education, and for driving change in medicine? It's one thing to be a skeptic, and another to be jaded. The skeptic is necessary to invoke thought.

Jaded goes along with the saying about doctors. They don't like the way things are, and they don't like change. Like @DermViser for instance .

 

[DermViser]

I'd argue that cynicism can be a good approach to gaining knowledge. It leads to questions, self doubt and challenging the information at hand. Isn't that good medical education, and for driving change in medicine? It's one thing to be a skeptic, and another to be jaded. The skeptic is necessary to invoke thought.

Jaded goes along with the saying about doctors. They don't like the way things are, and they don't like change. Like @DermViser for instance .

Don't know what I'm "jaded" about, but I guess the eye is in the beholder. Good luck to you and your cynicism - leading to questions and challenging the information at hand. Be sure to do it on your MS-3 clerkships.

 

[tantacles]

Don't know what I'm "jaded" about, but I guess the eye is in the beholder. Good luck to you and your cynicism - leading to questions and challenging the information at hand. Be sure to do it on your MS-3 clerkships.

Don't mistake skepticism with being an obnoxious dingus; when in the eyes of an authority figure, we tow the line. Complacency should never be your end game. As a physician, I'm certain you know that better than anyone.

 

[NontradCA]

Don't know what I'm "jaded" about, but I guess the eye is in the beholder. Good luck to you and your cynicism - leading to questions and challenging the information at hand. Be sure to do it on your MS-3 clerkships.

That's what a naive person would do...oh well. Let's just agree to disagree. Thanks for the talk.

 

[EsotericAlchemy]

skeptical is not the same as cynical

 

[tantacles]

skeptical is not the same as cynical

They're almost synonyms. In fact, the word skeptical appears in the definition for cynical.

 

[cs24]

A thread where Dermviser, of all people, is telling everyone else to be more positive?? Now I've seen it all.

 

[DermViser]

A thread where Dermviser, of all people, is telling everyone else to be more positive?? Now I've seen it all.

When have I told people to start off med school with a negative attitude?

 

[DoctorSammyU]

I can say at times I too was cynical during medical school, my mom started calling me Cynical Sam. I sometimes get that way now. What I mean about living and breathing medicine is not that its my whole life, but its a vocation in a way. Jon Leo, PhD, who taught Neuroanatomy to us told us during our first week of med school "you need to be obsessed with this" and to "keep a note pad next to our beds". I thought it was crazy. But, I found that studying the cranial nerves that I would sometimes wake up in the middle of the night thinking about this stuff, worrying about exams, etc. I did keep a note pad next to my night stand but didnt use it much.

Now, at this phase in my life, when I say "breathing" medicine, here is an example. I was at a pool on Friday. I heard a mother say to a lifeguard, "someone jumped on top of my son (Who looked like he was 7 or 8) in the pool, check him for a concussion". Obviously I had witnessed the entire incident occur, but I didnt spring to my feet to offer assistance. But I sat there and lost focus on the book I was reading because I thought about a concussion patient I treated earlier this week and wondered how he was.

And there are many times when I go grocery shopping, I have to do it late at night - I always run into chatty patients. My wife and I joke about it. When I say "Zofran" thats our secret word and I walk away and hide Usually, these situations can be avoided by wearing a baseball hat backwards and dressing like a college kid - no one recognizes you.

Anyway, enjoy your time in med school!