Rationalizing the throes of Medical Education?

[prokofiev]

I apologize in advance if this thread itself comes across as cynical or pretentious, I am not trying to disparage anyone's ambition or work-ethic. Here's some of the questions that I have:

We've all seen this before:

60% of Doctors Would Retire Now If They Could

"Yet despite this apparent increased demand for their services, 77.4% of physicians are “very pessimistic” about the future of medicine and 84% believe the medical profession is “in decline.” 57.9% would not recommend medicine to their children. Over a third wouldn't choose to go to medical school again. 82% of physicians believe they have little ability to change the healthcare system. 92% of physicians are unsure how they will fit into the medical system in 3-5 years. Surprisingly, practice owners and specialists are more pessimistic than employees and primary care docs."

Or posts like these, that echo the frustrations of the Medical Education:


How can anyone can still retain optimism despite being completely in the dark about the actual work of a resident/physician, where every inquiry towards a day in their lives is, more often than not, so deeply entrenched in cynicism/regret?

Don't get me wrong, shadowing/clinical work is a step in the right direction to get that perspective, but it's much easier to observe a bypass surgery than it is being the surgeon doing his 3rd procedure that day.

I've gone through discord servers, sdn, premed reddit, searching for these questions and to be frank, these comments in these sorts of posts are abounded with fallacies.
a. Sunk Cost Fallacy - "Yeah I realized this halfway through undergrad, but it's too late to turn back now"
b. Relative Privation - "Other careers have people complaining in them too"
c. Special Pleading - "Yeah the process is completely awful, but I am passionate (drawing themselves as the exception)".

Again, this is an honorable career and I respect everyone willing to work through it, regardless of what stage they're at but I have been pre-med and these sorts of questions have been an immense distraction from fully committing myself to this route. I still love the idea of medicine, I thoroughly enjoyed working at a clinic, but I don't know if I am being good to my self by going down this path based on everything I've read on these types of forums. Please post your thoughts. Thank you.

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[a_distant_dream]

There are many premeds with good reasons for going into medicine. Of the physicians I’ve shadowed, all of love the actual practice of medicine, with the most negative disliking all the administrative work attached but still loving the patient care / research.

 

[Goro]

My clinical colleagues love their jobs

 

[LunaOri]

I love being a physician!

 

[Med Ed]

We've all seen this before: 60% of Doctors Would Retire Now If They Could

What percentage of non-physicians would retire now if they could?

 

[futureapppsy2]

What percentage of non-physicians would retire now if they could?

This. Every job is exhausting. That's why it's, well, work.

 

[prokofiev]

I have edited the post, the title of that website does not reference the information that I wanted to reference. But this question is too philosophical, rather I am interested in the following-

If you could do medicine all over again knowing what you know now, would you do it? With all of the cynicism on Reddit and SDN, what really is a good answer to “Why Medicine”?

 

[Med Ed]

I have edited the post, the title of that website does not reference the information that I wanted to reference. But this question is too philosophical, rather I am interested in the following-

If you could do medicine all over again knowing what you know now, would you do it? With all of the cynicism on Reddit and SDN, what really is a good answer to “Why Medicine”?

I would do it again in a heartbeat. But it turns out that I'm the sort of person who likes this stuff.

There has always been a subculture of dissatisfaction in medicine. When I was a trainee there were a few very loud people who couldn't seem to get jaded fast enough. But their experience is not my experience, and I don't see why their opinions should influence my own journey.

A lot of this might go away if everyone spent two years digging ditches before starting medical school. It's easier to be satisfied with your life once you understand that the world doesn't owe you a single damned thing.

 

[Mr.Smile12]

I can pitch Becoming a Student Doctor again, so join the class. It tries to give you a more realistic perspective of what medical education and training are going to focus on for anyone pursuing a health professional career (any of the professions we support here on these forums, plus physician assistants). Using a lot of journalistic sources, one hears about the current state of healthcare as a system, and hopefully one understands better why having a passion for serving others in a health professional role is exciting and frustrating. The reddit post and most of us in prehealth recruitment and advising focus so much on why the career helps you that many applicants don't look for "the grind" that weathers one's idealism. It's great that science can "cure" anything, but you need people to also make a substantive effect on community health outcomes.

I don't try to give you rose-colored glasses, but short of a mandatory two-year service experience or military service requirement, this is a summary of how your passion can make you more competent as a leader and a healthcare provider. You aren't going to fix healthcare overnight... but maybe steady advocacy over 20 years...

 

[gyngyn]

If you could do medicine all over again knowing what you know now, would you do it?

Absolutely.
I have lived an amazing life because of this career. I have traveled the world and touched the lives of thousands of women (and men!). I am a part of the origin story for at least thousand and even if they never know me as adults, I am forever a signature on their birth certificate. I have seen life, death and everything in between.
The rich tapestry of my time on earth is largely due to my role as a physician. My colleagues are among the brightest, kindest and happiest of people. My residents are amazing and my students are adorable (mostly).

 

[Moko]

To offer a different opinion, I find medicine to be a mixed bag like any other profession. While I am glad to be a physician on most days, there are also many days when I am just exhausted and burned out from the high census, acuity of my patients, administrative burdens, and random BS. I'd like to think that I'm a fairly empathetic (albeit cynical) person and don't mind spending additional time to help my patients, but I've learned to set boundaries for my own physical and mental health.

I probably would still choose medicine again, but if finances were not an issue, I would give notice to my current job (really any job!) in a heartbeat, travel extensively, be a slouch, and just volunteer every now and then in roles that bring me joy (precepting, working with residents, medical students, being at the animal shelter, etc.). I recognize that no job is perfect, and the grass often appears greener on the other side, but medicine is much more stressful and demanding than many other careers, so people should have an honest evaluation of their strengths and priorities prior to committing to medicine. This stress, coupled with the reduced rewards for being a physician, amps up the dissatisfaction and burnout seen in our profession. Just my thoughts.

 

[CyrilFiggis]

This is why I constantly advocate that pre-meds take purposeful gap years. Not gap years specifically for making their resume better, but honest time off. Why do many residents and new physicians experience buyers remorse? They spent 8+ years going crazy to become a doctor and then hit residency which is all-consuming (and rightly so) and come out 15 years having missed a substantial portion of their 20s in a career field that is not as altruistic or satisfying as the motivation that initially drew them to medicine.

I come from the perspective of having had a career for 10 years before going to medical school. There’s no greener pasture, just a different type of grass. I worked with plenty of successful miserable people. That’s the world. The problem is that physicians who go right through don’t truly understand what it’s like to have a career until they’ve hit 30.

 

[barrelgrubber321]

The problem is that physicians who go right through don’t truly understand what it’s like to have a career until they’ve hit 30.

For clarification and curiosity; do you feel that there is a difference between a career and a job, and that students should engage in career type roles during their gap year instead of jobs? I'm completely on-board with the idea of purposeful gap years but I'm skeptical of the practicality of it.

(I currently feel like I'm wasting my gap year but I felt handcuffed to/by my application)

 

[GoSpursGo]

What percentage of non-physicians would retire now if they could?

To be even more specific, what percentage of non-physicians over age 50 would retire if they could? 65% of the respondents to that survey (which overall had a 2.2% response rate) were over the age of 50, so that more or less tracks with a comparable/slightly lower percentage longing for retirement.

Every field has plusses and minuses, and nobody is happy all of the time. The goal is to find a field where the pluses generally outweigh the minuses, and the minuses are tolerable rather than dealbreakers. Medicine fits that description for many people, and does not for many others.

 

[CyrilFiggis]

For clarification and curiosity; do you feel that there is a difference between a career and a job, and that students should engage in career type roles during their gap year instead of jobs? I'm completely on-board with the idea of purposeful gap years but I'm skeptical of the practicality of it.

(I currently feel like I'm wasting my gap year but I felt handcuffed to/by my application)

I think the thought behind your question is framed exactly why people burn out. You’re allowed to “waste” a year. An AdCom is not going to look at a gap year that shows you worked at Panera as a bad thing. If an essay or interviewer asks, it’s not wrong to say you took the time to explore/pursue non-medical hobbies, travel, spend time with family, etc. They want to see well rounded and thoughtful people.

 

[barrelgrubber321]

I think the thought behind your question is framed exactly why people burn out. You’re allowed to “waste” a year. An AdCom is not going to look at a gap year that shows you worked at Panera as a bad thing. If an essay or interviewer asks, it’s not wrong to say you took the time to explore/pursue non-medical hobbies, travel, spend time with family, etc. They want to see well rounded and thoughtful people.

I would hope that is true but isn't that under the assumption that one's application has little room for improvement or risk for re-application? I felt that I had to take a particular job to increase hours in a certain area of my application that could have been better and should I need to re-apply again, I can show improvement in an area that I assume is more attractive on an application than bartending.

Given that there will always be an applicant with more hours than you and there is no cap on EC hours yet, won't applicants always choose the path they feel forced to go down, to build their application in areas they feel are more closely linked to what AdComm's appear to want rather than what they want?

I really didn't want to take the job I have and it certainly doesn't feel purposeful, I wanted to take time to explore a path I left behind to pursue medicine but I couldn't help but feel like spending time not helping my application was effectively hurting it. I would be relieved to hear that I am wrong, that would be a great sense of liberation and I would turn in my 2 weeks in a hurry!

 

[Goro]

Given that there will always be an applicant with more hours than you and there is no cap on EC hours yet, won't applicants always choose the path they feel forced to go down, to build their application in areas they feel are more closely linked to what AdComm's appear to want rather than what they want?

How do you know that the bolded is true?

Even it is true, how do you know those applicants will be applying to the schools you want to apply to?

You can't look at applying to medical school with a single metric. Adcoms don't look at those, they look at the entire app. It's the entire app that counts

 

[barrelgrubber321]

I suppose that's true, I have just never aimed to be the biggest fish in the pond

regardless, would adcom's not prefer to see improvement in areas like clinical hours, volunteer work, research involvement?
(I can understand volunteer hours being a separate category here, considering they should be personally motivated)
but I can't imagine many applicants that aren't focused on gaining every competitive advantage they can to differentiate themselves given the nature of the admissions game

I assume this is an aspect of the application that applicants cling very tightly to because it is the only aspect left in control after graduating, for the most part

 

[CyrilFiggis]

Reapplying and applying are two different things. If a program told you those were weaknesses, then of course address them. My initial comment was specifically for any undergrad looking to become a doctor.

Statistically, less than half of first time applicants get in. Statistically, the majority of admitted applicants have fairly similar applications. Everyone focuses on ECs, GPA, MCAT, etc. But that’s not everything. When I was on our admission committee the things that stood out were the interesting aspects of who they were as a human. Sure some people were extremely successful academically or did something profoundly cool philanthropically/scientifically, but that’s few and far between.

Everyone races to have the “best” application to get in. But there’s at least 7 years that come after that before you are an independent physician. And those 7 years include less autonomy and more stress. Why not give yourself one year of your own life to have some fun?

 

[Goro]

regardless, would adcom's not prefer to see improvement in areas like clinical hours, volunteer work, research involvement?

We do.

(I can understand volunteer hours being a separate category here, considering they should be personally motivated)
but I can't imagine many applicants that aren't focused on gaining every competitive advantage they can to differentiate themselves given the nature of the admissions game

Don't underestimate how many people are ignorant of this process.

 

[Mr.Smile12]

Don't underestimate how many people are ignorant of this process.

Agreeing but modifying: it's not that many to me are ignorant (but that's sampling bias), but rather so many want a "cheat code."

 

[Sunon]

For some people medicine may be the best choice. Maybe they have a passion for healthcare that outweighs the negatives. Medicine is certainly fascinating and there are moments when you can truly help people. Either way, you have to examine what compromises and priorities you have in life. Best of luck to everyone making these decisions and good luck in your careers, whatever you decide!

 

[RangerBob]

My advice to anyone looking into a career is to go into something you enjoy and can be “content” in. Not to be confused for settling—I mean something that brings you a steady state of satisfaction.

Passion fades for the majority of us once things become routine—and most jobs do become routine. Even being an astronaut. The excitement of traveling for a job fades for most once they have a family. So spend your youth chasing those exciting jobs/changing things up (when we’re the most free to do that) and keep an eye out for which of those you can be happily content with for 20-30 years.

The initial excitement of my job has faded and I am now very happily content at my job. I never dread going to work. I feel that what I do matters, and I enjoy the people I work with. I don’t watch the clock. I never sit staring blankly at a wall and wonder “why am I doing this job.” But I’m not a slave—sometimes I work a little quicker to get home earlier to see my family or spend time in my garden (my biggest hobby along with photography).