I always appreciate your iconoclastic perspective on this strange system we're giving our lives to. I looked up systems based practice, and I'm still not totally sure what you're telling us though. Care to clarify?
Thanks! I was hoping to leave this a bit more open-ended so people could reflect, but I'll explain where I'm coming from.
I was talking to one of the medical students today and he told me that he used to be a scribe. We discussed this for some time and I began to think about systems-based practice in medicine, and how there is a huge disconnect between pre-meds and physicians.
Every day there are multiple threads on ECs and employment. These are two big factors that people have complete control over, where they can do as much or as little as they like. Before medical school, I worked as a pizza delivery guy in high school, majored in economics with hopes of getting into investment banking, and revenue management at two different airlines. If I came up to an investment banker and told them that they absolutely need to be an executive assistant before becoming an investment banker, then I would be laughed at. If I came up to a pilot and told them they needed to be a flight attendant or baggage handler before becoming a pilot, then I would be laughed at. So, why are pre-meds trying to tell physicians what they need to do before becoming a physician. I'm not trying to sound condescending or to be an ass.
Here's where my examples come into play:
1. As an internal medicine resident, I want you to tell me why I do not need to feed the patient?
This is done by the CNA.
Bathe the patient?
This is done by the CNA.
Clean up the patient?
This is done by the CNA.
Administer the patient's medications?
This is done by the nurse unless you're an anesthesiologist.
Why am I able to take my time jotting down labs and taking a leisurely stroll to the emergency department when there in a new admit?
The emergency medicine physicians and staff have the responsibility of stabilizing the patient and ruling out a life-threatening emergency. Once the patient leaves the emergency department, their job is done (unless it's the doctors on Chicago Med). Initial stabilization and rule out of conditions that will kill the patient are not my responsibility, they are the responsibility of the ED staff. And on the contrary, further treatment and interventions of the patient beyond the ED doors are not their responsibility.
It seems weird to write this, because it's hard to not come off as an ass looking like you're trying to pass off work to others. But everyone in the hospital has their place, from janitors to volunteers to techs to nurses to doctors to administrators. Everyone has their job duties, and performing them helps keep the complex system working efficiently. I'm not going to start littering trash all over the hospital because that's rude, but I'm not going to pick up a dust pan and broom and spend hours cleaning the rooms while I'm supposed to write notes and orders for the patient. The same thing with an investment banker, they aren't going to wipe down the bathrooms or sell coffee in-between projects. The same thing with a pilot, they are not going to be serving passengers food or loading/unloading luggage. Everyone has their place.
And this is what pre-meds are losing sight of. They are going off an doing every which thing in an ultra-competitive process. There are countless threads about jobs and ECs. People would start to get annoyed and call me a broken record if I keep trying to have philosophical discussions in every single thread. Plus, there is a repeating pattern with these threads. These are often new accounts with few posts, and then they drop off. Unfortunately this tends to be people getting burned in the pre-med process, and the results can be catastrophic.
So before pre-meds make these choices, they should take the time to self-reflect and see what their ultimate goals are...
Are you trying to be a chief scribe at Scribe America?
Scribing is like teaching a 15 year old that just got their learner's permit how to drift the car. 4th year medical students and even some residents still have trouble with H&Ps. Medical school starts you at step 0, you will not be at a disadvantage if you don't do this.
Are you trying to be the next Mother Teresa and then treat other pre-meds in a condescending way?
If you need to go on SDN and ask what volunteer gig is better, then it means you wouldn't have done it in the first place. You don't see me going on a forum asking if getting Mexican food for dinner or using a Canon SLR versus a Nikon will negatively affect my chances for a fellowship? You do the things you're passionate about naturally without even thinking about it. That's okay. Don't get wrapped up thinking that you're an ass if you have less than 100 volunteer hours. Plus, when is the last time you ever heard a pre-med ask about how they can help more people? Everyone is always asking about how to help themselves, and that's totally fine.
What about a CNA? You get hands-on experience, right?
You're performing patient care duties that physicians do not do. Not because physicians are mean and don't like doing work, but because in the systems-based practice environment, physicians are looking at the history, physical exam findings, and labs that help them create a treatment plan for the patient. Therefore, while you'll see patients and do finger sticks and clean their poop, you won't be analyzing all of the aforementioned things like a physician would. I got a lot of interaction with people by doing photography on the side, but you don't see me telling people that they need to become professional photographers in order to become physicians.
Long story short. I came here to help people. It's a gratifying feeling. I don't only want to help patients, but I want to help pre-meds. I want them to make the best possible choices in this incredibly unforgiving process so they don't get burned.
Sorry, I got carried away there... tl;dr
1. Just because you don't enjoy volunteering doesn't mean that you're not a good person.
2. You are not required to be a scribe, EMT, CNA, or any other entry-level clinical job to be successful in medical school. Just try to be a good person, follow the Golden Rule, and you'll be okay since you start at step zero.
3. Just because you don't enjoy Gross Anatomy doesn't mean you can't become a surgeon.
4. Labradoodles are one of the greatest inventions of all time.