Third Year Cynicism?

[Brizil]

I'm thinking about applying to medical school, but I only want to become a doctor so I can work with people who actually need help. I'd like to do some kind of public health program... I'm wondering if anyone here has gone to a medical school that ENCOURAGES this kind of attitude. I've heard a lot about third-year cynicism and I don't want to be in an environment like the one described here... where the first contact with a patient is to inquire whether or not she has insurance. http://upalumni.org/medschool/

Perhaps I am too idealistic, but Paul Farmer is doing stuff like what I'm interested in, and I'd like to know which medical schools are supportive of that kind of work. I'm really interested in the political application of health care and inequity in its distribution, as well as medical ethics of a more essential kind (i.e. a caring patient-doctor relationship). What have your experiences at medical school been? Do you think your school would encourage or discourage this attitude towards the medical profession?

Thanks so much for your replies! I'd love to hear about your experiences in this area (especially the financial implications of medschool debt to this direction?)

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[Mumpu]

Yes, you are being idealistic. Every healthcare system in the world has it's share of abusers -- you put up with them because you make the difference for everyone else. Med school does not encourage or discourage anything -- everyone goes through the same curriculum. A good deal of 3rd year cynicism comes from people who had never seen a patient until 3rd year of med school. Most folks with previous experience know what to expect and they take the bad with the good.

Have you looked into masters of public health programs? If you don't want to do hands-on medicine, med school may be the long and expensive way to go for you.

 

[quideam]

An MPH really does sound like it would be up your alley. Check out the Hopkins and Harvard programs (Yale too, I believe) - they have really good international health programs.

As an aside - Farmer's work is amazing, and inspiring, but don't think he doesn't deal with a ton of BS (from both patients and the healthcare system itself, whether here or abroad). Keep in mind that any sort of public health / international medicine work comes with a ton of red tape and the like.

Quid

 

[zion]

it is not that schools' curricula contains elements that make students cynics, rather you grow up as you go through med school and start dealing with ppl. you realize that there are ppl that truly needed your help and there are those that are out to screw the system (fortunately the later category is a small number).

but, again, you are being naive in being too idealistic, at least in uor perception of the us healthcare system. perhaps try cuba?

 

[pillowhead]

I'm thinking about applying to medical school, but I only want to become a doctor so I can work with people who actually need help. I'd like to do some kind of public health program... I'm wondering if anyone here has gone to a medical school that ENCOURAGES this kind of attitude. I've heard a lot about third-year cynicism and I don't want to be in an environment like the one described here... where the first contact with a patient is to inquire whether or not she has insurance. http://upalumni.org/medschool/

Perhaps I am too idealistic, but Paul Farmer is doing stuff like what I'm interested in, and I'd like to know which medical schools are supportive of that kind of work. I'm really interested in the political application of health care and inequity in its distribution, as well as medical ethics of a more essential kind (i.e. a caring patient-doctor relationship). What have your experiences at medical school been? Do you think your school would encourage or discourage this attitude towards the medical profession?

Thanks so much for your replies! I'd love to hear about your experiences in this area (especially the financial implications of medschool debt to this direction?)

You might want to do a search on the SDN forums about the guy who wrote that book he's promoting on his website. (I'm referring to the link you had in your post.) The general consensus is that this guy is totally off, and you should take what he says with a big heaping cup of salt.

I'm not saying there aren't problems in medicine because obviously there are, but to some extent, you have to put the idealism aside to get through the day and do your job. It is a fine balance between having enough idealism to make you a good person and keep you from being a jerk, but too much idealism and trying to be compassionate 24/7 with some patients will make you a very unhappy and frustrated physician. Look into public health programs--I'm not saying MD isn't for you--perhaps you could do both. But I would definitely do some more research.

To answer your question more directly, I think all medical schools will tell you that they try encourage that sort of attitude. It just kind of gets lost when you get caught up in the day to day work. I can't believe any medical school teaches its students to start off the patient-doctor relationship by asking if the patient has insurance. Perhaps a cynical resident or attending here and there has said that, but that attitude is absolutely not the norm.

 

[idq1i]

http://upalumni.org/medschool/

I actually read through most of the stuff that you now cite. The author is/was in desperate need of SNRIs. High dose.

Furthermore, he picked the wrong profession. There is no need to blame his choice on the "establishment".

Please don't base your career choice on the tirade of a disgruntled socialist.

 

[Adcadet]

An MPH doesn't automatically let you "work with those who need help" any more or less than an MD does. But public health is often focused on serving the disadvantaged. If you don't want as much hands-on stuff an MPH is fine. If you want to be the one diagnosing, treating, etc, than an MD (or DO) is required.

If you really want to change the world for the better by understanding health and disease, and want to work on a population-basis, an MD + MPH combo might be a good start.