What do you wish you had known?

[CRAZYTERP]

Alright, so this afternoon I went back to my undergrad institution (UMD in case anyone is wondering) to speak to prospective students. These were all HS kids who wanted to know more about the life of a pre-med/pre-dent and what to expect in their four years. Now part of me was like, this is cool, I wish I had someone tell me what I was in for before I started, but then I started to listen to the other members of the panel. It seemed as though many of my fellow premeds were trying to scare others. I realize there are harsh realities involved with going into medicine (ie prereqs SUCH AS orgo, MCATS, volunteering, etc) but do you think it is a little overwhelming to learn all at once? I dunno, when I spoke I tried to get across to them that they must also enjoy college and have a life. I felt almost ashamed when everyone else spoke about grades and MCATS, bc I did not mention them as much.

Anyhoo, I am now over it, but wanted to ask if anyone else would any other info such as what you wished you had known prior to entering this profession we call medicine?

For starters, I wish I had known taking the MCATS was so much fun I would do it twice! (like the majority of peeps)

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[Whisker Barrel Cortex]

I wish I had known how truly terrible and draining residency is. Even though I had heard all of the horror stories of 100 hour weeks and had a sister in med school, it really doesn't hit you until your first call as an intern how bad it can be. Even if you truly love medicine, residency has the power to make you a bitter person. It won't even matter if hours are limited to 80 / week. It not just the hours, its a whole lot more. I'd advise all premeds to truly think about their decision and realize what they are truly getting into.

Sorry to be so negative. Medicine, once you get out of residency is truly a rewarding career. If, however, you expect the satisfaction of "healing" people during residency, you will most likely be disappointed.

 

[agent]

views as "radiology resident year 1".. says it all.

 

[The Hulk]

I second agent's point. I work in a radiation department and I have heard multiple times how 1st or 2nd year residents wished they had chosen a field where they actually physically touch the patients once in a while... I don't think they have that complaint in family practice residencies, but then again, familiy practice Dr.'s don't make what radiologists do... I guess we all make choices...

 

[agent]

Originally posted by The Hulk
I guess we all make choices...

yup.

i dont know what kind of choices ill make yet.. but whatever i do I know i'll have to live with them.

 

[Whisker Barrel Cortex]

Ahhh, you picked up on the fact that I am going into radiology. The call I mention in my post is internal medicine call, where I get to see patients. All radiology residents must do a year of clinical internship before they begin radiology.

All of my friends here are categorical internal medicine interns (which means they will be going into internal medicine) and they all feel the exact same way. Its funny that you heard radiology residents say they wish they'd gone into clinical medicine. Many of the internal medicine and surgery residents I know have contemplated trying to switch into radiology.

I'll let you guys keep your idealism until you are in internship. The patient care is extemely unsatisfying during a ward medicn month. Not because I don't like people, I actually love working with patients. Its because you are so overworked that you CANNOT interact with your patients and care for them in they way they deserve to be cared for.

I started my inpatient ward month this Monday. Went hope at 9pm. Was on call Tuesday, didn't sleep, when home at 7 pm on Wednesday. Then, on Thursday, I left around 9 pm. Out of all that time I had maybe 5-10 minutes to spend with each of the 12 patients (6-7 of which are VERY sick) I am expected to care for. During my bitch session with 3 other interns last night, they expressed the exact same views.

So keep your idealism while you can. Trust me, it will disappear.

 

[agent]

well as far as I understand, most of the patient care is meant to be done by the nurses.

i guess if you wanted to focus more on patient care maybe you should have looked into nursing.

i know that sounds really jerky, but im trying to have a realistic view of what im getting myself into.

Feel free to set a pre-med straight as I'm sure you will not be the last

 

[Whisker Barrel Cortex]

Hey agent,

I am trying to give you a realistic view of what you are getting into but you insist on just hurling uneducated insults. I think the problem is that you don't really want a realistic view. You want your views confirmed.

It is really hard to explain to a premed or even med students the frustrations of residency. I tried, but get insulted instead. Oh well, you will see for yourself in a few years if you get in.

Again, I reiterate, medicine and all its specialties, once out of resdiency has the potential to be a very rewarding career. While in residency, it is not.

 

[agent]

the nursing comment wasnt meant as an insult.

I will see you in a few years

 

[The Hulk]

Whisker,

I respect the fact that you are trying to give us a look from the inside and that you are trying to make the point that residencies suck. Ok. Maybe your experience is the norm or maybe its an abberration. I just think that your experience has more to do with which residency you sought and where you sought to do it than the fact that you are a resident. That was my main point. The radiology residents I work with don't have as horrible hours as you do (they must be past your rotation). And they seem to have considerably more time for each case than you do. Either way, I respect your attempts to give us your view from the inside.

One question though... if your on call for about 48 hours out of a 3-day period, what exactly are you doing the whole time if you only get to spend 1 hour in total with your patients? I'm not being sarcastic, I'm just curious. Doing rounds with attendings?

TH

 

[cdreed]

Hi all. I'm a med tech in the military. We basically function as nurses within the hospital confines. But to my point, since i have been in my current job, i have seen three new sets of residents in a variety of specialties (ie urology, general surgery, ob/gyn, vascular, cardiothoracic, etc) come into the hospital setting. My unit is an ambulatory surgical procedure ward. in all three instances, the interns and residents suffer. and it never really is about the type of residency they chose to pursue. residency is meant to be an indoctrination into the medical arena. the hours are grueling. the lack of respect is unbelievable. and the amount of mundane chores overwhelms. yes, nurses are more in tune with patient care. but how can a physician treat a patient if he's never with that patient? and more importantly, how can a physician feel justified in asking a nurse to perform a task that he cannot do (like foley's, venipuncture and abg's)? god forbid that anything serious occur to a critical patient that a doctor could not attend to if no nurses were in the area to support him.

 

[Whisker Barrel Cortex]

The Hulk,

A couple of points.

First, radiology residency is a lot better than what I am doing now which is a year of clinical internal medicine PRIOR to beginning radiology. Every rads resident is required to do this year. I only get three month of radiology this year, the rest is general medicine. Once I start my radiology residency in August I am sure I will be infinitely happier. All of the radiology residents I know love their job, even with its occasional frustrations. It is the internal medicine, general surgery, OB/GYN, etc residents that are bitter much of the time.

The second point is about what the rest of the time is spent doing. This is part of the frustration. Part of the time is spent discussing the patients, which is educational and well worth it. The majority of the time is spent doing paperwork (daily notes on each patient outlining symptoms, physical findings, assessment of conditions, and plan), writing orders, getting calls from nurses on a multitude of issues, tracking down consults, tracking down radiologic studies, many other minor tasks which can often be VERY frustrating (try tracking down an ortho resident for example, they never answer their pages).

 

[The Hulk]

Whisker Barrel,

As to your first point, I can only say that we have had different circumstances (althouh given the fact that you are a resident and I am only working with them I can see why your point of view should be given considerable merit).

As to your second point, maybe its just me, but I see the paperwork and the discussion as part of the learning process, and I think the amount of time that takes decreases over your residency as you get more efficient and doing paperwork and spend less time checking your work with the attending. As to the other issues you brought up, they are completely valid points, but I have to say only some of those are commonplace; I think some of those problems are due more to issues related to your particular hospital than issues every resident in every hospital encounters.

 

[woolie]

Hey Whisker, I support you man. I definitely understand the reality of just what kind of hell it is as a resident and why people become so bitter and frustrated. I used to wonder: why are these dr.s and residents so "nasty" (how naive I was) and the truth is just as you describe.

I think your comments are wise and thoughtful and you seem to have a good head about yourself. Now, I am much more accepting of snappish, rude behaviour from residents and attendings, it's not personal and it's just part of the system/process. I find if I can 'let it go by' and see beyond their crappy behaviour then situations are much better. Even when nurses snap and are rude, well - look at their work load. Most people are there because they want to be and they like dealing with patients, but that still doesn't deny what you described and how the process can wear you down and turn you into an 'ice cube' personality.

Keep the faith man!

 

[pathdr2b]

Hi Whisker,

I also thank you for giving us your experiences in a realistic light. I am wondering, isn't the 1st year after medical school essentially the same no matter what area you plan to specialize in?

Again, the point has to be made about the choice of career. Because I know from having several friends that are doctors in a variety of fields that experiences like yours are "the rule" not the exception, I'm giving considerable thought now (and obiviously very early for a premed) to careers that I think will suit my personal life.

I'm shooting for Pathology which I hope will compliment a research career as well. Pros and cons to this choice too I'm sure, but from shadowing Pathologists at all levels of their careers, it looks like doable fun to me!

Again, thanks for YOUR truth!!!!

 

[agent]

Originally posted by cdreed
yes, nurses are more in tune with patient care. but how can a physician treat a patient if he's never with that patient? and more importantly, how can a physician feel justified in asking a nurse to perform a task that he cannot do (like foley's, venipuncture and abg's)? god forbid that anything serious occur to a critical patient that a doctor could not attend to if no nurses were in the area to support him.

ive actually considered getting a 2 yr RN first before getting my psych degree as preparation.. of course that would set me back about a year or so.

 

[Katie]

CRAZYTERP,

as a medical student who went to UMCP and knows all about the many competitive and high-strung pre-meds out there, I can assure you that you gave the kids the right advice! It is so important to remain human, have fun, date, exercise, and spend time with your family and friends in undergrad. Otherwise you will end up being burnt out and totally depressed in med school. I had a friend in our first year class who came in with a nearly perfect GPA then psyched himself out so much that he proceeded to fail 2 classes 1st semester and was in danger of failing so many classes the second semester that he had to be demoted to the M'06 class. He had never dated in undergrad or made an effort to be sincerely friendly with people in our class rather than being competitive (i.e. asking "what did you get on that exam" and acting odd towards others. It is important to get good grades and do your best on the MCAT, but also important to be a well-balanced person. The only additional advice I would give to UM pre-meds is: 1)If you are not admitted to UMAB (which is unfortunately a strong possibility), really consider what you want in a school while looking at other schools and not just the school's religious affiliation or reputation. A number of my classmates have said that they were lucky to end up at a school with H/P/F grading where the competition is very low b/c they did not consider the grading system as a factor during the application process. 2)Have as much fun as you can in your voluntering and research activities as you can, and enjoy your classes as much as possible. If you are not enjoying your classes, it may be time to switch your major, or if you don't like volunteering in the nursing home (an example), it may be time to switch gears and find an activity that suits you better. 3)Apply to a lot of schools; this will minimize the chance that you'll have to apply again!

Good luck!