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This is from a blog of this guy Ali Binazir on (blogs.law.harvard.edu)
In the few years since Ive graduated from medical
school, there has been enough time to go back to medical practice in
some form, but I havent and dont intend to, so quit yer askin,
dammit. But of course, people keep on asking. Their
comments range from the curious Why dont you practice? to the
idealistic But medicine is such a wonderful profession! to the
almost hostile Dont you like helping people? Since
its fairly certain that I will continue to be posed this question for
the rest of my natural existence, I figured that instead of launching
into my 15-minute polemic on the State of Medicine each time, which
could definitely end up cutting into my time sitting in
traffic, I could just write it up and give them the URL. And
so now, unfettered by my prior obligations as an unbiased pre-med
advisor, here are the myriad reasons why you should not enter the
medical profession and the one reason you should enter it. I have
assiduously gone through these arguments and expunged any hint of
evenhandedness, saving you time hunting for them. And here
they are:
You will lose all the friends you had before medicine.
No foolin. Youll be so caught up with taking classes, studying
for exams, doing ward rotations, taking care of too many patients as a
resident, trying to squeeze in a meal or an extra hour of sleep, that
your entire life pre-medicine will be relegated to some nether,
dust-gathering corner of your mind. Docs and med students dont
make it to their college reunions because who can take a whole weekend
off? Unthinkable. And so those old friends will simply
drift away because of said temporal and physical restrictions and be
replaced by your medical compadres, whom you have no choice but to see
every day. Which brings us to
You will have difficulty sustaining a relationship and will
probably break up with or divorce your current significant other during
training. For the same reasons enumerated above, you
just wont have time for quality time, kid. Any time you have
will be spent catching up on that microbiology lecture, cramming for
the Boards, getting some sleep after overnight call and just doing the
basic housekeeping of keeping a Homo sapiens medicus upright
and functioning. When its a choice between having a meal/getting
some actual sleep after being up for 36 hrs vs. spending quality time
with your sig-o, which one wins, buddy? I know he/shes great and
all, but a relationship is a luxury that your pared-down, elemental,
bottom-of-the-Maslow-pyramid existence wont be able to
afford. Unless youve found some total saint whos willing to
care for your burned-out carapace every day for 6-8 years without
complaint or expectation of immediate reward (and yes, these people do
exist, and yes, they will feel massively entitled after the 8 years
because of the enormous sacrifice theyve put in, etc etc).
You will spend the best years of your life as a sleep-deprived, underpaid slave.
I will state here without proof that the years between 22 and 35,
being a time of good health, taut skin, generally idealistic
worldview, firm buttocks, trim physique, ability to legally
acquire intoxicating substances, having the income to acquire such
substances, high liver capacity for processing said substances, and
optimal sexual function, are the Best Years of Your
Life. And if you enter the medical profession during this golden
interval, you will run around like a headless chicken trying to appease
various superiors (in the guise of professor, intern, resident, chief
resident, attending and department head, depending on your phase of
devolution) all the while skipping sleep every fourth day or so
and getting paid about minimum wage ($35k-$45k/yr for 80-100 hrs/wk of
work) or paying through the nose (med school costing about $40k/yr) the
whole while. Granted, any job these days involves hierarchy and
superiors, but none of them keep you in such penury for so long.
Speaking of penury
You will get yourself a job of dubious remuneration and high liability exposure.
For the amount of training you put in and the amount of blood, sweat
and tears medicine extracts from you (and Im not being metaphorical
here), you should be getting paid an absurd amount of money as soon as
you finish residency. I mean, youre in your mid-thirties.
You put in 4 years of med school, and at least 4 years of residency (up
to 8 if youre a surgeon). You even did a fellowship and got paid
a pittance while doing that. And for all the good youre doing
humanity you are healing people, for godssake you
should get paid more than some investment banker soullessly shifting
around spreadsheet numbers, some lawyer defending a tobacco company or
some consultant maximizing a clients shareholder value.
Right? Wrong. For the same time spent out of college, your I-banking, lawyering and consulting buddies are making 2-5 times
as much as you are. At my tenth college
reunion, friends who had gone into finance were near
retirement and talking about their 10-acre parcel in Aspen, while
80% of my doctor classmates were still in residency, with an
average debt of $100,000 and a salary of $40,000.
But wait, were not done yet. Who amongst these professionals
has to insure himself against the potential wrath of his own
clients? The doctors, of course. Average annual
liability premiums these days are around $30,000. That goes
up to $80,000 for an obstetrician-gynecologist (who remains liable for
any baby s/he delivers until said infant turns 18) and into
the six-digit realm for neurosurgeons. Atul Gawande
wrote a dynamite article about docs compensation in a recent (May 4,
2005) issue of The New Yorker entitled Piecework (http://www.newyorker.com/fact/content/articles/050404fa_fact) check it out.
You will endanger your health and overall well-being.
The medical profession is bad for you. Just ask any current
doctor or med student. You will eat irregularly, eat poorly when
you do get the irregular meal (unless its a drug-company
sponsored meal god bless their generous hearts and bottomless
pockets), have way too much cortisol circulating in your system from
all the stress you experience, have a compromised immune system because
of all the cortisol in your blood, get sick more often because of the
compromised immune system (and the perpetual exposure to disease
its a hospital, surprise), and be perennially
sleep-deprived. If your residency is four years long, on average
you will spend one of those years without any sleep. A whole year of no sleep. Do you get that? This is as bad for you as it is for patients (youve heard of Libbys Law, right? Check out http://www.newyorkmetro.com/nymetro/health/features/n_9426/).
My good friend and college classmate James a serious contender for
the title of Nicest Guy on Earth had a severe
car accident one morning on the way to the hospital because he fell
asleep behind the wheel. Luckily, his airbag deployed and he
didnt suffer long-term injuries. Everyone seems to know already
that medical care can kill patients (havent read The House of God
by Samuel Shem yet? Go get it now brilliant and
easily the funniest book Ive ever read), but its usually news that it
can kill the docs, too.
You will not have time to care for patients and treat them as well as you want to.
This is how the math works: Many patients. Few of you
usually one, unless you have florid multiple-personality
disorder. So you have to take care of many patients. And if
theyre in the hospital, that means theyre really sick, otherwise
theyd still be at home. So you are scurrying around trying
to take care of all of them at once, which means that each individual
patient can only get a little bit of your time. Which means that
you wont have a chance to sit at the bedside of that sweet old vet and
hear his stories of Iwo Jima. Or get to the bottom of why that
LOL (little old lady medical slangs been around way longer
than internet slang, buddy) cant get her daughter to come
visit. Or to do any of that idealistic stuff that you cooked up
in your adolescent brain about really connecting with
patients. Get a grip! This is about action, about taking
care of business, about getting **** done, about making that note look
sharp because the attending is coming to round in an hour and hes a
hardass, and thats the difference your passing and getting recommended
for honors, so get on it already and quit yakking with the gomer (which
is an older patient with so many problems you should have never
let him/her get admitted in the first place stands for get out
of my ER, and I didnt make it up the acronym, so direct
your indignant wrath elsewhere, thank you very much).
Its about CYA cover your ass. For better or for
worse, you just start to treat patients as problems and illness-bearing
entities for the sake of mental efficiency (55yo WM s/p rad
prostatectomy c hx CHF & COPD), which does not do much for your
empathetic abilities. Which brings us to
You will start to dislike patients and by extension, people in general.
OK, so now youre overworked, underpaid, underfed, and
sleep-deprived. Whose fault is that? Well, its not really
the hospitals fault its just drawn that way. And its
not your bosss fault, because somebody has to take care of patients,
and he cant do it because hes the boss, duh. So whom to
blame? Ah yes patients. Its the patients
fault. Theyre the ones creating all the work! The ones who
get in the way of your nap, your catching your favorite TV
show, having an uninterrupted meal, getting together with your
sig-o for some therapeutic nookie. How dare he have an MI while
youre watching CSI? Does she have any consideration,
letting her blood pressure tank to 40 over palp at 3.30am, while youre
making out with Elle MacPherson on the shores of Bora Bora (assuming
youre lucky enough to be actually asleep)? The logic may be
twisted patients, on the whole, dont get sick voluntarily or
out of spite to you but it is deeply ingrained
in medical culture. Heck, theres even a slang term for it:
a hit. As in, We got four hits on our admitting shift
at the ER today. Hit the same way you would be struck by a
mortar, or a shell, or a bomb. Getting hit is a Bad Thing.
These arent people these are potentially lethal disasters that
can explode all over the place and ruin your whole day. We got
hit again one more patient to take care of, says the
resident. But really, is that resident blameless? Or how
about Dr Hardass and his intransigent ways? Hell, theyre at
fault, too! Soon the circle of blame expands to the outer reaches
of the cosmos, and every potentially accountable organism from amoeba
to blue whale will be personally responsible for your misery. But
lest you think weve forgotten you, patients, take heart
its all still your fault.
You will start to be disliked by people who do not even know you.
Once upon a day, in a time somewhere between the Cretaceous and
Triassic eras, physicians were held in awe and respect by the general
public. Their seeming omniscience was revered, and TV shows like Marcus Welby MD glorified their empathetic sangfroid and cool grace. Heck, they
were even considered sexy or something. I only noticed in recent
years that this aint the case no more, and doctors rank on the
contempt scale somewhere above meter maids and at or just below divorce
lawyers (but still much higher than I-bankers and other
invertebrates). The average Joe and Janet are tired of the
ever-rising cost of medical care, tired of all the stories of
malpractice, tired of the perceived greed of the pharmaceutical firms,
tired of the heartless profit-focussed practices of insurance
companies. But where do they pin their frustration? To
whom can they direct their ire? Insurance and drug companies are
nameless, faceless entities, as are hospitals. We need a person
to blame, like a nurse or a doc. Nurses are overworked and
massively underpaid, so it doesnt really make sense to get mad at
them. But doctors those Mercedes-driving, Armani-wearing,
private-school using, golf-playing
arriviste docs! By being the most visible symbol
of the medical profession, the doctor will have the dubious
distinction of being the scapegoat for all its
maladies. Fair? Hell no we already told you
docs are overworked, underpaid, and often railing at the same
injustices Joe and Janet are. Most of them dont even play
golf! But such it is. Just letting you know which
direction the rotten tomatoes are flying so you can consciously
choose to stand at the toss or splat end of
the trajectory.
And the one reason why you should go into medicine:
You have only ever envisioned yourself as a doctor and can only derive professional fulfillment in life by taking care of sick people.
Theres really no other reason, and lord knows the world needs
docs. Prestige, money, job security, making mom happy, proving
something, cant think of anything else to do, better than being a
lawyer, etc are all incredibly bad reasons for becoming a doc.
You should become a doc because you always wanted to work for Medecins Sans Frontieres
and your life will be half-lived without that. You should become
a doc because you want to be the psychiatrist who makes a
breakthrough in schizophrenia treatment. You should become a
doc because you love making sick kids feel better and being the
one to reassure the parents that itll all be OK, and nothing
else in the world measures up to that. Or as my general
surgery resident put it, you should become a doc because my dad was an
ass surgeon, my big brothers an ass surgeon, and by god Im going to
become an ass surgeon. But woe betide you if theres
anything else, anything at all, that would also give you that
fulfillment. Because your pursuit of medicine would preclude
chasing down that other dream and a whole lot more a dream
that could be much bigger, much more spectacular, much more
enriching for yourself and humanity than being a
physician. Just ask John Keats, Walker Percy, Sir Arthur Conan
Doyle, Giorgio Armani, or Michael Crichton (some of these
guys being more alive than others these days). Or you can
just ask me a few years down the road, by which time I should have
a blog entry for that question, too.
How many people still want to go to medical school, and be a Doctor?
Me me me, this guy XeRex
Source:
http://blogs.law.harvard.edu/abinaz...go-to-medical-school-a-gleefully-biased-rant/
In the few years since Ive graduated from medical
school, there has been enough time to go back to medical practice in
some form, but I havent and dont intend to, so quit yer askin,
dammit. But of course, people keep on asking. Their
comments range from the curious Why dont you practice? to the
idealistic But medicine is such a wonderful profession! to the
almost hostile Dont you like helping people? Since
its fairly certain that I will continue to be posed this question for
the rest of my natural existence, I figured that instead of launching
into my 15-minute polemic on the State of Medicine each time, which
could definitely end up cutting into my time sitting in
traffic, I could just write it up and give them the URL. And
so now, unfettered by my prior obligations as an unbiased pre-med
advisor, here are the myriad reasons why you should not enter the
medical profession and the one reason you should enter it. I have
assiduously gone through these arguments and expunged any hint of
evenhandedness, saving you time hunting for them. And here
they are:
You will lose all the friends you had before medicine.
No foolin. Youll be so caught up with taking classes, studying
for exams, doing ward rotations, taking care of too many patients as a
resident, trying to squeeze in a meal or an extra hour of sleep, that
your entire life pre-medicine will be relegated to some nether,
dust-gathering corner of your mind. Docs and med students dont
make it to their college reunions because who can take a whole weekend
off? Unthinkable. And so those old friends will simply
drift away because of said temporal and physical restrictions and be
replaced by your medical compadres, whom you have no choice but to see
every day. Which brings us to
You will have difficulty sustaining a relationship and will
probably break up with or divorce your current significant other during
training. For the same reasons enumerated above, you
just wont have time for quality time, kid. Any time you have
will be spent catching up on that microbiology lecture, cramming for
the Boards, getting some sleep after overnight call and just doing the
basic housekeeping of keeping a Homo sapiens medicus upright
and functioning. When its a choice between having a meal/getting
some actual sleep after being up for 36 hrs vs. spending quality time
with your sig-o, which one wins, buddy? I know he/shes great and
all, but a relationship is a luxury that your pared-down, elemental,
bottom-of-the-Maslow-pyramid existence wont be able to
afford. Unless youve found some total saint whos willing to
care for your burned-out carapace every day for 6-8 years without
complaint or expectation of immediate reward (and yes, these people do
exist, and yes, they will feel massively entitled after the 8 years
because of the enormous sacrifice theyve put in, etc etc).
You will spend the best years of your life as a sleep-deprived, underpaid slave.
I will state here without proof that the years between 22 and 35,
being a time of good health, taut skin, generally idealistic
worldview, firm buttocks, trim physique, ability to legally
acquire intoxicating substances, having the income to acquire such
substances, high liver capacity for processing said substances, and
optimal sexual function, are the Best Years of Your
Life. And if you enter the medical profession during this golden
interval, you will run around like a headless chicken trying to appease
various superiors (in the guise of professor, intern, resident, chief
resident, attending and department head, depending on your phase of
devolution) all the while skipping sleep every fourth day or so
and getting paid about minimum wage ($35k-$45k/yr for 80-100 hrs/wk of
work) or paying through the nose (med school costing about $40k/yr) the
whole while. Granted, any job these days involves hierarchy and
superiors, but none of them keep you in such penury for so long.
Speaking of penury
You will get yourself a job of dubious remuneration and high liability exposure.
For the amount of training you put in and the amount of blood, sweat
and tears medicine extracts from you (and Im not being metaphorical
here), you should be getting paid an absurd amount of money as soon as
you finish residency. I mean, youre in your mid-thirties.
You put in 4 years of med school, and at least 4 years of residency (up
to 8 if youre a surgeon). You even did a fellowship and got paid
a pittance while doing that. And for all the good youre doing
humanity you are healing people, for godssake you
should get paid more than some investment banker soullessly shifting
around spreadsheet numbers, some lawyer defending a tobacco company or
some consultant maximizing a clients shareholder value.
Right? Wrong. For the same time spent out of college, your I-banking, lawyering and consulting buddies are making 2-5 times
as much as you are. At my tenth college
reunion, friends who had gone into finance were near
retirement and talking about their 10-acre parcel in Aspen, while
80% of my doctor classmates were still in residency, with an
average debt of $100,000 and a salary of $40,000.
But wait, were not done yet. Who amongst these professionals
has to insure himself against the potential wrath of his own
clients? The doctors, of course. Average annual
liability premiums these days are around $30,000. That goes
up to $80,000 for an obstetrician-gynecologist (who remains liable for
any baby s/he delivers until said infant turns 18) and into
the six-digit realm for neurosurgeons. Atul Gawande
wrote a dynamite article about docs compensation in a recent (May 4,
2005) issue of The New Yorker entitled Piecework (http://www.newyorker.com/fact/content/articles/050404fa_fact) check it out.
You will endanger your health and overall well-being.
The medical profession is bad for you. Just ask any current
doctor or med student. You will eat irregularly, eat poorly when
you do get the irregular meal (unless its a drug-company
sponsored meal god bless their generous hearts and bottomless
pockets), have way too much cortisol circulating in your system from
all the stress you experience, have a compromised immune system because
of all the cortisol in your blood, get sick more often because of the
compromised immune system (and the perpetual exposure to disease
its a hospital, surprise), and be perennially
sleep-deprived. If your residency is four years long, on average
you will spend one of those years without any sleep. A whole year of no sleep. Do you get that? This is as bad for you as it is for patients (youve heard of Libbys Law, right? Check out http://www.newyorkmetro.com/nymetro/health/features/n_9426/).
My good friend and college classmate James a serious contender for
the title of Nicest Guy on Earth had a severe
car accident one morning on the way to the hospital because he fell
asleep behind the wheel. Luckily, his airbag deployed and he
didnt suffer long-term injuries. Everyone seems to know already
that medical care can kill patients (havent read The House of God
by Samuel Shem yet? Go get it now brilliant and
easily the funniest book Ive ever read), but its usually news that it
can kill the docs, too.
You will not have time to care for patients and treat them as well as you want to.
This is how the math works: Many patients. Few of you
usually one, unless you have florid multiple-personality
disorder. So you have to take care of many patients. And if
theyre in the hospital, that means theyre really sick, otherwise
theyd still be at home. So you are scurrying around trying
to take care of all of them at once, which means that each individual
patient can only get a little bit of your time. Which means that
you wont have a chance to sit at the bedside of that sweet old vet and
hear his stories of Iwo Jima. Or get to the bottom of why that
LOL (little old lady medical slangs been around way longer
than internet slang, buddy) cant get her daughter to come
visit. Or to do any of that idealistic stuff that you cooked up
in your adolescent brain about really connecting with
patients. Get a grip! This is about action, about taking
care of business, about getting **** done, about making that note look
sharp because the attending is coming to round in an hour and hes a
hardass, and thats the difference your passing and getting recommended
for honors, so get on it already and quit yakking with the gomer (which
is an older patient with so many problems you should have never
let him/her get admitted in the first place stands for get out
of my ER, and I didnt make it up the acronym, so direct
your indignant wrath elsewhere, thank you very much).
Its about CYA cover your ass. For better or for
worse, you just start to treat patients as problems and illness-bearing
entities for the sake of mental efficiency (55yo WM s/p rad
prostatectomy c hx CHF & COPD), which does not do much for your
empathetic abilities. Which brings us to
You will start to dislike patients and by extension, people in general.
OK, so now youre overworked, underpaid, underfed, and
sleep-deprived. Whose fault is that? Well, its not really
the hospitals fault its just drawn that way. And its
not your bosss fault, because somebody has to take care of patients,
and he cant do it because hes the boss, duh. So whom to
blame? Ah yes patients. Its the patients
fault. Theyre the ones creating all the work! The ones who
get in the way of your nap, your catching your favorite TV
show, having an uninterrupted meal, getting together with your
sig-o for some therapeutic nookie. How dare he have an MI while
youre watching CSI? Does she have any consideration,
letting her blood pressure tank to 40 over palp at 3.30am, while youre
making out with Elle MacPherson on the shores of Bora Bora (assuming
youre lucky enough to be actually asleep)? The logic may be
twisted patients, on the whole, dont get sick voluntarily or
out of spite to you but it is deeply ingrained
in medical culture. Heck, theres even a slang term for it:
a hit. As in, We got four hits on our admitting shift
at the ER today. Hit the same way you would be struck by a
mortar, or a shell, or a bomb. Getting hit is a Bad Thing.
These arent people these are potentially lethal disasters that
can explode all over the place and ruin your whole day. We got
hit again one more patient to take care of, says the
resident. But really, is that resident blameless? Or how
about Dr Hardass and his intransigent ways? Hell, theyre at
fault, too! Soon the circle of blame expands to the outer reaches
of the cosmos, and every potentially accountable organism from amoeba
to blue whale will be personally responsible for your misery. But
lest you think weve forgotten you, patients, take heart
its all still your fault.
You will start to be disliked by people who do not even know you.
Once upon a day, in a time somewhere between the Cretaceous and
Triassic eras, physicians were held in awe and respect by the general
public. Their seeming omniscience was revered, and TV shows like Marcus Welby MD glorified their empathetic sangfroid and cool grace. Heck, they
were even considered sexy or something. I only noticed in recent
years that this aint the case no more, and doctors rank on the
contempt scale somewhere above meter maids and at or just below divorce
lawyers (but still much higher than I-bankers and other
invertebrates). The average Joe and Janet are tired of the
ever-rising cost of medical care, tired of all the stories of
malpractice, tired of the perceived greed of the pharmaceutical firms,
tired of the heartless profit-focussed practices of insurance
companies. But where do they pin their frustration? To
whom can they direct their ire? Insurance and drug companies are
nameless, faceless entities, as are hospitals. We need a person
to blame, like a nurse or a doc. Nurses are overworked and
massively underpaid, so it doesnt really make sense to get mad at
them. But doctors those Mercedes-driving, Armani-wearing,
private-school using, golf-playing
arriviste docs! By being the most visible symbol
of the medical profession, the doctor will have the dubious
distinction of being the scapegoat for all its
maladies. Fair? Hell no we already told you
docs are overworked, underpaid, and often railing at the same
injustices Joe and Janet are. Most of them dont even play
golf! But such it is. Just letting you know which
direction the rotten tomatoes are flying so you can consciously
choose to stand at the toss or splat end of
the trajectory.
And the one reason why you should go into medicine:
You have only ever envisioned yourself as a doctor and can only derive professional fulfillment in life by taking care of sick people.
Theres really no other reason, and lord knows the world needs
docs. Prestige, money, job security, making mom happy, proving
something, cant think of anything else to do, better than being a
lawyer, etc are all incredibly bad reasons for becoming a doc.
You should become a doc because you always wanted to work for Medecins Sans Frontieres
and your life will be half-lived without that. You should become
a doc because you want to be the psychiatrist who makes a
breakthrough in schizophrenia treatment. You should become a
doc because you love making sick kids feel better and being the
one to reassure the parents that itll all be OK, and nothing
else in the world measures up to that. Or as my general
surgery resident put it, you should become a doc because my dad was an
ass surgeon, my big brothers an ass surgeon, and by god Im going to
become an ass surgeon. But woe betide you if theres
anything else, anything at all, that would also give you that
fulfillment. Because your pursuit of medicine would preclude
chasing down that other dream and a whole lot more a dream
that could be much bigger, much more spectacular, much more
enriching for yourself and humanity than being a
physician. Just ask John Keats, Walker Percy, Sir Arthur Conan
Doyle, Giorgio Armani, or Michael Crichton (some of these
guys being more alive than others these days). Or you can
just ask me a few years down the road, by which time I should have
a blog entry for that question, too.
How many people still want to go to medical school, and be a Doctor?
Me me me, this guy XeRex
Source:
http://blogs.law.harvard.edu/abinaz...go-to-medical-school-a-gleefully-biased-rant/
i am sorry man i didn't knew that, no hard feelings though.
