You all have any psych related insight into the behavior of premeds?

[surftheiop]

Sorry that this has nothing to do with psych really, but figured this is the most insightful board on this forum so I'd see if you all had any ideas.

When I read the various pre-med forums it seems that many, many premeds tend to go on and on about how awful a career in medicine will be. I'm not sure if this is happening everywhere or just a SDN anomaly.

They talk about how its going to give away their best years, isn't even fulfilling, there are better career paths, wont actually make any difference in world, wont even make good money, etc, etc.

While obviously medicine is an extremely demanding/taxing career they can't possibly believe everything they are saying or else they wouldn't consider becoming a physician.

Is this some sort of a result of people trying to rebel from the "saving all the sick children" stereotype of premeds in order to try to make themselves seem more wise?

Is this some sort of outward defense mechanism where they lower expectations so it won't feel as bad if becoming a physician isn't everything they internally believed it would be?

Just seems so confusing that people would be completely trashing the profession that they are devoting a huge amount of energy to pursue.

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[whopper]

That wasn't the attitude when I was premed but things have changed. I don't encounter enough premeds to know what the prevailing attitudes are right now.

I do know a lot of medical professionals have mixed opinions about the possible government healthcare that is still being debated. That's not a nudge by me to criticize it which IMHO is a very different topic. I'm hearing more criticism than praise for the healthcare bill by fellow doctors which I'm wondering is trickling down to the premeds.

 

[SomeDoc]

Sounds most likely to me a rationalization ego defense in the face of unsure medical school admissions. It could also be general pessimism, or insecurity in the pursuit of medicine as a career (i.e. was the individual pressured/sees medicine purely as a business versus a profession, etc.)

 

[OldPsychDoc]

Some of them are also probably trying to discourage their competition...

 

[Sneezing]

Maybe it's what they believe. It doesn't mean what they're saying isn't true. I started out a little jaded, and am now more jaded. So much in medicine does suck, and at times you really wonder what difference are you really making? Is our medical machine really worth bankrupting our country? Will the increasing lack of personal responsibility ever reverse itself? How close are we to the tipping point of cost/benefits being unfavorable for the profession (for some it's already here)?

For me I knew these simple facts wouldn't change.
-Job security
-Certain specialties (like psych) will always maintain the ability to open their own practice and be your own boss.
-Intellectual rigor to ward off some dementia, and less of a chance for occupational boredom
-Pride. You jumped through a big hoop and you get a t-shirt. "trust me, I'm a doctor"

 

[whopper]

Do you think the negative views you're experiencing are indicative of a general trend? It could just be where you are.

 

[la petite mort]

Secretly interesting topic!

When someone commends me in any way on studying medicine, I usually find myself making some deprecating, buzzkill comment on the lines of "Well, it isn't all that it's cracked up to be, this aspect sucks, but I can't see myself doing anything else". I really think it's more of a generational-sociological thing. The age group of the people who are making the comments that the OP described, assuming they're American, grew up in wartime and then on the brink of adulthood saw the country spiral into one of the worst economic recessions in history among other major issues that affect the general population. When you grow up in a time like that, you sort of await terrible news every morning and no one wants to appear wide-eyed and optimistic, it makes you feel like an easier target for the bite of reality. It's a tough thing to describe unless you actually live it.

 

[billypilgrim37]

Fundamentally I think people say these things because they are true. Of course, that's only half the truth: you only get to be a doctor by shoveling a lot of bull****, and being a doctor isn't such a bad gig.

But it DOES involve giving up the best years of your life while you watch your friends enjoy themselves more, spending many years being treated much worse than you could be treated in most other contexts, extending adolescence nearly ad infinitum, and for many people, delaying starting families. And that does suck.

But hey, you do get to be a doctor. Which apparently is a good thing, based on how many of us go through so much to get there.

I also think it's important for pre-meds to say these things because it's their way of trying to signal that, while they don't know what they are getting themselves into exactly, they realize that the possibility that it will suck really hard is there. And I would rather admit a pre-med who understood that the path to being a doctor has some terrible lows than someone who thought it was going to be a walk in the park.

It's basically just a play on Jack Nicholson from A Few Good Men. "You can't handle the truth."

 

[Sneezing]

I think the generational-sociological thing you speak of has more to do with entertainment and parenting then the wars.

-Sarcasm. Cartoons shifted from quaint elmer fud/bugs bunny to sponge bob. Look at old SNL versus new SNL skits. How are children portrayed in 80's sitcoms versus now? We have multiple sarcastic news shows in the evening, a spoof newspaper (the Onion), and even political satire like South Park.
-parenting has decreased. Television, video games, handhelds, movies in vehicles, and other flashing lights have replaced actual supervision, parenting, and real play time (reinforcing the effects of sarcasm from above). Parents used to discipline their children, now they are more likely to run rampant. How often do you hear of parents spanking their children anymore? I grew up hearing stories of older generations being borderline abused, and subsequent generations having it easier. Yes, there is data out their supporting the non-physical approach to parenting, but some times you have to wonder...
-growing up spoiled in the 90's

 

[la petite mort]

I think the generational-sociological thing you speak of has more to do with entertainment and parenting then the wars.

-Sarcasm. Cartoons shifted from quaint elmer fud/bugs bunny to sponge bob. Look at old SNL versus new SNL skits. How are children portrayed in 80's sitcoms versus now? We have multiple sarcastic news shows in the evening, a spoof newspaper (the Onion), and even political satire like South Park.
-parenting has decreased. Television, video games, handhelds, movies in vehicles, and other flashing lights have replaced actual supervision, parenting, and real play time (reinforcing the effects of sarcasm from above). Parents used to discipline their children, now they are more likely to run rampant. How often do you hear of parents spanking their children anymore? I grew up hearing stories of older generations being borderline abused, and subsequent generations having it easier. Yes, there is data out their supporting the non-physical approach to parenting, but some times you have to wonder...
-growing up spoiled in the 90's

I don't know about your spastic set of ideas...especially the part of not being spanked leading to cynicism. Media is definitely a sign of the times, but I don't think we can really label premeds and MS1s as vapid brats raised by TV, your description makes me think of the cast of "Jersey Shore" rather than a group of dejected, academic 19-year-olds vocalizing their fears about their happiness in the medical profession.

 

[surftheiop]

Do you think the negative views you're experiencing are indicative of a general trend? It could just be where you are.

Not sure if that was directed at me or someone else who responded, but I'll give you my take. (Im still a premed myself so this is just a summary of what I have observed/read)

Now that I have thought about it more I think places like SDN are the breeding grounds for this sort of thinking and that as more and more pre-meds end up seeking advice online the trend will grow.

The way I see it, many pre-meds are surronded by tons of other idealistic pre-meds at their schools (if you aren't alteast somewhat optimistic
im not sure what would initially lead you to consider medicine). By the very nature of applying to med school about half of those people aren't going to get in any given year. Over time maybe 10% or whatever of each school's pre-meds stumble onto SDN and read what some of the more outspoken pessimists have to say. Then the pre-meds sort of start to feel like now they know the "real story" and begin to see errors in some of their more idealistic premeds thinking, but then they end up tossing the baby out with the bathwater.

(you notice all you level headed/ middle of the road posters don't become "rockstar" posters in the eyes of the premed population like some others have)

I think this causes the premeds who are "in the know" through SDN or other sources to start to believe you must be calloused/grizzled/bitter in order to actually be a physician (Remember they just saw half of their idealistic colleagues get rejected).

Then online forums in general create some sort of "arms race" where everyone needs to be the best, so pre-meds end up pitted in a competition to see who has the "most realistic" view of medicine. All the while they are being cheerlead by the most vocal pessimist residents/physicians.

I have no idea how many people actually believe all of what they are saying (Im sure deep down alot of us still feel we can "save the world" even though our knowledge says otherwise).

There just seems to be something terribly wrong when premeds who say " I want to do rads/gas because it sucks interacting with patients" end up getting applauded for having such great "insight".

 

[Sneezing]

Conceptually it made sense in my mind as I formed the post.

To clarify, I am trying to draw a link between poor parenting leaving a gap which entertainment filled in. These days the modeling of adulthood is shaped by sarcastic media, which I believe is just cynicism with a punch line.

However, I'm commenting on the issue from my personal perspective, not as an authority. My theories are likely wrought with many flaws.

 

[masterofmonkeys]

Conceptually it made sense in my mind as I formed the post.

To clarify, I am trying to draw a link between poor parenting leaving a gap which entertainment filled in. These days the modeling of adulthood is shaped by sarcastic media, which I believe is just cynicism with a punch line.

However, I'm commenting on the issue from my personal perspective, not as an authority. My theories are likely wrought with many flaws.

Sneezing, I would add entitlement mentality and a national epidemic of external locus of control to your set of ideas. And they are closely linked to the cynicism I feel.

Your post made a lot more sense than referring to us as 'growing up in wartime', given the fact that no one lived in fear of getting drafted, everyone under the age of 27 who joined the military knew what they were signing up for, and the societal turmoil and national effects of this war are far far smaller than they were in any previous war (except Iraq I). Seriously, we civilians are very very insulated from this war. As a 26 year old the worst effect I've suffered is a strong case of a form of survivor's guilt because I didn't serve, and I'm a freaking cripple! And lets not forget the 'worst recession since the great depression' which again while massively suckish does not even begin to start to come close to resembling anything even remotely similar to the great depression.

Medicine is suckish and is only becoming moreso. Our residencies are by most honest docs accounts a lot worse now than they were before due to increase in pace and turnover, as well as an increased drive to see us as free labor to increase profit margins and help safety net hospitals remain profitable. There is no doubt about that. I complain about it endlessly. I'm also the first to say there's nothing I'd rather do.

For all the flaws in my generation, though, I do think they have a point. I got into medicine to help people. I'm probably going to train between 6 and 7 years to make a lot less money than an ER doc training for 3. I'm ok with this because I am one of those 'save the poor little children' people.

But there will come a point where even idealists like myself say 'wait a sec, if all I really want to do is help people, do I have to put myself through this much garbage just to make a difference?' I saw among the few pre-med friends I had, that this answer became 'no' to more and more of them as they saw just how much they'd have to put up with. Most did end up doing something to help others. They just couldn't justify being treated like a cow-farmer's doormat to do so.

 

[whopper]

oops, error, should've posted this in a new thread.

But since I'm already here....

I just read a book called "Of 2 Minds"

It's written by an anthropologist and it's her opinion of the human experience in the culture of a psychiatry residency.

She brings up several things which are very true yet not what an outsider would expect or want within their healthcare system with a psychiatry bent.

E.g. residents who don't know have any real clinical experience are presented to the patient as if they are supposed to have a clue because the attending is often somewhere else.

So much of the training is not focused on mental health, and as a result, it makes psychiatrists view their patients as if it's not a mental health problem--> thus leading to the psychiatrist who throws pills at the problem without listening.

The difficulty having the patience to listen to patients when the resident is overworked, underpaid and ill-experienced.

Several in the field see it as a mark of honor to not have a balanced life. E.g. if some residents tell their doctor they had a good time at a party the night before, the attending would look down upon it.

Anyways, IMHO medical education and practice in several ways is counter-intuitive in how it should work. Take for example our healthcare system and our current rates of obesity which is almost 40% of all US citizens. Wouldn't it save several billions to get people in shape instead of throwing more money into the system? Yet fewer than you would expect are urging people to lose weight. I rarely see other doctors try to get their patients on a regimen of diet and excercise.

I do think the overall situation is improving. When I did residency, the new ACGME guidelines to prevent overwork were put in place about 1 year before. I do know of several programs that ardently follow the guidelines, not just because they're supposed to do so, but because they believe in it.

Unfortunately there are several old-timers and sadists in the medical system who still believe and enjoy seeing residents (and medical students) suffer. I don't know if this has anything to do with the negativity that's been mentioned.