Your opinion on medicine - who does well and why?

[DrArete]

I have recently spent a huge amount of time contemplating this question. I know now that if I go on, I will get into medical school, and that I have the ability to do as well as most of my classmates.

I think that many pre meds, non trads in particular, are so consumed by the desire to get into medicine, and by a possibly idealized image of what the practice of medicine will be like or what they themselves will be like, that they are either unable or unwilling to consider how and why so many people appear to be dissatisfied by their choice.

I am sure everyone reading this, has spoken to at least one doctor or medical student that is rather unhappy, and at least one that says there is no other career for them.

I look at documentaries like this - http://video.pbs.org/video/1114402491/
and threads like these:
http://forums.studentdoctor.net/showthread.php?t=55501

and I feel so torn.

So what do you guys think? Is there anyway to predict or classify those who do well with those who wish they had done otherwise?

For those of you already in medical school, residency, or in practice as attendings, or who have left the field, how have your views changed?

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[FutureDrB]

I have recently spent a huge amount of time contemplating this question. I know now that if I go on, I will get into medical school, and that I have the ability to do as well as most of my classmates.

I think that many pre meds, non trads in particular, are so consumed by the desire to get into medicine, and by a possibly idealized image of what the practice of medicine will be like or what they themselves will be like, that they are either unable or unwilling to consider how and why so many people appear to be dissatisfied by their choice.

I am sure everyone reading this, has spoken to at least one doctor or medical student that is rather unhappy, and at least one that says there is no other career for them.

I look at documentaries like this - http://video.pbs.org/video/1114402491/
and threads like these:
http://forums.studentdoctor.net/showthread.php?t=55501

and I feel so torn.

So what do you guys think? Is there anyway to predict or classify those who do well with those who wish they had done otherwise?

For those of you already in medical school, residency, or in practice as attendings, or who have left the field, how have your views changed?

You raise a good question, and a hard one to answer. There are brilliant people who are horrible doctors, and likewise, not so brilliant people who make great doctors. So I don't think you can answer the question based on intelligence.

The same goes for your passion towards caring for people. The mythical "House M.D." I would say is a great doctor, but obviously lacks the bedside manner 99.9% of patients desire. You can also be a patients' best friend, but if you lack the professionalism, knowledge-base, and ability to make extremely difficult decisions, all the caring stuff goes out the window.

I think the main thing perspective medical students need to do is gain real-world experience. That means shadowing and volunteering (directly) with sick patients. While being a physician certainly has its perks, I think because of society and TV, most people have an extremely skewed vision of what being a doctor actually entails. The blood, the tears, the death, the stench, the hours, and most importantly, the bureaucratic nature of the profession.

When people ask me why I want to be a doctor, I simply say, if you find something in life that you have the ability to do and would get up and do it every day for free, that is what you'll be happy doing, no matter what downfalls come with the job.

 

[Law2Doc]

...

I think that many pre meds, non trads in particular, are so consumed by the desire to get into medicine, and by a possibly idealized image of what the practice of medicine will be like or what they themselves will be like...
?

nah, you will find far more idealists among the ranks of the trads than the nontrads. If you've already been in the work force, you job expectations are significantly less idealistic. And most nontrads are expected to really explore medicine before applying -- to really look before they leap. You can get away with a lot less if you are still a starry eyed undergrad.

 

[QofQuimica]

So what do you guys think? Is there anyway to predict or classify those who do well with those who wish they had done otherwise?

I don't think there's any surefire way to predict it, because you can't know for sure how you're going to like practicing medicine until you start practicing medicine. But IMO, the qualities that people who dislike medicine seem to have in common include at least some of the following:

• Not service-oriented, someone who is not a "people person"
• Main motivations for going to med school are things like job security, desire for respect, desire to be in charge, desire to make a lot of money
• Inflexible, can't tolerate change, uncertainty or ambiguity
• Low tolerance for being inconvenienced, doesn't cope well with having to "take one for the team" sometimes, unwilling to put other people's interests above their own on a regular basis
• Dislikes teaching, perfectionism to the point of being intolerant of any human fallibility, takes their frustration out on others (particularly those lower in the hierarchy)
• "Free spirits" who cannot manage to conform to the hierarchical training structure, unable to make peace with the realities of working in the current health care system
• Cynical, avoids connecting with patients or colleagues in a human way, not introspective, does not "debrief" or ask for help when emotionally overwhelmed

I'm sure there are plenty of others that the rest of you can come up with, but there's a good starting point for discussion, at any rate.

For those of you already in medical school, residency, or in practice as attendings, or who have left the field, how have your views changed?

I've said several times that if I could do it all again, I'd probably pick pharmacy school over medical school. That's easy to say now, because I won't ever have to do it all again, and I know what the "ending" of my medical training story is. But in terms of finding my niche, I've been able to do that. I enjoy caring for patients a lot more than I expected to, and I wouldn't have been able to do that as a pharmacist.

One of the things that most surprised me (shocked me, even) when I got on the wards is how unscientific medicine really is. I've taken to joking about evidence-less medicine (as opposed to evidence-based medicine), because so much of what we do is based on personal preferences at worst and expert opinion at best. Now when I hear premeds say that they want to do medicine because they "love science," I always warn them that medicine is not a career for someone who truly loves science. It's a career for someone who loves working with people.

I'm at a point now where I've seen a wide enough range of human suffering that it's hard for me to not feel more aware than ever of the preciousness of human life, including my own. I don't ride motorcycles any more. I take time to discuss quitting smoking, especially with teenaged patients. I'm more aware of health care disparities, and also of vulnerable patients like kids, the elderly, prisoners, non-English speaking. I tell my friends and family that I love them more and try not to take them as much for granted.

I think medicine brings out the worst in some people, but it's brought out the best in me. I'm more patient with people who frustrate me. I make more effort to be pleasant to be around, even when I'm tired and grouchy, and especially when I'm dealing with students and ancillary staff who I could "blow off" if I wanted to. I'm more generous with my time. I'm more willing to go out of my way for my coworkers and more appreciative when they do the same for me.

I'm not a religious person, and I never have been. But if I had to imagine what it's like to experience "finding Jesus," I think I have some inkling. I feel like I'm closer to being the kind of person I would want to be than I ever have been at any other point in my life.

 

[45408]

I'm at a point now where I've seen a wide enough range of human suffering that it's hard for me to not feel more aware than ever of the preciousness of human life, including my own. I don't ride motorcycles any more.

It's a huge eye opener. I can't believe how many people I've seen die.

 

[n3xa]

Waiting patiently for the "Q decides to apply to pharmacy school" thread

 

[Pembleton]

In my opinion (and this will seem obvious), the people who do well in medical school are those who are most single-minded about the whole endeavor. I define doing well as getting great grades, great Steps, AOA and the residency of their choice at the program of the choice. For instance, the guys in my class who knew from the start they wanted Ortho and did not deviate from that goal at all earned AOA, did well on Steps and wound up in Ortho. Similarly for the girl who wanted Derm. They might not have done it without a few underhanded things, but they generally studied hard and pushed forward without deviation. Regardless of the specialty, I think those who do best and are happiest are those who have a set goal from the outset and reach for it.

The people who were 'wishy-washy' (i.e. undecided about specialty) or less focused due to other outside interests generally did not do as well in medical school. They seemed to settle towards the middle and got caught up in learned helplessness. They were more dissatisfied because they did not have a palpable goal they could feel true passion for.

I'd advise anyone going into medical school to choose your path early. The more passionate you are about your future specialty, the better the school experience will be for you. Don't let anyone dissuade you from any specialty if that is what you truly want.

 

[wholeheartedly]

I really like the posts on this thread...

I've only got an allied health person's perspective about who makes it, but I think Q's definitely hitting some of the biggies based on what I've observed.

 

[QofQuimica]

I really like the posts on this thread...

I've only got an allied health person's perspective about who makes it, but I think Q's definitely hitting some of the biggies based on what I've observed.

Yeah, I'm thinking this one may need to be added to the sticky.

Waiting patiently for the "Q decides to apply to pharmacy school" thread

Ha. Nope, I'm done with full-time school. I do want one more degree, but it will be done part-time, and it's to prepare for my "retirement" career once I'm too old to keep up with the pace of practicing medicine.

 

[Nasrudin]

Sweet post Q.

I can see myself and my many years riding the bench reflected in these posts. Penmbleton actually has an interesting point. As much as it tasted sour in my head.

If the question is who does well in medical school. Then it's really a different matter. And goals and focus can be essential. I dig that. Doing well on the Step is a huge uplift in motivation, focus, and discipline. And it has made the going smoother.

Doing well in the career. I'm convinced. Is something else entirely. And let's not think for a second. "Doing Well" isn't a loaded phrase. Depends entirely on the person that speaks it.

For me doing well will mean taking good care of the patients on my service. Working well with the team I'm on. Focusing lifelong on maintaining my knowledge and skills.

Doing well in medical school. Is doing well enough to get there. Doing it on the Pacific Rim. Where the insanity of human existence comes unexpectedly to a stop and stares in the distant cool blue. Having left most of it's notions behind in the process. And in that crash and burn nobody notices who's holding who's hand.

That's doing well. For me.

 

[n3xa]

[*]Low tolerance for being inconvenienced, doesn't cope well with having to "take one for the team" sometimes, unwilling to put other people's interests above their own on a regular basis

[*]Dislikes teaching, perfectionism to the point of being intolerant of any human fallibility, takes their frustration out on others (particularly those lower in the hierarchy)

One bit of advice I gave some of the post-baccs who are in faculty assistant positions this upcoming academic year is to treat your colleagues/classmates the same way you would a higher-up. You never know when your colleagues will be asked by said higher-ups about your performance.

Quality means doing it right when no one is looking.

 

[DrArete]

Sweet post Q.

I can see myself and my many years riding the bench reflected in these posts. Penmbleton actually has an interesting point. As much as it tasted sour in my head.

If the question is who does well in medical school. Then it's really a different matter. And goals and focus can be essential. I dig that. Doing well on the Step is a huge uplift in motivation, focus, and discipline. And it has made the going smoother.

Doing well in the career. I'm convinced. Is something else entirely. And let's not think for a second. "Doing Well" isn't a loaded phrase. Depends entirely on the person that speaks it.

For me doing well will mean taking good care of the patients on my service. Working well with the team I'm on. Focusing lifelong on maintaining my knowledge and skills.

Doing well in medical school. Is doing well enough to get there. Doing it on the Pacific Rim. Where the insanity of human existence comes unexpectedly to a stop and stares in the distant cool blue. Having left most of it's notions behind in the process. And in that crash and burn nobody notices who's holding who's hand.

That's doing well. For me.

You bring up a very good point in your focus on what "doing well" means.
My use of it was not just in a sense of technical expertise or getting a certain score on a certain exam.
My use was more holistic, meant to embody both a suitability for and a satisfaction with one's career in medicine.
I know truly brilliant people who have gone to medical school and hated it, and others who have loved it. The best surgeon I know has neglected his family, has one son who is a high school dropout, and another who is schizophrenic, and a wife who tells me she gets half credit for the lives he saves bc of what she puts up with.
I think about what a good physician is, and how that fits in with a balanced and whole life.
One thing interesting to me is that there are decidedly less nontrads going to dental school than medical school. This is interesting because dentistry has a quicker path to a paying job with a high chance of being able to also enjoy life while helping people in service oriented science profession. My guess on the reason is that going to medical school and being a doctor is seen by many as being some sort of higher calling, and as such, they do not do as rigorous a cost/benefit analysis as they might normally do.

 

[Nasrudin]

You bring up a very good point in your focus on what "doing well" means.
My use of it was not just in a sense of technical expertise or getting a certain score on a certain exam.
My use was more holistic, meant to embody both a suitability for and a satisfaction with one's career in medicine.
I know truly brilliant people who have gone to medical school and hated it, and others who have loved it. The best surgeon I know has neglected his family, has one son who is a high school dropout, and another who is schizophrenic, and a wife who tells me she gets half credit for the lives he saves bc of what she puts up with.
I think about what a good physician is, and how that fits in with a balanced and whole life.
One thing interesting to me is that there are decidedly less nontrads going to dental school than medical school. This is interesting because dentistry has a quicker path to a paying job with a high chance of being able to also enjoy life while helping people in service oriented science profession. My guess on the reason is that going to medical school and being a doctor is seen by many as being some sort of higher calling, and as such, they do not do as rigorous a cost/benefit analysis as they might normally do.

So it seems you're looking for fit criteria. In that case. Q's analysis is pretty forceful.

One thing I might slightly differ with her on is the notion of non-conformity being a marker for dissatisfaction. These things are highly contextual. If she means being able to fit in the low position on the team and to take direction well. Then sure. I agree. And check. Been doin that my whole life.

On the other hand if one follows or allows oneself to get pulled along by the nose into the depths of the driving paradigm of medical culture. Then expect inbred dissatisfaction to impregnate your every perception.

To me. It's like the right fit on the right person in the right place and time. I couldn't pull off some kind of Dolce and Gabanna suit. But am comfortable and sharp in the right kind of get up.

So your job once you get on board is to furiously search for the right niche for yourself. For the right reasons. Ones that lead you to deeper levels of satisfaction. Than the dull dictates of fashion. Which medical culture projects on it's young unrelentingly.

If your not on board. Your job seems to be to impress strangers. To make it passed the cultural sentinels at the gates of medical institutions. And you wouldn't be wrong. It's just you can't get any satisfaction that way.

So your real job is you. Finding out through close proximal experience if this job is for you. There is no other way. And it something very few people have taken the time to do before seeking admission. And sadly it is a lesser criteria for admission itself. Whoops. Lot's of cranky miserable @ssholes everywhere in medicine. Unreflective. Difficult to place in the artificiality of competition-bound criteria. And doomed to repeat itself. Forever it would seem.

 

[Lil Mick]

Free spirit, entrepeneur with many interests here. Med school will not be pleasant if you don't want to give up those interests (even if they're tangentially-related to medicine). I personally came to resent medical school for taking away time from teaching and research, as well as working out and seeing family and friends. Getting an MD isn't for someone who seeks balance in his life or has career plans away from clinical medicine, even if you are doing it as an MD/PhD.

 

[FiremedicMike]

One of the things that most surprised me (shocked me, even) when I got on the wards is how unscientific medicine really is. I've taken to joking about evidence-less medicine (as opposed to evidence-based medicine), because so much of what we do is based on personal preferences at worst and expert opinion at best. Now when I hear premeds say that they want to do medicine because they "love science," I always warn them that medicine is not a career for someone who truly loves science. It's a career for someone who loves working with people.

There's not very many people who will openly admit this, and I applaud you.

 

[QofQuimica]

There's not very many people who will openly admit this, and I applaud you.

Really? Well, all I can say is that I was a scientist before I was a physician, and IMO their approaches to problems are not the same.

 

[FiremedicMike]

Really? Well, all I can say is that I was a scientist before I was a physician, and IMO their approaches to problems are not the same.

I guess my implication was that many, especially on this forum, perpetuate the idea that medicine as a whole is a highly technical exacted science. It has been my experience thus far that it is largely based on the "most likelies" and the treatment plans that one is comfortable and experienced in. There is certainly some deviation from these methods, but they are in the minority.

 

[drdan83]

I guess my implication was that many, especially on this forum, perpetuate the idea that medicine as a whole is a highly technical exacted science. It has been my experience thus far that it is largely based on the "most likelies" and the treatment plans that one is comfortable and experienced in. There is certainly some deviation from these methods, but they are in the minority.

I just posted a thread in the DO section because I agree with you and Q. They are not being so nice to me and they are telling me to become a nurse or a PA because medicine is all about the sciences.

Again, I'm with you and Q because I think science is only a part of it, the rest has to do with the application of this scientific knowledge based on your skills.

 

[n3xa]

I just posted a thread in the DO section because I agree with you and Q. They are not being so nice to me and they are telling me to become a nurse or a PA because medicine is all about the sciences.

Again, I'm with you and Q because I think science is only a part of it, the rest has to do with the application of this scientific knowledge based on your skills.

I don't like research, I don't like laboratory work, and I have no passion for science. I can do well in the pre-req's but you won't find me doing any presentations. I am a business major too.

At some point in your career, you might have to give a presentation about something?

Aside from the naturopathic dirty hippie post, there wasn't anything really trollolololol-worthy/mean.

 

[Iwillhealyou]

I don't think there's any surefire way to predict it, because you can't know for sure how you're going to like practicing medicine until you start practicing medicine. But IMO, the qualities that people who dislike medicine seem to have in common include at least some of the following:

• Not service-oriented, someone who is not a "people person"
• Main motivations for going to med school are things like job security, desire for respect, desire to be in charge, desire to make a lot of money
• Inflexible, can't tolerate change, uncertainty or ambiguity
• Low tolerance for being inconvenienced, doesn't cope well with having to "take one for the team" sometimes, unwilling to put other people's interests above their own on a regular basis
• Dislikes teaching, perfectionism to the point of being intolerant of any human fallibility, takes their frustration out on others (particularly those lower in the hierarchy)
• "Free spirits" who cannot manage to conform to the hierarchical training structure, unable to make peace with the realities of working in the current health care system
• Cynical, avoids connecting with patients or colleagues in a human way, not introspective, does not "debrief" or ask for help when emotionally overwhelmed.

I thought your list was interesting and in some circumstances or specialties probably a very good indicator of whether or not someone would do well in medicine. Just like many other fields of work, however, different skill sets are optimal for different areas of work. Surely a pathologist does not have to worry about whether he is a good people person or enjoys working with patients, or a radiologist or anesthesiologist (not sure if I spelled that right lol). I think the skill sets someone needs to do well and enjoy their job as a physician totally depends on what their specific area of work is. A family practice doctor would probably rely more on people skills than many other areas of medicine and so on and so forth.

Teamwork, as you mentioned, I think is huge, as well as teaching others and being open to taking instruction from others as well. IMO the biggest factor for someone to do well in the field is to just have that desire to do well in anything they do and this can be magnified by the desire to WANT to help others and get that satisfaction out of it. If you are the type of guy/girl that gets a kick out of helping someone out, I mean if that is what really does it for ya, whether you directly work with the patients or not, then I think you are halfway there and the other half will fall into place by itself. It just has to make you feel good and all the other **** you have to deal with has to be outweighed by that feeling.

 

[Iwillhealyou]

Nasrudin by far always has the most eloquent posts on SDN. What is your price for writing essays and such

 

[drdan83]

At some point in your career, you might have to give a presentation about something?

Aside from the naturopathic dirty hippie post, there wasn't anything really trollolololol-worthy/mean.

Telling me to become a nurse or a PA is not mean? They don't even know me.

 

[n3xa]

Telling me to become a nurse or a PA is not mean? They don't even know me.

I agree with an above poster. If you really just want to socialize and talk with patients and do basic procedures... go into nursing or PA. I'm not saying this in a negative way... I'm just saying from the way you've come across in this thread, those fields may suit you better.

Nobody is doubting your ability to get into med school or a residency (well I'm not anyway).We are questioning your motivation for pursuing professional medicine, as opposed to one of the allied health fields, based on your previous posts.

Signs point to no.

I know it's tough to have people question your motivations for your desired path, especially when they're basing it off of posts on an internet forum, but on the bright side, take it as an exercise for the interviews/secondaries/applicationcycle. Don't forget to add a large grain of salt.

 

[qtpai]

This may be informative to some. I want to specifically point out that financial remuneration seems to be a significant factor in job satisfaction, as do number of work hours. It is interesting that Derm really does rate among the highest specialties in terms of job satisfaction.

http://www.semmelweis.org/ref/8c2.pdf

 

[Iwillhealyou]

This may be informative to some. I want to specifically point out that financial remuneration seems to be a significant factor in job satisfaction, as do number of work hours. It is interesting that Derm really does rate among the highest specialties in terms of job satisfaction.

http://www.semmelweis.org/ref/8c2.pdf

Thought the study was interesting, coincidentally, 2 of my top choices of specialty are both in the top 8 for 'satisfaction' levels. Thought that was cool but I wonder why.

 

[NuttyEngDude]

I expect in 15 years we all necro this thread with the word "Me"

 

[Dayzie]

I expect in 15 years we all necro this thread with the word "Me"

I'd actually contemplated responding that way just for the lulz, but I didn't want to jinx anything this far in advance.