Welcome To Hell

Hoover  1 Jul, 2008  Residency Training

Ahh, July 1st.

It came around so fast, just a mere two months of sleeping in and traveling since you walked across that stage with your medical degree in hand. Today’s a new day. Today begins the ritualistic flogging of new interns across the nation.

Waking up at 7am used to seem early, but now it will be considered late.  Weekends will now simply be another work day of another work week. Pimping will take on a whole other meaning now that you have to grin and bear it. Personalities that you thought never existed will be encountered every minute of your existence. While once sacred in your mind, medicine will — at some point — be something that you hate, even for a brief moment.

With the sound of a beeping pager going off somewhere in the background, we welcome you to Hell.

We’re glad you’re here.

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16 Comments so far »

  1. name said

    July 4 2008 @ 2:37 pm

    I just finished my first week of pathology residency. I’ve woken up at 7 a.m. every morning and been out the door by 5:30 p.m. It’s July 4th and I am goofing off at home, since we didn’t have to come in. I am off this weekend and most weekends. And I’m not on call until September.

  2. Somz said

    July 6 2008 @ 12:49 pm

    After reading your comments about the proposed 56 hour work week, I found it interesting to read an editorial representing the other side. I’ve read the majority of things you’ve written on this website, and as a 4th year medical student, I agree with you on the hazing and malignant atmosphere that med students have to go through. However, I do agree with the article that not all fields in medicine are equal and some specialties may require more than 56 hours of training to produce competent doctors.

    That said, here’s the article “Duty hours and neurosurgical education” …
    http://www.aans.org/young_neurosurgeons/spring_08.asp#DutyHours
    (scroll down just a little bit)

    You can definitely get the sense that the author has that “old school surgeon” mentality in him.

  3. CC said

    July 6 2008 @ 1:42 pm

    Ditto what “name” said. I am a pathology resident and am working pretty normal hours (and they’ll get shorter as I get the hang of grossing and dictating.) No call for me until November. My “patients” are duodenal biopsies and mastectomy specimens (as you can guess, they are compliant and don’t complain much.)
    4th years, the field you choose now will haunt you until the end. Take a good look at your intended field and ask yourself “do I want to be doing this when I’m 50?”
    Then, promptly abandon it and go for path/rads/derm/pm&r.

  4. CC said

    July 6 2008 @ 1:44 pm

    Hoover, this is an important time for a 4th year student, as they’ll be making decisions that will determine their futures. Now might be a good time to resurrect (or write some new) articles about choosing a field etc. I’d be happy to do some guest commentary.

  5. CG said

    July 8 2008 @ 1:01 pm

    CC: What is “/pm&r”?

  6. spanishspeaker said

    July 8 2008 @ 7:46 pm

    I’m currently an english major, working on med-school pre-reqs, as well. At first, this site frightened me, but the more & more I read, the more & more I’m interested in the field, specifically pathology.

    CC, what is pm&r?

  7. Somz said

    July 8 2008 @ 10:29 pm

    physical medicine and rehab

  8. CC said

    July 10 2008 @ 10:12 pm

    Physical medicine and rehabilitation. Also known as “plenty of money and relaxation.”

  9. namez said

    July 10 2008 @ 11:52 pm

    what i didn’t like about pm&r was that they were deluged in paperwork, and that the physical and occupational therapists had MUCH MORE fun than the pm&r docs did. essentially, pm&r docs order the physical therapists to have amazing fun with the patients (play basketball with them, board games, etc.). the docs don’t have time for that. sucks.

  10. talc said

    July 11 2008 @ 1:00 am

    not having to actually see patients, while still having a pivotal role in patient care, intellectual challenge, an excellent lifestyle, an excellent lifestyle, an excellent lifestyle, $200-250k pay, call taken from home, most nights and weekends off, no internship year, lots of fellowship opportunities and an excellent lifestyle, is what makes one particular field of medicine king.

    pathology rules.

  11. talc said

    July 11 2008 @ 1:01 am

    for the record, pm&r docs typically enjoy a good lifestyle but really don’t get paid much more than your typical primary care doc.

    it should be called sm&pr. “some money & plenty of relaxation”

  12. namez said

    July 11 2008 @ 4:16 pm

    Pathologists are also exposed to sh*tloads of carcinogens and other toxins on a daily basis.

    Most people consider patient contact to be a plus. William Carlos Williams wouldn’t be a famous writer if he didn’t have his patients to be inspired by.

    It depends on your perspective. One man’s hell…

  13. talc said

    July 12 2008 @ 1:25 am

    agreed. “one man’s hell…” exactly. i’m just glad everyone else’s hell isn’t mine :)

    i’ve never heard any cases or read any reports about an increased risk of developing any form of cancer as a pathologist, though

  14. Zuwie said

    July 13 2008 @ 1:53 pm

    Somz, thanks for the neurosurgery article. I feel like I need to comment on some parts of it:

    “…you feel the “creeping chill” of sleep deprivation, that unshakable sense that you’re cold and slowing down and you’re making a superhuman effort to keep your eyes open and stay on task…

    …you just want to stop, lie down, and go to sleep (or maybe just die).
    But you can’t because the patient you just admitted with traumatic intracerebral contusions needs an EVD and if you don’t place it, that patient will herniate and die…”

    Now, if you were that patient with traumatic intracerebral contusions, would you like an EVD to be placed on you by a person who makes superhuman effort to stay awake? Would you like to be in a plane flown by a pilot who makes superhuman effort to stay awake?
    And the worst thing is, the person who wrote that article doesn’t see the irony of it.

    Now, pathology is by no means a walk in a park. You need to know a lot and make a decision that creates a big difference in a patient’s life. What I appreciate in pathology, however, is the fact that you always take your time to make a diagnosis, you are never pressured and you always have your collegues to consult if you are not sure.

    Apparently, in neurosurgery you need to abandon your humanity and become some kind of superhero. The trouble is, no matter how qualified you are, you are still human and have limitations. I’m sure that once surgeons realize that and become more humble, all these preventable medical errors (and there are as many as 100000 per year) will go down precipitously.

  15. Somz said

    July 14 2008 @ 12:26 am

    An excellent point, Zuwie. Surgeons in particular still hold onto the idea that there is a “calling” to be a doctor and a sense of invulnerability with it. The new generation tends to have less of it, but it does persist. I remember talking to a surgery resident friend about the proposed 56 hour work week, and he balked at the notion because it would make surgery “like a regular person job”. Wait, surgeons are regular people (with normal sleep requirements)? What a crazy idea!

    I think part of the reason that so many physicians are disgruntled with the current state of the profession is the doctor-unfriendly environment. Paperwork, litigation, medical student debt, resident work hours, etc. Unfortunately, I believe it is largely due to physicians’ continued self sabotage. Doctors are (and have been) trained with the idealistic mentality that health care is more than a service and that there is some sacred ideal behind it. Thus, they currently push themselves to the limit in training and practice to take care of patients that often refuse to take responsibility of their own health and sue at the drop of a hat. While the ideal may have been true decades ago, the truth is that the medical field in this country is currently a business that makes profit for insurance companies at the expensive of the doctor. It is the failure of doctors to protest against these things and defend themselves that has allowed the situation to get so bad.

    Wow, that’s probably the most cynical bit I’ve ever wrote.

  16. Somz said

    July 15 2008 @ 12:02 am

    Zuwie, the author of the article I mentioned wrote another article that addresses your question about “who would want an EVD placed by someone making a superhuman effort to stay awake”.

    http://www.acgme.org/acWebsite/bulletin/bulletin02_04.pdf

    (last article in the PDF)

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