Monthly Archives: September 2008

Generational Differences and Medical Training

23 Replies

As I was looking through my comments tonight, I saw a very insightful comment left by someone who goes by the name of “Deaner.” He or she was responding to my post entitled Medical Students v 2.0. That post is very old, so I wanted to repost it here so that it will get some views. He or she makes some very good points, and it’s an incredibly well-written comment. Here it is, thanks Deaner:

I was recently describing the generational difference to a group of friends. Generation X and Y. Its not that we are “entitled, lazy, arrogant or non-caring.” It isn’t even that we leave in the midst of patient care and never would we refuse to be involved in an opportunity for education– as the physician above implied. This is a misinterpretation by an older generation that comes from their lack of regard to our goals, our mission and our acute understanding of our surroundings.

Looking at the physicians that make up today’s medical field, we are able to deduce the effect that traditional medical education has on its participants. We the older generation of physicians who are bitter, overworked, validation (read: money)-hungry doctors many of whom practice medicine without respect to the patient and without love for their work. We (generation X and Y) on the other hand, are committed to our own sanity, health and future. We want to be good doctors. Period. So when we see inefficiency and ineffectiveness in medical education, which leads to suffering and sacrificing of health, we want to fix it. We recognize that it takes not just one, but two elements to allows us care of patients in our fullest capacity:

  1. Rigorous and extensive education.
  2. Our own mental and physical health and continued enthusiasm towards patient care and medicine.

So we put our heads together to change what could be better. Cut out anything that is either impinging on one of the stated elements without fulfilling the other. Why? So we have more free time to play? No. Because we think we are too good for traditional methods? No. Because we think we’ve somehow earned it? No. Because we don’t care about medicine? Absolutely not. We want to fix it because we want to be good doctors. We want to learn every second that we are not working to stay healthy (sleeping, eating, feeling.) We know that we must stay positive (not resent the hospital or our patients) in order to open our minds to allow the maximal amount of education to enable us to be both wise and compassionate doctors.

We refuse to have our potential to be great and healthy physicians stripped from us by our experience with medical education.

I am not bothered by older doctors saying “blah, blah, we worked so much harder than you…” Instead, I pity them. I pity them for justifying their misery but ridiculing our commitment to change.

If I Were Your Attending

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  • Everybody will leave work no later than 5pm. Working late sucks.
  • Keggers will be held every Friday night after work, attendance is optional.
  • Rounds start at 11 am, and then end at noon. Lunch is important, and fuck getting up early.
  • Gym Time: I like my residents and medical students to be in shape, but I really don’t give two shits if you’re fat and dumpy. 9-11am is the designated gym time, but you can do it whenever it’s most convenient for you. As long as you get your work done, work out whenever. If you hate working out, do what you want to do instead.
  • Once your work is done, it’s time to go home. Don’t ask for permission, just leave.
  • Business attire in the hospital is stupid. Wear scrubs on my service if you like. If you want to pimp your nicest suit, I don’t give a fuck.
  • Saturday and Sunday are off limits for the hospital, I hire hospitalists to take care of that kind of shit. If you want to work on Saturday and Sunday, go for it.
  • Residents and students will spend at least 20% of their working time working on personal projects. Entrepreneurism is encouraged.
  • Residents and students will be expected to take at least one nap per day. I don’t care when you take it.
  • World of Warcraft and XBOX games (including, but not limited to, Call of Duty 4) will be played on a daily basis. If you’re not into this sort of thing, go do whatever it is that you like.
  • Anyone that is determined by me, to be a “gunner”, has to complete the following for time: [Run 1 mile, 100 pull-ups, 200 sit-ups, 300 squats, Run 1 mile], all while wearing a 25 pound weight vest. Any time greater than 35 minutes earns the “gunner” a week of doing nothing but scut work, digital rectal exams and manual disimpactions.

Let’s have some fun!

How Did You Stay Sane During Training?

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I didn’t, actually. I just worked all the time. I gained 25 pounds, and developed varicose veins and plantar faciitis so painful, I took analgesics constantly. My blood pressure went up, and despite my best efforts, I could not eat healthy as a resident. I developed prediabetes, and basically ignored my physical needs altogether. It is a show of weakness to express the need for the requirement of basic human needs as a surgical resident. Going to the bathroom was a big deal, actually. My only saving grace was the fact that I was only in my mid/late 20s, and my body tolerated the abuse…abuse that would be difficult (perhaps impossible) to physically recover from for someone a bit older.

I had no hobbies, nor could I engage in any meaningful discussion with other people (outside of medicine), since I had no time to engage in the world activities and issues. I became very one dimensional, and my entire identity became “me, the surgeon.”

Living the dream.