The following is contributed by Cousin Throckmorton.
When will it end?
Between the boredom
And bourbon
I haven’t much left
Empty
Hours
And hours
Of dry books and disappointed looks
Of diabetic feet and discharge sheets
Wading through patients
And patience
Knock kneed and faceless
From hackneyed cases
A doctor
Of guile
Hiding behind false smiles
Sweating away my soul
Into a day old shirt
I’m sinking
Gradually
Then suddenly
I haven’t much left
yo hoover can u explain universal health care to us? And what books/websites/etc. did you use to get the financial understanding that you have now? btw formatting in medschoolhell.com comments is fucked up in Safari.
Whenever comments are displayed it starts moving from left to rive so that you only see a word at a time.
Please fix it.
Also, do update your web blog more often, it’s very cool.
Yeah man, sorry about the Safari/Chrome shit. I update whenever I feel like it these days. Back in the day while still in med school I updated more often but now it’s just whenever. I’ll try to get the Safari/Chrome shit worked out, but it’s low priority.
Yeah I hear ya, I (we) really like your blog. I’ve read all your posts and it’s good stuff. It’s made me (potentially) take a step closer to law school as it’s more reasoning based from what it seems like.
I’m an undergrad and all my upper level bio classes are so retarded. It’s just pure memorization, and to make it worse, you have to LISTEN to the professor for the random information that will be on the test because either A) it’s not in the textbook B) it’s not in the slides C) the textbook is way too dry/too dense/etc. to really help you.
It’s funny how all the conceptual questions/classes I get As in but the “memory intense” classes some of the dumbest f*cks think they’re top shit.
It seems that you don’t care about profiting from your website, but honestly man this website is top notch. You should put some ads here or there, and make it more active if you can. A lot of us enjoy your website because it’s all the stuff that the SMART ones are craving to look for. After a while, you begin to think you’re crazy, a failure, and even not intelligent enough, but your website helped reveal the light.
When supply >>>>>>>>> demand, then med. schools can do whatever they hell they want.
The osteopathic schools are the worst, and the most hypocritical. They preach preventative care and specializing in putting people into PRIMARY CARE positions, yet many of them (I.e. NYCOM and Touro and NOVA) charge around $70,000 a YEAR (room, food, insurance, tuition, books, etc).
In the 70s, my dad’s friend graduated from medical school with $3000 (yes a dollar was worth more then but that’s besides the point).
Over the past 10 years, we’ve seen schools such as TUFTs, ALBANY, many other private schools, even osteopathic, and caribbean schools because ridiculously expensive.
The other thing is that there are so many ways of getting into medical school these days, that one questions him/herself where’s the prestige/status symbol? Is it there? Yeah, but it seems to be the case that the public opinion of doctors has been steadily decreasing over the past few decades (not saying who’s at fault, but just noting a trend here), and the prestige/status is there, but doesn’t seem like it’s worth it for the time put in.
Hoover, I’m really curious about the effects of universal health care on doctor’s wages overall and in specific specialties. That is not to say that I don’t support universal health care, hell yes I do, as I think HIGHER LEVEL EDUCATION SHOULD BE AFFORDABLE ($45,000-55,000 FOR UNDERGRADUATE? A B.S. REALLY IS BULLSHIT!), but now I’m just drifting away from another significant point I was going to mention.
A lot of kids going into medicine are from families where the pressure to enter medicine is high because of parents’, families life circumstances (crummy, unreliable job), first generation (indians, chinese, pakistani, etc.) where FAILURE and MISERY was a way of life.
I’m from the Ukraine, and I found that my parents put a lot of undue (but well intentioned pressure) for me to enter medicine because they went through a lot of suffering opening up a restaurant here in America (not able to speak English that well), and they knew that it’s a reliable field.
The problem for people born in America is that, well, if you are not a total and complete bum, and you’re not a fatass drunk, life in America is not that bad. Sure people get depressed and lonely and whatnot, but believe me in the rest of the DEVELOPING world, that’s the least of your worries.
Here in America, fear of FAILURE and being driven into starvation/poverty (what is poverty in America versus poverty say in China? Two statuses that are relative to their nation’s respective quality of life) is not an issue. You can still make $60,000-$70,000 a year and travel many times a year, eat well, and have a life. What more do you need?
I believe that there are genuine well-intentioned people who go into medicine, but I believe that the system the way it is set up now is and will never be able to find the few genuinely passionate AND intelligent (both are important) people who are really meant for medicine. In the meantime, gunners focusing on the job security + big bucks to marry the hot woman that will not care about the (by the time he comes out) stressed, unhappy, overweight, balding, etc. doc at that point.
Who knows, maybe I’m wrong, I’ll just let God (whoever, whatever he is…) guide me on the straight path through this crazy road called life.
When demand >>>>>>>>> supply*, then med. schools can do whatever they hell they want.
Hey Hoover
I left a question on the forums for you but I think they’re closed now =)
I was wondering if you completed residency or did you just get your MD degree?
I’m pre-med and an intrigued by everyone’s posts. I think the main issue (as touched upon) is that people are entering medicine for entirely the wrong reasons, such as financial stability, prestige, job security, wealth, etc. While these are sub factors, they shouldn’t be primary ones. I am going into medicine because I can’t see myself being happy doing anything else. I love science, I love solving puzzles, I love research, I love being challenged, I love learning, I love using complex clinical skills to help people, etc. If you go into medicine for any reason other than because you truly WANT to be a doctor, then yes, you WILL likely hate it.
If you find yourself bored and disinterested with your pre-med classes, that is a sign that medicine may not be for you. Save yourself now and get out. There are many other professions out there. For those already who have gotten in too deep and are actually in med school, finish, work for a bit, pay off your debt, and then apply to law, engineering, MBA programs, etc. You owe it to yourself to be happy. You have to go into medicine because you love it.
Or stay for awhile and see if things settle down. If you are hating endo rotations for example (I’d get tired of dealing with defiant obese Type 2 diabetics all day long too), don’t specialize in that field. You may find that you love neurology.
The bottom line again is that you should not go into medicine unless you truly want to be an MD. This is one reason why med schools are supposed to be selective of who they let in.
Some nurses somehow love their job (personally I would rather shoot myself than clean up sh!t, educate people about preventing STIs, and push pills all day), because it is what they truly want to do. If you are seeking fortune, respect, and recognition, medicine is not automatically going to bring you happiness. You have to love medicine for what it is, not what it can give you.
P.S. Now I’m scared to read the rest of this blog…*I* don’t want to get discouraged. Lol!
“I am going into medicine because I can’t see myself being happy doing anything else. I love science, I love solving puzzles, I love research, I love being challenged, I love learning, I love using complex clinical skills to help people, etc.”
Wow, that sounds exactly like me, four years ago. I wanted nothing more than to get accepted into medicine for those exact reasons. It took me two tries but I got in, and was so eager and ready to start “helping people”.
Fastforward to 2012, where I am a final-year med student who cannot wait to get out of this shit-faced hell-hole called medicine. I am literally counting the days (86) until I can graduate, and kiss all of those fuckers goodbye.
Unfortunately, those good, wholemeal reasons that got me here in the first place didn’t do shit to carry me through. Medicine will push you to your limit. Some don’t mind it, some even thrive on it. But don’t go thinking that good intentions will be enough to get you through.
And another thing. There is actually surprisingly little “puzzle-solving” in medicine. The field is so complex with specialties and subspecialties and subsubspecialties that all original thought is thrown out the window. Everything is now a “protocol”. If this, then that. Follow the flowchart and nobody gets hurt (literally).
But you’re speaking from naivety too as a pre-med but your recommendations don’t have the same strength in opinion as Hoover’s as he’s gone through the process.
The thing is if you’re not in it for the money now, you will be after the crap you’ll go through during the first 3 years and the way they pimp you in med. school. Even though you love all those things you’re learning, and the thinking things, I don’t know how much of a passion learning random factors is going to be compared to say having sex or going to the Virgin Islands.
Medical school is just a lot of memorization and hard work, and thus you don’t need to be extremely above average intelligence to do well in medical school.
The real intellectual endeavors are in the other fields (which are for the most part paid less in comparison to medicine) where the real advances are made.
Furthermore, I don’t really know how selective medicine is these days when you have so many options of practicing in this country.
Is it for the MD schools in america? yeah? But there’ll still be people from osteopathic schools, from the Carribbean, and from other countries getting their licenses too.
The other points are that universal health care, insurance companies screwing doctors left and right, the hospitals bossing the doctors, etc. you just end up following protocol rather than having any autonomy.
The ones who don’t end up miserable are those who seem to go into the subspecialties (i.e. pathology, radiology, dermatology (pff yeah right try to get into it) because they don’t have to deal with the bullshit in the primary care specialties.
But then again, the only reasons why one is going into that in the first place is to make good money, and have a good lifestyle.
Dr. Cox from scrubs said it best,
“I did it for the 4 reasons why everyone else goes into medicine, chicks, money, power and chicks.”
To ThisISmyrealname,
“I love science, I love solving puzzles, I love research, I love being challenged, I love learning, I love using complex clinical skills to help people, etc.”
^ Spoken like a true undergrad, naive and deluded. I’m a second year medical student, and like you, I loved problem solving and “hard” science when I was in undergrad. (by “hard” science, I mean non-biological sciences) I thought that medical school would offer critical thinking and problem-solving, because that’s what we are lead to believe. Boy, was I dead wrong.
I can honestly say to you that medical school and medicine as a whole has minimal problem-solving, and requires as much analytical ability as being a high school counselor. The vast majority of what you’re doing in medicine is routine bullshit and complete bitch work.
It’s absolutely fine if someone loves medicine, because they like to help people. But, if you like using your brain on a daily basis, medicine isn’t the answer.
“I love science, I love solving puzzles, I love research, I love being challenged, I love learning, I love using complex clinical skills to help people, etc.”
I’m going to be surprised if this sort of “love” takes you far past the first two weeks of any third year clerkship. That’s where you will really learn to “love” medicine.
You’ll learn to “love” the 90 hour weeks, the 1:4 call (all year baby), the sleepless nights, the lost relationships, the sadistic attendings, residents, nurses or fellow med students, the debt, the depression, the lack of sunlight and the fact that your friends are working, doing whatever, and living their lives. Love it all my friend. Breath in deep and let that “love” coat your lungs. Oh, and don’t forget the hours you spend studying on top of it all, the stress of those damned exams, and the residency match. Oh and then internship year, and eventually the career you “love” – complete with 70+ hour work weeks, falling compensation, a mountain of debt, no holiday pay, no benefits, no pension, an imploding health care system, and a medicolegal climate forever sharpening its teeth etc.
Yes, I “love” medicine, and she loves me too – bent over or hog tied (I let her choose).
But I mean, what the fuck do I know? It’s not like I’m actually doing this shit; no I’m just typing away from my science library work station, learning about Krebs and his cycle, and getting a hard on ever time someone mentions to me that I might just be special enough to become a doctor. Oh no wait..that’s you..
Hi, I actually deferred my first year because I was having some serious doubts about going into the medical field. This was the result of seeing a lot of the aforementioned problems of the medical field. I am considering going to graduate school for neuroscience. Of course there is a part of me that worries that I’ll regret this decision. I was just wondering for those of you who ended up disliking your chosen field: how did you start out? Did you have serious doubts in the beginning that got worse as time went on or were you all bright eyed and the system beat you down? I guess I am trying to ration this all out for myself, because I already feel disillusioned with the field and I haven’t even started yet…I’m guessing that you need a lot of motivation to get you through the first few years, and if I don’t have that now is there any chance that going down this path I will feel more motivated as time goes on. Thank you.
^u mad.
^
no u mad
“For those already who have gotten in too deep and are actually in med school, finish, work for a bit, pay off your debt, and then apply to law, engineering, MBA programs, etc. You owe it to yourself to be happy. You have to go into medicine because you love it.”
Do even know what you’re talking about?
We are in the middle of a deep recession where MBA’s and lawyers are getting laid off by the TENS OF THOUSANDS. Only the engineers are somewhat spared, but they work in cube farms and most pre-meds aren’t cut out for engineering.
I’m actually considering medicine as a second career, but Hoover is scaring the fuck out of me.
However, I can’t envision anything else that is a firmer career path after 7-8 years of work, pays as much, and is as recession-proof as medicine. So I’m open to suggestions.
sir, you have tunnel vision.
actually there’s dentistry (no real residency requirement you work after 4 years).
There’s law if you go to a top 20 law school (immediate offerings of 150,000+)
There’s the government through civil service exams.
You can do what Hoover did and open up a business.
If you make anywhere from 80,000-120,000 a year in America you will be fine especially with a family of 4 and you don’t decide to live in a city (you’re stupid if you want to raise a family in the city anyways…)
You can become a PA, you can do a master’s at some school, and do that.
There are some important points you should understand taht in medicine is the money guaranteed? Yes.
But the pot of gold has been shrinking because of the significantly higher debt loads that students are coming out of these days (we’re now quickly approaching total principals of $300,000 and this is, of course, excluding, interest accruing on undergrad loans + interest on med. school loans).
Two, it will be another at least 7-10 years of bullshit before you see that money.
Three, with universal healthcare (HOOVER FOR CRYING OUT LOUD PLEASE WRITE AN ARTICLE ON THE EFFECTS OF UNIVERSAL HEALTH CARE AND ITS POTENTIAL EFFECTS ON DOCTORS’ SALARIES!
) you’ll see cuts in doctors wages. Will they be significant? I don’t know, maybe not enough to screw the doctor, but enough to make you go why?
Fourth, whereas your business-savvy peers in the non-doctor field are making money at an earlier age, they have the potential to save that money and invest it wisely (though you can argue with today’s economy, but still… the principals still apply you still invest in mutual funds, bonds, etc.)
Fifth, if you make more money in America, expect to be taxed more. PROGRESSIVE INCOME TAX baby.
Will you come off ahead financially in 25 years? Yes.
But whoever said that the accountant, the lawyer, the physician’s assistant, the nurse anesthesiologist, the plumber etc. were poor or financially broke in the first place?
It’s all about how you deal with life, having quality friends, hobbies, YOUR VISION, your faith in yourself, and not feeling burnt out, and thus being happy that counts.
The pursuit of anything in life is about happiness, whether it be money, religion, a profession, etc.
“actually there’s dentistry (no real residency requirement you work after 4 years).”
The outlook for dental GPs isn’t great. Many states are oversaturated.
Dentists only average $100,000-$115,000 but tuition is more than med school tuition. Dentists who rake in $ are specialists (unpaid residencies) or practice owners (huge business risk, especially in a recession).
“There’s law if you go to a top 20 law school (immediate offerings of 150,000+)”
I did that. Now I’m laid off.
“There’s the government through civil service exams.”
Working for the gov’t is the same as working for the DMV.
“You can do what Hoover did and open up a business.”
If I had a brilliant biz idea, I would’ve done it by now.
“You can become a PA, you can do a master’s at some school, and do that.”
PA schools look for 2-3 years of clinical experience, and many PAs work just as hard as physicians and take call. All for $80,000.
“Fourth, whereas your business-savvy peers in the non-doctor field are making money at an earlier age, they have the potential to save that money and invest it wisely”
I don’t know a single peer who has done well in business on their own.
I know some pretty smart JDs, MDs, and engineers. The JDs are either burnt out, laid off, or looking for a career change. The MDs are pretty happy (but were miserable during residency; my own IM doctor looks very unhappy/stressed/struggling). The engineers are happy.
The subject of PA’s comes up frequently and I wonder if anyone can answer the question as to why PA schools require 2-3 years experience?
You can go to nursing school, med school, dental school, chiropratic etc etc all without prior paid experience. I assume PA schools will, like med schools, teach you everything you need to know about the job.
The only conclusion I can reach is to control the number of entrants, as Anonymous apparently experienced.
If that is the case the policy doesn’t make sense if you believe this country needs more primary care pros.
i suppose we’re both using anecdotal evidence to support our claims.
You’re saying that states are overstated with dentists, I see states where the potential to make a lot of money are still there…
You said, “Dentists only average $100,000-$115,000 but tuition is more than med school tuition. Dentists who rake in $ are specialists (unpaid residencies) or practice owners (huge business risk, especially in a recession”
True, but not really at some schools (like Buffalo).
The general dentists who make the money are those who have common sense and a decent/excellent business sense.
Likewise in law, thosse with ambition, with drive, with hope will make it even when getting laid off.
We can’t say for sure what happened to your friend and why he got laid off. Is it possible it was because of the economy, probably. I don’t know I can’t input on that.
You said, “PA schools look for 2-3 years of clinical experience, and many PAs work just as hard as physicians and take call. All for $80,000.”
True, but there are those that don’t, my colleagues are going into PA programs right out of undergrad maybe it’s a special program or something.
Some PAs may work just as hard as the docs, some may not, but for sure they don’t have to do 50 hours a week of bullshit, and they don’t have to pay malpractice, and they have controllable hours.
Again this is a variable factor.
In the end, what it comes down to is eschewing what others think of you and doing what you like the most, and if you don’t know what you like the most that’ll make money, then find the next best thing.
EVeryone should take time to find their strengths and weaknesses for starters, and if this necessitates taking time off after college (there ARE ways to defer loans and take time to think about what you wanna do with your life i.e. Peace Corps, Americorps, etc.) then do it.
There’s no rush especially when you’ll probably live until the age of 80, and the fact that you’ll be more mentally prepared for shit anyway.
Look at Obama, took 7 years off before knowing he was gonna go to Harvard Law.
And look at Jimmy Carter, he was a small peanut business owner (he was an engineer too) and look what happened to him.
The trick is that whatever you do, you do it with motivation, with interest, in good health, with optimism, etc.
The trick for all of that to work is to have faith in yourself, to eat well (cut carbs completely for starters), and exercise 5 days a week.
Once you do that, you’ll keep on going.
As long as you’re gaining $100,000 GROSS dollars (today’s value adjust for future of course) you’ll live a very good lifestyle.
Frankly, I would’ve gone into medicine if the field was a little better.
Primarily, if the debt was a lot less, the field was more reasoning and less memorization (which is unavoidable understandably) though every doctor I’ve spoken to and from personal experiene, no one remembers the shit from medical school. All that shit does is rank people, and I guess, from a positive perspective, gives them a better understanding of the knowledg and vocabulary.
So Hoover, what are the potential effects of universal health care on doc’s salaries in the future?
I am really looking for answers on whether to go to MED school or not and this message was very nice.
If you think medicine is all memorization, you are mistaken. That’s what you see on the front end, as you learn the basics. As you get further into practice, you see that you have to reason through everything.
Maybe you’re right. Are you a med. student or in residency?
MD, even in clinical situations, the thinking involved isn’t exactly the same critical thinking that pre-meds are often interested in. The vast majority of clinical “thinking” is just going down a list of criteria and molding a diagnosis around what seems to be the most plausible solution.
Yeah, pretty much. Critical thinking of the only type that really counts (the kind that doesn’t necessarily result in the exact same answer as your peers) tends to get you tagged as a maverick in medicine, you’re just supposed to spit out the standard answer everyone’s expecting based on the current literature.
With cookie-cutter evidence-based medicine all the rage, memorization is king more than ever. Screw anatomy, pathology, physiology, and that meddling reason; they’ve got that disease so this is the medicine they’re getting. I don’t care that the other medicine has the same mechanism, the preponderance of the research was on the first medicine so that’s what we’re using. Use the other one, it’s your ass should something go wrong.
And while it’s sweet you may have a vague recollection of the mechanisms of how the different medicines actually work, it really doesn’t come into play that much aside form pimp questions. And those pimp questions are just the weird little factoids the doctors happen to remember, they’ve forgotten most of the other stuff from disuse, too, which is why you’ll sometimes be frowned upon for asking them the same kinds of questions as a student.
That’s not to say there’s not sound reasons for the eyebrow-deep conservatism in medicine, it is people’s health and lives at stake, after all. Your joy of research and critical thinking and solving new puzzles and all that crap takes a way way way way backseat to not doing anything whatsoever that might possibly hurt someone. If you’re starry-eyed and dreaming of being a Dr. House who’s actually nice to his patients, keep dreaming. In the real world he most likely would have lost his license years ago for habitually breaking with the standard of care (read, pure cookie-cutter memorization with at times shaky underlying reasoning at best) and losing a few patients on the side, regardless of his underlying clinical reasoning.
That said, I’m still glad I did it. From the original post and other comments, I dunno, it might depend on where you’re training, but from what I’ve noticed you’re usually treated like a bitch if you act like one. It’s prison rules in the hospital. The ones who seem to complain the most about their treatment are the same ones scared shitless of saying or doing anything about it because it might affect their evaluations, when the truth is it seems to make little difference in the end and pushes them to burnout even faster. It’s an alien concept to some, but people who actually respect you often write good evaluations, too.
Saget, thank you for at least respecting my input enough to ask more questions. Bronx, I have to wonder where are you in the process? Out of training? If so what field are you in?
I’ve been out of residency for almost two years. My initial medical school experience was, without a doubt, geared toward memorization. As my clinical experience grew, I began to see more of the case-by-case decision making, and the way you begin to make decisions based not on a bunch of facts you memorize, but based on the patient you are taking care of.
And the thought process becomes, “why are you ordering that CT scan? Do they really need it? What are you concerned about? What in their history, or your exam, justifies this expensive and time consuming test? What will you do if the CT shows a POSSIBLE early appendicitis, but clinically they appear well after the CT and some IV fluids and antiemetics? Do they need a CT to begin with, if their exam is consistent with appendicitis and they are a young healthy male with no comorbities? Different surgeons will have different preferences….
I could go on all day but ultimately my point is, reasoning does come into play much more so than you may imagine early in the course of your training. Ultimately as a resident when you present to an attending, the questions will be: why are you doing this, and what are you going to do with the results?
Ultimately if there is literature to support your decision that carries some weight. But it’s astounding how often this is not the case.
Look, I’m not here to convince anyone medicine is right for them if they think this is not the case. I’m not here to convince people this is the greatest career imaginable. It’s hard, it’s not for everyone, I have my days when I wonder if I made the right choice.
But ultimately I’m still here, and I’ve gravitated toward this website because I was there once and I know what it’s like. I was angry as a medical student on MANY levels about the educational process. But I persevered and if I hadn’t I don’t know what I’d be doing now, but I know I’d always wonder what would have happened if I’d fought through the BS.
Hoover, at least according to his posts, has found another route that works better for him. If that’s what is right for you then go for it. If your heart is not in the right place, do something else.
But if your heart is in medicine, you can persevere, you can make a good living, and if you pick the right field you can have a decent lifestyle and good income….
“And the thought process becomes, “why are you ordering that CT scan? Do they really need it? What are you concerned about? What in their history, or your exam, justifies this expensive and time consuming test? What will you do if the CT shows a POSSIBLE early appendicitis, but clinically they appear well after the CT and some IV fluids and antiemetics? Do they need a CT to begin with, if their exam is consistent with appendicitis and they are a young healthy male with no comorbities? Different surgeons will have different preferences….”
Yay. A good mechanic will probably go through roughly the same reasoning process using roughly the same amount of brainpower and time to get a poorly maintained car dumped in his lap running again, you don’t see them crowing about their mad reasoning skills or starry-eyed college kids who like research and solving problems and the occasional appreciative smile of a satisfied customer studying hard with dreams of maybe fixing cars one day if they’re lucky. There’s reasoning, sure, there’s reasoning involved in most work out there beyond the most menial of tasks, but if that’s what someone’s going into it for, I see disappointment ahead.
Hector if this is what I’m dealing with on here when I try to have some meaningful dialogue, I’m done with this website.
I could open a book on mechanics, buy a few tools, and fix my car in my own driveway. If I screw it up, so what? No big deal, no one dies, I’ll read through everything again and I’ll probably figure it out. And the best part is, no matter what is wrong with the car I’ve got all the time in the world to figure it out.
Medicine is slightly different. People who go online to try to self-diagnose, even the most educated ones, are often way out in left field. There’s a reason why it takes so many years to get through the process. What about the old lady who comes into my ER with altered mental status? She’s on about 20 medications. Did she take too many of one of them? Is this sepsis? Stroke? Electrolyte imbalance? Laundry list of potential diagnoses and it’s up to me to sort through that. Not every encounter takes this level of reasoning but some do and those are the ones that keep me interested.
That being said, if problem solving/reasoning process is your one and only reason for going into medicine, you’d probably be better off in engineering of some kind. You have to have some level of interest in medicine itself, and the people you are taking care of.
I’ve tried to post on here with the “other side of the coin” and be open and honest about medicine, from someone who has more experience than most of you but also understands where you’re coming from on some level. I feel like I’m beating my head against a wall at this point. Good luck guys, I’m sure you’ll figure it out and find something in life that makes you happy!
Don’t let them get you down MD. I have always found your comments articulate and intelligent.
When I was a kid I worked for awhile for a vet. It wasn’t long before I could reasonably diagnose (to myself) any cat or dog that came in, as most of the problems hit the middle of the bell curve.
One of the docs told me once that they were told in vet school that a monkey could do 90% of what a vet does every day. They were being trained for the other 10%.
Perhaps much of medicine is the same. I would guess the best docs are those that focus on that 10%.
How many mechanics can fix a car with the engine still running?
“Hector if this is what I’m dealing with on here when I try to have some meaningful dialogue, I’m done with this website.”
Chill out, it’s not that I can’t appreciate anything you say, I’m just an argumentative bastard, this is the Internet, and this is really a much faster and easier way to get to business than playing patty-cake about how grateful the world should be that we all decide get up every morning before broaching the subject. If you think this is cause to leave in disgust, I’ve given and received orders of magnitude more bile than this in arguments over video games. Get out more, or maybe less.
“I could open a book on mechanics, buy a few tools, and fix my car in my own driveway. If I screw it up, so what? No big deal, no one dies, I’ll read through everything again and I’ll probably figure it out. And the best part is, no matter what is wrong with the car I’ve got all the time in the world to figure it out.”
First, you sound suspiciously like the internet self-diagnosers here talking about how easy someone else’s profession is. Secondly, if you think there’s no stakes, consider what happens if your ham-handed repair job with all the fancy books and stuff decides to come apart at 70 mph on a crowded freeway because you forgot one of those basic steps the books assume you knew about. Sorta like one of those otherwise intelligent self-diagnosers armed with the best Google has to offer with no concept of renal function. I have no doubt you could pull off the trained monkey work of oil changes, but plenty of professions out there also have lives riding on their competence, including mechanics. Rationally, the terrible, horrible responsibility of all these lives in our hands just doesn’t carry all that much weight in the argument to me. Some minimum wage flunky working at a peanut butter plant recently killed and sickened more folks than most of us will in an entire career or at least a sizable portion of one, I’ll be waiting for the new 7-12 year training program to properly prepare folks for the onus of that weighty responsibility.
“Medicine is slightly different. People who go online to try to self-diagnose, even the most educated ones, are often way out in left field. There’s a reason why it takes so many years to get through the process. What about the old lady who comes into my ER with altered mental status? She’s on about 20 medications. Did she take too many of one of them? Is this sepsis? Stroke? Electrolyte imbalance? Laundry list of potential diagnoses and it’s up to me to sort through that. Not every encounter takes this level of reasoning but some do and those are the ones that keep me interested.”
It takes so long to become a doctor in no small part because it takes so long to be a doctor. It’s a self-fulfilling prophecy, because there’s really no other way to get there than what we have, so it’s not like you can exactly make much of a valid comparison. I guess midlevels, but then again they’ve been pretty successful at making large strides into our market.
Once upon a time, people figured you had to be a eunuch to be a good at certain jobs, go figure. Eventually all the suitable jobs were filled by eunuchs, so you did need to be a eunuch to hold them. I’m sure if someone had the idea all prospective doctors had to literally rather than figuratively surrender their gonads to get into med school, people would, and there’s no doubt we’d have some awesome gonadless doctors out there. As to whether that proves you need to be gonadless doctors, well, give the system 150 years and no one will know the difference anymore. Oh wait, sounds familiar. That’s right sonny, we’re only doing all this because it’s the only way we can make you a good doctor, just like it’s always been.