Have you ever heard “I’m not in medicine for the money?”

When people say they aren’t in it for the money, what they are really saying is “I’m too proud to admit I’m in it for the money.” Seriously guys, not many people are going to put in the financial and time investment required to become a physician without adequate compensation. The ass-backwards medical training process has brainwashed people into thinking that it’s not OK to desire financial reward for rendering services to people who largely don’t care that much about their health to begin with.

So I’m calling all of the posers out. They don’t love sick people enough, they don’t enjoy doing that 135th appendectomy, they don’t love the long hours and nights on call without sleep. Those old ladies with dizziness at 3 am are enough to make them want to puke. Their work gets long, boring and monotonous after a few years no matter what specialty they’re in.

I challenge you all to submit an anonymous poll to your medical school class and here is the question:

If physician reimbursement were capped at $35,000 per year with no other changes, would you continue to practice medicine?

Everybody’s in it for the money.

First I’d like to give a shout out, if you will, to this website and its creator(s). A fascinating concept and an equally fascinating read. No doubt.

Next, I’d like to state in clear and unfortunate terms that I am a recent medical school graduate. I state that so you’ll take me seriously, as I plan to offer several insights about the profession in the coming paragraphs. I’ll also state that I’m not a D.O. or an international medical graduate, thus increasing my status, if you will, even more in your minds. Really though, no offense to my osteopathic colleagues and immigrant/temporary emigrant physicians/physicians-in-training.

I’d like to start out in existential mode, if you’ll allow me. *Squints eyes and rubs chin*. Why would anyone in their right mind choose to apply to, or for that matter, attend medical school? Ah! You’re taking on the pensive pose too now, aren’t you?

Brief and simple answers first come to mind. Money. Status. Ego. Race. Ethnicity. Those were too easy to come up with. I’ll expound on those very shortly, but let’s brainstorm, as my KG teacher used to say, and think of a few more. Ah yes, it’s coming to me now. Retardedness. Delusion. Lack of common sense. Boredom. My parents told me to. My parents did not tell me to, but I know they would have if I didn’t. I pretend like my family did not influence my decisions, but in reality (and don’t tell anyone), I’m a complete slave and bitch and indeed they are the reason why I am an aspiring physician.

Okay good, now we’re getting somewhere. We’ve laid the groundwork to incredibly profound thoughts which are yet to come.

I have to go eat dinner now, so as they did in 1980s sit-coms, I’ll make this a to-be-continued. Rest assured that I will be back for several follow-up visits (no put intended.. medical and medical-related jargon is not my cup of tea and frankly bores the shit out of me). Let me rephrase.. I will be with you in my usual brilliant form in the coming days. And to those of you starting to get pissy, I say pipe down, take a step back, and re-evaluate your existence. What do you really have? A kick-ass histology text? Superior ABG obtaining technique? A stethoscope with a hip pediatric chest piece? Sweet pics from your “white coat ceremony” which you subsequently uploaded on Friendster? Wait, did the AMA hook it up with a free Netter’s? Man that is lame. I suggest you take a seat and listen to what I have to say…

Before starting medical school, I worked many jobs. If something wasn’t going right on the job, not one time did I ever fake that everything was OK. Once I got to medical school, I started to pick up on many students coming to me in private expressing distaste in something that was going on in class or on rotations. These were the same people who I thought were loving every last minute of their medical school days! I admit, I was guilty of faking dissatisfaction with medical school also, especially early on.

What’s different about medical school? Why do people treat it differently than a job? In my opinion, it boils down to this:

Your teachers or attendings are directly evaluating you. While you are a paid employee on a regular job, you’re paying for school. Therefore the dynamics are much different. There is the feeling to “impress” or to otherwise “not piss off” those that are essentially behind the rest of your future. As a result, you “grin and bear” much more than you would in an ideal situation. On a regular job, it is the employers responsibility to assure that the employees are happy. The dynamic shift results in employees that demand a certain standard of treatment. If that treatment falls below a standard cut-off, employees are more vocal about the situation.

You Are Building Your Inner Workplace Dynamics

The problem with “faking it to get by” is that you are actively creating the attitudes and actions that you will use in the workplace from this day forward. The chances that you will magically change once you finish residency and get into practice are slim.

If you are a practice owner, you’re expectations for employee complaints might be much higher — something along the lines of what you’re used to now on the wards.

If you’re a member of a larger practice group, you might be less open about voicing dissatisfactions in the workplace.

Be Careful. It Might Continue Into Residency

Residency might be the first “real job” that many medical students have ever experienced. Taking the attitude to accept whatever is thrown your way — no matter how unfair it might be — with you almost guarantees that you will negatively impact your workplace dynamics for life. Being afraid to voice dissatisfaction with your employer increases your chances to become a disgruntled employee, and you’ll have to vent at some point.

Polite, But Stern

Don’t be afraid to complain when things aren’t right. You do not deserve to be whored out into Scutville on a daily basis. Your primary responsibility is to learn.

If a resident or attending asks you to complete a trivial, menial task such as getting their food or running a personal errand — outright refuse to do it and then offer an explanation as to why you won’t oblige them.

Next, have them explain their reasoning for expecting you to complete such tasks. You just might be surprised at how low you sit on the totem pole.

Medical school blows. If one were to believe one actually likes medical school, one should please reread the first sentence carefully and completely.

Posted recently at the USMLE website, the Step 2 Committee decided to increase minimum passing scores on both the CK and CS versions of the exam.

Step 2 CK

The Step 2 Committee decided to raise the three-digit score recommended to pass Step 2 CK from 182 to 184. The new minimum passing score will be applied to Step 2 CK examinations for which the first day of testing is on or after July 1, 2007.

Step 2 CS

The Step 2 Committee decided to increase the performance levels required to receive a passing outcome on two of the three Step 2 CS subcomponents: Communication and Interpersonal Skills (CIS) and Spoken English Proficiency (SEP). There will be no change to minimum passing requirements for the Integrated Clinical Encounter (ICE) subcomponent of Step 2 CS. If these increases in the performance levels required to pass were applied to a recent group of first-time examinees, the overall passing rate for examinees from US schools would have decreased less than one percent and the overall passing rate for examinees from international medical schools would have decreased approximately eight percent. The new passing requirements will be applied to Step 2 CS examinations for which the first day of testing is on or after July 15, 2007.

Read the full report here.