Bioethics Discussion Blog: Uncertainty and the Life of a Doctor

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Wednesday, April 06, 2005

Uncertainty and the Life of a Doctor

The life of a physician is full of uncertainties. With regard to diagnosing or treating a disease we know that illnesses by the same names are not the same in every patient and neither is there always the outcome we had expected on treatment. There are days, however, when everything goes as expected. We are please with ourselves and get the warm loving hug of a patient who is pleased with us and what we have accomplished. We have all experienced this. But then there is the day when we experience the cold sweat of personal concern: was the diagnosis correct? was the treatment the best? why did the patient die? We have all experienced this too.

Following on this theme is the poem "Doctor Meyers" by Edgar Lee Masters and located at AmericanPoems.com


No other man, unless it was Doc Hill,
Did more for people in this town than l.
And all the weak, the halt, the improvident
And those who could not pay flocked to me.
I was good-hearted, easy Doctor Meyers.
I was healthy, happy, in comfortable fortune,
Blest with a congenial mate, my children raised,
All wedded, doing well in the world.
And then one night, Minerva, the poetess,
Came to me in her trouble, crying.
I tried to help her out -- she died --
They indicted me, the newspapers disgraced me,
My wife perished of a broken heart.
And pneumonia finished me.


Yet, you know, our medical schools are still filled with students. There must be, despite the uncertanties of the medical profession, still something worthy to become a doctor. ..Maurice.

84 Comments:

At Wednesday, October 24, 2007 1:07:00 AM, Anonymous HARRY said...

yes, once in a while, i will ask myself regarding the reasons of i want to be a doctor?

Frankly speaking, during i get into medical school, i was not able to answer the above question.

however, after 4 years i has been in medical school, i found that i interested in medical as i can learn many things along this career. with this career, i get to know many secrets of our human life, exploring the reasons behind each clinical condition with at the same time i will feel very happy when seeing i successfully helping a patient.

however, sometimes, i do ask myself what i did is wrong or not?
is it every patient felt happy when they are not facing us?

whatever, i will try my best to let the happy and satisfaction spread around the world, let my patients can have a bright future once i graduated from medical school..


sorry of my broken english...

 
At Wednesday, October 24, 2007 8:18:00 AM, Blogger Maurice Bernstein, M.D. said...

Harry, I think you are doing the right thing by once in a while "ask myself regarding the reasons of i want to be a doctor."
I think it is the doctors who don't stop and remind themselves of the way they looked at the medical profession when they started their career that can lead to a forgetting of what medicine is all about. Without thinking back, being a doctor becomes a money-making business ("what can I do to make more income?") and not the real goal to help people who are sick.
Thinking back also helps when a doctor begins to get depressed with the work of the profession and provides a renewed meaning and value to continuing to be a doctor. Anyway, those are my thoughts after 50 years working as a doctor. Harry, best wishes for your career. ..Maurice.

 
At Wednesday, November 07, 2007 7:55:00 PM, Blogger Melvin Ram said...

Maurice,

I stumbled upon your blog in my quest to find more clarity on this subject of "why do I want to be a doc?"

After years of thinking my future was in business & management, I started taking premed classes. I'm pulling some of the highest grades in my class so it's been going well... however it is a lot of work. I am fully willing to do the work but what I'm afraid of is that I'll end up regretting my decision for selecting the surgeon lifestyle.

My reason for switching into this career path was to become a psychiatrist but I have decided that I will go into med school with an open mind. After doing some disections recently, I'm starting to think surgery may be my pursuit.

Still, I am questioning whether this is the lifestyle for me. I wan to travel the world and enjoy life's luxuries, with family. I want to enable people to reach their potentials. I want to build strong relationships with people important to me. And I'm not sure if this path will allow me to live life as I'd like.

What started (at the beginning of this semester) as a pursuit to prove to myself that I am capable of doing something very difficult has turned into a facination with the human body and all it's wonders.

So... why do I want to go to med school and become a doctor? I want to learn... through books, through practise, through collaboration and debate. And I want to perform. I want to do things that are meaningful years after it is done. And finally I want to climb this personal everest.

Still... I am not sure if this is the lifestyle for me.

~ Melvin Ram

 
At Friday, November 09, 2007 8:46:00 PM, Blogger Maurice Bernstein, M.D. said...

Melvin, you have an important and difficult decision to make. Nobody can make it for you as you already realize.

You write: "So... why do I want to go to med school and become a doctor? I want to learn... through books, through practise, through collaboration and debate. And I want to perform. I want to do things that are meaningful years after it is done. And finally I want to climb this personal everest." Being a doctor should be more than concern about yourself and what you can accomplish in your life. Of course, we are all concerned about our own lives and how we progress through life. But being a doctor should be more than that. The direction of concern is toward the betterment of each patient. The ethical and professional way a doctor must think and behave is that the primary goal of the profession is toward the patient and not ones self. I can't promise that every doctor follows this direction. Obviously there are some who have found that their own interests trump any interest of their patients. The doctors may be skilled but I don't think, in the long run, patients always benefit from their care. But because there are outliers in the profession who do otherwise, shouldn't change the profession's goal.

So, in making your decision, consider what you really want. If it is to make yourself bigger in the eyes of others and leave a distinctive mark, perhaps medicine as a practicing physician is not really for you. Business is one vocation but if you find science and the anatomy and biology of the human body fascinating, you could go into medical research with or without a medical degree.

I hope you understand these are just my thoughts as a physician for 50 years and my suggestions. The final decisions are yours. ..Maurice.

 
At Friday, February 29, 2008 8:16:00 AM, Anonymous Anonymous said...

Hi,

I am a pre-med student and have finished all of my med school requirements except for biochemistry. For the past four years, studying and work have taken precedence over my social life, and it has taken its toll. Now that I am beginning to prepare for the MCAT, I have second thoughts about becoming a doctor. I enjoy medical science and helping people (the people aspect is what has drawn me to the profession).

Through my journey so far, I have realized that in order to be able to take care of others, one must take care of themself. My main concern in becoming a doctor now is whether I can keep going after 4 more years of school, four or five more years of residency...the whole life seems incredibly unbalanced and unhealthy, is it possible to find a balance in this lifestyle? I am just not sure it's worth it...

I feel like a bride or groom before she or he is getting married, uncertain and scared about the future...

Thanks,

Rick

 
At Friday, February 29, 2008 8:32:00 AM, Blogger Maurice Bernstein, M.D. said...

Rick, of course, I can't decide for you but remember if your feelings are "enjoy medical science and helping people (the people aspect is what has drawn me to the profession)" you can always go into other areas of the healthcare profession and activities which don't involve such a burdem in terms of time and cost or uncertainties as to become a physician. Nursing, medical technicians such as in radiology, cardiology or surgery are available as well as first responders as emergency medical technicians. These may provide a good beginning to a medical career in themselves or progression to additional responsibilities. ..Maurice.

 
At Wednesday, April 09, 2008 10:44:00 PM, Anonymous Anonymous said...

I'm just starting college next year and dont know what to do.

Well being a doctor, can you still travel the world, start businesses, have hobbies,

or is your life completely overshadowed by your career?

KZ

 
At Thursday, April 10, 2008 5:28:00 AM, Blogger Maurice Bernstein, M.D. said...

KZ, it is all about what specialty of medicine you finally enter and whether you practice solo or are working within a group. If you are in clinical practice, you are responsible for the care of your patients and that is your professionl and legal responsibity. However, that doesn't mean you can't have hobbies or a family life or travel. You should realize though that attending to another business may conflict with your duties for your patients and if so your patients come first in your list of priorities. ..Maurice.

 
At Saturday, April 19, 2008 7:29:00 PM, Anonymous Anonymous said...

Hi
I'm a pre-med student and I have been having a few doubts about going to medical school. I really do not enjoy most of my science classes. I see them as hurdles over which I just have to jump. Also, I have noticed that being at a university full of competitive premeds has made me competitive too (but not in a good way) From what I have experienced, I know that I really do not want to spend my professional years in such a competitive environment and from what I see, the medical profession is quite competitive... From your experience, is this true?
Here at school they tell us, "do not rush into medical school ... find out what you like..." But then, time is passing, loans have to be repaid, parents want to know what you've decided to do after college... Any thoughts?

Tek

 
At Sunday, April 20, 2008 5:57:00 PM, Blogger Maurice Bernstein, M.D. said...

Tek, once you are accepted to medical school, the competition of pre-med should disappear, at least when your first year colleagues finally realize that they are no longer competing with each other. The goal in medical school is to learn to be a professional and competent physician. Yes, there are National Boards to pass, so you will want to also have studied to pass but really you are in no competition there with your classmates. Yes, there is national competion to hopefully get the residency you desire but again you are not simply competing with those in your medical school class.
As for competition when you enter the practice of medicine on your own, whether you think you are competing against other physicians is more in your desires of what is important for you. Since the job of a physician is for the care of the patient and not diverting attention to jumping ahead of another physician money wise or for prestige. Now, those medical students who end up in academic medicine and medical research, obviously there is an unfortunate competetion amongst the participants to get the choice position or research grants. I can't speak to that since I have not been personally involved.

So, in conclusion, Tek, forget the concept of competition in medical school, learn and enjoy and have fun simply learning and preparing yourself for your medical future and not about the other student. ..Maurice.

 
At Monday, April 21, 2008 3:28:00 PM, Blogger VIVI said...

Hi am VIVI i am in my 3 year of college. I live in Illinois en my dreams and golas are to become a Surgeon. THe only thing that gets me a little scared is the big question? of how am I going to pay my mmedical School???????????? My parents and all my famil ylive in my country in South America, and I leave here with no Family. Not having my parents is allready hard for me, but not knowing how to pay medical school is worst and depresing for me.. What would you do if you where in my place or what would you recomend? I work in a hospital my position is not that bad, but in my future I want to work there or any other place as a doctor not a regitrar

 
At Monday, April 21, 2008 4:07:00 PM, Blogger Maurice Bernstein, M.D. said...

VIVI, you might check with the medical school you would want to attend with regard to your financial questions. If you are a permanent resident of Illinois, you may be eligible for the lower fees of a state rather than a private medical school. Also, have you considered going to medical school in the South American country where you came from?Perhaps it will be financially much easier for you. I don't know all the issues involved in that decision. Can't you talk this over with a career counselor at your college? I wish you the very best in your career. ..Maurice.

 
At Friday, June 27, 2008 2:31:00 AM, Anonymous Anonymous said...

Hello, Dr. Bernstein

This is very generous of you to take away your precious time and talk to those of us who are interesting of going into medical school but do not have a trusted person to discuss our concerns and to share our worries. I apologize for not taking the time to read over all of your postings here but I will promise to take the time to get to know you better once I get my side of the medical dream shared with you :)

Just like many of pre-med students out there, I always feel enthusiastic and never feel tired when it comes to helping low-income patients to get their health related concerns solved. I have been volunteering at a community clinic as an interpreter for the past two years and am getting more involved with the clinic in different ways more recently. I always feel the urge to help these patients, especially of those who do not speak English because I shared the same experience before.

I am not sure if you notice or not from my writing, I am not a native English speaker. In fact, I have immigrated to this country about 10 years before. Anyway, as a graduating undergrad, my GPA has been dropping - now is around fives - due to several extra curricular activity commitments.

I am writing my personal statement and just do not know how to convey my enthusiasm across to the medical admission committee. I really hope that I have someone who can guide me through this path since no one in my family has gone through this path before. In fact, no one in my family has ever been this far in education before. That is why I was feeling all alone fighting the competitive battle while struggling to do well in those classes.

Thanks for your time :)

Torturefrom2006

 
At Friday, June 27, 2008 7:39:00 AM, Blogger Maurice Bernstein, M.D. said...

Torturefrom2006, I have had no direct experience with a medical school admissions committee except when I, myself, wanted to enter medical school. From talking to colleagues who have been on admission committees, I would say that the best advice is: be yourself. Don't try to present an image that is different from whom you really are. You can't do anything about your gradepoint average if you already finished your undergraduate experience but your interest and activity in medicine or other social relationships will be important. Admission committee members are very attuned to looking for "acting" by the candidate so I write again "be yourself". My best wishes to you and your career. ..Mauric.

 
At Friday, July 18, 2008 4:40:00 PM, Anonymous Anonymous said...

Hi Maurice,
I'm at a crossroads right now. I'm trying to seek inspiration, because I really want to decide my path pretty soon.
Currently, I'm either indifferent or distasteful of science, but I love the thought of becoming an advocate for human beings. However, it's only the thought of helping other people that seems inspiring (thought and action are two different things). For example, anesthesiology seems like a beautiful, poetic profession, relieving people of their pains. However, I do not know whether I'd enjoy the science and technology of it. Am I being too idealistic about the medical profession? Would you say the medical profession involves equal amount of science and feeling or more science than feeling?

 
At Friday, July 18, 2008 8:20:00 PM, Blogger Maurice Bernstein, M.D. said...

In virtually all aspects of medicine science is a major part of a medical professional's armamentarium and without a good understanding and the proper application, all the touchy,feely aspects of the humanitarianism will not necessarily provide the result of diagnosis or appropriate treatment and hopefully cure. This even applies to psychiatrists where these days knowledge of pharmacology and neuroscience is necessary. The only specialty which I can, off hand, think of where direct patient contact and interaction with patients is absent would be pathology. There, it is basicly science.

So there you are. A knowledge and active use of scientific evidence is necessary to become a good doctor in addition to empathetic caring and emotional support to the sick patient.

On the other hand, the clergy in medicine might provide the feelings you desire to experience with much less scientific technology knowledge.

To you also..best wishes on your career. ..Maurice.

 
At Wednesday, July 23, 2008 1:34:00 PM, Anonymous Anonymous said...

What are some qualities that makes a good physician? I am still trying to decide if I have what it takes to be a doctor.
Thank you!!
-JT

 
At Wednesday, July 23, 2008 5:52:00 PM, Blogger Maurice Bernstein, M.D. said...

JT, as in all professions, there are "good" professionals and "bad" professionals and medicine is no exception. The question is what makes a doctor "good" and are there certain qualities which if present lead to a "good" physician. This is not so simple since to some a "good" doctor is one who is successful "curing" the patient who is making the evaluation. Well, the doctor may be a suburb technician but is a poor example of a compassionate or warm physician. A patient might size up a doctor as "bad" who has poor judgment or technical skills or failed to provide a relief or cure even though the doctor has wonderful interpersonal skills. And finally, a patient who has an incurable disease might find that a physician who doesn't appear to abandon the patient but is supportive and caring even though not providing a cure as a "good" physician.

So you see, interpersonal skills are still very important in medicine since much of medicine is dealing with the emotions or psyche of the patient as well as the physical. A student who wants to be a doctor should have an interest in other people and not just ones self and "feel" for the burdens and troubles of others, in a therapeutic way, not simply out of sympathy,and want to help the patient resolve those burdens and troubles. Help, even when it means ones own personal sacrifice of time and personal needs. In this regard, personal qualities of being honest and ethical are important too. And then there still is the requirement for the student to want to learn about the human body and disease and want to learn how to evaluate the patient, make a diagnosis and treat the patient and desire to become skillful in all of this.

Would all of this make a "good" physician? Maybe and maybe not since in the final analysis it is the patient who must make the judgment, but to me as a physician and teacher of medical students, the qualities I noted above satisfy me as an answer to your question. ..Maurice.

 
At Saturday, July 26, 2008 9:46:00 AM, Blogger Maurice Bernstein, M.D. said...

Read this story from a physician, how as a student not yet into medicine, had a life-changing experience which directed him into his current profession. ..Maurice.

 
At Sunday, July 27, 2008 9:44:00 PM, Anonymous JT said...

Hi Dr. Bernstein. Thank you once again for your time and patience. What would you recommend the students to do in order to "count the cost" before embarking on a career in medicine? Such as reading, internship, experience etc.

 
At Sunday, July 27, 2008 10:25:00 PM, Blogger Maurice Bernstein, M.D. said...

JT, I am unsure what exactly you mean by the expression "count the costs." Do you mean money, time, interference with your non-professional life and so on? If so, there is a dramatic cost in these areas compared with other jobs but that also depends into what area or specialty of medicine you go. ..Maurice.

 
At Thursday, August 14, 2008 2:26:00 PM, Anonymous Anonymous said...

Dear Maurice,

Hi, thanks for your wonderful blog. I was wondering what your beliefs about the physician assistant career are? I have the option of attending med school (all that's left are the interviews), but at the same time I dunno if I am ready for such a daunting personal sacrifice. Therefore, I think the PA career might be a good choice for me...you get nearly all the "fruits" of being a doctor without such dedication and responsibility (I know that everything has it's costs though).

Sincerely,

Rick

 
At Thursday, August 14, 2008 4:11:00 PM, Blogger Maurice Bernstein, M.D. said...

Rick, I wish I could answer your question but I can't and I can't even validly speculate. That is because most of my career there was no physician assistant and in the later years when PAs were introduced and practicing, I was never professionally involved with one nor have I met one to discuss the career.

What I can say is only that I suspect if helping remove the burden of illness from a patient is your main professional and humanistic goal, then a PA would certainly be consistent with that goal. If in addition to that role, you want to be the final one responsible for making the medical diagnosis and therapy, then you should train for being a physician.
More than that I can't say unless it also involves an income prospective.

The best I can suggest is to go to your nearest hospital and get names of PAs on the staff and directly communicate with them about their work.

Finally, whatever specialty you have including pathology and radiology, working as a physician will from being a student to resident to established physician definitely affect your non-professional life. My best wishes to you, too. ..Maurice.

 
At Monday, August 18, 2008 1:41:00 AM, Blogger appocox said...

Hi

what is tropical edicine? What are the advantages of working in a rural or remote area- i.e. working with native people and especially if your main aim is to help those people who are really poor. For example kids in Africa. So basically working as a doctor towards social justice. And suppose, why would come to univeristy promoting rural and remote medcine? Could there be any good reason to achieve the social justice goal or any other reason. Thanx

 
At Monday, August 18, 2008 8:51:00 AM, Blogger Maurice Bernstein, M.D. said...

Appocox, I am not sure what you mean by "advantages" since the logistics for the care of patients in such a rural or remote area may be much more difficult than if you were practicing medicine in a city. However, despite the hardships involved in the practice, you will be highly befitting your patients and you will be receiving from what you are accomplishing the personal moral and ethical benefit of your work in attempting to provide social justice in medical care. My best wishes to you if you set out in this direction for your career. ..Maurice.

 
At Monday, August 18, 2008 10:51:00 PM, Blogger appocox said...

thnx for your reply. I am applying to university that ask me why I want to come to their uni. they have rural, tropical medicine as a theme for medicine. I want to work towards the social justice n I can't make the link between their university medicine theme and my goal as a doctor. Could you give me some ideas and help in any way.

 
At Tuesday, August 19, 2008 8:29:00 PM, Blogger Maurice Bernstein, M.D. said...

I'm not sure, if I understand your questions, that I can add more than what I wrote yesterday. Rural and tropical medicine is usually pertinent to countries where infectious diseases and lack of hygiene play a significant role in the overall health of the country's population. If you learn from that medical school and if you can work within that country's rural areas you may well be meeting your own personal goal of contributing to social justice-- providing all, regardless of location or financial status or environment, as best medical care as you can provide and better than what these residents have been getting--that's social justice. ..Maurice.

 
At Friday, August 29, 2008 7:24:00 PM, Anonymous Anonymous said...

Maurice,

I recently finished my bachelor’s in biology, took all the pre-med requirements, did relatively well on the MCAT, submitted my primary before AMCAS was sending them to schools, completed applications to 36 schools (including the secondaries), and already (late August) I have gotten two invitations to interview at med schools. I am currently working at a hospital as a clinical research assistant, a position I love because it enables me to have meaningful interaction with Spanish-speaking stroke patients by translating healthcare information to them. I was born in Argentina and moved to the US when I was 7 because my dad (who was a surgeon) always dreamed of practicing in the US. I KNOW I will be a doctor, I have known it my entire life, yet here I am, 2 weeks away from my first interview and I am freaking out, searching the internet for an articulated response to the question "Why do I want to go into medicine?" Its funny, I can’t seem to remember why I so desperately want to become a physician. Actually, scratch that. I know exactly why I want to be a physician but I just feel my reasons are not convincing enough. I think my biggest concern is that my motives sound too "cliche". I have a passion for understanding the inner workings of the human body and I want to use this passion to help people. I want to be able to impact their lives, to be an advocate for them, to offer empathy, provide treatment, and if nothing else, give them peace of mind. I guess I just feel like the admissions officer won't believe me because my reasons are too straight forward and common. This all started when I commented to a friend about my interview and, testing me, she asked, “So, why do you want to be a doctor?” After I answered, she said I sound deliberate and insincere. Here is the irony though, now I find myself under pressure to plagiarize somebody else’s words because my (true) motivations are not "sincere." Looking through blogs and forums, I see comment after comment about how outdated, boring, and lame the reasons "I like biology and I want to help people" are. I know what I am doing is wrong and, ultimately, I know I will be true to myself during the interview, but I guess I just feel very unsure of myself at the moment. I know you know nothing about me aside from the words I’ve written here and that mine is a personal question, but perhaps you understand what I mean. Why do I feel such desperation to get them to believe me? Like I have to go in there and give a disclaimer… “Listen, I know you hear this all the time, but…”

 
At Friday, August 29, 2008 7:58:00 PM, Blogger Maurice Bernstein, M.D. said...

Anonymous from today August 29, 2008:
First, I want to explain that I am not on a medical school admissions committee and never had that experience. I do have the experience of over 20 years of teaching first and second year medical students how to relate to patients, take a history and perform a physical examination. And I know something about students in their very first days of medical school.

In response to your symptoms, I would say your concerns are par for the course. It is not emotionally easy to anticipate being scrutinized by a stranger who has some power to turn off or on your wanted career. But don't try to make your task more complicated than needed. What you wrote in response to an open-ended question is just fine. "I have a passion for understanding the inner workings of the human body and I want to use this passion to help people. I want to be able to impact their lives, to be an advocate for them, to offer empathy, provide treatment, and if nothing else, give them peace of mind." What happens next and makes this opening response "non-generic" is what will happen next. The stranger across the table will ask some direct questions that will help to develop and expand on what you had just said. Your responses to the direct questions will present the meanings and nuances of what is really what is motivating you to become a physician. You cannot know now how those direct questions will be phrased and so your response most likely will not be something you read but something you feel. Trust me..you are on the right track. Go to your interviews with the confidence that what you have written here is a good response and what you say beyond that represents your meanings and goals. You will not be disappointed that your responses will be ignored as generic. My best wishes. ..Maurice.

 
At Thursday, September 04, 2008 12:52:00 AM, Anonymous Anonymous said...

What are the things that may interest people in human body and to 'help people'

 
At Friday, September 05, 2008 8:06:00 AM, Blogger Maurice Bernstein, M.D. said...

"What are the things that may interest people in human body?" Answer: To have an interest about one's self.

"What are the things that may interest people to 'help people'" Answer: To rise beyond interest in one's self but act in the interest of others.

..Maurice.

 
At Saturday, September 06, 2008 1:03:00 AM, Anonymous Anonymous said...

What are things that make you 'application stand out'. An ideas that I can say on why i want to become doctor?

Here are my reasons, but can anyone expand or make them more stronger PLEASE

Interest in human body
I have lived in Third world countries so I know about many people who have been withheld from basic health rights. (HELP PEOPLE)- social justice
Fascinating world (?????)
Challenges (???????)
COnstantly learnign new things ??????

I would deeply appreciate your suggestions.

 
At Friday, October 17, 2008 3:12:00 PM, Blogger Fortuna said...

Maurice,

I was actually a first year medical student this year and after a few weeks of school, I decided to take a leave of absence. I've been using this time to decide if I truly want to be a doctor and make such a huge personal sacrifice. I call myself the "yo-yo" right now because I am up and down about being a doctor. I want my weekends so I can travel with my boyfriend and go on adventures. I decided this week that maybe nursing is a better fit, so I plan to go back to school to become a RN. I was a bit unsure though because I LOVED Anatomy Lab and dissecting the cadaver. (my original aspiration was to become a surgeon). But your blog reminded me that Med School and Residency requires a huge personal sacrifice. I had to remind myself that that will not go away. Your blog really helped me. It was nice to hear a doctor promote other medical careers like nursing. Thank you for your blog. I will be checking back and hopefully contributing to your ethical discussions.

-Tara

P.S. My blog is at fortunecookiefuture.blogspot.com.

 
At Friday, October 17, 2008 7:42:00 PM, Blogger Maurice Bernstein, M.D. said...

I wrote the following response to Tara (Fortuna) on her website. I reproduce it here because I think it will be of benefit for other prospective medical students to read. ..Maurice.


I am the moderator of the Bioethics Discussion Blog where the tread "Uncertainty and Life of a Doctor" is present.

Fortuna, I am apprehensive about your "flirting" back and forth between studying to be a physician vs to be a nurse or as you note in this blog, maybe some other activity.
I think you need to know more about the life but also the options available in both professions and in others you might have interest. You need the real help of a skilled occupation counselor. And you need that resource now!

You have to decide now whether you want to have a career that deals with mostly ill people.. people that will be looking to you for help with their burdens. That is what most of what a career as a physician or a nurse is all about.
Would you be comfortable to spend the rest of your life until you retire to put the patient first and your own personal or family interest second. Putting your personal or family life second doesn't mean that you cannot have an enjoyable second side of your life because I did and you will. It does mean that there will be times when the attention to the patient will trump some personal desire. I does mean to climb up into your career either nursing or becoming a physician, you will have to make that climb, often to the separation of family and friends as you study and practice your intended profession. But medical snd nursing students do it and survive.

And remember, there are other paths within both careers where you can contribute to your profession but with less direct patient contact and more free hours. For example, as an M.D., how about you teaching anatomy or being a radiologist or doing basic science or clinical research or as a R.N. teaching nursing students or running a public health clinic with more regular work hours but yet contributing to your profession and having a good salary.

Think about all this but get help from professionals in the field including your teachers in med school and both medical school and university counselors. But you must attend to this promptly since your current uncertainty with it's psycho-physiologic potential harmful consequences on your health and well-being would not be uncommon.

By the way, as a teacher of first and second year medical students, I can tell you that uncertainty starting out in medical school is not rare. Fortunately at my school we have counseling services available for the students to which we can refer if we detect such a student who is in need of help. I am sure your medical school has such services too. Please don't allow your career to be a "fortune cookie future" since career education and professional help will be of great value to put you on the right track.

I hope this comment is helpful since I had no intention to only raise your uncertainties by what I write. By the way, I think that ventilating as you have done to your blog and maybe some more also to mine should be therapeutic. But it won't fully substitute for direct professional help. Best wishes. ..Maurice.

 
At Monday, October 20, 2008 3:35:00 AM, Blogger shipei said...

Dear Maurice, it's amazing how a post that you wrote 3 years ago threads until this day! Anyway, I just wanted to say thanks for all the advice and questions on this blog. I am applying to medical school as well and many of the questions posed here are inner questions that I have myself =)

 
At Tuesday, October 28, 2008 7:58:00 PM, Blogger Spencer M said...

Dear Maurice, I have found this blog as an amazing source of information. It was the first thing I clicked on when I searched Google. I am in my 2nd year in human nutrition and I am strongly considering medicine. My question for is, as a doctor is there any chance for showing or using leadership because that is one of my main skills and I love it. I feel that by leading I give other people the chance to really improve and grow at what ever they are doing. I have another question, what types of places do you recommend me to volunteer at to find out if I would enjoy being a pediatrician. One a side note, on 2 posts above me you wrote about counseling, well I got some career counseling and I am now in a mentorship program where I am going sit down with a pediatrician and ask some questions one on one. Awesome blog

Thanks, Spencer Martens.

 
At Tuesday, October 28, 2008 8:27:00 PM, Blogger Maurice Bernstein, M.D. said...

Spencer, you can use your training, M.D. degree and leadership skills in many different areas of medicine. Academic medicine is one possibility where you can practice your profession but also teach, do research and eventually lead medical school departments. Outside of medical schools, hospital department staff positions or chief of staffs provide vehicles to demonstrate your leadership skills.

With regard to gaining insight into the life and demands of a pediatrician, talk to your mentor but also find how you can also trail a pediatrician in his or her daily work, perhaps when you have free time. Try to talk to more than one pediatrician so you can get, perhaps, a more balanced perspective into the career.

Thanks for your kind comments about this blog and my best wishes for you. ..Maurice.

 
At Wednesday, November 05, 2008 4:57:00 PM, Anonymous Anonymous said...

Physician Assistant vs. MD/DO

Dear Maurice,

I was wondering what your take is on the PA profession? For example, does it come with the satisfaction that comes with being an MD?

 
At Wednesday, November 05, 2008 9:17:00 PM, Blogger Maurice Bernstein, M.D. said...

As I already noted in my August 14 2008 comment, I don't have any experience with physician assistants nor had any talked to me about their personal satisfaction regarding their profession. The best way to get an answer to this question is to find and talk to a PA. I'm not sure, though, how a PA can compare satisfaction with that of an MD without having progressed from a PA to an MD (or vice versa!!!)

With regard to uncertainties in medicine,if not the clinical challenges, it obviously, from reading the comments here, is the concerns which those planning to enter or who have just endered the profession to become a physician bear. ..Maurice.

 
At Thursday, November 20, 2008 7:55:00 PM, Anonymous Anonymous said...

Hi Maurice. I'm a finance analyst, working for 15 months already. Everyday, I think about what my life would be if I pursue medicine. Back in college, I didn't take premed (I wanted to, but the conviction isn’t strong enough) because of long, costly schooling and because I know I have to support my sister's tuition as she reaches graduation. So, I took up Management so I can find a job right away. Now that my sister already finished college, my childhood dream of being a doctor is coming back. I haven’t had extraordinary experiences similar to Rick Finder’s that I can term as “calling” (at least none that I could remember), but everyday I think about being a doctor for a number of reasons. Sometimes, I can’t weigh which reason is heaviest: because I want financial stability and networking; because I hate my job of working 8 hours in cubicles, doing non-meaningful computer work; because I love the feeling of helping people, making them breathe easier, being consulted and trusted; because I want to save lives; because I believe studying 7 years is worth even just saving 1 life, giving empathy, or aiding the health situation of many; etc.. Some articles noted the cons of being a doctor. I’m also not very good in some science subjects like chemistry and physics. I haven’t brought this up to my parents; I chicken out everytime I try to tell them I want to stop working and pursue Med, for it means I’d be an investment again. Also, I wonder what my relatives and colleagues will say, that after marching away from Business course with medals, I will pursue Med? Despite all that, I still want to be a doctor. I want a doctor’s job because I find it challenging and noble. Everyday I think about this. The call is just getting louder and it affects my current work as I lose motivation, dreaming of another career. Maybe I’m not fully aware of the long journey, but my end in mind is: being a doctor. What should I do? How do I start?

 
At Friday, November 21, 2008 9:55:00 PM, Blogger Maurice Bernstein, M.D. said...

Making a transition from a business management occupation to becoming a physician is a big leap but it certainly is possible with the appropriate motivation and willingness to give over a lot of your time to the education and practice of the new career of medicine. I would say a good starting activity would be to have a detailed discussion of your desires with a university career counselor. That person should be able to tell you about the academic work necessary to complete before applying to medical schools and about other important information you should know about training and the career.
You might also go to the local medical school and obtain additional information and guidance from the administrative offices there. Finally, to get some "been there, done that" views, it might be wise to talk to a few doctors in your community.
Then, considering the financial costs and the information you received, if you are satisfied with a decision to proceed..do it!
As a teacher for first and second year medical students, I know they all aren't 23 or 24 year olds.. we have had some good ones starting out in their early or mid thirties and, though I have not had one, even older.

Best wishes.. ..Maurice.

 
At Sunday, January 11, 2009 8:11:00 PM, Anonymous Oldie said...

Dr. Maurice, great blog! I am a married 39 year old mother of 11and 7 year old children. I am currently finishing my PhD in public health while working fulltime. I desire to start my premed this year and then start medical school at age 41 or so. This means that I will start practing at age 48 at the earliest. In your experience as an educator, how do older, parent students fair in medical school? I am afraid that I am being selfish since I will be constantly absent from my family. I also feel guilty about leaving my husband as the only bread winner and the sacrifices we will all have to make. I am considering settling for a midlevel career such as PA (2years) which will give me the clinical opportunity, but I am afraid that I may be dissatisfied. Your thoughts are greatly appreciated.

 
At Sunday, January 11, 2009 9:16:00 PM, Blogger Maurice Bernstein, M.D. said...

My experience is limited with regard to the older student despite over 20 years teaching first and second year medical students. The oldest student I had was a male in his late thirties, (usual ages 23-26)as I recall, and he performed well in my "Introduction to Clinical Medicine" group but I don't know any followup at all. I recall one female student in her mid 40s, who had just graduated from our medical school talked to our first year class about her experiences as an older student in medical school but again I don't know any followup. I am sure that associate deans of medical students could give you information regarding their experience with older students but I doubt they could say much about how their individual careers went in later years. In fact, this would be a great topic, after research on the available information in the literature, to put up as a thread on this blog. Though, there may be a paucity of information available since I know that, for example, studies correlating the behavior as a medical student with that student's years later behavior in practice is minimal in number.

You know, starting out into a career as a physician is challenging enough at the "usual age" (as you can see from some of the postings here) but to start out at a much later age is very complex. So much, beyond your motivation, has to do with your health, finances and social-marriage-parenting status that one answer can't fit all.

But, I would never tell a prospective physician whether "usual age" or older not to enter the profession. Physicians, especially those in general medicine are greatly needed in the United States and certainly elsewhere too. The main personal goal in healthcare is that the professional, whatever capacity or title, should find what they do emotionally rewarding. If not, it becomes just a "job" which shouldn't have required such a financial,emotional/intellectual burdens over a long time period to attain.

My best wishes for you, whatever you finally decide regarding your career. ..Maurice.

 
At Tuesday, January 13, 2009 8:16:00 PM, Blogger Mary said...

This is such a great opportunity to be able to ask you these questions. I'm a 23 year old violinist working on my grad degree at one of the best music schools in the country. I have been very successful, but am feeling intellectually bored by many aspects of the career and very disillusioned by a life in a professional orchestra. I know music sounds like a great life, but what I think I really want to do is be a doctor. I'm fascinated by the science. I feel excited when I think about becoming a doctor. Do you know anyone who has made this transition? Is it crazy to leave a successful pursuit and gamble on medicine? Sorry, I know this is more of a general life advice question.

Thanks very much.

 
At Tuesday, January 13, 2009 9:50:00 PM, Blogger Maurice Bernstein, M.D. said...

Mary, for you and others who want to make a career change into becoming a physician, I definitely recommend that you learn about the career of medicine (from university career counselors or from medical school counselors themselves). But also and most importantly have some experience in the work of medicine. And I mean not from the perspective of being a patient but from the other side of the bed rail. This clinical observation can be readily made by volunteering for duty at a hospital (particularly within the emergency room) or clinic including free clinics where volunteers are greatly needed. The experience is received by being within the medical environment, watching (as permitted) but mainly talking to different physicians and, of course, the patients and patient families themselves.

As I have written here previously, becoming a physician is expensive, time consuming and a real burden on your own personal time and life.

It definitely is challenging from your first contact with the deceased in anatomy, to your first contacts with real, alive patients, taking their personal histories and examining their bodies, to your first responsibilities to contribute to establishing a sick patient's diagnosis and to participate in their care, to your first management of a patient alone with no help from others, to your first conflict between taking care of a patient while dealing with a stressful or urgent personal issue and even more firsts.

Mary, of course I don't know your personal circumstances beyond what you have written so I can't provide any more specific information but I would say if you feel you want to change your career, don't wait much longer but take time now to investigate and learn and, if possible, experience a bit and make sure the career of medicine is what your really want. If after this education and after comparing your satisfaction and benefits of both careers, if you find you want to become a physician--don't delay and go to it! Best wishes.. ..Maurice.

 
At Friday, January 23, 2009 4:38:00 PM, Anonymous Anonymous said...

First of all, thank you so much for your informative responses. I recently graduated, and is planning to apply to medical school. I love to work with people, and helping people is my uttermost and (maybe) the only reason motivates me to choose becoming a doctor. However, I do not feel confident in my intelligence, and I am afraid that one day I will ruin my career because of an accidental incidence. Everyone says medical school is hard academically and mentally, and I just afraid that I cannot survive the academic part of the journey. Would you please give me some advice? Thanks.

 
At Friday, January 23, 2009 5:55:00 PM, Blogger Maurice Bernstein, M.D. said...

My experience as a participant in the education of medical students is that there are two parts of the medical school education. There is the informational or didactic aspect which I think is no problem for most students who have been able to complete college/university courses to reach medical school. So if you functioned well and learned in college, in this respect you should not worry about medical education. The other part is the part regarding learning and experiencing the relationship with patients and dealing with them not as acquaintances, friends or family members but as patients. It means to be able to talk to, examine and understand human beings who often are in distress. This involves both a way of protecting oneself from personal emotions which may destroy any potential therapeutic value of the student's relationship to the patient but yet at the same time learn to not withdraw but instead engage the patient and develop that understanding and perhaps empathy that promotes a therapeutic medical student-patient relationship. That is the part that some students find difficult. It's hard to predict which students this will be a problem but I think a lot has to do with the student's own personal feelings of security or insecurity and whether or not they have had previous experience of interacting with people with severe burdens or in distress. Knowing about these parameters and making one's own evaluation can be helpful in making a decision about a medical career. But, on the other hand, don't be too analytical in this regard. Most students of varying backgrounds and personalities make it through medical school satisfactorily. Unfortunately, as I have already noted elsewhere, we still don't know through careful studies what really happens to the behavior of the students "who make it through" as they move on in their career as physicians.

I hope what I wrote helps you with your concerns. Best wishes for you too. ..Maurice.

 
At Friday, January 30, 2009 4:53:00 AM, Anonymous Catchetat said...

Hi Maurice. Since everyone's posting, I thought I'd give in some of my ideas as to why I want to become a doctor, and at the same time, practice for my medicine interview.

My first motive for me in studying medicine is because I've always had an interest in studying how the body works. I've done a lot of preparation in this respect and really studying along those lines during my limited free time, whilst balancing my studies in high school. I also want to be able to empower myself and utilize and build upon all of my abilities to help people, such as teamwork and communication.

I've done quite a lot of volunteering in recent years and what I like best is hearing and acknowledging the contentment and satisfaction that people say about you when you help them. Of course, it's not what I'm just looking for, but I'm almost always happy after doing the activity.

I also really enjoy learning and I know medicine is a lifelong career, with the never-ending technological breakthroughs and discoveries.

Perhaps you could give me some professional input on what you think about my reasons for studying medicine, like whether you agree or just give some examples.

Btw, just out of interest, what specialty do you work in? I am most interested in gastroenterology because I really love using high tech equipments and using the endoscopy is the best part. It may seem naive but it compliments my desire and you also really utilize your brain powers by diagnosis of elimination.

Thanks.
-Simon

 
At Tuesday, March 24, 2009 2:16:00 PM, Anonymous Anonymous said...

My question about being a doctor is that how strong of a leader do you have to be to become a doctor? I see myself as an able leader but more than often, I like to sit back and let others take control. I duck my head and ride things out. I know the lives of patients require an aggressive approach to finding a diagnosis and treatment, but does a personality that is afraid to offend others, that is non confrontational conducive to medicine? Is this a personality trait that can be remedied or changed over time? Is this a dumb question???

 
At Tuesday, March 24, 2009 3:55:00 PM, Blogger Maurice Bernstein, M.D. said...

A good doctor should be able to lead a patient toward recovery and a healthy life if the doctor has the capacity (knowledge and skill) to do that. If in certain clinical situations where that specific knowledge and skill are absent the doctor should reliquish the lead by referring the patient to a doctor who can continue to leading. A doctor who assumes strength when no strength exists can only harm the patient. That's why it is characteristic of a good doctor to know his or her limits and always set the principle of beneficence to the patient as the goal rather than trying to support his or her unrealistic image of ones self. Yes, if you are the responsible doctor and can lead, you should lead with strength.

Confrontation is rarely a successful attitude in relating to patients, family or colleagues. Patients respond most to education and help in understanding rather than debate. So, as you describe yourself, if you keep to the criteria I noted above, you should do well in medicine. ..Maurice.

 
At Wednesday, May 20, 2009 10:41:00 PM, Blogger Ivy said...

Hello,

I recently spoke to my premed advisor who only brought up more questions in my mind. I even wrote on a forum...and it seems as if everyone is thinking I don't have what it takes to be a doctor.

I don't have time to go into much detail, but I'll do my best to give an overview.

I am a third year at UCSD, currently majoring in Human Biology. I might change the major to dance, because I want to fulfill another passion in my life before medical school consumes all my time (not just to take easy classes, like my advisor & other premed peers have insinuated).

My cumulative GPA is about a 2.72. I have yet to take the MCAT's.

With that being said, I have a few questions.

How important is it to surround yourself with other premed peers?
I think a part of the reason why I did not do well in my science classes was because I never really had people to study with. My closest friends are non-premed, social science majors. They are very supportive and they keep me sane, but perhaps I've hurt myself & my chances of getting into med. school because I didn't have other people to study with for those hard science tests. I feel like I don't always study efficiently by myself.

Also, how helpful would post-baccalaureate programs be to me? I brought this up with my advisor, who basically told me that I would spend more time & money, but would still have a slim chance of getting into medical school afterward.

I've also heard of people retaking or taking more science classes at community college....my advisor said that would not be very helpful to me because medical schools will look down on my application for attending a 4 year university & then going back to take "easy" science classes at a community college. Is this true?

I came into my advisor's office wanting to hear more details about community college and post-bac. programs (b/c they're my 2nd chance to boost my GPA) and she basically shot those ideas to pieces.

Also, is it common advice that people give to premed students about not taking so many "hard" classes at once so as not to burn out? I know it's quality over quantity, but what if I can't take all science classes in one quarter & excel in them? I wrote this in a forum, and they laughed at me saying "WEll, what do you think medical school is??" I realize medical school will consist of ALL voluminous science courses, but I'm still an undergraduate that still needs to do extracurriculars to get into medical school...as well as explore other interests to be the "well-rounded person" they're looking for.

I tried to spread my premed classes out & still complete them in time to take the MCAT's but I had a hard time balancing extracurriculars with those classes, and did not have premed peers to study with. Even if one of the ways to redeem myself is to do really well on the MCAT's, my advisor said medical schools will still question the disparity between my GPA & my score.

I just don't want to do a post-bacc. & more volunteering & research if I don't have a chance of getting into medical school. I'm sorry to write so much, but I am at a crossroads of what to do at this point. No one I have asked so far has really been supportive in my premed path :(

 
At Thursday, May 21, 2009 6:28:00 AM, Blogger Maurice Bernstein, M.D. said...

Ivy, maybe the main issue regarding medical school is more about your real motivations and interest in a career as a physician rather than your grades. It's easier to blame the numbers than to face your own motivations and interests. Of course, I don't know if this is a pertinent comment for your particular case but it is a important consideration. Have you talked over with those advisors your thoughts about why you want to become a doctor? Have you talked to other pre-med students and found out why they want to spend years in study, spend lots of money on their medical education and then often face a career which may put limits and burdens on their private lives? What is it that they want to get out of this career that balances these demands? The particular reason I bring all this up is that in your posting you really don't mention your motivations for going into the career of a physician.

By the way, of course, if it is your grades that prevent admission to medical school and your desire is really to help the sick and keep the healthy well, as you probably know there are many other medical careers available where your grades may be quite acceptable for entry into an education program for that career.

I hope my comments are helpful and I send you my best wishes for attaining what you really desire. ..Maurice.

 
At Saturday, May 30, 2009 7:05:00 AM, Blogger scorpio said...

hi~everyone.i am Racheal.I got a admission from University to study medic.I am hesitating because i afraid of i can't handle it as i am not a clever student.I am thinking to be a teacher as well but because i don't want my life just going on that way.Hwever,if i choose to be a doctor,then my life will totally change.

 
At Sunday, May 31, 2009 6:47:00 AM, Blogger Maurice Bernstein, M.D. said...

I received the following e-mail from a male visitor who wrote the following. ..Maurice.

Hello Maurice,

I am from Singapore and I think I want to be a doctor. However, I would really like to hear some advice from you because I feel that being a doctor is a lifetime commitment.

My decision to be a doctor was quite recent. I decided after one of my friends also decided to try for medicine. So I feel that many will think that me wanting to be a doctor is just a spark of the moment kind of thing.
To me I think that yes this is the spark but, giving some serious thought to this career path, i think i may have been unconsciously thinking about being a doctor since young.

Why will i say that?

Since young i have been told that a doctor is a great job, and i know that that is many parents' dream job for their kids. (or so i think) What i want to say is that i may be rebellious and kept giving excuses and reasons that always put myself down, throwing the thought of being a doctor aside whenever the talk about being a doctor arises. Lame excuses like my hands were trembling due to the cold in my exam hall, i don't think i can be a doctor and like you say blaming the grades is easier than facing one's own motivation and interest. Yes, i blamed my grades.

My results for my A levels are not good and i am quite sure i can't get into the Medicine in National University of Singapore (NUS). I gave up without trying. Now, i regretted it. Although i know that my application may just be thrown aside due to my grades, i regretted my actions for not even trying. As for now, i applied for a university in Australia. I went to a agency and they advised me to apply only to University of Adelaide because that's the only university in which i met the minimum requirements. Now i have to wait for a test and also an interview if i made it through the test. As for the other Universities the agency told me i could try but it would be a waste of money and the point of going to them for advice would be pointless. Thus, my only chance now is Adelaide or i could apply next year to medicine in NUS to try my luck. Another alternative is of course graduate entry. However, studying overseas as an International student is really expensive. In terms of finance my family is just average i suppose, so that is also another problem. Thankfully, i have supportive parents who asked me to try out the application to the University of Adelaide and then we'll think of a way if i ever am able to get in. There are bank loans and stuff we need to look into.

I think i have decided to face what i want to do and not give myself excuses anymore.

Then there is the question of why i want to be a doctor? My parents asked me that as well. I could not really answer them. i don't know why, maybe it is the lack of confidence i have in myself.

But i think my answer to the question will be because i feel being a doctor is very exciting and challenging. I will be able to meet a lot of different situations all the time. I also have interest in Biology and human body and really like to know how to deal with different illnesses. I also want to help people. I hate looking at people suffering with an illness and not knowing what to do. I want to be able to diagnose, know what is wrong, help and hopefully improve their lives and save them. I also prefer interacting with the patients so i do not just want to be a researcher and discover new cure for illnesses.

So this is basically the issues i have in wanting to be a doctor, i really hope to hear some advice on whether i am suitable to be a doctor and any other things you can advise me on this career. It would be great if you could tell me more on what to expect as well like after studying, we will have to do internship or housemanship and then residency? Is it the same in different countries?

 
At Sunday, May 31, 2009 6:53:00 AM, Blogger Maurice Bernstein, M.D. said...

My response to the student from Singapore was:You write "But i think my answer to the question will be because i feel being a doctor is very exciting and challenging. I will be able to meet a lot of different situations all the time. I also have interest in Biology and human body and really like to know how to deal with different illnesses. I also want to help people. I hate looking at people suffering with an illness and not knowing what to do. I want to be able to diagnose, know what is wrong, help and hopefully improve their lives and save them. I also prefer interacting with the patients so i do not just want to be a researcher and discover new cure for illnesses."

Clarence, most importantly, your answer to the question should be "IS" and not "WILL BE". "IS" defines your goal but "WILL BE" sounds more like an excuse. If it is the "IS" that you really want to use to express your goal then go to it! Proceed..even if you have to go to Australia to get your medical education. If you are unsure about the career and its benefits but also burdens and limitations to your personal life then consider another career. That is why, as you may have noted repeatedly on the thread, I have advised the students to talk to medical students and also physicians in practice so you get a more complete insight into what you are about to get into. Of course, I wish you the best career for you.. if my wishes thousands of miles away carry any power. ..Maurice

 
At Saturday, July 18, 2009 8:26:00 AM, Blogger Eni said...

Hi ,my name is Eni and I live in Albania( a small country in south east Europe ).My parents are both doctors and since I was a child I had made up my mind that my future would be medicine school .Now I'm almost 18 and in a few months I''ll have to decide what I'm going to study .Here in Albania ,as in most of countries , medicine school is about 11 years long . That means that I'll be studing until I'm 30 and till then I won't be able to work or be indipendet cause it's a very demanding career. In addition Iwant to study abroad and this makes things even more difficult ...I don't think I can find a full scholarship so my parents spend as less money on me as possible . And I have to mention I'm a very good student but I'm still confused and I wonder if I could become the kind of skillfull and successfulm doctor I've always dreamed to be. So ,to conclude, I wanted to know if it is worthy to go for medicine as in such a small country like Albania doctors will never have the attention ,position and salary they deserve .It's very important to me to know if this is the right path .After all ,I 've never thought of becoming smth else ...so medicine os my only alternative .I would really appreciate your answer as soon as possible cause I'm terrified... thank you in advance .
best wishes ,
ENI

 
At Saturday, July 18, 2009 9:08:00 AM, Blogger Maurice Bernstein, M.D. said...

Eni, since I am not aware of the life of a medical student and the life of a doctor in Albania, the answers to your questions must come from those students and doctors in your country if that is where you want to study and practice. Although the general principles of medical education and medical practice should be almost universal in application, there still are differences in the application of those principles and cultural issues between countries. Some have to do with religious directives and some have to do with economics and some with traditions amongst other factors.

My suggestion is to take plenty of time and talk to medical students and doctors in practice to learn their experiences, issues and views. Also perhaps there are other avenues in healthcare that would interest you which would have a shorter training period along with less financial burden to you and your family. These are my recommendations. My best wishes to you. ..Maurice.

 
At Thursday, July 30, 2009 3:45:00 PM, Anonymous Anonymous said...

Hello Dr. Bernstein,

I am a Pharmacy student and as part of our 2nd year curriculum, we spend 1 month in hospital pharmacy, and 1 month in retail pharmacy to get a feel of the profession. I have worked retail pharmacy for about 4 years and was not very happy with it as it seemed that I was dealing with insurance rejections, and meeting corporate quatas and numbers instead of taking care of the patient. However, I was hopeful that hospital pharmacy would offer a bit more satisfaction and self-worthness. In the past week that I have been there I haven't found it yet, instead I walk by the emergency room, and patients beds and dream of actually working hands on with them, not simply checking that the medications they're taking are constituted or filled correctly. I am a optimistic individual, and I feel that pharmacy is a great profession in the field of medicine, but it seems that for the level of compassion and care that I have, I feel out of place in the basement of the hospital verifying orders. I have been pondering medical school for about 1 year now, but never put as much thought to it as I have in the last couple of days. Any thoughts about this matter would be greatly appreciated.


Sincerely,

A.K.

 
At Friday, July 31, 2009 7:58:00 AM, Blogger Maurice Bernstein, M.D. said...

A.K., a persons life is really a complex mixture of long term and short term goals which are then painted with realistic and unrealistic expectations. It really is impossible to get assistance to sort out which career goals are more possible and best for you over a internet blog. What can be more valuable is personal communication with a career counselor. I would strongly suggest that you contact one at the university or college where you are currently studying. They are trained to sort out these goals and expectations and help you find a career that is realistic but yet more desired by you. Best wishes. ..Maurice.

 
At Monday, August 03, 2009 4:21:00 PM, Anonymous Anonymous said...

Hi,

I'm currently in the process of applying to medical school, and I wanted to know whether I'm making the correct decision in the long run. I wanted to share some of my thoughts and musings, and hopefully get some feedback on them.

I've read through a lot of the comments on this blog, and it seems that a career in medicine is about other people first, and yourself second. I mean 'yourself' in every aspect -- not just in terms of time commitment, but also in terms of personal goals and motivations for becoming a doctor.

My reasons for becoming a doctor is that I want to learn more about the science of human health, and I want to pursue that to the fullest extent. And it also fascinates me to be able to use that knowledge in a practical sense by understanding and then hopefully curing diseases. I don't think any other profession out there can do the same thing.

I've worked in EMS for several years now, and while being an EMT seems to satisfy this thirst, in actuality, it does not. True, I get to apply medical knowledge to cure diseases (I'm using "cure diseases" very broadly), but we don't actually get to know the underlying reasons -- if someone has a condition, we treat it with drug X -- we don't really get to know WHY that person would have the condition, much less the physiological reasons for developing that condition. And that's the main reason why I chose to apply to medical school.

So I guess this comes down to the big question. Is it "wrong" for me not to "love helping people"? I'm not saying I don't want to help people, or that helping people is a waste of time -- I'm saying that I view the humanitarian aspect of medicine as secondary. For me, personally, I think that being able to help someone is a wonderful "byproduct" of medicine, but it is not at all the main reason why I'm applying to medical school to be a doctor.

Is that wrong?

If medicine is so much about helping people, why become a doctor at all? Why not join the Peace Corps? Or be a social worker?

-JD

 
At Monday, August 03, 2009 5:52:00 PM, Blogger Maurice Bernstein, M.D. said...

"If medicine is so much about helping people, why become a doctor at all? Why not join the Peace Corps? Or be a social worker?"

Why not? It all has to do with the skills which the individuals personally have learned and has available for use to help others.

There is nothing wrong with representing the Peace Corps, social work or EMS. There is also nothing wrong to be contributing to the world's healthcare but not necessarily "in the trenches" "in the first line" but in the laboratory as a clinical researcher and in the role of teacher of doctors, providing others with the tools and skills to go out to do the "dirty work" in the "trenches".

And just as there are students who see themselves directly interacting with patients and requiring the need for "instant" display and use of their knowledge and skills, there are those who find their life fulfilled by knowing those students going into the trenches will be using the resulting medical disease understanding, diagnosis and treatment knowledge tools and skills that the medical researcher/teacher has developed in the laboratory and classroom.

I hope this wisdom helps you. Best wishes, too. ..Maurice.

 
At Wednesday, August 05, 2009 11:05:00 AM, Anonymous Anonymous said...

Hi
I have completed my high school and am going to start my college now.I have decided to take biology as my major.. i really want to become a doctor but the problem is that medical is really long and expensive.. and i just wonder why a profession i want to chose would bring so much difficulties in my life.. even after thinking about all this.. i really can not take my mind out of the medical field and wish to become a doctor badly. Sometimes i just think should i change my mind just because of those hectic long years and the loans which i have to repay back..

BB

 
At Wednesday, August 05, 2009 1:00:00 PM, Blogger Maurice Bernstein, M.D. said...

BB, the unknown, the known but uncertain and taking chances is all part of the profession of medicine and to enter that profession and to complete the training, those characteristics are all there too. It is not easy but to many of us the challenges can be stimulating, can be intellectually interesting and even occasionally fun. But also the work can in a way be altruistic. Altruistic? In a way, sacrificing one's life (finances, personal time, personal relationships) for the health benefits of others--gets the physician or even a physician-to-be something higher, attempting but also often providing life and health and happiness to others.

There are other professions and work available with perhaps less demands on time, life and finances and this is the time in your education, it's not too early, to begin to set some personal goals after researching the careers available. Good luck. ..Maurice.

 
At Saturday, December 05, 2009 2:15:00 PM, Anonymous Anonymous said...

Hi,

I truly enjoyed your post and comments here as they are very helpful for premeds. I am an undergrad in majoring in finance, just like some of the people who commented before. I'm graduating in one year. I've been very fortunate and landed an internship at a bank last summer as an analyst. Some of my classmates were envious of me, as with the economic crisis it is extremely difficult to find a decent position. However, I don't feel so honorable myself. My heart isn't in business. I feel like I'm doing this for the sake of making the most out of my degree. Truthfully, I never enjoyed business. I loved physics and chemistry in highschool. I only went into business because I didn't want to be one of the thousands of first yr science population who aim for med school and I knew i wouldn't like research. My interests in science never died. I enjoyed reading scientific journals more than the wall street journal. I enjoyed STUDYING my science electives than my mandatory business courses. I'm in a very difficult position now and I really need some advice as I personally don't know any doctors that I can ask for help. I like helping others, and of course i understand that there are many many other people helping profession, but they are not as academically stimulating and challenging. I remember back in the internship I had at the bank I would stare at the three computer screens in front of me looking at the numbers, rates, curves, figures etcetc thinking why am I looking at all these when I could be perhaps analyzing a patient's history and helping an individual instead. I couldn't find a reason or motivation for my job. My parents had a big reaction when I mentioned that I was considering switching field of study. However, I want to make sure this would be something I want to do for the rest of my life before commiting to it. Are my reasons justifiable to become a doctor? I know many people say its a lot of sacrifice to be one, but I really want to know what the degree of sacrifice is. I mean, yes its a lot of studying in the four year in med school and future years, but when i think about it, its a lot of studying anyway wherever you are. If i choose to do accounting I would have to study for my professional accounting designation in addition to my everyday work; if i choose to stay in finance, i would have to study for my CFA, or other designation. Many says that its a lot of working hours to be a doctor, but being in finance is not much better as I worked 12 hrs a day before while i was in internship. I know I don't like finance, but I'm not too sure if i'd like medicine. I'm afraid I would get tired of medicine one day, just like i am with business. I know for sure though I really enjoyed sciences, and i like helping people. I could have applied for full time positions in the investment banks like JP Morgan, GS, etc which many of my classmates were interviewing for. I didn't, because I was thinking of finishing those prereqs for medicine. However, before I gave up my last chances in the business field, I want to be sure that medicine is something that I can risk my business career for. I don't want to regret later on if I don't get into medicine and end up nowhere, or getting into medicine and found that my passion isn't there either. I started volunteering in a hospital setting a while ago trying to expose myself to the environment. I can't say I love being in the hospital, but I find it very rewarding to help others. Any advise from you, or anyone else reading this, would be GREATLY appreciated. Thank you.

Sincerely,

Jessica

 
At Saturday, December 05, 2009 2:52:00 PM, Blogger Maurice Bernstein, M.D. said...

As a physician and not one in the world of finance and accounting, I quite appreciate your attitude as you describe it and if my interpretation is correct, I would say GO TO IT into looking into a path towards medical school and medicine. In this upcoming last year, make some effort to find some experience in being in an environment with the sick such as a volunteer within a hospital. Try to find physicians with whom you can talk about a career in medicine. Your being unsure about medicine may be clarified by such attempts.

My own view is that manipulating numbers and dollars is nowhere near as stimulating as making a medical diagnosis, presenting a patient appropriate options for treatment and then following through trying to help the patient through their symptoms and suffering.

What you wrote is very encouraging. Continue on and investigate a medical career further. Best wishes. ..Maurice.

 
At Friday, January 01, 2010 6:10:00 PM, Anonymous Anonymous said...

Hello,

I would also like to express my gratitude for the wisdom contained in the previous posts. I am a business student like Jessica, and am completing my second year of undergraduate studies in Canada. I can relate to some of Jessica's experiences; I was an avid science student in high school, and so far I've been far more interested in my electives than my business courses. I hope that some of my own experiences below may be useful to other business students interested in medicine.

I chose to study business mainly due to my parents’ urging – as immigrants who have had to endure the ups and downs of the high-tech industry, they hold job stability and earnings potential in high regard, and thought that working in business would be a good fall-back plan in case I do not get accepted into medical school. While I often feel as though I don’t belong in business school and miss the rigour and freedom to question of my arts and science courses, studying business hasn’t been a waste. It’s an unconventional pre-med major, but through it I have become a better public speaker, learned how to work with groups, made decisions given limited information, and gained some experience in negotiating and dealing with conflict – skills that are useful in life, and likely in the life of a doctor. I’ve also heard that a business background can be useful for medicine, and at a healthcare conference I could see how business knowledge would be helpful, such as in improving hospital governance or implementing health outreach programs to developing countries.

Despite learning new things that I wouldn’t have been exposed to otherwise, I still feel disengaged from my courses. My grades in business have been good, but sometimes I am uncomfortable with some of the things that are done in business, such as the high level of politics, blindly maximizing shareholder value, and marketing things that people don’t really need. After reading the blogs of some doctors, I see that some of the same challenges exist in medicine as in business: unsatisfied customers are replaced by unsatisfied patients, rigid organizational structures by ineffective policies, and competitive pressure by anxiety over patients’ health. I don’t mind working hard, but I wish to work for something that will benefit other people directly, rather than through the ripple effects of income and consumption.

Right now I am facing the decision of whether to transfer to another program. I am very interested in studying English literature and received one of the top marks in the first-year required English class, making me wonder if studying something I truly enjoyed would be a better use of time and money and if, in case I excel at it, of greater use to society. However, I’ve had several arguments with my parents over this topic – maybe I’m just too scared of change, but my sense of duty towards them is still there. I’ve often heard the advice that students should “study what they’re passionate about,” but maybe that should be followed by “given their circumstances.” Maybe a stronger person might do something different in my position, but I think I will just finish my business studies, take away what’s useful and leave the bad, and then apply to medical school.

So thank you again for the advice you’ve given – I will definitely talk to some medical students and doctors to see if I am fit for medicine.

Sincerely,

Jai

 
At Friday, January 01, 2010 7:27:00 PM, Blogger Maurice Bernstein, M.D. said...

Jai, I would go along with the advice "set your goal based on what you are truly passionate about but one that is truly realistic." Medicine, because of its burdens associated with the doctor's education and then the burdens associated with going further into the actual practice and responsibility of medicine does require passion. The passion is to learn, be skilled and to be "passionate" in the attention and concern for practicing toward the benefit of the patient. Yet, one has to be aware of one's own responsibilities in other areas of life and also the financial and personal costs of becoming a doctor and making medicine your profession.

I can tell you, after relating to first and second year medical students for 23 or 24 years, passion to become a doctor is what makes a great medical student!

So don't give up on passion, but yes, talk to medical students and doctors first to be sure despite the passion that the profession of medicine will fit your life now and in the future. ..Maurice.

 
At Monday, September 06, 2010 9:00:00 PM, Anonymous Anna said...

Hello,

I am a premed student and after having shadowed several doctors and volunteering in a hospital I began to question why I want to become a doctor. I'm not sure if I am pursuing this career because that is what my family wants for me or because that is what I am truly interested in. In the beginning I wanted to become a doctor because I loved biology and I was extremely fascinated by the human body. I believed that I would make a good doctor because I truly wanted to make a connection with my patients. But, I don't know if becoming a doctor is the right profession for me.

Going through all the classes and preparing for the MCATs has made me question my ability to get into med school. Looking at all those smart students in my classes makes me feel like I don't have a chance because I don't feel that I am as smart as the other students. I mostly get A's and B's but I am definitely not like those students who get all A's.

Back then I had a burning passion to do this and I always said to everybody that I couldn't picture myself doing anything else and that if I couldn't make it then I would be so upset. Going through all the requirements has made me lose my faith a little bit. Do you have any words of wisdom or encouragement?

Thanks,
Anna

 
At Monday, September 06, 2010 10:18:00 PM, Blogger Maurice Bernstein, M.D. said...

Anna, all I can say is that you don't have to be an "A" student in undergrad to learn to be a doctor in medical school. It really isn't the letter grades that count and that is why tests in most medical schools are either pass or fail. You should base your decision about medical school and career as a physician on your interest in biology and your interest in helping the sick. ..Maurice.

 
At Thursday, March 17, 2011 1:45:00 AM, Anonymous Anonymous said...

Hi Maurice, Im not sure if you still respond to this blog but I thought I would give it a try. I was lying in bed not being able to sleep yet again before I came across this post. I was lying there thinking about how I could still become a doctor and if it would be the right decision. I have always wanted to be a doctor and last April I complete my Biology degree with an A- average. I have never had much confidence that I would be accepted into medical school so didn't write my MCATs and instead enrolled in a program to become a high school science teacher, which I have almost completed. I've tried to make the best of my new career path but I still have so much desire to become a doctor. I think about it constantly. I am now 24, Im getting married this summer and I want to be a mom someday. Is it possible to be a good mother and a good doctor? I just wish this decision could be made for me, so I could forget about it and get some sleep! Even if you don't respond your blog and all these posts have been very informative...thank you! LL

 
At Thursday, March 17, 2011 11:02:00 AM, Blogger Maurice Bernstein, M.D. said...

LL, I can't tell you from experience how being a doctor impacts the personal life of being a "mom" to the children who will come along in the marriage. But there are now plenty of female physicians in the United States, for example, and I am sure many of them have the responsibility of their children. There are so many medical/surgical specialties a woman can enter whose professional styles and demands are different enough to allow these female physicians a choice for managing their personal life. Look up the names of female physicians in your locality and talk with them about their choices and family burdens.

But my best advice I can give you is DON'T WAIT to investigate and start the process to enter medical school if that is your desire since
you don't want sleepless nights wondering about your career to disrupt your work as a high school science teacher.

My best wishes to you for the two major upcoming events: your career and your marriage.
..Maurice.

 
At Monday, April 11, 2011 8:03:00 AM, Anonymous Anonymous said...

Hi Doctor Maurice..
I enjoyed reading this page. Reading this thread, I was relieved to know that a lot of people out there are also going through the same confusion I am experiencing. Its been a war with myself since start of summer break from first year medschool.
I was 23 when is started working as a nurse and felt like I didn’t have much satisfaction from my job, just taking orders and not being able to decide on my own. I didn’t feel fulfilled with my job as a nurse, although there rare times when I get off from work feeling great that I have helped saved a life, ease someone’s pain.. you know. That comes very occasionally though, usually I drag myself to work cause I wasn’t sure anymore if I was happy.
While working I realized I wanted more challenge, more than caring for patients, I wanted to be able to cure them. I wanted that kind of impact. I wanted to be a doctor. So, I quit my job, and I got into one of the top performing medical schools in my country.
I was in med school for a year. I had no idea what I got myself into, studying til wee hours in the morning, doing paper works for research, cutting back on my leisure time and social life. And just when I was ending my first year, I lost my sense of purpose for studying medicine.
Now its summer break, I am rethinking if I still wanted to pursue the medical career of a doctor or just work as a nurse. Im also thinking if the years, money and time I spent in medschool and as resident would be well paid off when I become a doctor who specializes in a certain field, healing sick. Plus im not quite sure if ill be happy with the lifestyle of a doctor, having to put service above self. My family and friends say it’s a waste of opportunity if I quit now since they know im doing well in medschool, but I myself am not sure if I really really want that kind of life. I know ill have a balanced life as a nurse, I can work my shift and go home to my friends and family, take a leave and enjoy my youth travelling and experiencing the world, but the question that runs through my mind is, would I be satisfied with my life’s work? Any comment you may have, I would deeply appreciate. Thanks and kudos to you doctor, for taking the high road! _ tory

 
At Monday, April 11, 2011 7:32:00 PM, Blogger Maurice Bernstein, M.D. said...

Ahh, tory..you used the expression "high road" as a description of my own career and this gives me insight in how you feel about the two careers of physicians vs nurses. I think as you go beyond your first year in medical school and get experience participating and learning in the various med/surgical clerkships, you will see the various opportunities you have available in a career as a physician. Some of the specialty possibilities may fit the life-style that would be comfortable for you. Check, for example, into the current salary and hours in the role of the hospitalist. Particularly if you are doing well in medical school I would advise discussing your concerns with a counselor in your school and also do some research into the various possibilities that are available for you as a physician. ..Maurice.

 
At Monday, August 29, 2011 9:38:00 PM, Anonymous Anonymous said...

To Tory... It seems to me that you are unhappy with your sense of purpose. Finding the positive in whatever you do will give you the feeling of safety and grounding to then make any changes that you desire. What is most important is to be happy. I think a personal counsellor could help to support you. - Sivan

 
At Tuesday, February 07, 2012 12:40:00 PM, Anonymous newmedstudent said...

Hi Dr. Bernstein,

I happened to come across this entry today and it has caught my attention as I am in the same position as many of the individuals who have contributed questions.

A little about my background. I graduated from a top tier undergrad with a degree in biology. I was always a little back and forth about whether medicine was the right field for me, but in the end after taking some time off decided to pursue becoming a doctor. I have always been the type of person to be interested in so many things, but after gaining acceptance into medical school, felt confident (at that time) that this was where I wanted to be professionally.

Upon starting school, my eyes were suddenly opened to the real personal sacrifice, late hours, and time commitment involved. I think before I was so caught up in the "idea" of becoming a doctor that I never truly took the time to understand the lengthy and trying process involved. I struggled with conflicting feelings as to what my true motivations were for entering the field and whether or not I wanted to remain enrolled, yet I decided to stay at least until first semester ended before making any decision to leave. What's unique to my case, compared to the others who have posted, is that during the initial few months I was experiencing intense stress and anxiety. And while I know that medschool is difficult and has the potential to cause these feelings, I felt as if I could not handle what I was going through and didn't want to put myself through such physical and emotional stress as it was manifesting itself in ways that were very uncharacteristic to who I am.

I spoke with school counselors and a psychologist both of whom seem to think that my heart just really isn't in it. However upon speaking to another physician and my dean, the option of medication was thrown at me as a first option (which I am not too inclined towards, simply because I know my symptoms are directly tied to school). At the same time the psychologist highly recommended against medication, confusing me even more.

As it stands, I took a leave of absence and have a couple months to decide whether I will return. I have really tried using the resources around me to decide what I should do but am left confused. It's hard to untangle the mesh of thoughts I have. Sometimes I think I entered school too naively without understanding the sacrifice, compromise of personal health, time commitment/stress now and throughout my career, and the bureaucracy involved with the state of our health care system (in addition to so many medstudents and doctors advising me against the career) and had I been more aware may have chosen otherwise. I am starting to realize that there are other satisfying careers out there in which i can hybrid my interest in science and enjoyment working with people. I've just been on his premed road for so long (whether for the wrong or right reasons), it's hard to leave simply because it's all I've known.

I am wondering what your take on the situation is. I feel that if I was to go back and take another shot something would need to change so that I wouldn't be experiencing what I was before, but starting medication from the getgo really isn't an option that I'm comfortable with. But even aside from the anxiety, I'm not even sure if this is the path I want to set myself down.

Ultimately the decision lies in my hands, but it's always nice to get perspective from someone in the field as well.

Thanks,
newmedstudent

 
At Tuesday, February 07, 2012 5:45:00 PM, Blogger Maurice Bernstein, M.D. said...

Newmedstudent, when you wrote "I think before I was so caught up in the 'idea' of becoming a doctor that I never truly took the time to understand the lengthy and trying process involved" you set the basis for my making a conclusion as to what has happened to you. What you wrote is analogous to jumping into a pool of water without first testing its temperature with your toes. You may be surprised and suffering from the unexpected cold. But once you are surrounded by the cold water, your human mental and physical compensatory mechanisms can be brought into play and you will survive.

You have now, in the first semester, jumped into the "cold water" and your experiences and emotions could be expected from the unexpected. This reaction doesn't necessarily reflect your final decision about participating in the profession. You have left the "cold water" and have a bit of time to make a decision of whether to return to the water and proceed with your initial desires to jump in and take a swim. But now, you will have been informed and you can use compensatory mechanisms to enjoy the swim.

What I am trying to get at with this analogy is that you should not try to anticipate in advance your previous symptoms with what you will experience when you return.

As I mentioned to Tory in my comment of April 11, 2011 above, once you have a medical degree there are a host of various career opportunities and investigation into this and finding a direction in medicine more comfortable for you will be part of compensatory mechanisms that will provide you emotional support as you continue through the remainder of your medical school experience.

Drugs are for symptomatic relief. Your current introduction to the "process" which you had ignored previously and compensatory mechanisms may be now enough to avoid further symptoms and thus negate the need for drugs.

I hope my interpretation of your problem and advice will prove helpful. Please write more if you desire. Best wishes. ..Maurice.

 
At Wednesday, February 08, 2012 9:03:00 AM, Anonymous newmedstudent said...

Hi Dr. Bernstein,

Thank you for replying to my post with such helpful advice. It's difficult to know whether or not my compensatory mechanisms will be able to drastically lesson what I was previously feeling, should I return to school. Because I so disliked the constant drain/depletion my body was feeling, anxiety, and lack of balance that is inevitably a part of the consuming schooling, everytime I even envision going back I am deterred simply because of the negative association I have between my emotions and school. Additionally, I just felt so overwhelmed simply thinking about the idea of being in school for so many years and having to put my career/patients before everything else in my life, especially when the profession gets a lot of negativity from those practicing in the field.

I know the medical profession offers a wealth of avenues to explore and that was part of the reason I chose it as compared to pharmacy, optometry, etc. At this time I am still unsure as to what my decision will be, but I do think that it's important for people like myself to realize that while I could make a great contribution as a medical doctor, I can also make a great contribution in another arena as well.

I have always been a very positive and happy individual and whatever path I choose I believe it is critical for me to maintain that mindset (and much of the time this was not the case while in school).

I also wanted to ask your opinion about entering the field of primary care. I hear/read mixed opinions with many believing that unless one specializes in their field, medicine is just not worth the economic/personal costs anymore. What is your take?

Best,
newmedstudent

 
At Wednesday, February 08, 2012 9:43:00 AM, Blogger Maurice Bernstein, M.D. said...

newmedstudent, I understand your concern about "jumping back into the water" and to what extent you are able to develop the "compensatory mechanisms" and how effective they will be in your case. Now, being aware of most of the "facts" of life in medical school and the medical career beyond may still not be sufficient to develop such mechanisms to relieve anxiety and develop confidence.

I would like to present you with another view. I took the liberty to submit your initial anonymous posting to the medically oriented website Medpedia with the Question to the subscribers "How would you advise a first semester medical student who discovers medical school and a medical career is different than what the student had anticipated and has caused emotional distress?" Within a few hours, I got a response posted on Medpedia which does give a different and personal view of your concern. I think it is very important that you read this view in addition to what I had previously written. Therefore, I will reproduce it here, but anonymously (except to say that the writer is male) in my following posting. ..Maurice.

p.s.- It is not clear from your postings what is your gender. Perhaps gender might possibly affect decisions and advice by some.

 
At Wednesday, February 08, 2012 10:12:00 AM, Blogger Maurice Bernstein, M.D. said...

Here is the response to my Question on Medpedia. It will be reproduced in 2 sections because of the Blogger.com limitation of the number of characters in any one posting. ..Maurice.
-----------------------------------
SECTION 1-
I read your student friend’s message with great interest and an immediate resonance to my experience. I am not sure this is helpful, but I wanted to explain my experience, in case it might help give some perspective.

As an initial disclaimer, I am always aware that people are different, and that this is what makes advising someone an often redundant pursuit. I was acutely aware of this when in his/her situation. However, as your friend says, the perspective can help! The useful perspective is shared experience that helps them see themselves and their current situation more clearly, or at least in way that helps them move forward. The catch is that someone “in the system” cannot give certain perspective, whereas someone outside cannot understand it.

Anyway, I am a med school dropout, but now work in a usually enjoyable, and certainly far less intense (for me) job developing new book ideas for medical publishing. I also studied Biology at a top UK university, and am very interested in science and health in general. These things are still core to my motivation.

The key sentence for me in your friends very rational and well written message is “I felt as if I could not handle what I was going through and didn't want to put myself through such physical and emotional stress as it was manifesting itself in ways that were very uncharacteristic to who I am. ” I struggled with this for 2.5 years and tried everything in my power to override this anxiety – exercise, counseling, moonlighting as drummer, intense hiking in exotic locations in (increasingly brief!) vacations, getting involved in global health projects, an interesting community health project in Ecuador, trying to find a “mentor” I could see myself in, for example. None of it helped – I could not escape a constant grating feeling that I was trying to drag myself down a road that wasn’t for me. I only left when it was no longer a “decision” but simply what I had to do. I’ve never felt such sweet release in all my life.

 
At Wednesday, February 08, 2012 10:17:00 AM, Blogger Maurice Bernstein, M.D. said...

SECTION 2-
Which isn’t to say I am not disappointed in myself sometimes (I wouldn’t term it ‘regret’). I still don’t entirely understand why I found it such a struggle. I’m a fairly gentle but confident person, hugely fascinated with people, really interested in clinical skills, science, and community/national health service. I was constantly aware of the unbelievable privileges and opportunities that a career in medicine can bring. But, when I am really honest with myself, I think my personality means that I find it overwhelming – not necessarily emotionally - but in trying to process all the things you experience as a med student/doctor. I have more of an artistic temperament (if not skill!), and require time to properly reflect on new experience, or else I am left on-edge. Also, if I am honest, I think the pure biomedical model is redundant, and I could not fit with the reality of the culture of medicine (rushed, linear thinking, bureaucracy, short-termism, treating symptoms over causes, body-mechanics, Cartesian reductionism [as an aside – even Descartes would prescribe his royal patients rest and exercise and discuss (perhaps partly from having little to offer!) ‘disease of the spirit’], etc.).

A third thing I often consider is that medicine alters the way you interact with people and bodies. These are core aspects of our identity. I found, perhaps compounded by a generally increased level of anxiety, that I started to feel more detatched from people, as if a sensitivity towards people I valued was being lost. I am not a sentimental, prudish or squeamish type, but it is very important to me to feel I am “connecting” to people. I don’t think this is an absolute thing, for or amongst individuals: it changes over (life)time. It is more a problem of learning to adapt, and I felt that I didn’t want to.

I suspect by the way your student writes that he(?) is quite a deep thinker that struggles with the reactive, immediate need of medical culture and its focus on a purely physical world-view. The anxiety doesn’t sound like it comes from fear of failure or inadequacy, but more from the high-demands of something they don’t want to commit to. I am only guessing. The culture and requirements of the job can be flexible after the (long) period of training, but you need a clear goal that sees you through this. There is not much time to search for this if it isn’t forthcoming, but needs must.

 
At Wednesday, February 08, 2012 10:18:00 AM, Blogger Maurice Bernstein, M.D. said...

SECTION 3-

I now have quite a few young doctors as friends. I do feel that we inhabit different bubbles of reality – if not planets – and I know nearly all struggle, even now. But suffering with meaning is OK. It’s when you don’t believe in or are not aware of the goals that it drains the spirit. Sometimes the goal that sees you through is simply discipline, determination or a competitive identity. There is nothing wrong with that, for the most part, but I am wary of comparing myself to others in this way. Or I am just not as ambitious as I thought. I still have struggles, of course, and in something as demanding as medicine, at least your struggles are usually right in front of you, and you can often act to alleviate them.

I am personally against any medication that is not necessary. Psychoactive drugs can sometimes jolt a person out of a psychological rut, but they are overused as a crutch that blurs ones sense of identity and surely cannot then influence clear-mined decisions based on self-determination.

I hope some of this is useful. I am certainly not advising them to quit. I still think it is one of the noblest professions with huge opportunities and a passport to places few others can safely go. But I found my time at medical school erosive and it always felt that I had an instinctive aversion to ‘joining the community’ I was trying to. It seemed at the time that it would really help to find a good mentor, and I always considered that medicine should be learnt as an apprenticeship, so that all elements of its practice can be passed on.

Please wish them well from me, and I would be interested to discuss more if they thought it helpful.

 
At Wednesday, February 08, 2012 10:42:00 AM, Blogger Maurice Bernstein, M.D. said...

It turned out that the comment from Medpedia required 3 sections. I hope, newmedstudent, you found the personal story presented of help. ..Maurice.

 
At Thursday, February 09, 2012 11:41:00 AM, Anonymous newmedstudent said...

Hi Dr. Bernstein,

I found this post very helpful. In fact, so much of what was discussed exactly explain my thoughts. I know that the poster mentioned they would be interested in discussing the situation further, is there an email address at which I could possibly reach them?

Once again, thank you and all this advice has been very insightful.

newmedstudent

 
At Thursday, February 09, 2012 1:50:00 PM, Blogger Maurice Bernstein, M.D. said...

newmedstudent, I am sure he will be willing to communicate with you but I will make contact with him on Medpedia for confirmation. If you will write me e-mail with your e-mail address, I promise not to reveal it to anyone except the Medpedia subscriber but only if he agrees to communicate directly with you.

Would this person on Medpedia be the first person whom you may write to that has suffered the similar dilemma as you have?
..Maurice.
My e-mail address is:
DoktorMo@aol.com

 

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