Yes! It is worth it


Category : Medical Rants

I worry about Panda Bear. This post has fueled many comments – Is it Worth It?

I will comment on Panda’s angst, then I will link to another outstanding post on the topic. I hope my post complements the #1 Dino post.

I give a regular talk to 3rd year students on picking a career in medicine. Each time I give this talk I stress the importance of picking a specialty which you will love. Many students pick a specialty which is trendy, especially one which their colleagues think provides “good lifestyle and high income.” If one does that, he/she often makes a big mistake.

The phrase that I use is listen to your heart. Do not choose your career unless you love the field?

I admit that I was fortunate. Within the first week of my internal medicine rotation, I knew that I was an internist (just needed the training). I know students who know that they are pediatricians, or surgeons or family docs.

Many students have difficulty figuring out which field of medicine gives them passion. These students do suffer in choosing a field. The students who “like everything” do much better than those who like nothing.

The biggest mistake that I see is students chasing money. While money is wonderful, your career lasts for 30-40 years. Each day you awaken, get dressed and go to your calling. If you choose correctly, you look forward to most days.

Those of us who are fanatics cannot imagine any other career. I know many physicians who feel this way. At age 58, I still regularly get excited discussing a patient situation, making a diagnosis, and helping a patient through conversation.

When I awaken each morning and look in the mirror, I see someone who wants to help.

Many students start medical school with that attitude. Unfortunately, we (medical school faculty) turn eager incoming 1st year students into jaded 2nd year students. I often have stated that 2nd year students are the most undesirable students to teach.

But then the 3rd year comes and most students have their joy rekindled. 3rd year students should learn the humbling power of the white coat. As Stan Lee wrote for Spiderman – “With great power there must also come – great responsibility.” Most 3rd year students come to love medicine.

Note that I say most. Some schools, some attendings, some residents make 3rd year students miserable. I personally find this unconscionable. If we truly love medicine, we have a responsibility to share that love with our students and residents.

Residencies differ greatly. Residents at some programs are happy, learning and excited about their specialty choice. Residents at other programs are unhappy and question their career choice.

Choosing a residency is fraught with hazard. Residencies have personalities, and those personalities can change.

The Panda has chosen (in my opinion) a high risk residency. Emergency medicine, while it continues to attract many students, probably epitomizes a problem specialty. ER physicians see the worst of humanity. They have the greatest challenge in sorting out acute problems. And they do all this with little feedback.

I worked as an ER physician for 4 months (after a year of ER moonlighting.) The problem with ER work is that you never really develop any relationships with patients. Your job is to treat ’em and street ’em. Your job is to decide if someone needs admission, and then find someone to take the patient.

Now for me that excludes much of the joy in medicine. I love figuring out the problem, and that often takes several days. I love establishing a relationship with the patient, and that really takes a couple of days (at least.) I love seeing a therapeutic intervention make a difference.

So, I will suggest this to the Panda. Find another field in medicine. I will suggest this to medical student readers – pick your specialty with a long view. Do not let that view become tainted by “expected earnings” or your colleagues opinions. Find a field in medicine that fits your personality and way of thinking. I know happy pathologists, radiologist, surgeons, internists, pediatricians, family physicians, obstetricians, etc. I also know unhappy …

Happiness in your daily vocation trumps money. I could have made more money had I finished a subspecialty fellowship. I could have made more money if I had continued ER work. Fortunately, I understood that I loved general internal medicine.

The #1 Dinosaur also found love – Is it Worth It? A Response

Medicine is more than a job. It is more than a career. It is a calling. (Perhaps that’s what Panda means when he says that fanatics “…hear things that normal people do not.”)

Is it worth it? I would answer, is it worth what?

Don’t pursue a career in medicine because you think it would be a good idea. Don’t do it because you want to. Don’t do it because you love it. Do it because you cannot possibly imagine being happy doing anything else.

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Comments (5)

I don’t have any angst. I was just pointing out some of the potential economic consequences a career in medicine.

I would also say that the physicians with passion are a minority, at least if you define passion the way I think you mean it, that is as something other than liking your job.

Just a question: Do you mean passion in the same way some mean “calling”?

I am happy to hear that 3rd year gets better, because I fit your description to a “T”. I had to be idealistic to start med school in my 30’s, but I can tell you that I am as cynical and jaded now as I have been in a LONG time.

About Emergency Medicine, I hear the comment a lot about no relationships with patients. As an EMT before this, I disagree. In many primary care settings people see patients for years, but there are few acute events that warrant serious introspection on either part, patient or MD. In EM, you have but moments with some patients. But due to the situation, often, those patients open up their hearts, fears and show you not only what matters, but sometimes what they are ashamed of in hopes of somehow attaining redemption for their sins before they die. It is very humbling and I find I am very close to patients I saw as an EMT. I still think about many and I hope I never STOP remembering them.

Praying for 3rd year….. ScutM

I feel P. Bear’s pain. I would have agreed with everything he said when I was a resident. I was overworked and burned out.

As an attending, I love my job and thank God that I stuck it out. I’m an EM physician and I can’t imagine any other specialty as challenging, entertaining (exciting in EM is usually bad) or rewarding.

You could NOT have said it any better: “Don’t pursue a career in medicine because you think it would be a good idea. Don’t do it because you want to. Don’t do it because you love it. Do it because you cannot possibly imagine being happy doing anything else.”

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