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Doctor Blog-Medical School: Is it for me?

Posted Jul 30 2008 4:13pm



This reader has several questions about medical school, medicine, and a life
taking care of people.

Thank you AS for asking the questions and giving me the opportunity
to provide some of the answers.

AS writes:

Hello,

I know that you must be busy but I saw this as a great opportunity to get some
much needed information. I am a freshman in college and thus about to decide
where I would like my life to go. I am looking to go into Pre-med, but there are
some questions I was wondering about concerning being a doctor.


One concern
I have is that I am very torn between the artistic side of me and the
part that loves science and medicine. I feel that if I choose one, I am giving up
the other and I want to make the right decision. I am very interested in the field,
in the science aspect and also because doctors have been such a help to me when
I seriously ill,  but sometimes I am not sure that I could hold up to the rigorous
demands and schedule
of medical school and medicine itself.

I am a very good student and can memorize well, but the prospect of someone's life
resting in my ability to remember information is frightening.

What is the typical schedule a doctor has ( length if shifts, typical hours)? I noticed,
through reading your blog, that you have children. This is encouraging to me
because in the future, I know I may want to have a family but I was very concerned
that becoming a doctor would not leave me any time to be at home. Is it ever
difficult to find free time or family time?

Another question I was curious about is if you had a hard time when you first had
to work the ER. This seems like it would be a very difficult thing to face, not only
because of the sometimes gruesome nature of the situation, but also because of
the need to be able to come up with snap diagnoses.

A final question I have is if you ever had  doubts about your profession during the
hard intern/resident stage or, even now, when things get rough.

Thank you for your time and also for your blog. It is very interesting and a great
way to get a look at a doctors perspective

                                                                           sincerely
                            
                                                                                             A.S.

ANSWERS

1.  With regard to your artistic side, many physicians are artistic.  Many of them
play musical instruments, sing or paint.  That is entirely consistent with what
you will find among other physicians.  Those who are physicians have decided
to make being a doctor their vocation and their artistic side their hobby.  Being
artistic can really help you be a "human" doctor and relate to patients better.
It can also help with the creative side of medicine that requires a doctor to make
decisions with pieces of information that may not look like much to other people.

2.  Yes, training is very rigorous although, in the US, accreditation agencies have
demanded less hours for residents overall.  You will still face many long hours of
work.  I always found that the best policy was to get regular exercise and a good
diet to help keep up my energy.  It really is amazing that if you are dedicated to
what you are doing, you will find the energy.  It is mind over matter.  You will be
fatigued and sometimes sleepy but, most residents have learned how to master
their fatigue and have learned to focus their minds on the task at hand. 

Keep in mind that there is training (
internship, residency, chief residency, fellowship)
and then there is being
in practice.  These two things are different and the
schedules are different.  Read on.

3.  There are no "typical hours" for doctors.  The great thing is that there are many
settings you can pick from when you start your career today.  And, as far as
having children, make them a priority and you will find the time.  But, make sure
you have a partner who can understand your committment to medicine and
who is willing to share daily tasks (cooking, cleaning, picking up the kids, shopping,
etc. etc.).

Residencies are tough--period.  It is necessary training and you deal with it.

As for real life practice hours, it really depends on the field you choose. 
It also depends on the setting in which you decide to practice.  For example, if you
decide to go into
Obestetrics and Gynecology(Babies and Women), your
schedule will depend on when the baby decides to be born.  Most doctors
have partners to share "on call" hours so that they do get a break periodically.
If you are in private practice, you are it if you are on call.  If you work in a large
teaching hospital or large clinic, doctors will usually work "regular days" (that
might start as early as 5-6am and may last until 8-9pm) for 3 to 4 days in a row and
then be "on call"--meaning they are the person to call if a patient has problems
in the overnight hours. 

The more rigorous specialties tend to be surgical (
General Surgery, Neurosurgery,
Orthopedics, etc.) because people hurt themselves and can require surgery at
any time of the day or night.

Less rigorous specialties (as far as schedules) might include
Dermatology and
Ophthalmology, again, depending on the practice setting.

These days, there is even beginning to be a differentiation of doctors
by whether they practice in hospitals (hospitalists) or in clinics (outpatient care). 
Doctors who work in outpatient clinics see patients only in clinics.  If a
patient needs to be admitted into the hospital, they will arrange for the
hospitalist to care for the patient while they are in the hospital. 

Primary Care (includes Family Practice, Internal Medicine, Pediatrics) is primarily
practiced in clinics now with support from hospital based doctors in most locations.
These specialties usually have fairly predictable hours in this type of setting with
work being mostly 8am-5pm and paperwork time after.

4.  Working in the
Emergency Room is only one mandatory rotation during Medical
School.  All residents have to learn to negotiate the ER during Internship and
Residency because that is where many patients come into a hospital.
Your concern of having someone's life in your hands and having to make rapid
decisions is "Hollywoodized".  You would not be allowed to hold that much power
until you have learned to make many decisions on your own.  Also, not everyone
wants to work in the ER unless they want to specialize in Emergency Medicine
(a very stressful field with one of the highest rates of burn out in the medical
profession).  So, don't stress about working in the ER.  It is one experience out
of hundreds that you will have along the way.

5. As far as doubts, read about
my moment of doubt in Medical School.
The bottom line is, if you feel it is your calling to be a doctor, you will find solutions
along the way for many of your concerns.  If you are having really grave doubts
about committing, you might consider some other degree in the health
professions that would allow you to care for patients without the extended
and difficult training program of an MD.

Examples might include
Physician's Assistant, Nurse Practitioner (for nurses),
Nursing, or one of the "Therapies" such as
Physical Therapy or Occupational
Therapy
.  All these fields provide patient care but are less rigorous in training
in terms of time spent in school and time spent in residency training.

Good luck A.S.  Let us know what you decide.


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