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Medical school can be brutal, and it’s making many of us suicidal

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Re: Medical school can be brutal, and it’s making many of us suicidal

#21

Post by ReallyAnonymous »

medical school is humbling and difficult. Being a physician is difficult. I finished medical school in 1996 - didn't find it ridiculously hard, but then again, studying a lot was what I did in my youth. Now, I'm 47 years old, and work about 90 hours a week as a surgeon - I laugh when people say that we make too much. All I know is that 25 years ago, you had to be in the top 10% of your class to become a surgeon. When I applied, it was top 20%. Now, it's basically if you graduate from medical school and want to be a surgeon, you can become one. General surgeons put in long hours for not that much glory - today I waited 2 hrs to drain an abscess that took me 10 minutes, so I got home at 6:30 pm.

The upside is that when I do a great job, it really is rewarding. The downside is telling families and patients I do not have much to offer, and their disease is too far gone. Anyway, don't go into medical school / surgery if you don't want to work hard. No one has a gun to your head. Physicians that pick the right profession for their personality / skill set are very happy.

PS my undergraduate degree was computer science

Re: Medical school can be brutal, and it’s making many of us suicidal

#22

Post by LeifCarrotson »

mmagin wrote: post #17

This is the important part, I think: "But one part of medical school culture has been especially hard to overcome: the stigma of mental illness. When they need help most, medical students in anguish rarely reach out. Students attribute this reluctance to seek care to fear of stigmatization by peers and to concerns over professional ramifications, particularly during applications for residency and licensing."

Interesting they say they attribute it to stigmatization and judgement.

What I have observed among family in the medical industry is a reluctance to use the care they provide: not just Do-Not-Rescusitate orders but a tendency to just suffer through the sickness instead of seeking medication, and to let the illness take its course rather than seeking second opinions and treatment.

Of course, these are with regards to physical ailments. Family has been much less public about mental issues. But I wonder if these same fears and proclivities also translate to mental health problems.

Re: Medical school can be brutal, and it’s making many of us suicidal

#23

Post by agumonkey »

ReallyAnonymous wrote: post #21

medical school is humbling and difficult. Being a physician is difficult. I finished medical school in 1996 - didn't find it ridiculously hard, but then again, studying a lot was what I did in my youth. Now, I'm 47 years old, and work about 90 hours a week as a surgeon - I laugh when people say that we make too much. All I know is that 25 years ago, you had to be in the top 10% of your class to become a surgeon. When…

What do you think about current day surgery and potential technological change in the field (robot driven, nanotech [not smart molecules, but increasingly simple interaction at sub micron scale], large data monitoring and analysis for prevention) ?

Re: Medical school can be brutal, and it’s making many of us suicidal

#24

Post by Lordarminius »

jimmywanger wrote: post #3

I see parallels with medical school in tech hiring. They put the students through hell because that's what they had to go through, and they're rent seeking. In most other countries, doctors don't have an accreditation board. Most things are simple, and it doesn't require years of school to set a bone or put in some stitches, or even diagnose the flu or pneumonia. Similarly, you don't need a rockstar or ninja to write…

Wait a minute... Im a doctor and I disagree with this.

> They put the students through hell because that's what they had to go through...

True. But the reason is that it toughens you up and winnows the wheat from the proverbial chaff. The forced marches through the wards at 2am in the morning prepare the budding doctor for the real world where he can be called upon as say, the sole doctor for miles in a rural area to attend to a mass casualty event.

>In most other countries, doctors don't have an accreditation board. ...

I do not know of any country that does not have an accreditation board. The difference between countries is the process of accreditation. Sometimes it is direct: the student takes centralized a board exam; sometimes indirect: the student takes a uni exam approved/supervised by the board.

> it doesn't require years of school to set a bone or put in some stitches

Maybe. But it requires erudition and experience to anticipate that a poorly set bone can heal with complications(malunion, non-union,infection etc.) Fun fact: when Admiral Nelson was wounded in the battle of Santa Cruz de Tenerife in 1797 field surgeons had his arm amputated but mistakenly trapped his nerve in a ligature that caused him great pain until the mistake was corrected )

> it doesn't require years of school ...(to) diagnose the flu or pneumonia

That pov is exactly how people get misdiagnosed and killed (by quacks).

There are many different diseases that present alike and even subgroups of the same diseases that have different management regimes. While it may seem obvious for instance, that a patient has pneumonia, one would also do well to ask what kind of pneumonia he has, why he has it (immunocompromise?, zoonosis?) and what the alternatives could be( the differential diagnosis). More than once has "ordinary pneumonia" been found to be lung cancer. It takes years of post graduate training and practice to become proficient enough to identify different disease conditions and manage them with confidence.

Medical school hazing is not done because the seniors are sadists. Some aspects of the process could be improved but the rigor works and makes for good doctors.

Re: Medical school can be brutal, and it’s making many of us suicidal

#25

Post by paviva »

Compared to previous generations (and the change is quite steep -- I am talking about students today vs. students 5-10 years ago), a growing proportion of medical students have entitlement issues.

Those issues are roughly two-fold : (1) feeling entitled to a "balanced" lifestyle; (2) feeling entitled to help people. The first one is obvious: student want to leave early, they don't understand that patients always come first, that, sometimes, you have no choice but to be sleep-deprived for days, and so on.

The second one is a kind of "Mother Teresa Complex" when students experience uncontrolled anxiety and distress upon seeing a fully competent adult actively undermining his own care. I see it all the time when they try to talk a lung-cancer smoker into stopping for 30-40 minutes, come back almost crying that he's not interested, and can't believe that their "trying to help" means they are now late, and I'm not happy at all.

Re: Medical school can be brutal, and it’s making many of us suicidal

#26

Post by LeifCarrotson »

sparky_z wrote: post #14
cylinder wrote: post #11

The presence, or increase, of suicides does not mean that medical school is too "brutal." It could very well mean that young people are becoming worse at coping with stress. Or perhaps students feel more pressure because of their perceived consequences of their failures: basically no alternative career path that would provide the same standing as medicine, whereas in previous generations, med school dropouts could go…

"I will say that there's definitely a hazing culture across all professions in America that's completely unnecessary and inappropriate." I'm a structural engineer. I don't recall any sort of hazing culture, or even a single instance of hazing.

Where did you do your internship, and what were you asked to do there? How many hours did you work and study while in school? Were you expected to work much longer hours as a junior employee to "work your way up the ranks?

I think these are the sorts of elements of a hazing culture that GP is discussing. Not necessarily fraternity-prank style hazing.

Re: Medical school can be brutal, and it’s making many of us suicidal

#27

Post by jrowley »

PhasmaFelis wrote: post #19
drcross wrote: post #4

Many people want the status associated with being a doctor (of course some are pushed that direction by parents and some also just want to help people). When you have an abundance of people trying to get into an industry the profession have the ability to only choose the absolute pinnacle of talent. It's the same with being a pilot. Many of them work long hours in shit conditions for years hoping to get a decent rout…

How much longer until programming is the same way, now that we're pushing it to every kid and idolizing tech billionaires?

The barrier to entry to becoming a programmer is significantly lower, so hopefully the pressure will never be as bad. But as a recent CS graduate I certainly feel a lot of stress about my skills or lack thereof. Coincidentally, my twin brother is applying to med schools right now (on the order of 40). I applied to exactly 2 jobs, got an offer and took it.

Re: Medical school can be brutal, and it’s making many of us suicidal

#28

Post by cylinder »

LeifCarrotson wrote: post #26
sparky_z wrote: post #14

Earlier quoted context omitted.

"I will say that there's definitely a hazing culture across all professions in America that's completely unnecessary and inappropriate." I'm a structural engineer. I don't recall any sort of hazing culture, or even a single instance of hazing.

Where did you do your internship, and what were you asked to do there? How many hours did you work and study while in school? Were you expected to work much longer hours as a junior employee to "work your way up the ranks? I think these are the sorts of elements of a hazing culture that GP is discussing. Not necessarily fraternity-prank style hazing.

Yes, this is the type of hazing I am referring to. Call it "institutionalized hazing" rather than fraternity style hazing. The bar exam for lawyers is one good example of hazing. Most law grads who apply themselves will pass, it's just a form of hazing for new entrants. Other countries with common law have just as good, if not better, bars and they do not have postgraduate law degrees and bar exams to become admitted. I don't buy the "it reduces supply" either, because of the high pass rates, but even if it was used for this, it would simply be injustice. If you want to filter people out, do it before they waste three years and $150,000.

Re: Medical school can be brutal, and it’s making many of us suicidal

#29

Post by lanius »

ReallyAnonymous wrote: post #21

medical school is humbling and difficult. Being a physician is difficult. I finished medical school in 1996 - didn't find it ridiculously hard, but then again, studying a lot was what I did in my youth. Now, I'm 47 years old, and work about 90 hours a week as a surgeon - I laugh when people say that we make too much. All I know is that 25 years ago, you had to be in the top 10% of your class to become a surgeon. When…

Interesting, I assumed that the field would become more selective over time. Or is it because just getting accepted to medical school itself is already extremely competitive?

Re: Medical school can be brutal, and it’s making many of us suicidal

#30

Post by shams93 »

cylinder wrote: post #11

The presence, or increase, of suicides does not mean that medical school is too "brutal." It could very well mean that young people are becoming worse at coping with stress. Or perhaps students feel more pressure because of their perceived consequences of their failures: basically no alternative career path that would provide the same standing as medicine, whereas in previous generations, med school dropouts could go…

The staggering level if debt accumuliated to get all the way through is another factor, you could invest a huge amount of money and still fail out 3/4 of the way through the process. That's incredible pressure.
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