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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

#61

Post by northern_lights »

erentz wrote: post #37
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…

Do you really work 90 hours? That's 13 hours a day 7 days a week. How does that even work logistically when you need to eat, sleep, commute, do laundry, shop for food, and hopefully also see family or friends on occasion.

I am nearing the end of medical school now, and I can assure you there are many surgeons who consistently work 80-90 hours/wk. I see it most often in surgeons who have subspecialized and do extremely technical work. Family, social, laundry, food, etc, all become things that you take care of whenever you get a free second. It's very, very difficult to describe the path a person takes to get to that point, but the profession can absolutely be all-consuming. It's one of the reasons surgery is less competitive as a specialty than it used to be - people see the brutal hours and make the choice to pursue options with a more attractive work-life balance.

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

#62

Post by ljk »

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…

> They put the students through hell because that's what they had to go through, and they're rent seeking.

that's what i think too, especially when students go through rounds in the hospital they get "pimped"[1] it's like hazing on top of rent seeking

[1] https://drottematic.wordpress.com/2009/11/30/pimping-in-medi...

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

#63

Post by seanseanme »

I just finished residency and, based on my experiences, I have three points.

1) This situation seems analogous to the higher rate of suicide in very competitive colleges. Both feature putting people who did very well in the prior stage and then demanding a high level of content mastery in a short period of time. Interestingly, some places a pushing for a 3 year med school experience for primary care to reduce loan burden and get more productive years out of the training. I wonder how this will affect this pressure.

2) I wonder if discussing the harsh reality of medicine - charting, team management, things being beyond your control - rather than emphasizing the 'higher calling' and 'privilege to care' would dissuade those seeking prestige form entering medical school. I think it is a much greater service to have them figure out before school starts and not be saddled with 40-50k of debt that first year.

3) A big transition I always heard in med school was the difference of the trainees in that they value work/life balance much more than the titans of medicine in the past. How to rectify this priority with traditional medical school is a VERY interesting question.

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

#64

Post by FreedomToCreate »

erentz wrote: post #37
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…

Do you really work 90 hours? That's 13 hours a day 7 days a week. How does that even work logistically when you need to eat, sleep, commute, do laundry, shop for food, and hopefully also see family or friends on occasion.

And get time to read articles on HN

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

#65

Post by viraptor »

Lordarminius wrote: post #24
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…

> the sole doctor for miles in a rural area to attend to a mass casualty event.

Seems like the issue is not a lot of doctors in the area. While we can't test this easily, wouldn't reducing the forced marches give more people incentive to join the profession? Then you have more doctors, better coverage and people scheduled to be on call for this.

Essentially, where's the balance between few superheroes who survived and a large number of doctors who are just pretty good.

> but the rigor works and makes for good doctors.

You're commenting on an article which talks about medical students being suicidal. And I know of 2 local doctors actually going through with that. That's not my definition of "good".

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

#66

Post by jimmywanger »

Lordarminius wrote: post #60
jimmywanger wrote: post #38

Earlier quoted context omitted.

> 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. When has that happened to you, or anybody you've known? > There are many different diseases that present alike and even subgroups of the same diseases that have different management regimes. Sure, ho…

> When has that happened to you, or anybody you've known? Are you kidding me? I practiced medicine until 8 months ago when I burned out and had to take a break. One of the cases I recall having on an offshore medical center, involved 4 victims who had suffered burns(in one case over 80% of his body surface area), on a night when I had 2 other patients on admission. It easily took my team of four 5 hours to stabilize…

In these incidents, how many times did you have to reach on your advanced medical training instead of the basic ones to treat burn wounds and fix food poisoning?

How was any aspect of your job improved by your years of medical school, your years of residency?

Would you rather have more less trained doctors, or fewer elite doctors in those circumstances?

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

#67

Post by naveen99 »

> average acceptance rate for fall 2015 was 6.9 percent

But most students apply to multiple schools. Actual acceptance rate is 40% across all demographics. https://www.aamc.org/download/321480/data/factstablea12.pdf

Edit: also, 25% of the applicants are repeat applicants. So, first application acceptance rate is probably closer to 50%.

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

#68

Post by northern_lights »

flukus wrote: post #55
northern_lights wrote: post #44

Earlier quoted context omitted.

"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." The thing is...when that fracture extends into the joint capsule, or is in multiple pieces and needs a surgical repair, you'll want the doctor around to manage that. When that flu weakens your immune system and causes you to get a superimposed bacterial pneumonia, you'll want…

> I have noticed that it's become popular on HN to refer to parts of the healthcare industry as "rent seeking," and while I agree to some extent, I haven't seen much evidence that doctors or medical schools themselves are rent seeking. If we get a cold and need time off we need to visit a GP, this is rent seeking that could easily be handled by a non doctor for half the price. As for the other points, that's just a m…

>If we get a cold and need time off we need to visit a GP, this is rent seeking that could easily be handled by a non doctor for half the price.

I'm not sure where you work, but I have never needed a doctor's note to get off work for a simple cold. That's a company policy issue, not the fault of the medical industry.

As I said, a lot of the front-line work is now handled by NPs and PAs. There are still physicians in primary care, but they spend much of their time handling the more complicated patients.

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

#69

Post by cloverich »

erentz wrote: post #37
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…

Do you really work 90 hours? That's 13 hours a day 7 days a week. How does that even work logistically when you need to eat, sleep, commute, do laundry, shop for food, and hopefully also see family or friends on occasion.

I still remember the first day of my surgery rotation, when the head surgeon came in to give us a lecture: "Sorry if I'm a bit off, I just finished a 30 hour shift and haven't slept yet." lol. It varies greatly by specialty and program but I can assure there are physicians who literally test the limits of how much you can work in a week.

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

#70

Post by sp332 »

northern_lights wrote: post #61
erentz wrote: post #37

Earlier quoted context omitted.

Do you really work 90 hours? That's 13 hours a day 7 days a week. How does that even work logistically when you need to eat, sleep, commute, do laundry, shop for food, and hopefully also see family or friends on occasion.

I am nearing the end of medical school now, and I can assure you there are many surgeons who consistently work 80-90 hours/wk. I see it most often in surgeons who have subspecialized and do extremely technical work. Family, social, laundry, food, etc, all become things that you take care of whenever you get a free second. It's very, very difficult to describe the path a person takes to get to that point, but the prof…

Isn't that a little backwards though? The more surgeons there are, the more the work could be spread out, and the hours would be saner.
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