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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

#91

Post by northern_lights »

sp332 wrote: post #70
northern_lights wrote: post #61

Earlier quoted context omitted.

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.

1.) It's a very time-consuming and hands-on process to train a surgeon. There aren't many other fields that I'm aware of with the same level of intense apprenticeship as surgery (and medicine in general). My first thought after entering medicine was to marvel at how much effort goes into training a single physician. There is a lot of training at between a 1:1 - 1:3 student-preceptor ratio in an effort to produce very high-quality physicians. So, the solution is not exactly as easy as, "well just make more surgeons."

2.) The federal government controls the number of residency slots each year, through Medicare funding for residency programs. I don't pretend to know the details of how it works, but my impression is that to get more residents per year, you need to convince Congress that it's necessary.

3.) Classic chicken-and-egg problem. Any medical student can go into surgery if they want to, unless their performance up till that point is seriously below par. However, there are many other specialties that offer more attractive lifestyles. So to increase the number of students who choose to do surgery, you'd need to find a way of signaling to students that the life of a surgeon isn't all back-to-back divorces, microwave dinners, and 80-90hr work weeks.

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

#92

Post by pjlegato »

deelowe wrote: post #84
chriskanan wrote: post #16

My wife finished medical school a bit over 4 years ago. While she thought medical school was brutal, it was comparatively easy compared to the challenges she faced in residency (she did her prelim at UCLA-Harbor and is now at Boston Children's hospital doing pediatric neurology). 80+ hour work weeks are the norm, and sometimes she works 14 days straight and has a pager that beeps throughout the night that she must re…

As a father whose young son had a compound fracture recently and had to wait in the ER for 3 hours to get it patched up by a grumpy, rushed, and tired ortho, this is horrifying. Something really needs to be done about current crony capitalistic US medical industry.

I'm not sure that capitalism as such has much to do with the problem you describe, as anyone who ever went to a Soviet emergency room will be happy to tell you.

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

#93

Post by ukat »

I love the medical school analogy "drinking from a firehose" since a lot of the knowledge has to be frontloaded. This makes sense since making errors is less forgiving.

software engineering might be closer to "drinking from a running facet.. forever". I know doctors have to keep learning but I always wondered if it was more or less than engineers after school.

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

#94

Post by jhanschoo »

jimmaswell wrote: post #46
PhasmaFelis wrote: post #19

Earlier quoted context omitted.

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

From what I've heard, the vast majority of people just can't understand the kind of thinking required to be a programmer. The rate of application to Computer Science programs has increased, but it has the highest dropout rate among other subjects, which is said to be because of the problem of programming requiring a certain predisposition. One of a few articles on the subject: https://blog.codinghorror.com/separating…

I've found the conclusions of the paper that blog post discusses to be overreaching ever since I was linked to it. The authors have since retracted the paper.

http://retractionwatch.com/2014/07/18/the-camel-doesnt-have-...

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

#95

Post by gnu8 »

pjlegato wrote: post #92
deelowe wrote: post #84

Earlier quoted context omitted.

As a father whose young son had a compound fracture recently and had to wait in the ER for 3 hours to get it patched up by a grumpy, rushed, and tired ortho, this is horrifying. Something really needs to be done about current crony capitalistic US medical industry.

I'm not sure that capitalism as such has much to do with the problem you describe, as anyone who ever went to a Soviet emergency room will be happy to tell you.

The Soviet healthcare system suffered from underinvestment due to their command economy's focus on heavy industry and military production. The problem in the United States is the exact opposite: unproductive overinvestment due to the proliferation of waste, fraud, rent-seekers, and all other types of interests that rake a profit off the top without contributing anything to patient care. It seems like a false argument to claim that because a radically socialist regime provided inferior care, our radically capitalist regime is not the cause of our inferior care.

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

#96

Post by lloyd-christmas »

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.

My father is an oncologist. He's out the door before 5am and gets home at 7:30.

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

#97

Post by catscratch »

frozenport wrote: post #90
catscratch wrote: post #80

Earlier quoted context omitted.

The majority of today's US med school students admitted in 2016 were born in 1992. They grew up watching the silly kids and stupid parents sit-com world of Disney Channel and Nickelodeon while getting soccer trophies for showing up. They wasted a lot of time playing non-educational games rather than reading or working hard to accomplish real things. While they had to work incredibly hard to get into medical school, a…

I can't tell if this sarcastic, but I think its important to point out that much of the challenge and stress of US medical school is self inflicted by the current culture - and leads to bad health outcomes for patients.

My point was that medical school culture hasn't changed. It's been brutal for years.

The main difference between those going to med school and the 90s and now in my opinion is a mix of the expectations by students that the increase in level of difficulty should be comparable to the transition between high school and college, or college and graduate school. It's not, and it never was. High expectations have always been the rule.

However, for the past 25 years, there have been many more immigrants or children of immigrants that work their asses off competing harder and raising the bar.

The medical schools should not lower the bar to make it less stressful. Instead, we need more medical students to matriculate to P.A. programs and nursing programs, where they can do just as much good helping many of the same patients, sometimes making similar salaries. Eventually there will be more medical schools, which will help some. Or, maybe some of these doctors that feel that they had to go through too much can work their way up and teach so that they can give their students an easier individualized and sensitive education and see where that leads.

However, imo it should always be extremely difficult to get in and to succeed. That's the point. I don't think people should commit suicide. They should just quit.

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

#98

Post by Spooky23 »

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.

When I had my back surgery, my doc was there at 630a when I arrived for a 730a surgery, which took about 6 hours. He met me at 800p in PT to check on me.

I asked and he told me that was a fairly typical surgery day.

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

#99

Post by M_Grey »

chriskanan wrote: post #16

My wife finished medical school a bit over 4 years ago. While she thought medical school was brutal, it was comparatively easy compared to the challenges she faced in residency (she did her prelim at UCLA-Harbor and is now at Boston Children's hospital doing pediatric neurology). 80+ hour work weeks are the norm, and sometimes she works 14 days straight and has a pager that beeps throughout the night that she must re…

And that... is why I politely, yet firmly instruct anyone rendering medical care to not let a resident within 10 feet of me. "This is a teaching hospital!" doesn't cut it when the means of teaching are so irresponsible.

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

#100

Post by Spooky23 »

jseliger wrote: post #2

I wish more people knew and understood this. I didn't write about the suicide angle specifically, but I did write, "Why you should become a nurse or physicians assistant instead of a doctor: the underrated perils of medical school:" https://jakeseliger.com/2012/10/20/why-you-should-become-a-n... , which covers similar topics.

Nurse practitioners and PAs have it made these days. Great pay and crazy flexibility and job prospects.

My sister in law got annoyed about changes at her workplace with respect to scheduling. She griped about it in the break room, word got out and she had three unsolicited, real interview offers by the end of her shift.

Her requirements were to get her kids on the bus and be home at 5PM. That's written into her employment contract, along with a significant raise and retention bonus.

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