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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

#41

Post by FireBeyond »

LeifCarrotson wrote: post #22
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…

"not just Do-Not-Rescusitate orders" makes a lot more sense when you realize things like the fact that survival-to-discharge ratios for CPR outside of Rochester MN and the Puget Sound are often dismal and out of the control of any one element (effective, timely and progressive pre-hospital care, early access to defibrillation, Cath labs and the like), and that as a whole, the general populace needs to realize that oftentimes, it -is- just better to let go. Too many "heroic efforts" are made for the family's sake, not the patients.

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

#42

Post by rdiddly »

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.

Does 12 months doing nothing but anchor-bolts count? That's what my boss had me do. I practically had ACI 318 Appendix D memorized.

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

#43

Post by cm2187 »

One thing that strikes me is that the medical profession is one of the only professions that hasn't industrialised. Basically one highly paid, highly trained doctor in front of every patient. It's a craft industry... It doesn't scale well, and it is very hard to maintain a consistent quality.

Perhaps will AI change that...

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

#44

Post by northern_lights »

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…

"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 the doctor around to manage that.

The days when a doctor could make a living managing only simple problems are long gone, if they ever existed. These days, PAs and NPs handle the majority of healthcare's equivalent to CRUD applications, and physicians handle the complicated cases.

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.

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

#45

Post by stephencanon »

lanius wrote: post #29
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?

The specialties with better quality of life (e.g. dermatology) have become increasingly competitive, drawing some of the top students away from the more masochistic fields.

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

#46

Post by jimmaswell »

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?

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-programming-sheep-f...

I've personally found it to hold in a few instances where I've been able to observe different people trying to learn programming - they seem to either understand it right away or not really get it. A Computer Science professor of mine said this same thing once - he said "it's an aptitude."

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

#47

Post by ejstronge »

jimmywanger wrote: post #38
Lordarminius wrote: post #24

Earlier quoted context omitted.

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 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…

I'm not sure how you can prove what you're saying. It sounds a lot like someone seeing an app/website and thinking, "I could do that in no time."

The scope of what a paramedic does and what a doctor does are totally different. The way medical care is organized capitalizes on each person's training: paramedics stabilize and transport patients; nurses carry out treatment plans; and doctors create treatment plans.

It sounds like you're saying, just because we don't always need to use an efficient algorithm all the time, we should never be trained to use efficient algorithms. This could make sense in the context of the next Rails app, but, when your life is at stake, the extra training matters.

> When has that happened to you, or anybody you've known?

In the state I grew up in, there were only three pediatric psychiatrists for multiple millions of citizens. If a doctor's training confers the ability to affect hundreds of children's lives, I definitely want them to be as knowledgeable of their area of practice as possible.

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

#48

Post by kcanini »

rifung wrote: post #7
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…

I have a friend in med school and his experience doesn't sound like tech hiring at all. From what I can tell, med school isn't hard because of rent seeking, but because there is frankly just a very large amount of things you have to learn in a short amount of time. They also have to work extremely long hours on certain rotations. I was shocked at how little sleep he could get on some days. On the other hand, he seems…

Doctors do go through an accreditation process: https://en.wikipedia.org/wiki/United_States_Medical_Licensin...

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

#49

Post by dnautics »

cm2187 wrote: post #43

One thing that strikes me is that the medical profession is one of the only professions that hasn't industrialised. Basically one highly paid, highly trained doctor in front of every patient. It's a craft industry... It doesn't scale well, and it is very hard to maintain a consistent quality. Perhaps will AI change that...

? Every patient is exposed to a surface area that comprises several doctors. Currently my father is hospitalized with a failing liver and kidneys. He sees a GI doc, a liver doc, a kidney doc, an anaesthesiologist, residents for each of these, an intensivist.

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

#50

Post by nijiko »

cylinder wrote: post #28
LeifCarrotson wrote: post #26

Earlier quoted context omitted.

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…

What is your plan to replace these to filter out or vet people prior to learning the knowledge required to sufficiently do the jobs they trained their minds to do during those years?

I am curious, also, to these other countries that have better bars, can you cite some countries and studies that back up these allegations?

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