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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

#51

Post by dominotw »

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…

one of my ex girlfriends broke up with me because I dint get into a medical school and her parents, both of whom are doctors, didn't want her to get involved with someone who isn't a doctor. Strangely( Or not strangely) that kind of 'made sense' to me back then, Indian community and all.

Her whole life was geared towards her becoming a doctor. Things like volunteering purely to make your med school application look strong. Bunch of my Indian friends are doctors from pure Inertia, not due to any particular passion of medicine.

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

#52

Post by ejstronge »

jimmywanger wrote: post #18
ejstronge wrote: post #6

Earlier quoted context omitted.

Which are the countries where doctors don't have an accreditation board? The history of physicians controlling who is allowed to join their ranks goes back centuries, at the very least.

In the US, medications are controlled through doctors. In most of Latin America (the countries I've been to), the pharmacists were the first source of triage. "Pooping too much? Here, take this pill. Oh wait, there's blood in there? You should probably go see somebody more informed."

This doesn't address the question of a country where physicians aren't trained/recognized by other physicians.

Incidentally, the free availability of drugs in the way you described is being curtailed in Latin American countries.

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

#53

Post by tcj_phx »

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…

> 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.

Sometimes the treatment is worse than the disease.

> 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.

Most mental health medications are palliative, and tend to make the underlying condition worse over time [1].

[1] https://www.madinamerica.com/anatomy-of-an-epidemic/

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

#54

Post by jimmaswell »

jrowley wrote: post #27
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?

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.

The barrier to entry to call yourself a programmer or possibly make it through a Computer Science course is definitely lower, but there's potentially an immutable barrier to being a programmer regarding the ability to work with the kind of thinking required to do it, as mentioned in a comment I made elsewhere in this thread. I haven't heard the same said about becoming a doctor - I think it's considered something most people could do if they put in all the time and effort required.

So, the barrier to programming might be either impassable or not there depending on who you are, while I'd assume the one to being a doctor would be difficult but doable for most people. So for those people who can't be a programmer, "difficult" would be easier than "not possible," so the barrier would be lower to be a doctor to them, while for someone with the predisposition for programming, programming would definitely be easier.

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

#55

Post by flukus »

northern_lights wrote: post #44
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…

> 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 matter of having escalation procedures. The current system has highly paid specialists doing front line technical support.

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

#56

Post by cm2187 »

dnautics wrote: post #49
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.

I had more the generalist model in mind, as many small problems could certainly be dealt with in a more automated way. But the example of your father is illustrating my point. All these professionals each individually has to stay up to date on all the developments in their profession. And you hope they were not bottom of their class, barely making the exam.

For complex medical problems, algorithms are unlikely to do it for many years. But to recognize common skin diseases for instance it is perhaps not so far fetched.

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

#58

Post by dragonwriter »

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...

Lots of medical work is done by non-doctor medical specialists (and non-spwcialist assistants) of various kinds with doctors in a supervisory (functionally, not necessarily in the personnel management sense) role. It certainly has "industrialized" in that sense.

There are certain decisions that remain reserved to doctors which limit scalability, but that's also the case in other regulates professions, it's not unique to medicine.

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

#59

Post by xanderstrike »

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'm assuming it's 90 billable hours. He said he waited two hours to do a ten minute procedure, sounds like most of his day is spent waiting rather than working.

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

#60

Post by Lordarminius »

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…

> 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 the patients and have them evacuated by helicopter.

In 2014, the oil company we subcontracted for had an incident where over 90 people suffered acute food poisoning from eating dinner at the staff canteen. This was a bacillus cereus infection with vomitting and stooling. Dont attempt to imagine that number of sick patients. There were only 2 doctors and five nurses initially to manage the incident. I could tell you war stories all day so could many other doctors.

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