For a lot of children, teenagers, even young adults, when asked "why medicine" their immediate thought, whether they want to admit it or not, is about the money. Yes, it is no secret that physicians are well paid. But also keep in mind how expensive it is to pursue medicine. As a first-generation student, some of the fees that I hadn't thought about were:
MCAT testing fees
Primary Application Fee through AMCAS/AACOMAS
Secondary application fees (something I didn't originally even know about it)
Travel cost for interviews
Housing for interviews
All those points above are just a fraction of everything and it's all just geared towards the POTENTIAL of you being accepted into medical school. Once you get accepted, there are even more fees to think about and a lot more to consider dependent on whether you're an in-state or out-of-state student.
Material for Supplemental Learning
Note taking device
Club Fees if you choose to participate
Again, a very short list of everything to consider. Student loans help but remember loans have to be paid back so you have to be able to balance that out.
Me throwing out all these fees and cost to consider isn't to defer someone from pursuing medicine. But if you're only pursuing medicine for the salary, then quite frankly I don't think it is going to be worth it to you. Medicine is HARD…mentally and physically!
If you don’t truly love medicine and working with patients, the money is NOT WORTH IT!
How societies showcase physicians are through rose-colored lenses. Majority of what people see in the news, books, tv shows, movies are physicians who live a glamorous life with no problems, a large house, and what seems to be no obstacles in the world. Nothing exists but happiness and full bellies. Yes, some physicians may very much be blessed with that. However, what isn’t displayed as much are the stresses with repaying loans, finding that job security, having work be brought home with you on the worst cases, and physician burnout.
The assumption is that medicine is a straight path. Straight path to become a physician, straight path in practicing, straight path to diagnosing patients, and straight path to treatment. The reality of it is that medicine is anything BUT a straight path. Symptoms that patients present aren’t just some checklist for one specific diagnoses. There is so much information and things that physicians must consider when they see one patient and a lot is going to be up to interpretation and using their best judgement. It is a high stress situation.
For the harder cases where a physician loses their patient, people often think that the physician is so detached from the patient because they show no emotion and head onto the next case like nothing happen. But think of it from this perspective:
You’re the physician, Dr. M. You are called over by many nurses and staff asking what to do next for patient X who just went into heart failure. Patient X has been your patient for years and your goal was always to help better the patient’s life. You rush over to patient X’s bed and you must do a quick assessment all within the matter of minutes:
Current level of distress
Whether patient has been given anything new lately?
What organ system in the patient is in acute distress?
That is just a small list of things to consider. While doing that you have to come up with your action plan as well and be able to tell the nurses what you need them to do to save this patient’s life.
Is this the correct medication for the patient?
Risk vs benefit analysis
Keep in mind again, all this happening in a matter of minutes. Against your best efforts of trying to save them, your patient doesn’t make it. As the physician you call time of death. Almost immediately after, you get called over by another nurse for help with patient Z.
During that time with Patient X, that physician didn’t get that moment to step back and reassess the situation. Those were decisions made in a split second. Dr. M couldn’t go and consult with colleagues because patient X was under acute distress. As the signing physician on the chart, this is Dr. M’s patient, this is Dr. M’s responsibility. Patient X didn’t make it and now there is Patient Z to attend to. Dr. M didn’t get their moment to process their emotions of what just happened. Dr. M can’t carry that emotion and thought onto patient Z. Dr. M has to be able to set all other thoughts aside to attend to Patient Z’s specific needs so that judgement is not clouded and proper care can be administered.
Shifts like these can happen for hours and there is that possibility of the same scenarios occurring repeatedly. When Dr. M gets to leave their shift and head home, those cases, especially the harder ones where lives are lost, will follow Dr. M home. Physicians learn how to cope with what happened, analyze the whys, and think of how to prevent it in the future. The next day, it’s a whole new set of patients. Physicians do care about their patients, but they can’t radiate those emotions to the next patient. They must be able to still be professional.
Why did I just paint this horrible scenario for you?
I am not saying everyday of a physician’s life is like this, but every physician will have a day like this. This is where it is important that you do love your career and have a passion for it. You have the passion to help patients and it is that passion that will help push you through the difficult cases and continue forward, it’s not going to be about the money.
Money should not be on that list of why you want to become a doctor. If it is, it may be a lot harder than you imagine. Physicians must be able to find effective coping mechanisms and be able to process those emotions to move onto the next day. When a physician comes home their thought isn’t going to be “Man I made a lot of money today” but more like “I can’t believe I lost that patient today.”
Be sure you are pursuing medicine for the right reasons. How can you be sure? Interact with patients and shadow!
I may not be a licensed physician right now but the scenario above IS something I have seen in person. As a student who was shadowing at the time, I was able to take a step away to compose myself before returning to the physician’s side and continuing my observations. As a student, it was hard for me and I can’t imagine what the physician was going through.
From all my shadowing experiences, the ones that stick with me the most are the harder cases. I have seen child abuse cases, Munchhausen’s cases, and they stick with me because of how hard they were to witness. I reflect on those cases for the times that I think medicine is going to be easy and to remind myself of my whys of pursuing medicine. I want to be able to be a part of the team that makes those cases better and improves the patient’s life.
Medicine IS NOT easy. Medicine IS NOT a straight path. Medicine IS NOT about the money. It is about being able to be selfless and putting patient needs over your wants. You may want for a certain outcome to happen, but ultimately it is going to up to what the patient wants done and you have to treat them the exact same regardless of different views.
If there is anything that you get from today’s post, please shadow as much as you can and in as many specialties as you can so that you really get a sense on whether medicine is right for you. To really get an insight into the world of medicine, come prepared with questions to ask the physician you’re shadowing. I don’t mean the generic “why did you become a doctor?” but the questions that you don’t always get to hear.
What are the hardest cases that you have encountered in your career?
How did you cope through those cases?
What do you think is the hardest part about medicine today?
These are questions I asked at almost all my shadowing experiences and the amazing part about those questions are that not one physician had the same answer as another. You get to see from so many different perspectives and learn about yourself through that as well.
Shadow. Discover. Learn. Reflect.