The Secret to Career Success

From XKCD:

And the ten minutes striking up a conversation with that strange kid in homeroom sometimes matters more than every other part of high school combined.

And the ten minutes striking up a conversation with that strange kid in homeroom sometimes matters more than every other part of high school combined.

It’s not too far off from the truth.

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Thinking About Studying Medicine? Read This First.

For some honestly bizarre reason (which I have yet to discover), Malaysians are particularly kiasu about young people going to medical school. The biggest drama with JPA scholarships revolve around medicine. There is a bigger demand for spaces in medicine than anything else. Students who are the slightest bit brilliant or intelligent are pushed into medicine, regardless of their passions and skills. Apparently Medicine is the “holy grail” of Malaysian higher education: if you’re not studying to be a doctor, you’re stupid.

But do any of these people – the students and those that push them – really realize what it means to be a doctor? Do any of these people really know what medical practice involves?

It’s not just about grades or intelligence. It’s not about dissecting frogs. It’s not about tests.

It’s about sacrificing whole chunks of your life for the sake of someone else’s. It’s about having someone’s life – and death – in your hands. It’s about dealing with wheezy old people and mucusy babies in the middle of the night when you haven’t slept for a week. It’s about not crying too much when a child dies. It’s about being on call 24/7, knowing that even in the middle of a much-needed romantic interlude with your dream partner, your pager could go off because someone somewhere is having a medical emergency. It’s about life.

On Ask Metafilter today there is a question about being cut out for medical school. The person in question isn’t necessarily quick-witted or bright; however, he more than makes up for it in persistence and effort. He loves medicine to death and has worked with sick people, but comes from a liberal arts background. Can he still make it in medicine?

skepticallypleased gives an answer that is practically REQUIRED READING, though the rest of the thread is necessary too. If you are considering going to medical school for any reason, ESPECIALLY if it’s due to societal pressure, READ THIS FIRST.

Wow, loaded question. It’s funny I saw this one early but I’m about to ask another question. And, it’s not just medical school you have to worry about but residency and practice too so I’ll hit on it.

I’m almost like the person you mention although I tend to do well in school and upon standardized tests. I was liberal artsy and well, after some post bac classes, the MCAT, and lots of applying to grad school again am I am now a doctor and, barring the winning of the lottery, won’t be able to retire till I am 75.

I HAVE TO KEEP THIS SHORT FOR MY OWN SANITY.

Only go to medical school if:

1. YOU WANT TO HELP SICK PEOPLE GET BETTER. That’s the only thing that will help you get through the long, painful hours learning material that you will soon forget and is very dry and rote, sadly. (And, that’s the first two years of medical school).

(As for the next two, you have different challenges). If you actually feel good about sticking your finger up a 80 year old’s behind to see if she’s bleeding at a 3:30 AM admission in the ER when instead you could have been sleeping, you’ll like being a doctor.

In short, it’s not going to be about the money. At least not for your 20’s and 30’s anyway. Plus, if medicine has taught me anything, tomorrow is not guaranteed. You give up other things as well. On a side note, I luckily wined, dined and married the woman I love before medical school and, when I had more normal hours as lawyer. I could never fathom having developing the relationship I did with my wife while in medical school. I got to know her ambitions, got to know her family, and we really did a lot of stuff together. In medical school, that life is not so feasible. It’s simply because unlike any most other work, you have to keep reading when you come home (after a couple hours of lecturing or in dissecting the cadaver).
(I probably need to take MeFi off my favorites).

Most of your day is spent filling out stupid paperwork stupid lawyers demand of us, navigating the bureuracy of the hospital, reading labs, and just making sure your patients are getting better. Honestly, it’s tasks that nurses and PAs with some experience do just as well as doctors. The place we separate ourselves from them is our “fund of knowledge” and that requires a lot, a lot, a lot, a lot of dedication if you want to do it well.

The sad secret about medicine is that the imaging and treatments are so good, that you can be a lazy doctor but also a fine doctor. Read this excellent piece by a doctor who has a brain power far above mine and you’ll understand what it takes:

Sorry to ramble but to sum up: At least for 7+ years medicine is going to require your all (that’s when the last of many, many tests you will take end). And, it’s hard to maintaing deep relationships, be well rounded, and sort of follow the other pursuits your liberal artsy mind is going to care about also. It’s not just crap like knowing the Classics either. If you wanted to guarantee a loss in a current events trivia tournament, field a team of doctors.

And the latter is not a knock on the profession at all. Honestly, under the knife or when I am truly sick, the last thing I want to be going through my doctor’s brain is a Hamlet soliloquy. I want her to know the best evidence based medicine possible and have the best technical and manual skills possible. Some of my classmates fit this bill and I would humbly and readily trust their opinion over mine anyday.

How can I live with myself then? Well, I’m a lot slower and I hope superior reasoning skills will help me in the end. In short, I can’t name 4-5 leading causes of a left to right heart shunt off the top of my brain, but I’ll probably recongize it on a physical exam or an EKG and it will be diagnosed more accurately on an echocardiogram. (The ability of 21st century imaging to make mediocre doctors like me excellent is a topic for another debate. But, again, read Gawande’s piece and you’ll see where, well some doctoring is actually needed.).

2. Ok, enough of my baggage. Back to your question. Is medical school “doable” Yes. Yes. Yes. Yes. and Yes.
It honestly does not take much intelligence in memorizing a lot of stuff and spit the right answer back on a multiple choice test. I would say you need about a 115 IQ to be a doctor. If you’re slow at accumulating lots of information, then, well, you’re butt is going to be on the desk chair longer than most people. If you bad at science, well, then, your butt is going to be on the desk chair longer than most people, but you’ll get it. You’ll pull through. And, it seems like you have the intelligence and drive to do it. And, really, that’s all it takes. A friend of mine in medical school got a horribly low MCAT score (I’m talking really, really bad I’m shocked she was in an American medical school bad.) And, she had a liberal arts background from a prestigious school also. But, she wanted to be a Plastic Surgeon (a very tough specialty to get into) and she essentially worked real hard at it for a four years and got into a plastic surgery residency.

I’m not worried about you as you seem to have a true passion for helping people and want to be a doctor.

I’d be more worried about your discipline. Science is not harder than the liberal arts. It just requires a lot more discipline. You have to understand things from the ground up but, strangely, you can’t just reason how we got there. I hope you the reason you are not a good science student is that it’s not because you hate science either. That’s no good in medicine. You have to be both a scientist and a humanist and I feel you have to like both too.

As far as getting into medical school. If your science grades are bad, it will be tough. You might have to retake them again or hope you rock your MCAT. Even then, you can go to a foreign medical school and just work your way into medicine here as you are an American citizen. (Some of the foreign schools are not even requiring a Bachelor’s degree! But, if you can pass the liscensing tests they make you eligible for, you can be a doctor here! (Not a competitive specialty of course, but a doctor nonetheless — perhaps even in Psychiatry which might be good for someone who is not too too excited about the so-called “hard” sciences.

Ok, I hope I helped you out a bit. Medicine sucks a lot, but I’m not going to be a doctor that convinces you out of it. I still have a ridiculous amount of pride when people ask what I do and I say I’m a doctor. And, in those rare times that I feel I influenced patient care past what the mechanized delivery of algorithmic medicine gives a person these days (surgeons might not have this feeling as much, but that field has its own drawbacks), it feels REALLY GOOD to be a doctor.

And, well, medicine has its share of nasty politics (something I find incomprhensible because you see how fragile life can be everyday), it definitely has a decent amount of bad attitudes (although I’d bet perecentage wise less than other professions) and, sadly, the work is basically repetitive. I can’t remember more than 4-5 patient’s names from over 75 I saw last month. You do do a lot of the same stuff until something new comes along, but that something new is probably not something you invented or pushed along anyways and it builds off the previous stuff in the first place. Talking to patients is not repetitive but you rarely have time for really getting to do that. (I guess you would in Psychiatry and you know the conversations are going to be different…..:))

I really feel anyone can be a doctor if they work at it. How good of a doctor and how much time they will have for other pursuits is questionable and you’ll need intelligence to help you out there. (I can guarantee you my friend who became a Plastic Surgeon has never read a blog of any kind, but someone like Gawande, well, people blog about him).

Still, medicine is a lot more social than other professions. And, really, no patient is the same. And the desire to be well rounded can be carved out later in life or at level that you can be individually at peace with and things.

So, in short, if your friend can simply stay disciplined for a decent amount of time and get organized and work hard, he’ll be a great doctor and he’ll like it. Plus, being a doctor only opens more doors than it will ever close for you. He won’t have to practice medicine at all — he can work for a drug corp, teach, research, etc. So, it’s a big world and most people find their way in it.

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