Are You Even Happy With a Career in Medicine?

[anonymousername]

I'm an undergraduate student debating a career in medicine but I'm a little hesitant about the lifestyle of a physician. My motivations are the same as most premeds: financial security, prestige, power, and responsibility but I'm concerned about how "happy" actual doctors are with their career choice.

I see med students saying "i have lost interest" or "i hate it" and interns/residents/attendings telling them "It'll get better, just wait it out..." but I honestly don't see where it actually gets better.

In M1 & 2, you study hard and kill yourself to understand the material, you adjust to a new life, competition, study methods, and a huge amount of material that you will be tested on. Step 1 is hell compared to anything you have ever encountered before. M2 and M3 are clinical rotations/clerkships, you are constantly busy. Instead of just learning new material, you need to learn new material and fulfill your responsibilities in a clinical setting (im still unclear about what they are). You are treated with less respect by everyone in the hospital, doctors, nurses, ect. Step 2 is taken, I don't know anything about it but I assume it's no cake walk.

As a resident (i will be 27 if everything goes to plan) you spend 3-7 years making **** money and doing the "grunt work" for people above you in the hierarchy. You have debt to your eyeballs, you work an unimaginable amount of hours, and you have to deal with call. You still get **** from everyone above you.

I'm not clear what the options are after residency but I understand there are a variety. I hear this is the part where you may be able to make the real money depending on what specialty you go into. But by the time I'm here, I'll be between 31 and 34 and from what I understand you will be an employee of some kind and it is very unlikely that you will open your own practice (even more so in the future).


I have a genuine interest in the human body and making a difference in the world is important to me. But if I look at the career from a extreemly selfish and realistic standpoint, I'm not sure if I want to devote my prime years to something that will sacrifice the things in life that people in other careers don't have to: sleep, stress, time with family, vacation, a month without thinking about death (a little out of the ordinary...I know), lawsuits, hospital politics, working over christmas, ect.


I've been thinking more and more about dentistry, it gives a decent income after 4 years of dental school and after a 2-3 years of being an associate, one can open up their own practice. After that they work 9-5 for 4 days/week. It's not as interesting, fulfilling, or prestigious but it seems to "fill in" what I consider downsides to a career in medicine. From my perspective, for the 4 years of undergrad and 4 of dental school, dentists are rewarded much better than physicians (working 4 days a week, ownership of business, low stress environment...). But I never considered a career in dentistry because medicine is respected much more and because doctors can make a substantial difference in a patients life.

Right now, I need to make a decision between the two careers. I outperform my peers academically and I believe that won't change for the standardized exams. I'm currently operating under the assumption that I will gain admission to whichever school I apply to whether it be dental or medical. I need to make a decision now about what I want to do until I retire (or die) because I damned sure don't want to get into a career that I hate!


Is my representation of the trajectory to become an established physician accurate?

No one wants to admit that they hate their career but did you ever seriously consider another career between medical school and now?

Besides satisfaction and being worth more to society, what are the benefits of being a doctor that dentists don't have? (something tangible, not "intellectual challenge" or "respect from the community")

In your experience, what is the best thing about being a doctor that you didn't expect as a premed/medical student?

In your experience, what is the worst thing about being a doctor that you didn't expect.....?

Are there some possible deterrents for a career in medicine? if so what?

Are you happy with your career choice? are your colleagues/peers?

---

Members don't see this ad.

 

[Winged Scapula]

I suggest doing a search here and in the Practicing Physicians forum as this question has been asked multiple times before. Indeed, I am fairly sure every specialty forum has some form of this question as well.

Long story short, I enjoy my career despite its frustrations and it is inaccurate to say that you must be an employee. Although difficult it is still very viable to be self-employed in private practice.

You have to assess what is more important to you. There ARE careers in which you can make more money with less training, less hours, less work...whether or not these appeal to you is a different story. I never thought of it as wasting my "prime years" as you're going to get older anyway, might as well be doing something you enjoy and find interesting. Medicine is a second career for me and one that I enjoy, even while complaining vociferously about it to my friends.

 

[Apollyon]

But, since "Practicing Physicians" is a limited forum, the thread can go there, but the OP can't respond.

If the OP is added to the list, then it's not limited anymore, and the other people who were removed would, justifiably, have to be reinstated.

 

[Winged Scapula]

Yeah, I realized that...so will move it back. Not sure what to do with these posts, since it is not a General Residency issue.

 

[filter07]

I applaud you for your refreshing honestly, insight, and understanding. It is rare to see these qualities in premeds, who are usually hopelessly idealistic and have no idea what they are getting into.

Being a physician will be more prestigious than being a dentist, both among the lay public and the educated elite. This sounds pretentious but I am just laying out facts. I will say though that prestige matters to wildly different degrees in most people and you will have to do your best to determine how important it is to you. Prestige does not make me feel warm and fuzzy inside, and I often take it for granted. But if you ever go for a period without it, you will definitely notice what you are missing. Like money, people get used to a certain amount, whether poor or rich, and its effect diminishes over time.

You have power, but doctors are no longer treated as infallible demigods. There are administrators, social workers, nurses, big pharma, insurance companies, and medical malpractice attorneys that keep checks on you. After all that though, you have considerable power by being a physician, a lot of which is associated with the prestige mentioned before. Doctors still have a lot of autonomy and impact on patients.

I think you are right to look at medicine from a selfish standpoint. When you are on your 30th hour making less than the pharm rep who majored in sorority makeovers and doing the walk of shame, remembering self interested motives goes a long way. Medicine is a long and painful endurance test and unless there is something in it for you, no amount of humanitarian happy thoughts can overcome that.

What doctors have over dentists is all intangible, unfortunately. Dentists kick our ass in terms of lifestyle. Some physicians make more than dentists but also work a lot harder, especially during your prime years, as you stated.

The best thing about being a doctor is being able to save someone's life or make it a lot better for them. And appreciative patients. Also by being a doctor (especially surgeon) you are more attractive to women by like 1-2 points on a 10 point scale. That might work against women physicians because it scares off a lot of dudes of lower education or prestige... such as dentists.

The worst thing about being a doctor is unappreciative, manipulative, and poorly educated patients who care less about themselves than you do.

 

[ReadyFreddy]

I think dentistry would be a smart career choice for many of the reasons you listed. If I had thought about it before medical school, I may have considered it.

That said, I am excited about my future career path and have no regrets as of now. (Disclaimer: I am currently "only" an MS4.)

I would be wary of anyone basing career choices based on prestige or power, though. These factors are often intangible or unstable, and will never be motivating enough get you up in the morning to go to work if you actually hate the work. "Lifestyle," however, in the sense of what duties you perform day to day, and how much you can separate your job from the rest of your life, is a consideration that would be important for me.

It seems like you are asking the right questions of yourself and of others. Best of luck in your decision.

 

[WholeLottaGame7]

Sounds like the OP has a fairly good understanding of the issues at hand, which is a good start. Now it's up to them to prioritize.

Personally, I couldn't work in someone's mouth all day long, no matter what the lifestyle Also, power/prestige are not really my thing. I like the subject matter, I like working with people (co-workers and patients), and I like the relative stability. I don't like losing basically my entire 20s (until I have kids), but honestly I've been able to balance life/med school to an acceptable level, so I have no regrets right now. Ask me in 5-10 years.

 

[rmbsstock]

Are You Even Happy With a Career in Medicine?

 

[Slack3r]

I'm debating the same thing OP. My main qualm with dentistry is the saturated markets in most major cities. I'm from Phoenix, I want to live in LA. Both are extremely difficult to establish practices in. There is also no guarantee what is happening in medicine won't happen in dentistry. Most of what makes dentists profitable is the fee-for-service model and low percentage of dental insurance patients. If dentistry were to adopt a medicine-style insurance/practice model, it may be less profitable.

I hear you though, 4 days per week with only 4 years of training is nice. But I keep coming back to the immense debt incurred in dentistry (usually $250k+) and the grim job outlook in most cities. Dentistry is nice in that it's very business oriented, but this can also be detrimental if you're not a savvy business owner. Also, specializing in dentistry (i.e. increasing your earning potential) is like gunning for ROADs in medicine.

It's driving me crazy too, and I only have 6 months to decide.

 

[BlueAvenue]

I understand where you're coming from since I am a pre-med too, but I don't think you should pick any field on prestige or power. most of the physicians I know seem to feel unappreciated but we work in baltimore with a very indignant patient population. I'm not saying you couldn't be a good physician but if you could be happy doing something else why bother? 4 years of medical school + 3-7 years of residency+ fellowship is a long haul for prestige. I'm in RT school right now and the reason I'm applying to medical schools is because I realized my love for clinical medicine and because I honestly don't think I'd be happy doing anything else. PA school is another option if you don't want to make the commitment that is medical school, no prestige really but I've met some hardcore PAs in the ICU who know their stuff. you seem to me like you could live a full life without an MD. explore your options, if you're smart enough to get into medical school then you have plenty

 

[cyneuron]

u simply nailed it man....really appreciate such maturity level in pre-med...

it seems the situation is same everywhere in the world.....every single line you wrote describes the situations equally good even in my country India....though so many doctors in India think that situation is good in US....but now i guess its not....

but i will say its also unfair to label any profession, medicine or any other, good or bad based on your preference.....you can't say that medicine is bad because you don't like x, y or z things.....every profession has its inherent pros and cons....its you who is not an ideal match for that profession based on certain interests.....

what you should be focusing on is that what excites you most.....try to know that.... everybody has one or even more things which realty excites him/her way more than other things.... explore those areas.....

also its appreciable that you are even able to ask such questions....but try to look it from different point of view....

in steve jobs words :
make the thing you love your work, and you won't have to ever work again in your life....

on a specific note, you can also consider options of research after med school, or may be direct phd after you college....

 

[rmbsstock]

out

 

[BlueAvenue]

there are policies in place for physicians to report drug use to the police?

 

[ozzie33]

I applaud you for your refreshing honestly, insight, and understanding. It is rare to see these qualities in premeds, who are usually hopelessly idealistic and have no idea what they are getting into.

Being a physician will be more prestigious than being a dentist, both among the lay public and the educated elite. This sounds pretentious but I am just laying out facts. I will say though that prestige matters to wildly different degrees in most people and you will have to do your best to determine how important it is to you. Prestige does not make me feel warm and fuzzy inside, and I often take it for granted. But if you ever go for a period without it, you will definitely notice what you are missing. Like money, people get used to a certain amount, whether poor or rich, and its effect diminishes over time.

You have power, but doctors are no longer treated as infallible demigods. There are administrators, social workers, nurses, big pharma, insurance companies, and medical malpractice attorneys that keep checks on you. After all that though, you have considerable power by being a physician, a lot of which is associated with the prestige mentioned before. Doctors still have a lot of autonomy and impact on patients.

I think you are right to look at medicine from a selfish standpoint. When you are on your 30th hour making less than the pharm rep who majored in sorority makeovers and doing the walk of shame, remembering self interested motives goes a long way. Medicine is a long and painful endurance test and unless there is something in it for you, no amount of humanitarian happy thoughts can overcome that.

What doctors have over dentists is all intangible, unfortunately. Dentists kick our ass in terms of lifestyle. Some physicians make more than dentists but also work a lot harder, especially during your prime years, as you stated.

The best thing about being a doctor is being able to save someone's life or make it a lot better for them. And appreciative patients. Also by being a doctor (especially surgeon) you are more attractive to women by like 1-2 points on a 10 point scale. That might work against women physicians because it scares off a lot of dudes of lower education or prestige... such as dentists.

The worst thing about being a doctor is unappreciative, manipulative, and poorly educated patients who care less about themselves than you do.

I kind of understand what you are saying, but at the same time, I don't think that you should make a career decision based on prestige. In my opinion anyone who is nice to/friends with/ marries you because you are a "real Dr." and not a dentist is not worth the time spent telling them no.

I for one respect people because they deserve it, not because they have a degree that tells me to, and I certainly hope others do the same. If you go into a career for any reason other than actually loving the career (at least primarily) then you are asking for a life of unhappiness.

First look at whether or not you want to be an MD or a Dentist, then if you wouldn't mind being either, look at other options. The years saved in Dental school won't mean anything if you hate what you do every day, for the rest of your life. likewise the time spent as a resident won't seem so bad when you have a comfortable living and love your job.

 

[mglavin]

I'm not sure if I want to devote my prime years to something that will sacrifice the things in life that people in other careers don't have to: sleep, stress, time with family, vacation, a month without thinking about death (a little out of the ordinary...I know), lawsuits, hospital politics, working over christmas, ect.

your not going to find any career that pays more the the "sh-t money" residents make that don't include some of these things...

 

[McGillGrad]

I have loved the whole medical school process so far, even though most people have hated basic sciences and MS3. I find medicine to be a calling that has job security and a comfortable salary.

I started med school a few years after the average student and previously lived a life with a great income, but it was unsatisfying and banal. A significant portion of med students have hated every step while I have enjoyed 99% of it. That may be why I am not too concerned about salary when I enjoy what I do.

 

[SocialistMD]

In M1 & 2, you study hard and kill yourself to understand the material, you adjust to a new life, competition, study methods, and a huge amount of material that you will be tested on...

The competition part is actually better in medical school than as a premed undergrad. Everyone is where they wanted to be, so most people are chill. Unless you want to be a dermatologist, radiologist or the like, the competition phase is over.

No one wants to admit that they hate their career but did you ever seriously consider another career between medical school and now?

Not seriously. The thought of becoming an assassin has crossed my mind a few times, but I don't think I would actually follow through on it.

Besides satisfaction and being worth more to society, what are the benefits of being a doctor that dentists don't have? (something tangible, not "intellectual challenge" or "respect from the community")

Depending on what you do, the variety is probably more than in dentistry. There can also be a greater sense of urgency in some fields than you'd see in dentistry (if that sort of thing gets you off).

In your experience, what is the best thing about being a doctor that you didn't expect as a premed/medical student?

I honestly can't remember my premed days, but I know that 3rd year of medical school was pretty eye-opening and (mine) gave a pretty realistic view of what my life would be like for the next 10 years. I haven't been let down yet.

In your experience, what is the worst thing about being a doctor that you didn't expect.....?

See above, though I'll tell you that the bureaucracy of hospital administration is more painful than I thought it would be.

Are there some possible deterrents for a career in medicine? if so what?

Ask medicinesux. He is a wealth of knowledge when it comes to this.

Are you happy with your career choice? are your colleagues/peers?

For the most part, yes. Those who weren't went into another (medical) field and are now happy.

 

[dragonfly99]

Pretty good post for a premed.
However, I would worry about you going into medicine because of some perceived prestige. Some people will respect you more because you have an MD, but some won't. I don't think it is worth the pain of med school plus residency just to get some prestige. As far as power, you could get more by probably getting an MBA and doing some corporate thing, or getting a JD and becoming some sort of gov't employee or politician. But it depends on what kind of power you mean...as a doc you'll have unseen power...I mean I've probably saves some people's lives along the way even at my level of training, so that is power. It's also STRESS...big time...because if you screw up you may help kill someone.

Not sure that a MD is more valuable to society vs. a DDS or DMD type...oral health is pretty important. Periodontal and dental dz can lead to other systemic dz if not treated. If you say dentists are not important then you should say that dermatologists aren't either...or cosmetic or some plastic surgeons who do mainly elective procedures or just things to make people look better...

I think it is incorrect for you to think you only have a few months to make a life altering decision. If you are not sure about medicine, better to take a year or two to figure it out, vs. making a wrong decision and 5 or 10 years from now wishing you had chosen differently. Remember, too, that every career or job has pluses and minuses...there are no perfect jobs...dentistry and medicine included. However, being a physician requires very crappy hours...not just during training but potentially forever. Someone has to do hospital rounds on Christmas, New Year's Day, etc. and that someone might have to be you if you do anything like peds, internal medicine or surgery.

 

[lipomas]

This is a hard question. Personally, I think all potential premeds - even those who are POSITIVE about their career path - would benefit by taking time off after college, or during college even, and working for a living. I know this isn't always possible or practical, but you sure as hell learn a lot about yourself. Stuff that you don't learn by being a perpetual student. I think there are a lot of people who go to med school because they just don't know what else to do with themselves other than keep getting edumacated.

The comments above about prestige are right on - NEVER pick a career because of perceived prestige or peripheral benefits. No matter what the lifestyle is or benefits, it is still going to be a job that you spend most of your awake hours doing. If you don't like it, your life is going to suck. And when you get awash in debt, it makes it even worse because you are essentially trapped, and having not had a real job ever you will have no real skills or experience that can translate to another decent career without going BACK to school for something else.

Now, part of the problem with taking time off is that some med schools might question your application if you don't have a defined path to get there. Like, if you took a year or two off, why? Weren't you committed to medicine? If you do it for the right reasons these questions become easier to answer. But some people take a year or two off because they want to party, travel, and essentially be a drain on society while they have a part time job in a coffee house. This is NOT what I am talking about in the first part of my post.

Do not discount a career because you think you are either too smart for it (like, you would be wasting your talent if you picked it) or because you think you aren't smart enough. Every career needs smart people and every career needs passionate people. If you do something well and love doing it you are likely going to excel at it. That's what your goal should be - to find your passion. Don't get tunnelvision and think that it has to be a career in medicine before it's too late to change your mind.

 

[cyneuron]

If you do something well and love doing it you are likely going to excel at it. That's what your goal should be - to find your passion. Don't get tunnelvision and think that it has to be a career in medicine before it's too late to change your mind.

thats all u need man...

 

[DarthNeurology]

Do not discount a career because you think you are either too smart for it (like, you would be wasting your talent if you picked it) or because you think you aren't smart enough. Every career needs smart people and every career needs passionate people. If you do something well and love doing it you are likely going to excel at it. That's what your goal should be - to find your passion. Don't get tunnelvision and think that it has to be a career in medicine before it's too late to change your mind.

If you are smart and talented it is still possible that your skills will be wasted in medicine, or at least won't be exercised. Third and fourth year is basically abuse while doing relatively easy tasks, and residency can be painful for a lot of residents. You could use your skills/brains as an attending to help take care of patients in a more efficient/precise manner years later, but your successes will be hard to quantify and will come after years of abuse and idling your brain.

Remember the average IQ of doctors is pretty wide and overlaps with a lot of other professions, i.e. perhaps 110 to 130 or so, if George Bush's IQ was 124 or so then a lot of the chums in your med school class are dummer than Bush! Doctors do idiotic things all the time and the more intellectual docs may not be in academics where people attracted to power go.

If you do well in college remember that there are great opportunities which will allow you to use your brain instantly *and* come with a much better work environment than medicine. What is more intellectually satisfying, designing airplanes or being a family practice doc? If you really love taking care of patients then do medicine, but don't do it to maximize your intellectual gifts as you really don't get to use your brain that much as a doc, a lot of pattern recognition, but most of your brains will be devoted to trying to deal with your bosses and colleagues.

A lot of other professionals, such as lawyers and CEOs look down on doctors, as many patients do at times, this is because there is a service component to being a doctor, i.e. taking call, sacrificing family life, and working long hours. I think this might be why some older attendings hate medicine because when you are in your fifties you will have patients spitting on you and filing lawsuits against you, while for the professor of engineering or the corporate lawyer, this is a rarer event. Realize that there is a lack of civility in medicine and little intellectual atmosphere on the wards.

Look at the guy who got kicked out of the John Hopkins surgery program, probably did well at Stanford Medical School, and probably wanted to give back to society, he has to sit on the benches while he fills a lawsuit and may not get another residency. Medicine attendings are insecure and love to tear down trainees and students in bad ways, . . . sure there is politics in other fields but medicine remains draconian and black balling is for life in a lot of cases.

Look at what might pass Congress in the health care bill, large cuts in Medicare. Lawyers, of whom the President is one, want increased litigation penalties for doctors and the chief of staff wants decreased pay for specialists like cardiologists. It is likely that physician income will drop, which is good as it will keep out potential doctors who are in the field for the wrong reason, but the profession will be dealt a black eye in the mythic "prestige" factor. Even if doctor paid decreased drastically, let's say cut in half, there would still be enough idealistic college students who are smart enough to do it.

I think this is why Howard Dean is protesting the latest health care deal which will slash Medicare payments to keep it solvent . . .

 

[medicinesux]

Great post Darthneurology! I do take one exception to your post however. Are you sure George Bush has an IQ of 124!? I need to see that in writing.

 

[rmbsstock]

there are policies in place for physicians to report drug use to the police?

out

 

[DarthNeurology]

Great post Darthneurology! I do take one exception to your post however. Are you sure George Bush has an IQ of 124!? I need to see that in writing.

Apparently so, I always thought he was playing stupid a little bit so we would misunderestimate him, or maybe he just didn't care what came out of his mouth, but here is from a list I found:

George W. Bush
IQ Score 125

Hillary Clinton
IQ Score 140

John F. Kennedy
IQ Score 119

Jimmy Carter
IQ Score 156

Geena Davis
IQ Score 140


http://www.kids-iq-tests.com/famous-people.html

 

[Winged Scapula]

Apparently so, I always thought he was playing stupid a little bit so we would misunderestimate him, or maybe he just didn't care what came out of his mouth, but here is from a list I found:

George W. Bush
IQ Score 125

Hillary Clinton
IQ Score 140

John F. Kennedy
IQ Score 119

Jimmy Carter
IQ Score 156

Geena Davis
IQ Score 140


http://www.kids-iq-tests.com/famous-people.html

Interesting. I have a family member who worked in the White House from the Johnson through the Reagan eras. She always said that she thought Carter was the brightest and a tie between Nixon and Ford for the least, although she admitted the Nixon's "personality disorder" may have gotten in the way of her assessment.

 

[DrJD]

Apparently so, I always thought he was playing stupid a little bit so we would misunderestimate him, or maybe he just didn't care what came out of his mouth, but here is from a list I found:

George W. Bush
IQ Score 125

Hillary Clinton
IQ Score 140

John F. Kennedy
IQ Score 119

Jimmy Carter
IQ Score 156

Geena Davis
IQ Score 140


http://www.kids-iq-tests.com/famous-people.html

My wife had the chance to spend some time with Bush, and she was amazed at how smart he was. Apparently he is a totally different person one on one, but when he gets in front of the camera, well you've seen what happens.

 

[McGillGrad]

My wife had the chance to spend some time with Bush, and she was amazed at how smart he was. Apparently he is a totally different person one on one, but when he gets in front of the camera, well you've seen what happens.

There are different types of intelligence and morals are not necessarily enhanced with a higher IQ.

 

[smq123]

Step 2 is taken, I don't know anything about it but I assume it's no cake walk.

Compared to Step 1 it is.

But I never considered a career in dentistry because medicine is respected much more and because doctors can make a substantial difference in a patients life.

The "prestige" of being a doctor is not universal. It depends where you are, who you are talking to, etc.

Some people will hold you personally responsible for something that their pediatrician did to them 25 years ago. As an MS3, when I mentioned to a friend of a friend that I was doing my OB rotation, he stuck his finger in my face and held me personally responsible for his circumcision 26 years before, and for all the subsequent mental anguish having a circumcised penis had caused him.

It also depends, sadly, on what you look like and how patients react to that. I've had patients ask me to leave the room because "nurses don't need to be here for this," and then apologize profusely when the attending points out that I am an MD. The worst story I've heard was when a patient pointed to the (African-American) trauma surgery chief resident and yelled, "Get the janitor out of here when you examine me!" (And no, he didn't apologize when someone told him that the "janitor" was actually the head physician on the trauma team that month.)

Besides satisfaction and being worth more to society, what are the benefits of being a doctor that dentists don't have? (something tangible, not "intellectual challenge" or "respect from the community")

Well, I would disagree with the assessment that a dentist is somehow worth "less" to society.

There's more flexibility to being a physician. If you're more cerebral, and have such poor hand-eye coordination that you're better off with loafers instead of sneakers, then there are specialties that allow you to focus on that (i.e. radiology, psychiatry). If you're better with your hands, there are specialties for that, too (surgery, anesthesia). There's a wider gamut of what you can practice.

If you want to be a dentist, there has to be, I think, some baseline level of hand-eye coordination and manual dexterity. If I'm not mistaken, they actually even test for that at the interview (I've heard stories about pre-dents being asked to carve soap figures). Not that you have to be a junior Rodin or something, but if you're REALLY not good with your hands, you probably should reconsider dentistry.

There are specialties that offer you what dentistry offers. There are fields with decent hours (even as residents), few emergencies (again, even as residents), and few dying patients.

Finally, assuming that all dentists have good hours is kind of a fallacy. Remember that most dentists are in private practice, and their pay is related to the number of patients they see. My own dentist is a very popular and well-respected guy who is insanely busy. His office is open 9 hours a day for 3 days a week, 12 hours a day for 2 days a week, and he works on Saturdays, until the early afternoon. Then, if you drive by his office late at night, the lights are still on (presumably because he's catching up on paperwork). It's not an "easy" lifestyle, by any means.

 

[Goran]

It also depends, sadly, on what you look like and how patients react to that. I've had patients ask me to leave the room because "nurses don't need to be here for this," and then apologize profusely when the attending points out that I am an MD. The worst story I've heard was when a patient pointed to the (African-American) trauma surgery chief resident and yelled, "Get the janitor out of here when you examine me!" (And no, he didn't apologize when someone told him that the "janitor" was actually the head physician on the trauma team that month.)

Aww, this happens after you've introduced yourself?

 

[smq123]

Aww, this happens after you've introduced yourself?

Yep, even after I say, "I'm Dr. smq123."

It doesn't have anything to do, I don't think, with nurses who wear white coats, or DNPs calling themselves doctor. Some people have just not adjusted their mental image of a doctor to include a female....and I include some male physicians and med students in that group, unfortunately.

 

[deleted87716]

The worst story I've heard was when a patient pointed to the (African-American) trauma surgery chief resident and yelled, "Get the janitor out of here when you examine me!" (And no, he didn't apologize when someone told him that the "janitor" was actually the head physician on the trauma team that month.)

Wow...that's asking for a two-fingered DRE.

 

[lipomas]

If you are smart and talented it is still possible that your skills will be wasted in medicine, or at least won't be exercised. Third and fourth year is basically abuse while doing relatively easy tasks, and residency can be painful for a lot of residents. You could use your skills/brains as an attending to help take care of patients in a more efficient/precise manner years later, but your successes will be hard to quantify and will come after years of abuse and idling your brain.

Well, that is of course true but it's true of any profession. One could argue that GWB's intelligence and skills were wasted or he wasn't allowed to use them. Smart people flame out of schools and career paths all the time. Success is not only based on intelligence and talent. Some people mistakenly assume that.

 

[cyneuron]

may be you should read " SO you want my Job" Section at artofmanliness blog...

Art of Manliness

 

[Slack3r]

Finally, assuming that all dentists have good hours is kind of a fallacy. Remember that most dentists are in private practice, and their pay is related to the number of patients they see. My own dentist is a very popular and well-respected guy who is insanely busy. His office is open 9 hours a day for 3 days a week, 12 hours a day for 2 days a week, and he works on Saturdays, until the early afternoon. Then, if you drive by his office late at night, the lights are still on (presumably because he's catching up on paperwork). It's not an "easy" lifestyle, by any means.

I think the difference most people draw on is that most dentists work less hours that physicians on average. Where the doctor working 4 days/week is the outlier, the dentist that works 6 days a week is the outlier in their field. I think it also has to do with the fact that you can still be successful as a dentist with more reasonable hours than you can as a physician (again, generally speaking).

 

[anonymousername]

Thank you for the responses, you've given me a lot to think about.


On prestige:

To me prestige is a function of respect and as someone who's planning on going into the health care field, I feel that the respect of my colleagues is important for me to take pride in what I do. From my perspective, if my peers don't see my work as important, how will I? Although my self-esteem is quite intact, I fear the idea of forming an inferiority complex, valuing my work less, and resenting my choices.
Dentists are compared to physicians on a daily basis and more often than not they are regarded as "pseudo-doctors" that deal with unimportant issues compared to physicians. If the lay public doesn't respect my work, how can I? More importantly, if my colleagues don't respect my work, how can I take pride in what I do?


On dentists having better hours:

After speaking to a dentist I shadowed a while ago, it seems as though they work a similar amount of hours as residents (but without the supervision) and earn the same kind of money when opening up their own practice, unless I was misguided, their schedule becomes much easier after they become well established and begin to see a profit. From what I understand, most graduating dental students become associates at existing practices and earn a decent salary until they decide to buy or open a practice.

On going for the career based on passion:

I have a perception about what a career in medicine and dentistry are about, both are probably wrong. I have a true interest in the human body and its functions and I think that one day I could develop a passion for it. But after a few months of shadowing, I know it's an interest and I don't want to base my career on it.


An attending at the local hospital is letting me follow her around for a few days over winter break, hopefully I'll get to interact with her residents and get some perspective from them.
I feel like I'm really rushing this decision..

 

[Slack3r]

Thank you for the responses, you've given me a lot to think about.


On prestige:

To me prestige is a function of respect and as someone who's planning on going into the health care field, I feel that the respect of my colleagues is important for me to take pride in what I do. From my perspective, if my peers don't see my work as important, how will I? Although my self-esteem is quite intact, I fear the idea of forming an inferiority complex, valuing my work less, and resenting my choices.
Dentists are compared to physicians on a daily basis and more often than not they are regarded as "pseudo-doctors" that deal with unimportant issues compared to physicians. If the lay public doesn't respect my work, how can I? More importantly, if my colleagues don't respect my work, how can I take pride in what I do?


On dentists having better hours:

After speaking to a dentist I shadowed a while ago, it seems as though they work a similar amount of hours as residents (but without the supervision) and earn the same kind of money when opening up their own practice, unless I was misguided, their schedule becomes much easier after they become well established and begin to see a profit. From what I understand, most graduating dental students become associates at existing practices and earn a decent salary until they decide to buy or open a practice.

On going for the career based on passion:

I have a perception about what a career in medicine and dentistry are about, both are probably wrong. I have a true interest in the human body and its functions and I think that one day I could develop a passion for it. But after a few months of shadowing, I know it's an interest and I don't want to base my career on it.


An attending at the local hospital is letting me follow her around for a few days over winter break, hopefully I'll get to interact with her residents and get some perspective from them.
I feel like I'm really rushing this decision..

You'll never be happy chasing other people's expectations. No matter what, you'll always be inferior to someone somewhere, in some way or another.

 

[JackADeli]

...More importantly, if my colleagues don't respect my work, how can I take pride in what I do?...

Generally you got it a little backwards....

If you do not respect yourself, your work, etc FIRST.... you can not expect your colleagues to respect you or your work.

 

[dragonfly99]

Agree with above...if you base your feelings about yourself and what you do primarily, or even to a large degree, on external validation from other people you are likely to become unhappy with your career at some point.

I also disagree that dental residents work similar hours to allopathic medical residents. I'd like to see some documentation of that. There just aren't that many life and death dental emergencies that happen at 2 a.m.
Oral maxillofacial residents work a good deal, but I've worked with them and I would say even they have better work schedules than internal med or surgical residents. They do work a lot and have to do a lot of years of training, though.

 

[DarthNeurology]

Agree with above...if you base your feelings about yourself and what you do primarily, or even to a large degree, on external validation from other people you are likely to become unhappy with your career at some point.

I also disagree that dental residents work similar hours to allopathic medical residents. I'd like to see some documentation of that. There just aren't that many life and death dental emergencies that happen at 2 a.m.
Oral maxillofacial residents work a good deal, but I've worked with them and I would say even they have better work schedules than internal med or surgical residents. They do work a lot and have to do a lot of years of training, though.

I think there are a lot of different types of "external validation" and some are important.

For example, say you are a dentist who has been practicing for ten years, and say that you are very well respected by your peers, i.e. other dentists, and say that you are dedicated to being a good dentist and maybe take a special interest in preventive dental care (also good gum health is important for preventing heart disease according to a lot of research). So you are externally validated by your peers, which is important.

Of course, being a dentist, there are many "patients" who may be fearful of you/dislike you on some level as they are afraid of dental pain. I think dentists can be more "disliked" than even lawyers. But say a good portion of your patients are satisified customers, then you are externally validated.

If you are a dentist and feel let down that you didn't do medicine this is more an internal issue as nobody is going to treat you that way, not for the least of which reasons is that dentists have their own practices and often their own staff. There is more an "internal issue" than any external problem.

Same thing with medicine, say you are a family practice doc who is well respected by your peers, i.e. other doctors, and your patients love you and you by all measures both internal and external are doing a good job. This external validation is important. However, if you feel that you somehow are being "looked down on" by specialists docs I think this is more your own misgivings about not having into cardiology. I.e. it is an internal validation problem.

External validation is important to know you are on the right course. Medicine is bad in this respect as there is a lot of competition/back stabbing and harassment between attendings and residents. Even when attendings attack each other it is bad, basically saying that your training was wasted and that you don't know what you are doing. Of course there is "internal validation" i.e. thinking you are a great doc and doing your best to treat patients, every doctor feels this way, but external validation is important too.

From non-docs there is little "external validation" i.e. may be decades ago doctors got early reservations in restaurants, but outside of a hospital there is no hiearchy where the CT surgeon get to go to the front of the check out line at the grocery store while the bus driver waits. On the contrary, the image of the caring doctor has been replaced in the media by shows that glorify plastic surgeons and discuss doctors who unethically prescribe pain medications. Beyond having maybe a fancier car or house if you want that, there is not much external validation for doctors outside of the hospital and the peer group.

Though everybody talks down family practice as having the worst prestige factor, most docs in reality respect family practice doctors as they have to know so much info, . . . I think that general internal medicine docs have the lowest prestige factor as they don't have the breadth of a family practice doc, but they obviously aren't cardiologists and some assume they weren't smart enough to get a fellowship. IM was very prestigious, but now seems to have unfairly or not to have earned a reputation for being a place where confused medical students go when they are uncertain what they want to do, i.e. for the passionate-less. Though many people, including me, admire IM docs for their breadth of knowledge of adult patients . . . seriously, there are articles written about why general IM docs are "irrelevent" . . . in terms of medical education and "real patient care", other than that docs in any field easily earn the respect of their peers.

 

[dragonfly99]

I disagree that other docs respect fp docs.
In academics I feel it is the opposite. I've heard so much crapola heaped upon them in the academic setting. However, a lot of their patients love them, and in the community the specialists have to give them respect b/c that is where their referral base comes from...at least in areas that still have private practice and PPO's or maybe some fee for service insurance plans, where patients and their primary docs actually have a choice of which specialist to refer to.

 

[lipomas]

People respect good doctors. The specialty is less important. Certain specialties get more abuse heaped on them behind their back but at the same time, those physicians who are good and earn the respect of their colleagues are always going to have it. I cringe whenever I hear someone talk about "prestige" as a major factor in their decisions. It suggests to me that they want to gain their prestige through artificial or bogus methods, or by glomming off of others.

 

[frank51]

People respect good doctors. The specialty is less important. Certain specialties get more abuse heaped on them behind their back but at the same time, those physicians who are good and earn the respect of their colleagues are always going to have it. I cringe whenever I hear someone talk about "prestige" as a major factor in their decisions. It suggests to me that they want to gain their prestige through artificial or bogus methods, or by glomming off of others.

Very true, and doctors that are truly good, are widely respected by doctors in all fields.

 

[Ariee]

I LOVE MEDICINE! It is the best field in the world, IMHO !

My piece of advice to you is, do not feed into the ego of medicine, feed into the practice of it. What I mean, is why care about prestige, tiers, $, etc?. Yes, you will think about it. Prioritize, what is important for you. If you feed into prestige, tiers, $, it will destroy you, IMHO. You chose what you want to do and what makes you happy. Put aside all the other bull crap and work on your goal 100%. At the end of the day you are treating your patient, the only difference is how you got there and where you're going with it...

 

[ukdoc74]

You can use the same argument for private practice psychiatry. If you do something like child psychiatry you can have 9 to 5 hours M thru Fri with no call, weekends. or holidays and still bank 300K. Yet no one picks psychiatry. Instead people pick the highly litigenous specialties like radiology and ortho and work weekends, holidays, and nights. Very puzzling to me. In fact with the fact that all radiologists get sued I still cant understand why people will not pick low liability specialties.

Agree with above...if you base your feelings about yourself and what you do primarily, or even to a large degree, on external validation from other people you are likely to become unhappy with your career at some point.

I also disagree that dental residents work similar hours to allopathic medical residents. I'd like to see some documentation of that. There just aren't that many life and death dental emergencies that happen at 2 a.m.
Oral maxillofacial residents work a good deal, but I've worked with them and I would say even they have better work schedules than internal med or surgical residents. They do work a lot and have to do a lot of years of training, though.

 

[2011MS1]

I applaud you for your refreshing honestly, insight, and understanding. It is rare to see these qualities in premeds, who are usually hopelessly idealistic and have no idea what they are getting into.

Since I am an excessive reader of this forum (both at medical school and resident level), I have a good grasp of the "reality of medicine". However it seems to be true especially during admission. it is almost a MUST that you portray medicine in its perfect idealistic. It is like religion. And you are trying to be a priest.

Life style, difficulty, and the forbidden word (money), are all impurities that must be purged! If you express any consideration, you will be chastise by your peers on their high horses. (I guess this doesnt get better as you go on either, even at resident level where any complains on the forum is always meet with attempt to purge it by idealist reasoning)

For example, If I say I care about money, people are going to be like. "That is not the reason to go into medicine." "You should care about the patient." "I dont care about money"

Well lets see...I am trying to get a job. Not trying to be a saint. Not only do I have to take care of my wife and kids, I have to take care of my parents. Just because I mentioned money I didnt say I am going to get more at the expense of my patients (hell maybe I will work longer to earn more money?) I DO care about patients, but that is not the ONLY thing I care. I have more reasons to go into medicine than one this way if one of them become bad halfway, I can keep going. If you really dont care about money please hand me your wallet.


It is crazy people think I am some kind of devil when i mention money and doctor together. Hell isnt it American Ideal to work hard and make money? Isnt that what doctors are doing?

so I guess I will just have to deal with it for the next 10 years oh well. I will have them discover it the hard way. (I am sure there are a few who know but would rather not speak out and risk being unidealistic)

 

[doc05]

I think the OP has already answered his/her own question. If you are readily cognizant of the downsides in a career, and aren't too keen on these disadvantages, maybe medicine isn't for you. There are plenty of good (better?) choices, including dentistry. best of luck.

 

[Lonestar]

I'm an undergraduate student debating a career in medicine but I'm a little hesitant about the lifestyle of a physician. My motivations are the same as most premeds: financial security, prestige, power, and responsibility but I'm concerned about how "happy" actual doctors are with their career choice.

I see med students saying "i have lost interest" or "i hate it" and interns/residents/attendings telling them "It'll get better, just wait it out..." but I honestly don't see where it actually gets better.

In M1 & 2, you study hard and kill yourself to understand the material, you adjust to a new life, competition, study methods, and a huge amount of material that you will be tested on. Step 1 is hell compared to anything you have ever encountered before. M2 and M3 are clinical rotations/clerkships, you are constantly busy. Instead of just learning new material, you need to learn new material and fulfill your responsibilities in a clinical setting (im still unclear about what they are). You are treated with less respect by everyone in the hospital, doctors, nurses, ect. Step 2 is taken, I don't know anything about it but I assume it's no cake walk.

As a resident (i will be 27 if everything goes to plan) you spend 3-7 years making **** money and doing the "grunt work" for people above you in the hierarchy. You have debt to your eyeballs, you work an unimaginable amount of hours, and you have to deal with call. You still get **** from everyone above you.

I'm not clear what the options are after residency but I understand there are a variety. I hear this is the part where you may be able to make the real money depending on what specialty you go into. But by the time I'm here, I'll be between 31 and 34 and from what I understand you will be an employee of some kind and it is very unlikely that you will open your own practice (even more so in the future).


I have a genuine interest in the human body and making a difference in the world is important to me. But if I look at the career from a extreemly selfish and realistic standpoint, I'm not sure if I want to devote my prime years to something that will sacrifice the things in life that people in other careers don't have to: sleep, stress, time with family, vacation, a month without thinking about death (a little out of the ordinary...I know), lawsuits, hospital politics, working over christmas, ect.


I've been thinking more and more about dentistry, it gives a decent income after 4 years of dental school and after a 2-3 years of being an associate, one can open up their own practice. After that they work 9-5 for 4 days/week. It's not as interesting, fulfilling, or prestigious but it seems to "fill in" what I consider downsides to a career in medicine. From my perspective, for the 4 years of undergrad and 4 of dental school, dentists are rewarded much better than physicians (working 4 days a week, ownership of business, low stress environment...). But I never considered a career in dentistry because medicine is respected much more and because doctors can make a substantial difference in a patients life.

Right now, I need to make a decision between the two careers. I outperform my peers academically and I believe that won't change for the standardized exams. I'm currently operating under the assumption that I will gain admission to whichever school I apply to whether it be dental or medical. I need to make a decision now about what I want to do until I retire (or die) because I damned sure don't want to get into a career that I hate!


Is my representation of the trajectory to become an established physician accurate?

No one wants to admit that they hate their career but did you ever seriously consider another career between medical school and now?

Besides satisfaction and being worth more to society, what are the benefits of being a doctor that dentists don't have? (something tangible, not "intellectual challenge" or "respect from the community")

In your experience, what is the best thing about being a doctor that you didn't expect as a premed/medical student?

In your experience, what is the worst thing about being a doctor that you didn't expect.....?

Are there some possible deterrents for a career in medicine? if so what?

Are you happy with your career choice? are your colleagues/peers?

Its not worth it. Now that I have practiced Anesthesiology for 1.5 yrs, I can tell you its not worth it.

Worst part of it all: not many people respect you. Worse. Many despise you for "making a lot of money". Good luck with dentistry. If you don't get in, don't worry. Atleast you won't have negative net worth until your mid to late 30s.

Oh and call $ucks!!! It $ucks big time. Without it, you are not gonna make much money. so with lots of loans, you will be working your ***** off for a very long time. And god forbid you get sued anytime in this equation from med school to private practice.

 

[Raggaman]

Disclaimer: not edited for typos or grammar. I also go off topic. Read if you must.

I am currently an intern at a program where interns are never abused and are treated with respect. I also have a pretty flexible schedule. This might have something to do with me not being currently bitter. Even though my salary is peanuts to compared to my loan, it is overall adequate for my single self.
It is true that being a physician is a respected job but that respect goes out only so far. It is up to you make sure that you keep it by earning it more or loose it by being a douche. We have all seen attendings/residents who act like douches and expect respect. If you do your job (no matter what job) with honor and respect for others they will come to respect you for you and not just your title (or lack thereof). All too often I see an attending who tries to command respect by virtue of his title alone. Looking past this fascade you can see a person who grew up being made of and ridiculed for one reason or another. Then, finally, when this person gains some value per virtue of his title, they go a little beserk. If you are not such a person and are able to respect patients who don't even respect themselves, you will do fine.
It is human nature to expect a thanks or appreciation when we do something for others, but the fault often lies in us for the expectation. If you are go into medicine believing that every patient and their family (oh specially families!) will be greatful and will send you cards and cookies for the rest of their lives then you are in for a huge eye opener. Being sick or having a loved one who is sick brings out the best and very too often the worst side of people. They will even consider you the enemy at times and you will have to learn to live it and believe that you are doing what you are doing for the best of the patient. Just like parents did for us when we didnt know any better. In short just be nice and do, without any expectations, if u get thanks (which you will), then be grateful, as this is something extra.
As far as dentistry goes, it is a good field, but personally not for me as I couldnt imagine looking into mouths day in and day out. Another odd thing I have noticed with dentists and dentistry students is how they like to point out that their first 2 yrs were the same as med school. I am sure it was but i dont know what they are trying to achieve by mentioning this. (no offense to dentists!)
Yes medicine is a tough field in terms of studying, hours and the whole dedication aspect. There is also alot of jealously from some other non-physician medical staff/professionals especially againt us young docs who are fresh out of med school and are now writing 'orders'. The general public now also has many issues with physicians especially when they are sick and the attending is driving a bmw 'with tinted windows' and lives in a 'palace on a hill' so far away from 'their reality' (what is reality?another discussion perhaps). How dare do these doctors profit from our sickness? How dare they accuse all our problems on obesity and smoking? I know being overweight is not good and smoking causes cancer but my current issues involve getting SOB while I walk to the bathroom and swelling in my legs- that can't be blamed from my lifelong smoking issue. You Doc don't listen and blame it all back on me and keep taking money from me.
It is true, you will also meet such patients, despite your best effort will see you someone who doesn't care and wants to blame everything on obesity and smoking. Many people also secretly resent doctors as we are the ones they have to divulge their hefty secrets. This puts physicians in a powerful position with respect to their patients - not for malice or command but it is the inevitable as it is the nature of this business. Patients who are normally fully in command of their lives and have jobs where they are managers and directors are now responding to a physician for their health. This increases resentment.
Another thing, in my opinion that is increasing resentment against physicians is that health is such a personal issue to people that they fail to see the reality behind the fact: healthcare is a business. If my med school was free, no body sued me and my insuarance premium was $0, I worked 40 hours a week, residency + med school was total 4 yrs or less, the clinic rent and expenses were paid for by whatever magical force out there then YES, I would be very happy to work for 1/3 the salary of a regular physician,not drive a fancy car and live in a one bedroom apartment my whole life.
It is ok to make millions playing football, because you have talent. It is also ok to own several million dollar cars/houses because you entertain the masses and have earned it because you have talent. Entertainement is a right- wait no, you pay for it and the rookie qtrback makes his millions. Thats ok though, he has earned it through hard work and talent. Low IQ high IQ? Doesn't matter I am now going in circles.
Wow, how selfish of me! I am supposed to be 100% selfless, this is people's lives we are talking about....ummmm. EXACTLY! The more reason to ease the BS of physicians so we can take care of things that really matter- your health. But then again you would rather watch AVATAR 3d and eat popcorn then pay your medical bill to that money grubbin Dr Raggaman, who is as cynical as he is uncaring. Shame on him. He is a physician (an itern but still), he should have no human needs and work for free. munch munch

 

[Publicola]

I am a second year resident currently at an academic institution. I went to a top 25 U.S. medical school and graduated with $165K in debt which has since gone up, with a loan average of 5.5%.

The questions asked in this post are interesting. The pre-med who originally posted clearly has an above average understanding of what life will be like. My question to you is given everything that you described in your post, "Does medicine sound like a great 8 years of your life?" Your decription and understanding of the process seem to point to not going into medicine, I can assure you it is no fun.

There are many things to consider when thinking about a career in medicine...too many to list here. For me it all boils down to one central theme; "knowledge". You will notice when you are on inter-disciplinary teams with APRNS, NP's, PharmD's, PA's, SW, Psychologists, Administrators that the MD is the focal point of knowledge. We have to understand everything that each field is talking to us about are generally the leaders of these teams. As an MD you will have a huge toolbox of knowledge acquired over many hours of slavery. The MD's knowledge of the body and pathophysiology is really neat and something that some people can no do without. As a dentist you will not have this knowledge.

Debt. You talk about financial security. Going to medical school is a huge investment. You can see from my numbers up there that I have a lot of debt. My debt isn't even close to people who go to private allopathic medical school, Osteopathic medical school, or Carribean medical school. Many people who go to the aforementioned schools have debt in the range of 300-400K after interest accrues. So when you go to Carribean med school or DO school and become an FP making 150K per year think about how long it will take you to pay off your loans. You will not have the financial security you might imagine in this situation (and grads from these schools do not routinely get high paying fields). I don't think that going to dental school will really change the financial security picture as debt is high and general dentistry salaries by report seem to average only slightly higher than FP.

Malignancy. This is one where medicine takes the cake. People above you have every right to abuse the **** out of you. This can make life miserable. I think you will largely avoid this in dentistry and this is a huge selling point.

I think all in all it sounds like dentistry is a better fit for you given your hesitation regarding all of the negative you mentioned regarding medicine.

 

[DrJosephKim]

Many physicians don't realize this, but they have the potential to excel in many careers outside of the clinical world. Some have a strong business sense and they make excellent entrepreneurs. Others are very creative and are great at writing. Keep and open mind and explore "outside of the box" to maintain career satisfaction.