the indoctrination starts with matriculation and the Oath
then there's typically some sort of humanities course about being a physician that covers ethics, professionalism, etc
the whole "professionalism" thing is a big deal, and rightly so, I think, but it can get taken to ridiculous levels
the next thing that sort of tears you down is being a big fish in a big pond, meaning you go from the top of your college classes to a mediocre med student, "average" in a class of above average people
moments of supreme boredom during orientation and lectures
feeling the breakdown of 4-8 hour exams every few weeks, like finals week every other week, that are very difficult, the price of failure is high
it's competitive and you start to feel not good enough on many levels, especially as you compare yourself to your peers and those above you in the hierarchy
then of course is the extremely hierarchical nature of not only medical education but general practice as well
next comes the ultimate med student Rite of Passage, the Step 1 exam
basically how "good" you are gets reduced to a number that you can use to adjust your self esteem
it also determines so much more of your life
after that begins the constant uncertainty of rotations - uncertain locations, times, you often don't know even until Friday before Monday where/when to be, or even what days off you might have for the next 4 weeks
everyone around you is overworked, has different expectations, and who you work with can change even on a daily basis, those grading you might only meet you 2 or 3 times
you are pushed to the limits of your endurance regarding how much you can study, how long you can stand, how long you can go without food, without urinating, how little sleep, how long a shift
on top of this, you can "expect" to be randomly quizzed on all sorts of bits of knowledge that you maybe couldn't possibly be expected to know
some people will go out of their way to throw you under the bus or humiliate you
the deprivation and the random nature of punishment that you don't feel you have control over - has been done in experiments to dogs, and basically is the recipe for trauma, indoctrination, learned helplessness
at the same time that your soul is taking this beating from those you work with, you are thrust, rather unprepared (no one could really be prepared) to watching the modern medical for profit establishment treat human beings like meat for the gristmill
you watch people who have been worn down and possibly lost some of their empathy and compassion, struggle to cut the "right" corners (after you've been taught the "proper" way in your humanities course) and juggle a million demands
you watch a lot of the worst of human suffering, and watch them treated by some who have lost something of themselves
one way of dealing with this is to emulate it
there's a psych term for this, I think reaction formation or something, like blaming the victim, sort of
it also goes to some Milton experiments about obedience to authority
at some point, you can feel like so many things are hopeless - the ability to give patients the care they need, the time, the handholding, for them to change, lose weight, stop doing drugs, for the waste in healthcare to be avoided