Is anyone on SDN actually happy with their decision to go to medical school?

[DrZeke]

All,

I've been reading through the topics on this forum and all I can say is...wow this is depressing lol. Forgive my possible naivety, but is anyone on this forum actually happy and excited about their career choice? I was recently accepted to medical school and all of the med students I personally know are very happy (on the surface, at least). I know the education and training are grueling, but is anyone genuinely happy with their current experience?? I am confident that I am getting into medicine for the right reasons, but the litany of negativity surrounding some of the topics in this forum is quite disheartening.

I'm very happy. I can't say it doesn't have it's ups and downs and challenges. I've always felt privileged that I got into med school and got to become a doctor. So, when these challenges come my way, I know it's because I am capable of this life and this choice. Not everyone can say that and not everyone can handle the trials and tribulations of med school and becoming a doctor. As much as people like to look back and talk about the long road and this and that, you are immersed in each phase as it is happening. It doesn't all hit you at once like a freight train and it's very doable if you made it this far.

I will say that I am not an idealist and never went into medicine with happy happy joy views that I was going to save the world. I never got involved in public health stuff before med school and never come up with awesome ideas that involve curing cancer or starting free clinics . So, I never had any crushed ideals. This may be why I'm very happy

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[CardiacIntensivist]

Completely agree with your post. Just curious, what specialty are you a resident in?

Anesthesiology going into Critical Care

 

[Sirach38]

Anesthesiology going into Critical Care

Awesome. Good to hear I'll be going into a field with colleagues like yourself

 

[Postictal Raiden]

Awesome. Good to hear I'll be going into a field with colleagues like yourself

It's very pleasing to read these positive comments coming from a field that has been, unfortunately, filled with pessimism.

 

[Sirach38]

It's very pleasing to read these positive comments coming from a field that has been, unfortunately, filled with pessimism.

The pessimism comes from the old timers that are seeing BIG changes coming to their field. For us up and comers, there is not much to be pessimistic about in this awesome field.

 

[656844]

The pessimism comes from the old timers that are seeing BIG changes coming to their field. For us up and comers, there is not much to be pessimistic about in this awesome field.

I'm assuming the field you speak of is anesthesiology? I don't see how anything pessimistic can be said about that field. As long as there's surgery, you'll need anesthesia to dull the pain. There will always be death and disease, and for that fact of human life, I am forever grateful for pathology.

 

[Winged Scapula]

I'm assuming the field you speak of is anesthesiology? I don't see how anything pessimistic can be said about that field. As long as there's surgery, you'll need anesthesia to dull the pain.

The pessimism comes from the rapid influx of nurse anesthesia providers and hospitals who hire them over physicians.

 

[Ophthoseidon]

I'm having a lot of fun. I feel like striking a balance is the biggest thing. Too many people are either holed up in their apartment and miserable or out partying everyday, failing, and miserable. Have some fun enjoy your hobbies, but make sure you are in a position to do well.

 

[jdh71]

It was all one big big mistake.

Every step of the way.

Abandon hope all ye who enter.

 

[jdh71]

Sometimes I think before ALL applications can be considered one needs to write an essay, a serious essay, about what a "sad sack" is and how one is not as a point of matter of fact a "sad sack".

 

[xffan624]

It was all one big big mistake.

Every step of the way.

Abandon hope all ye who enter.

My Orgo prof put that on the door to one of our tests that was scheduled on Halloween evening. Should have taken that as a sign then.

 

[VisionaryTics]

Sometimes I think before ALL applications can be considered one needs to write an essay, a serious essay, about what a "sad sack" is and how one is not as a point of matter of fact a "sad sack".

Seriously though, I support your point.

 

[giantswing]

The pessimism comes from the rapid influx of nurse anesthesia providers and hospitals who hire them over physicians.

Nothing brings out the fight in me like when an np or nurse anesth says they have the equivalent training and/or the clinical competency of practicing physicians.

 

[Sirach38]

The pessimism comes from the rapid influx of nurse anesthesia providers and hospitals who hire them over physicians.

It's actually more due to big AMC companies and anesthesia providers having to be responsible for supervising many CRNAs. CRNAs are not getting hired over physicians, yet.

 

[vm26]

The pessimism comes from the old timers that are seeing BIG changes coming to their field. For us up and comers, there is not much to be pessimistic about in this awesome field.

Some reasons to be pessimistic: More government control, more paperwork, increased student debt, decreased reimbursements, stable liability, increasing competition from PAs/NPs/CRNAs, medicare running on fumes. Outside of all this, it is an awesome field.

 

[FIREitUP]

Medical school was one of the best things to ever happen to me. Believe it or not, there really are people out there who enjoy all four years!!!

I absolutely LOVED the pre-clinical years. It helped that I freaking obsessed over Biochemistry, Anatomy, Microbiology and Physiology. I loved it so much, I went back to TA those courses! Life is easier than most people whine about during those years. Your SOLE goal is learn and study. How much easier can that be? I was even able to hold down a small part time job with Kaplan (I worked about 10hrs/week). Yes it is competitive, yes you are surrounded by high achievers and yes the material is high in volume and difficult to master. But, honestly, you don't have any real responsibilities. Most of my classmates were able to pass and still have a life outside of school.

The clinical years were also phenomenal. I found that it tends to be easier for those who have held jobs before. The ones that struggled the most were those who were socially awkward or didn't realized that no one gave a crap what their opinion was. This was definitely the most difficult year in medical school but like any job, there are rules. The number one rule in third year? Be easy to get along with. Why? Your evaluations are subjective. There is nothing you can do about it and complaining won't change anything. So learn the rules and play the game. Bring your personality. There is nothing worse than being around a rude/awkward/lazy medical student (I have witnessed this as a resident). My poor friends who came from these liberal arts schools where all their opinions matter; what a culture shock for them!

It sounds awful doesn't it? Well, remember, you get to LEARN MEDICINE. Finally, after all that studying, you put what you learned to use in a clinical setting. You realize the subtleties of medicine they can't teach in a classroom. You learn that while it is great that someone can memorize the entire differential list to a symptom, really, you need the most likely disease states to work with. You learn to do procedures. You learn to interact with patients. You learn to interact with nurses and other support staff. I think some people fail to realize that third year is NOT just about learning the medicine, it is about learning how to work in a medical profession. It is about how to communicate with your colleagues. It is about learning how to gather evidence (history and physical), putting a treatment course into action (assessment and plan) and if needed, providing an argument for others to help you (consults, nursing orders).

So do I regret medical school? Heck no! I would seriously do it all over again if I absolutely had to (though I would like to avoid that scenario as I value my time). Could I do ANYTHING else? Absolutely not. There is so much more to just being a doctor. You could choose that route if you want to: getting your degree, doing your residency and working for the weekend. There is nothing wrong with that. But you can choose to do other things like research, teaching, writing, politics, consulting etc.

I am saying this as a senior resident nearing the end of my residency. I do not think I am a rare entity. I wholeheartedly believe there are plenty others who think similarly. Misery breeds complaints and complaints need to be heard which turn into threads. Who wants to read a post about how great someone's day was? Boring! So don't be dishearted premeds and soon to be MS1s. Life in medicine is what you make of it. You will not love everything about medical school or even the practice of medicine. But there will be specific pockets that you will fit well in. Find them and embrace it. You will find that it is not all despair and frustration as toted in this forum.

obviously, YMMV. I would be far pressed to find very many with the outlook of this poster. I would say for the vast majority of us medical school is a mixed bag; most of it being ****ty. This is coming from someone who did well in med school.

 

[Ost3oclast]

I think I made the right choice going to med school. Some days suck but that isn't unique to our situation. I love the material and I manage to take a lot of time off on weekends for hobbies although not anymore as I'm studying for step I

The thing that gets to me the most the is constant feeling of being behind, even when you aren't. Got that chapter in FA down? Cool story, you've got 10 more. You think you know something and you find out that there are always exceptions and exceptions to the exceptions. Sometimes its easy to feel like you will never get on top of all of it.....I think that is the field though. There is alway more to learn.

Long story short, yes it was a good decision.

 

[Winged Scapula]

It's actually more due to big AMC companies and anesthesia providers having to be responsible for supervising many CRNAs. CRNAs are not getting hired over physicians, yet.

Sorry--but that's not true. I understand you may not be privy to what's happening out there. Here's my experience in 3 different states.

A large hospital near my office refused to renew their contract with an all physician anesthesia group and instead hired CRNAs except for cardiac cases.

I can't get a physician to provide me anesthesia at that hospital (part of the largest hospital system in the state) which is why I relinquished my OR privileges there.

Another hospital I moonlit at during fellowship was mostly staffed by CRNAs during Gen Surg cases, again for the same reasons given by management: "same care, less expensive". After I witnessed an intraoperative death there related to mismanagement of hypokakemia, I was less interested in working there after graduation.

The 2 groups I work with know my feelings: 1 is physician only and the other only provides me physicians for my cases.

It's happening.

 

[Mmedran]

Medical school was one of the best things to ever happen to me. Believe it or not, there really are people out there who enjoy all four years!!!

I absolutely LOVED the pre-clinical years. It helped that I freaking obsessed over Biochemistry, Anatomy, Microbiology and Physiology. I loved it so much, I went back to TA those courses! Life is easier than most people whine about during those years. Your SOLE goal is learn and study. How much easier can that be? I was even able to hold down a small part time job with Kaplan (I worked about 10hrs/week). Yes it is competitive, yes you are surrounded by high achievers and yes the material is high in volume and difficult to master. But, honestly, you don't have any real responsibilities. Most of my classmates were able to pass and still have a life outside of school.

The clinical years were also phenomenal. I found that it tends to be easier for those who have held jobs before. The ones that struggled the most were those who were socially awkward or didn't realized that no one gave a crap what their opinion was. This was definitely the most difficult year in medical school but like any job, there are rules. The number one rule in third year? Be easy to get along with. Why? Your evaluations are subjective. There is nothing you can do about it and complaining won't change anything. So learn the rules and play the game. Bring your personality. There is nothing worse than being around a rude/awkward/lazy medical student (I have witnessed this as a resident). My poor friends who came from these liberal arts schools where all their opinions matter; what a culture shock for them!

It sounds awful doesn't it? Well, remember, you get to LEARN MEDICINE. Finally, after all that studying, you put what you learned to use in a clinical setting. You realize the subtleties of medicine they can't teach in a classroom. You learn that while it is great that someone can memorize the entire differential list to a symptom, really, you need the most likely disease states to work with. You learn to do procedures. You learn to interact with patients. You learn to interact with nurses and other support staff. I think some people fail to realize that third year is NOT just about learning the medicine, it is about learning how to work in a medical profession. It is about how to communicate with your colleagues. It is about learning how to gather evidence (history and physical), putting a treatment course into action (assessment and plan) and if needed, providing an argument for others to help you (consults, nursing orders).

So do I regret medical school? Heck no! I would seriously do it all over again if I absolutely had to (though I would like to avoid that scenario as I value my time). Could I do ANYTHING else? Absolutely not. There is so much more to just being a doctor. You could choose that route if you want to: getting your degree, doing your residency and working for the weekend. There is nothing wrong with that. But you can choose to do other things like research, teaching, writing, politics, consulting etc.

I am saying this as a senior resident nearing the end of my residency. I do not think I am a rare entity. I wholeheartedly believe there are plenty others who think similarly. Misery breeds complaints and complaints need to be heard which turn into threads. Who wants to read a post about how great someone's day was? Boring! So don't be dishearted premeds and soon to be MS1s. Life in medicine is what you make of it. You will not love everything about medical school or even the practice of medicine. But there will be specific pockets that you will fit well in. Find them and embrace it. You will find that it is not all despair and frustration as toted in this forum.

Well said! Preach!

 

[Sirach38]

Sorry--but that's not true. I understand you may not be privy to what's happening out there. Here's my experience in 3 different states.

A large hospital near my office refused to renew their contract with an all physician anesthesia group and instead hired CRNAs except for cardiac cases.

I can't get a physician to provide me anesthesia at that hospital (part of the largest hospital system in the state) which is why I relinquished my OR privileges there.

Another hospital I moonlit at during fellowship was mostly staffed by CRNAs during Gen Surg cases, again for the same reasons given by management: "same care, less expensive". After I witnessed an intraoperative death there related to mismanagement of hypokakemia, I was less interested in working there after graduation.

The 2 groups I work with know my feelings: 1 is physician only and the other only provides me physicians for my cases.

It's happening.

Yes this is true. I think I missunderstood your post. There are certain surgical areas that are dominated by CRNAs but one of the main reasons for this is that there are not enough MDs to cover all of the ORs right now and many areas have used CRNAs to fill this gap. What I meant is that physicians are not yet directly competing for jobs with CRNAs in most locations because the demand for MDs still outweighs their supply and most places in the country do not yet allow independent CRNA practice. Places where CRNAs compete directly with MDs are still very rare. This will likely change in the next 5-10 years.

So most of the doom and gloom and pessimism on the gas forums comes not from having to compete directly with CRNAs but from other factors.

 

[Postictal Raiden]

Sorry--but that's not true. I understand you may not be privy to what's happening out there. Here's my experience in 3 different states.

A large hospital near my office refused to renew their contract with an all physician anesthesia group and instead hired CRNAs except for cardiac cases.

I can't get a physician to provide me anesthesia at that hospital (part of the largest hospital system in the state) which is why I relinquished my OR privileges there.

Another hospital I moonlit at during fellowship was mostly staffed by CRNAs during Gen Surg cases, again for the same reasons given by management: "same care, less expensive". After I witnessed an intraoperative death there related to mismanagement of hypokakemia, I was less interested in working there after graduation.

The 2 groups I work with know my feelings: 1 is physician only and the other only provides me physicians for my cases.

It's happening.

Damn. This is much more serious than I thought.

I'm pretty sure that those who are already practicing and others who are in training now will have no problem getting a job somewhere, but for us who are 5+ years away from entering the job market, this should be clear warning.

 

[Winged Scapula]

Yes this is true. I think I missunderstood your post. There are certain surgical areas that are dominated by CRNAs but one of the main reasons for this is that there are not enough MDs to cover all of the ORs right now and many areas have used CRNAs to fill this gap. What I meant is that physicians are not yet directly competing for jobs with CRNAs in most locations because the demand for MDs still outweighs their supply and most places in the country do not yet allow independent CRNA practice. Places where CRNAs compete directly with MDs are still very rare. This will likely change in the next 5-10 years.

So most of the doom and gloom and pessimism on the gas forums comes not from having to compete directly with CRNAs but from other factors.

I understand where you are coming from and that is certainly true in many parts of the country and competition is not the only reason for doom and gloom.

But you are still misunderstanding: I live in the 5th largest city in the US. This is not some backwater where we can't get physician Anesthesiologists and are forced to hire CRNAs. These are hospitals preferentially hiring CRNAs because they can (currently) pay them less than Anesthesiologists.
These are the same hospitals hiring APNs to cover observation and step down units over physicians because they were presumed to be cheaper (until they realized that it took 3 APNs to cover the work of 1 Hospitalist).

You are right that the states in which CRNAs function independent are in the minority. But the majority of states only require supervision which may not be required to be an anesthesiologist; it may be the surgeon. That it one reason I've drawn my line in the sand. Or it may be an anesthesiologist who is in another OR several minutes away. As long as they have someone to "supervise" them, they can be quite independent.

Some anesthesia groups do the same in hiring CRNAs to cover the "simpler" cases. We are fortunate to have many MD/DO-A only groups here and others who respect my preference.

What we are facing are hospitals and groups hiring a large contingent of CRNAs and a few Anesthesiologists to "supervise" them (and I'm sorry but when I supervise a medical student or resident, I'm actually in the room) OVER a qualified physician. While this town may not be for everyone, it's quite popular for many especially the attraction of private practice.

Ignorance and naïveté about what is happening out there has led many to assume "won't happen here" and to look the other way until their livelihood is taken from then. Surgeons and others need to take a stand. Believe me, I work everyday with Anesthesiologists and every single one lists the influx of CRNAs as one reason for students to avoid their field.

There are definitely lots of reasons for doom and gloom in Anesthesia and the CRNA issue is definitely at, or very near the center.

 

[Sirach38]

I understand where you are coming from and that is certainly true in many parts of the country and competition is not the only reason for doom and gloom.

But you are still misunderstanding: I live in the 5th largest city in the US. This is not some backwater where we can't get physician Anesthesiologists and are forced to hire CRNAs. These are hospitals preferentially hiring CRNAs because they can (currently) pay them less than Anesthesiologists.
These are the same hospitals hiring APNs to cover observation and step down units over physicians because they were presumed to be cheaper (until they realized that it took 3 APNs to cover the work of 1 Hospitalist).

You are right that the states in which CRNAs function independent are in the minority. But the majority of states only require supervision which may not be required to be an anesthesiologist; it may be the surgeon. That it one reason I've drawn my line in the sand. Or it may be an anesthesiologist who is in another OR several minutes away. As long as they have someone to "supervise" them, they can be quite independent.

Some anesthesia groups do the same in hiring CRNAs to cover the "simpler" cases. We are fortunate to have many MD/DO-A only groups here and others who respect my preference.

What we are facing are hospitals and groups hiring a large contingent of CRNAs and a few Anesthesiologists to "supervise" them (and I'm sorry but when I supervise a medical student or resident, I'm actually in the room) OVER a qualified physician. While this town may not be for everyone, it's quite popular for many especially the attraction of private practice.

Ignorance and naïveté about what is happening out there has led many to assume "won't happen here" and to look the other way until their livelihood is taken from then. Surgeons and others need to take a stand. Believe me, I work everyday with Anesthesiologists and every single one lists the influx of CRNAs as one reason for students to avoid their field.

There are definitely lots of reasons for doom and gloom in Anesthesia and the CRNA issue is definitely at, or very near the center.

Got it. I didn't know this was the case . Thanks for the info and thanks for stepping up to defend your fellow colleagues. We need more surgeons like you.

 

[giantswing]

A million times this over. This scares me. What i don't know already scares me ,but the idea of having to be respnsible for what a crna doesn't know scares me more.

 

[656844]

The pessimism comes from the rapid influx of nurse anesthesia providers and hospitals who hire them over physicians.

I can see that as a distinct possibility. I bet this is why psychiatry will eventually be taking a hit....the training and hiring of NPs who can both prescribe medication and conduct therapy. Because of that fact, I think psych may eventually be on its way out.

For me, it's going to be pathology all the way with a forensic path fellowship. PAs will never take over that field, and I can't see any other kind of "mid-level practitioner" doing so. The PAs are only responsible for the physical dissection of specimens, not the microscopic work (among other tasks). Besides garden-variety AP/CP, I'll specialize in forensic path because A) I love the blood and guts, physical aspect of the job, and B) I predict a ton of violence and murder to envelop this God-forsaken country in the future. Forensic pathology should be a BOOMING business over the next 50 years, and I know I'm going to be needed. (and yes, I will mention these reasons, among others, in my med school interviews)

It is in my honest and humble opinion that the USA is due for a violent and bloody revolution of a highly bureaucratic and economic nature. I'll be first on the scene!!

 

[Chipster.]

I can see that as a distinct possibility. I bet this is why psychiatry will eventually be taking a hit....the training and hiring of NPs who can both prescribe medication and conduct therapy. Because of that fact, I think psych may eventually be on its way out.

For me, it's going to be pathology all the way with a forensic path fellowship. PAs will never take over that field, and I can't see any other kind of "mid-level practitioner" doing so. The PAs are only responsible for the physical dissection of specimens, not the microscopic work (among other tasks). Besides garden-variety AP/CP, I'll specialize in forensic path because A) I love the blood and guts, physical aspect of the job, and B) I predict a ton of violence and murder to envelop this God-forsaken country in the future. Forensic pathology should be a BOOMING business over the next 50 years, and I know I'm going to be needed. (and yes, I will mention these reasons, among others, in my med school interviews)

Not only is this fairly creepy, and will probably get you rejected, it's also just flat out wrong. The homicide rate, and crime rate in general, has been steadily decreasing over the last few decades. Also this is f*cking creepy.

 

[656844]

Not only is this fairly creepy, and will probably get you rejected, it's also just flat out wrong. The homicide rate, and crime rate in general, has been steadily decreasing over the last few decades. Also this is f*cking creepy.

Guaranteed it won't get me rejected. Hopefully a few hearty laughs, but no rejections. And if it does get me rejected from all schools, then they'll just have to be my autopsy subjects, won't they? If I get denied a right to the livelihood that's best for me, I have no problem actually making the livelihood by myself.

 

[W19]

I can see that as a distinct possibility. I bet this is why psychiatry will eventually be taking a hit....the training and hiring of NPs who can both prescribe medication and conduct therapy. Because of that fact, I think psych may eventually be on its way out.

For me, it's going to be pathology all the way with a forensic path fellowship. PAs will never take over that field, and I can't see any other kind of "mid-level practitioner" doing so. The PAs are only responsible for the physical dissection of specimens, not the microscopic work (among other tasks). Besides garden-variety AP/CP, I'll specialize in forensic path because A) I love the blood and guts, physical aspect of the job, and B) I predict a ton of violence and murder to envelop this God-forsaken country in the future. Forensic pathology should be a BOOMING business over the next 50 years, and I know I'm going to be needed. (and yes, I will mention these reasons, among others, in my med school interviews)

It is in my honest and humble opinion that the USA is due for a violent and bloody revolution of a highly bureaucratic and economic nature. I'll be first on the scene!!

The beginning of 2015 has been good so far, please try not to spoil it... As for now, NP are not allowed to prescribe narcs in some states (ex. FL); therefore, that will limit their ability to take over psych...

 

[656844]

The beginning of 2015 has been good so far, please try not to spoil it... As for now, NP are not allowed to prescribe narcs in some states (ex. FL); therefore, that will limit their ability to take over psych...

Really? You think their inability to prescribe only one specific class of drugs will make that much of an impact?

 

[W19]

Really? You think their inability to prescribe only one specific class of drugs will make that much of an impact?

From my limited knowledge of the field, I have seen psych docs use a lot Class IV schedule meds to treat anxiety and sleep dx... Also, a lot of these people are looking for 'prestige' (whatever that means) so they can say they are 'doctors' and psych does not provide that kind of standing...

 

[Winged Scapula]

Guaranteed it won't get me rejected. Hopefully a few hearty laughs, but no rejections. And if it does get me rejected from all schools, then they'll just have to be my autopsy subjects, won't they? If I get denied a right to the livelihood that's best for me, I have no problem actually making the livelihood by myself.

Totally off topic, but I have to say I agree with Chipster.

While I agree with your sentiments about choosing a field that will have some longevity and protection from midlevel encroachment, medical school is designed to provide you a foundation, not a stepping stone to your predetermined specialty. Going in with the attitude at interview of "one specialty only" will be seen as immature and shortsighted, and misunderstanding the role of medical school. When you couple that with the fact that traumatic deaths are declining in this country and the rather indelicate (or gross) way you stated it, I only caution you to be careful, because it CAN get you rejected.

I've seen a lot of unsavory things in my career as a surgeon and if I ever interviewed a medical student or resident who professed a love for "blood and guts", I'd be seriously concerned about a psychiatric disorder. That may be the farthest thing from the truth for you but please recognize how what you typed above comes across.

 

[Winged Scapula]

Got it. I didn't know this was the case . Thanks for the info and thanks for stepping up to defend your fellow colleagues. We need more surgeons like you.

You're welcome.

More of my surgical colleagues need to take a stand instead of going with whatever is easiest for them.

As I've said on the same topic in the surgical forum, if we refuse to support our anesthesia colleagues, who will support us when someone tries to claim that doing an appendectomy or hernia repair is "easy" and doesn't require a fully trained surgeon. I say the same thing to my Ortho and CT colleagues who are letting their PAs do increasingly more (I hear what these PAs say in the physicians lounge when they don't know who I am or think I will agree with them because I'm nice; they think they are qualified to do more and more).

 

[stuart114]

I am happy. The alternative was doing nothing with my life so i am am doing something at least. I am broke now but one day capitalism will pay off i hope

 

[W19]

You're welcome.

More of my surgical colleagues need to take a stand instead of going with whatever is easiest for them.

As I've said on the same topic in the surgical forum, if we refuse to support our anesthesia colleagues, who will support us when someone tries to claim that doing an appendectomy or hernia repair is "easy" and doesn't require a fully trained surgeon. I say the same thing to my Ortho and CT colleagues who are letting their Pas doing increasingly more (I hear what these PAs say in the physicians lounge when they don't know who I am or think I will agree with them because I'm nice; they think they are qualified to do more and more).

Why is it so hard for physicians to take that stand? When my spouse was having a surgery, I requested for the anesthesiologist to be in the room at all time and the surgeon gave me that speech that 'CRNA are as qualified as MD/DO' when I know that she knows that is BS... They had to abide by my request anyway, but a friend of mine who work at that surgical center told me they labeled me as a dingus for making such request...

 

[Winged Scapula]

Why is it so hard for physicians to take that stand? When my spouse was having a surgery, I requested for the anesthesiologist to be in the room at all time and the surgeon gave me that speech that 'CRNA are as qualified as MD/DO' when I know that she knows that is BS... They had to abide by my request anyway, but a friend of mine who work at that surgical center told me they labeled me as a dingus for making such request...

Let's use one of my partners as an example.

Most of her patients live near or prefer to go to the hospital I mentioned above that employs CRNAs.

My partner has been operating there for years; they allow her to run 2 rooms, for her PA to close; essentially they cater to her and she's got a good gig there. Add in her fear that if she insists patients go to another hospital further away (15 more minutes down the road, where I go), they will refuse or complain to their PCP and she will lose business. This IS a realistic fear as I've lost patients who have been referred to me but refused to travel any further for their OUTPATIENT (e.g., one day) surgery.

So she doesn't take a stand even when I mentioned to her that she could be considered the "supervising" physician and when she found out that the hospital also does not have any physicians on the floors and ICU in house at night (only APNs and the ED physicians); both things disturbed her but not enough to change her practice.

Surgeons are afraid of doing something that might affect their livelihood - in private practice, if you make waves (i.e., tell your anesthesia group that you won't use their CRNAs), they can refuse to cover you, remove your hospital privileges, you'll get a bad rep and lose referrals etc.

 

[656844]

Totally off topic, but I have to say I agree with Chipster.

While I agree with your sentiments about choosing a field that will have some longevity and protection from midlevel encroachment, medical school is designed to provide you a foundation, not a stepping stone to your predetermined specialty. Going in with the attitude at interview of "one specialty only" will be seen as immature and shortsighted, and misunderstanding the role of medical school. When you couple that with the fact that traumatic deaths are declining in this country and the rather indelicate (or gross) way you stated it, I only caution you to be careful, because it CAN get you rejected.

I've seen a lot of unsavory things in my career as a surgeon and if I ever interviewed a medical student or resident who professed a love for "blood and guts", I'd be seriously concerned about a psychiatric disorder. That may be the farthest thing from the truth for you but please recognize how what you typed above comes across.

Oh of course. What's said in a social forum and on paper vs. in person face-to-face doesn't always correlate well together, so typing something as opposed to actually knowing a person and how he/she behaves/acts are two totally different things.

As far as "medical school is designed to provide you a foundation, not a stepping stone to your predetermined specialty", let's be honest here: it does both. You're being educated with a great foundation of multiple sciences and patient exposure during your initial 4 years, and at the same time, you ultimately will be choosing a specialty. So yes, medical school is also a stepping stone to a specialty, whether you feel it's predetermined or not.

Also, you never know what you may be exposed to during your medical education that can completely change your career interests, and I will remain open-minded throughout (even though the medical profession happens to be a rather conservative field, ironically enough...they can use more open minds, for sure). I'll be sure to communicate a specific specialty that I have in mind based on past experience (because I had prior exposure to it, which would make me a great fit), while at the same time expressing interest in a very diverse range of medical fields. Hate to say it, but you really do have to slather on the BS with a lot of universities, and sometimes give them what they want to hear. Such is the nature of bureaucracy.

 

[Winged Scapula]

I presumed you were being outrageous @PathAsst in your earlier post about your love for "blood and guts" but when you were equally as adamant that it wouldn't result in a rejection, I felt the need to reply. I understand that there is internet communication and IRL communication and many times, they differ. For some, they do not, hence my comment.

Being open minded and playing the game is necessary, even if those around you don't.

 

[Sirach38]

NO field in medicine is safe from midlevel encroachment. None. Not path, not psych, not surgery. It's just a matter of time. Anyone who feels otherwise has not talked to midlevels and gotten to know their attitudes. They WANT our jobs and bean counters will do anything they can to replace us with them because it makes them more money. Newsflash, our healthcare system is run by administrators, not MDs and they couldn't care less about patients or patient safety. They are after the $$ and nothing else. The sooner we as a profession realize this, the sooner we will start to fight for eachother.

 

[656844]

NO field in medicine is safe from midlevel encroachment. None. Not path, not psych, not surgery. It's just a matter of time. Anyone who feels otherwise has not talked to midlevels and gotten to know their attitudes. They WANT our jobs and bean counters will do anything they can to replace us with them because it makes them more money. Newsflash, our healthcare system is run by administrators, not MDs and they couldn't care less about patients or patient safety. They are after the $$ and nothing else. The sooner we as a profession realize this, the sooner we will start to fight for eachother.

And because of the very nature of the health care system in the USA, which you so eloquently described above, I am seriously considering going to medical school in another country and staying there to practice. Which country do you think is good if one wanted to "defect" from the USA? I noticed that there are a number of foreign schools that have ties to the U.S. so that you can get federal loans. See https://studentaid.ed.gov/prepare-f...ols/types/international#international-schools You'll see that some med schools have connections with the USA for financial aid.

To me, I think this is genius if you can do it. What country besides the USA would be great to study and practice medicine in? Just imagine it....getting federal aid to study medicine in Australia, then working on obtaining Australian citizenship, renouncing your US citizenship as a huge F.U. to capitalism and the state of health care in that country, and saying hello to your new country. I absolutely LOVE the idea!

P.S.: After researching some of the admissions requirements for these foreign medical schools, most don't even require letters of recommendation (which I think is good). The practice of gathering LORs for med school entry is a currently criticized admissions procedure here in the USA. Also, we all know that the MCAT is drastically changing in a few months. A lot of foreign med schools require the MCAT if you're from the USA, but exactly how well will they be familiar with the new version? My guess is that the time to take the MCAT is now, since not much statistical research will be available on it until maybe 2 to 3 years down the road. Therefore, I think foreign med schools probably won't put much weight on that exam.

 

[Baller MD]

Let's use one of my partners as an example.

Most of her patients live near or prefer to go to the hospital I mentioned above that employs CRNAs.

My partner has been operating there for years; they allow her to run 2 rooms, for her PA to close; essentially they cater to her and she's got a good gig there. Add in her fear that if she insists patients go to another hospital further away (15 more minutes down the road, where I go), they will refuse or complain to their PCP and she will lose business. This IS a realistic fear as I've lost patients who have been referred to me but refused to travel any further for their OUTPATIENT (e.g., one day) surgery.

So she doesn't take a stand even when I mentioned to her that she could be considered the "supervising" physician and when she found out that the hospital also does not have any physicians on the floors and ICU in house at night (only APNs and the ED physicians); both things disturbed her but not enough to change her practice.

Surgeons are afraid of doing something that might affect their livelihood - in private practice, if you make waves (i.e., tell your anesthesia group that you won't use their CRNAs), they can refuse to cover you, remove your hospital privileges, you'll get a bad rep and lose referrals etc.

I hope something like this never happens to your colleagues:

http://forums.studentdoctor.net/thr...-had-been-there-idiocy.1114486/#post-16043658

 

[Sirach38]

And because of the very nature of the health care system in the USA, which you so eloquently described above, I am seriously considering going to medical school in another country and staying there to practice. Which country do you think is good if one wanted to "defect" from the USA? I noticed that there are a number of foreign schools that have ties to the U.S. so that you can get federal loans. See https://studentaid.ed.gov/prepare-f...ols/types/international#international-schools You'll see that some med schools have connections with the USA for financial aid.

To me, I think this is genius if you can do it. What country besides the USA would be great to study and practice medicine in? Just imagine it....getting federal aid to study medicine in Australia, then working on obtaining Australian citizenship, renouncing your US citizenship as a huge F.U. to capitalism and the state of health care in that country, and saying hello to your new country. I absolutely LOVE the idea!

P.S.: After researching some of the admissions requirements for these foreign medical schools, most don't even require letters of recommendation (which I think is good). The practice of gathering LORs for med school entry is a currently criticized admissions procedure here in the USA. Also, we all know that the MCAT is drastically changing in a few months. A lot of foreign med schools require the MCAT if you're from the USA, but exactly how well will they be familiar with the new version? My guess is that the time to take the MCAT is now, since not much statistical research will be available on it until maybe 2 to 3 years down the road. Therefore, I think foreign med schools probably won't put much weight on that exam.

I don't know much about this option. I would imagine gaining citizenship in another country could be a nightmare in of itself but I could be mistaken.

My plan is to do an anesthesia residency followed by a CCM fellowship and a cardiac fellowship. This should keep me well insulated from the CRNA garbage for at least a while. Then if and when **** hits the fan here in the US, I can go practice in Canada or Mexico where physicians are still respected. It's unlikely that it will ever get that bad here though. Things will swing the other way, I hope.

 

[yancantcook]

I've regretted the decision for medical school for a while now and luckily I was able to persuade my sibling from not going into medicine like me. Now I completely understand why older physicians are not sending their children to medical school. Think about it, if you are a smart young college graduated, why would you want to go through 4 years of rote memorization followed by 3-7 years of a hospital grunt to come out with 300k in debt and have the government and administrators dictated how you practice, with insurance companies cutting your reimbursement in every possible way?

The young bright students now a days are going into business, IT, computer science. Go work for Google, uber, facebook, etc that is where the future is, not rounding on your 12 patients as a hospitalist for the rest of your life. Next year, the hospital will want to increase your cap to 14 and then to 16 two years later, while you pay will get a decrease every year.

Stay away while you can.

 

[Beargryllz]

It was probably the best decision I ever made

Having said that, I still get sad, angry, defeated, and full of regret

I think if I ever stopped having those feelings I would be dead

 

[oldbearprofessor]

I've regretted the decision for medical school for a while now and luckily I was able to persuade my sibling from not going into medicine like me. Now I completely understand why older physicians are not sending their children to medical school. Think about it, if you are a smart young college graduated, why would you want to go through 4 years of rote memorization followed by 3-7 years of a hospital grunt to come out with 300k in debt and have the government and administrators dictated how you practice, with insurance companies cutting your reimbursement in every possible way?

Older physicians may or may not be "sending their children to medical school." It's remarkable how independent children are these days about their life's decisions. Of course, when us "older physicians" do send them, we may try to make sure they don't have a huge debt.

 

[jdh71]

Older physicians may or may not be "sending their children to medical school." It's remarkable how independent children are these days about their life's decisions. Of course, when us "older physicians" do send them, we may try to make sure they don't have a huge debt.

My sons can do whatever they want . . . After they finish medical school.

 

[656844]

My sons can do whatever they want . . . After they finish medical school.

Hopefully they came to their own decision about whether to attend medical school. I always hate to hear stories about how parents pressured their children to be this or that, and they end up hating whatever profession they chose while ruining their futures in the process.

 

[656844]

I've regretted the decision for medical school for a while now and luckily I was able to persuade my sibling from not going into medicine like me. Now I completely understand why older physicians are not sending their children to medical school. Think about it, if you are a smart young college graduated, why would you want to go through 4 years of rote memorization followed by 3-7 years of a hospital grunt to come out with 300k in debt and have the government and administrators dictated how you practice, with insurance companies cutting your reimbursement in every possible way?

The young bright students now a days are going into business, IT, computer science. Go work for Google, uber, facebook, etc that is where the future is, not rounding on your 12 patients as a hospitalist for the rest of your life. Next year, the hospital will want to increase your cap to 14 and then to 16 two years later, while you pay will get a decrease every year.

Stay away while you can.

I wouldn't say to stay away. But you're right about computer science and IT. That's a booming industry, especially out West in the San Francisco Bay Area. I was out there briefly to pursue an alternate career, and I couldn't believe how many people were in tech. The most alarming part is that a lot of the employees have only high school diplomas (especially those people working at start-ups, which is all the rage out there). To think that you can make so much money without having a decent amount of education behind you really makes my blood boil. The tech industry out there is also to blame for the extremely ridiculous rents and cost of living in a city that's destined to be rocked by a massive, killer earthquake real soon...but I digress.

As far as I'm concerned, I'll deal with the rote memorization for a couple years and work towards a specialty I can get a job in. Just pay me enough to live decently well with food and a nice place for shelter, and I'm good. Seriously. I'm not a materialistic person, and all I need are the basics. As far as the $300,000+ debt goes, bring it! I'll be single, unmarried, no kids...and they'll get whatever I can give them. My 2 goals in life will be these:
1) Making a substantial contribution to society's well-being (even if it's on its way towards failing miserably), doing something that I enjoy doing; and
2) Engaging in the most intense sexual pleasure known to man, with men and/or women. I don't discriminate! Whatever feels good IS good. There's nothing like diagnosing 80 cases a day, coming home to eat, and then calling up your bud for a little man on man time. It's glorious! Pleasure over pain, always.

 

[VisionaryTics]

I'll be single, unmarried, no kids...and they'll get whatever I can give them. My 2 goals in life will be these:
1) Making a substantial contribution to society's well-being (even if it's on its way towards failing miserably), doing something that I enjoy doing; and
2) Engaging in the most intense sexual pleasure known to man, with men and/or women. I don't discriminate! Whatever feels good IS good. There's nothing like diagnosing 80 cases a day, coming home to eat, and then calling up your bud for a little man on man time. It's glorious! Pleasure over pain, always.

 

[jdh71]

Hopefully they came to their own decision about whether to attend medical school. I always hate to hear stories about how parents pressured their children to be this or that, and they end up hating whatever profession they chose while ruining their futures in the process.

I was being a bit facetious. Though the stories I hate worse are those stories where parents coddled every idiotic whim of their children who after four or five unimpressive years have some horse**** liberal arts degree and are living at home because they *have to* working low wage at Starbucks or Home Depot. Not to mention the 5 to 6 figures of debt.

Not all paths are equal or even smart. The problem with those younger than 25 or 26? They are all mostly idiots. You can't tell them anything. Maturiry arrives slowly in a country as rich as ours because you don't starve like you naturally should from being a **** up, you also luckily often don't die when you jump your jet ski over a flaming pile of rocks into a building. We try and save idiots in this country.

Lastly, not much is going to get you told to mind your ****ing business faster than wondering into some random conversation and trying to give parenting advice. At minimum you need to actually show you have the capability and chops to even get into medical school before trying to give a whole thread advice? No?

 

[656844]

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