Personal hesitations about Medical School

Hesitations about medical school:

Before I invest over $120,000 and over 15,000 hours of studying into four years of medical school as well as work long hours for low wages in residency, I’d like to address some of my personal concerns about doing it.

Am I ready for more theoretical learning/memorization of irrelevant facts? I’m not looking forward to several more years of memorizing the Krebs cycle, studying action potentials etc. Throughout college, I found some of the information interesting, but mainly my goal was getting through all of it by sheer dedication to my studies and being re-compensated for it through doing well on tests and gaining the feeling of “getting somewhere.” This somewhere for me was medical school. Of course in medical school, there is more of that waiting for me.

Is it my ideal lifestyle? Although my ideal lifestyle does include working 50-60 hours/week as I would probably be doing anyway throughout medical school, I would prefer the freedom to work on what I desire as opposed to learning information that is pre-chosen for me. Additionally, I can’t say I’m excited for working for 80 hours a week throughout residency for several years. Talking with other prospective medical students, they feel the same way, but they justify it as it all pays off in the end. Given an investment of over $120,000 for four years and working for low wages and 80 hour weeks for another four years, I would hope it would.

Would I get bored with the same job? I like a lot of variety in my life. I’ve been realizing that I might not be able to do just one job all of my life regardless of what it is. In order to stay interested, I think I would prefer doing multiple jobs or a lot of different and new challenges within the same job. Because medicine is becoming more and more specialized, (as it should if efficiency is the aim) that also means that the career responsibilities are less diverse. I’ve seen family practice doctors who’s jobs I would abhor because most of the patients come in with similar issues. The one doctor I shadowed who I felt had a good amount of variety and challenges within her job through being a bilingual Pediatrician and Family practice Doctor said she felt she was getting bored of her job and needed more of a challenge. I suppose doing anything for too long will produce that sort of a feeling.

Will I help people as much as I’m thinking I will? The nature of a doctor's work is little known by people who are not in the field, and most people just take it as you are helping people. In my opinion, it's not quite that simple for a few reasons. Our achievement-driven society often looks to doctors to medicate themselves and children. Attention Deficit Disorder is far over diagnosed and wasn’t even a classified disorder until recently. Thinking about it, I’d hate to succumb to parents wishes of diagnosing their children with it and prescribing Ritalin and Adderall to boost their focus in school. After reading several articles and the book Pushed, I’ve realized that there are many other controversies regarding quick interventions for other psychotic disorders, and childbirth. You might say “but you could still take trips to other countries and help people there.” After participating in a Global Medical Brigades trip to Honduras, I had a long discussion with the doctor there about how much she felt she was helping. She mentioned how she felt she was just prescribing hundreds of temporary treatments like Tylenol and Asprin without providing a sustainable impact on any of them. I’m not saying that all medical work abroad is like this, but for me it would be crushing to see a whole lifetime of investment lead to ineffective work with good intentions. I talked with other students about our impact, and we came to the conclusion that at no one can refute that our intentions were positive and that is what is REALLY important. But I already have good intentions. My science wired mind needs to see positive results of my work for me to be satisfied. Aside from this, I’m also not looking forward to seeing patient after patient who enters my clinic with a cough or cold. I want to make a change, not distribute medicines to mildly sick and overly concerned people who would probably get better anyway. Although I could choose to work around these situations eventually, I would inevitably confront many of them for years before I would have the chance to work with people to make a lasting change.

Do I want to work within the USA’s style of medicine? I’ve never been a fan our large, profit driven insurance and drug companies that try to wield doctors into making them gain more money. Nor am I excited about HMOs running a business over me that will severely limit the time I spend with each patient. I’m also not too keen on potentially being sued for making a mistake or hurting someone because of it as all physicians do from time to time. What would make me more irate is not having the ability to be confess my mistakes with patients for fear of providing incriminating evidence against myself in court. After reading a few books by Atul Gawande, I realized this is one of the biggest difficulties in his job.

How much material will I actually retain after studying? Although I’d love to say that I would have a complete understanding of medicine and be able to answer any medical question asked to me after four years of medical school, I believe the reality would be far from that. I like everyone else, forget things. How long does it take for me to forget something I’ve studied and used multiple times (as opposed to a one time fact)? My estimation would be about one month, and much less time for information that was never used on a consistent basis. In fact, after using my combination lock all throughout South America and Thailand, then coming home and not touching it for just over a month, the numbers became disordered in my long term memory. I had to buy a new one. Looking at the years of “drinking medical information out of a fire hose,” as the medical school saying goes, and speaking with other medical students about how much they remember from prior years, I’ve come to the conclusion that what a person learns at the beginning of one year will soon be forgotten in a few months unless actively worked upon. It of course will be actively studied again and again and again for school exams and USMLEs. In my opinion after school, only some of the concepts, and something like .2% of relevant information will be used for one’s job. Feel free to disagree if you are a medical student or doctor.