A diary from a med student

I’m curious what the general reaction is to this diary from those currently in or having already gone through med school?


I’m naturally skeptical of all extremes, but emotionally I identify with this person’s reactions to events. For instance, I wouldn’t relate well with someone that found jokes about women’s breasts entertaining while performing surgery.

Is this person in an unusually abrasive school, or just full of crap?

Color me curious.

One thing I wanted to add, my opinion at this point is that much like any difficult experience, you can find the dark mass inside the silver lining and focus on it, or vice-versa.

I can’t imagine all that he reports is accurate, devoid of drama, and representative of what is really the goal of medical school. If his observations were correct, only sociopaths could be successful in such an environment, and I’m exceptionally confident that MDs are not all sociopaths.

It’s still interesting to read, and I’m still curious to see what reactions are to this diary.

Pretty much the most depressig thing I have read in the last month. Thankfully I have two or three physics chapters to read today to cleanse the palate.

I read the preface and I have to say that he has very valid points. Somehow this process known as medical education takes people who enter this endeavor with very humanistic intentions and strips that away from you. I feel that the increasing business pressures of medicine will only worsen this. For example, the ER calls a consult on a patient because they have been there longer than 20 minutes (a time by which the ER will get “judged” about their efficiency). This causes the poor resident who gets called with the consult to dislike/hate seeing patients. Their frustration is at the patient who comes to the ER for non-emergent problems as well as the ER for not doing their own job and creating more work for you.

I am also one who on some level is disillusioned with the profession of medicine. I am hoping that in returning to the military I find some of that humanism again.

I’ll post more after I read more.

I finished this diary today. I have to admit, it’s left my head spinning, wondering how much of this I could stomach.

My wife and I can handle the burden of having me as a student again (it’s something we have to do no matter what path I choose). I believe I’m capable of mastering the material, getting the appropriate grades/scores. We can even come to terms with the financial aspects. Being in intense debt at that point, I’d have to finish, but if this is an accurate depiction of what is experienced during third year and residency and beyond, candidly, it just doesn’t come close to lining up with my expectations of myself or the practice of medicine.

Don’t get me wrong, I didn’t expect it would be anything like what you see on TV, or some Mother Theresa style experience, but I did expect Doctors to be the advocates in the system. I expected and believed that if anyone in the healthcare ecosystem really, deeply cared for patients, it was those that spent so much of their lives training to care for them. From this diary, it sounds as though the personal care of patients is a backseat to nearly every other concern and this is the institutions intent.

There are people, specialties, work places/environments that will meet what your personal inside-feeling of humanism is. It is a matter of finding it. For me, I think that will be working in hospice. For others, it’s working in a remote international clinic or an rural/inner city free clinic. It will likely be in many ways a decision between money and personal satisfaction as well as an acceptance that there will always be people in medicine, as in all professions, who look out for themselves. I think one of the things I had to accept in medicine is that the people who become physicians are human and fall to human temptation. However, I do believe that it would be possible to create a medical education system that fostered humanism. However it would take a complete and total overhaul as well as a willingness on the part of those who have completed this journey to get the chip off their shoulder and not expect those that follow behind them to “suck it up” and “get over it” because they did. If the premiere leadership organizations such as the military academies can do it, then medicine can.

What I can’t get past, and maybe this is what everyone means when they say “This is what I’m meant to do”, is that when I consider other options, things I could do instead, my heart isn’t there.

I don’t want to go through a process that sounds like it attempts to strip compassion and humanity from you, but if that process is a necessary hurdle to find yourself in a place where you have some hope of changing the process itself, and to become the kind of practitioner that lead you to try in the first place, then so be it.

I see here that wonderful people have gone through the process and still remain wonderful, I have to believe I would do the same.

I cant comment on the reality of medschool as I havent been so lucky as to have personal experience (yet) but I do agree with the last poster. Well said.

“I don’t want to go through a process that sounds like it attempts to strip compassion and humanity from you”

This is often seen during med school and training. . . but no one can strip the compassion from you in reality. You will definitely be frustrated with many of the issues you will face, especially the way medicine is becoming more of a business than that of a healing art. Then you will have the one patient that really touches your heart; the patient you can laugh and/or cry with; the child that lights up your face with a smile; the thank-yous from a patient’s family for working diligently to make their loved ones final days better. These are the things that have made the difficult journey towards becoming a physician bearable to me.

I agree in that all of the doctors I know and work with, none are as the author describes. However, none of them are actively working toward changing the system either. Since reading the article, I have wondered if, during the journey do individual doctors find some reason to justify the humanity stripping treatment that they endure throughout the course of thier education. Is it that they need a tough outer shell to cope with the daily grind of being a physician and find the means are justified? Or are they so beat down that by the time they land at a final practice setting, overwhelmed with debt and hours, that there is no time or desire left to go back and try to change things. I think it takes a rare individual to continue to swim upstream and buck the system year after year. While I personally don’t connect with the writer on some levels, I must admit I admire him alittle for taking on the battle. As I said before, I found it to be a depressing read and I hope that things are not truly that bad when I go through, but as the poster stated above…what other choice is there when your heart is set?

I think part of why it persists is “academic medicine.” From the outside, you would think that academic medicine is filled with people who love teaching and who strive to make the next generation of physicians better. I think you find these people at community hospital programs. However, at large traditional academic centers, those programs are filled will researchers, which is the definition of academic medicine. Those people may or may not have any desire to teach the art of medicine. Many of them are focused on their grants and research, as for them it is “publish or perish.”

One other thing that is going to seriously impact medical teaching that will blossom in the next few years is that departments do not get paid to teach. Medical student tuition is a very small part of a medical center’s accounts receivable. Medicare, and subsequently insurance companies, are reimbursing less and less, which places pressure on departments to have their staff physicians see more patients in less time. Yet, teaching takes time. Seeing a patient with a medical student or a resident takes time, slowing down your “productive efficiency.” Unfortunately, it will be teaching that looses out in the battle for time.

I read the diary of a medical student. I am not sure how much of the material is reality or how much is dramatization or exaggeration, but i must give the writer credit for this thought provoking piece. I believe one can look at the information therein, in many different ways. For those of us who are aspiring to travel the road on becoming a medical doctor, may this information serve to give us another prospective into the life of a third year medical students; so that, if or when we are faced with similar circumstance we may be more ready to deal with the situation. Who promised that there is not excessive pressure in academic medicine? Prestige and power can be brutal forces; they do not always regard humanity.

I still believe that the profession of medicine has many intelligent compassionate people; but, to thrive as a profession, medicine needs many different kinds of people. In the medical field, there are about 50 specialties and subspecialties. Many doctors go into private practice. Many teach, do research, run screening programs, establish companies, write computer programs, and edit journals and more. To sustain such vibrant profession, all medical schools cannot be equal. They are not equal in demanding that their students must be caring, compassionate, and humane in their care of patients; not equal in emphasizing that their students show respect for human differences, and not equal in their commitment to ethical practices.

We nontraditional students have had many different life experiences. No doubt, these life experiences helped to shape us into the kind of person we are today. We are now responsible to find out about different schools and try to find the ones which we think might be the best fit for us.

An interestingly depressive read!

The further you get into the diary the more you get the sense of this person’s agenda going in. If he had stopped about 1/2 way through it would have been more meaningful. Once he gets into the “Dr’s love Nazis” rants he completely loses focus.

Talk about a healthy dose of discouragement! Wow, I sure hope it’s not as bad as that picture paints.

  • nnylacire Said:
Talk about a healthy dose of discouragement! Wow, I sure hope it's not as bad as that picture paints.

From the first noble truth of the teacher Buddha

Pain and Suffering

Pain in life is inevitable but suffering is not. Pain is what the world does to you, suffering is what you do to yourself. Pain is inevitable, suffering is optional.

Medical school from all whom I have observed is painful from work, stress, exhaustion, etc. Whether you suffer is up to your ability to remember the path and accept the journey you have taken.

I have often suggested to people to write down, it their own hand, a letter to themselves why they have decided to take this path. Keep it with you and read it to yourself when those moments of weakness and doubt lead to suffering while in school. My Rule 10: The FUD Factor of Fear, Uncertainty, and Doubt destroys more budding doctors then organic chemistry, MCAT, or anything else.
  • TAChicago Said:
The further you get into the diary the more you get the sense of this person's agenda going in. If he had stopped about 1/2 way through it would have been more meaningful. Once he gets into the "Dr's love Nazis" rants he completely loses focus.

Ok, I can entertain the argument that the author has an agenda, however, I still don't see what it is. Irrespective, he has gone to great lengths to cite his references and research valid contemporary issues on the practice of medicine and its teaching to students. I even checked some of his references and they are correct.

He has certainly made references to doctors and Nazis however I haven't yet seen the 'Doctors love Nazis' quote. His Nazi connection allegations are valid since doctors were indeed involved and complicit in the Nazi pogroms.

In fact I had an as-American-as-apple pie researcher once say that although the act was condemnable, it was a shame that we didn't have access to, and couldn't use the research that Nazi doctors carried out in the concentration camps since they gathered some very valuable data. Of note is that his wife is jewish and I don't think I'd be justified in calling him a Nazi sympathizer.

So I guess I'm still trying to separate the truth from the hyperbole. Either way I'll find out this fall. Hopefully the author is either completely incorrect or Tufts SOM has a questionable culture.