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Is It Possible To Finish Med School Without Becoming Too Salty Or Cynical?

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Reflective practice helps.  I remind myself why I went into medicine and when I feel like I've been unkind or impatient, I reflect on it and try to do better next time.  The way I practice medicine is tied in to my spirituality in a way and sometimes I need to go back to that base.

 

I don't think I'm particularly cynical yet.  I've met lots of physicians who aren't.

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I have seen so many people become cynical or careless. I have seen specialists interrupting patients, not caring about the other issues raised by the patient. 

I have seen truly overworked physicians not being able to spend time with their own families, who become truly salty as a result.

I have a few friends who are residents now and they're getting ridiculously cynical.

So many lecturers just don't give a flying poo about the quality of their teaching and the lecture notes (not bashing McGill. It's the case in many places)

I'm a preclerk, and sadly, I'm definitely way more cynical than last year. I'm pretty much sure I'm not the only one...

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Med students often look at residents or preceptors and wonder how they got so jaded then they tell themselves that "that will never be me, I will never cut off a patient, or use big words, or make a joke at the patients expense". The thing is everyone comes into this a reasonably good person with mostly solid motives; we all want to be "good doctors", do the right thing. The sad thing is that after a year or two of 1/4 call, where your worth as a person is determined by how quickly and efficiently you can keep the system moving, all of that goes out the window. It is a broken system that makes broken doctors. Of course it is program dependent. Psych residents work chill hours with preceptors whose billing is based on hour long chunks of time, O&G residents are on the other end of that spectrum and are literally sleep deprived all of the time while being expected to catch the next baby or do the next assessment. In hard core surgical specialties residents get treated like crap and any praise (or lack of discipline) comes from doing as much as their preceptors work as possible. Dictate, round, operate, admit, go go go. Of course med students get a small taste of this as they are coming through. All of this patient centered stuff takes time, which is the one thing that is always in demand. 

 

The day you realize you have no choice but do the wrong thing because there just isn't enough time not to, or that you prioritize not getting yelled at over a patient's praise, is the day you will understand where your friends are now.

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I have seen so many people become cynical or careless. I have seen specialists interrupting patients, not caring about the other issues raised by the patient. 

I have seen truly overworked physicians not being able to spend time with their own families, who become truly salty as a result.

I have a few friends who are residents now and they're getting ridiculously cynical.

So many lecturers just don't give a flying poo about the quality of their teaching and the lecture notes (not bashing McGill. It's the case in many places)

I'm a preclerk, and sadly, I'm definitely way more cynical than last year. I'm pretty much sure I'm not the only one...

 

It is important to take a step and look at the big picture once in a while. Life is really too short to be unhappy  :)

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I talked to some people doing their clerkship recently and was also a little disheartened to see the difference in their attitude towards medicine as a profession vs. our seniors still in pre-clerkship. Hopefully the memory of how disappointed I was by that will keep me in check from developing the same kind of negative outlook. But then again, I'm not in their shoes and I don't know all the stressors and experiences that may be contributing to such a change.

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I have seen so many people become cynical or careless. I have seen specialists interrupting patients, not caring about the other issues raised by the patient. 

I have seen truly overworked physicians not being able to spend time with their own families, who become truly salty as a result.

I have a few friends who are residents now and they're getting ridiculously cynical.

So many lecturers just don't give a flying poo about the quality of their teaching and the lecture notes (not bashing McGill. It's the case in many places)

I'm a preclerk, and sadly, I'm definitely way more cynical than last year. I'm pretty much sure I'm not the only one...

 

I have seen the best and the worst during clerkship. Attendings/senior residents with best and worst bedside manners.

 

I have become way more cynical than I was when I was at your stage. I have been seeing old people being hit by horrible diseases, young people causing themselves harm and innocent young people that die from a disease we had no way to treat. People will die under your care and you will save a good majority of them. 

 

Patients under my charge remain a the top of my priorities even if I am overworked/tired/drinking coffee more than I should. I still believe my work makes a difference in the life of the sick ones and their relatives. Sometimes, all it takes is 15 minutes to chat and answer questions to reassure and "heal" (yeah, all the stuff they teach in physicianship curing versus healing) well we do a lot of curing (or we try to) but maybe we should try to heal a bit more.

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It's definitely happened to me as a clerk and in the first few months of residency, especially on off-service rotations, but on-service too, where I just haven't had the time or the energy to do things for patients that I really would like to be able to do.  Or where I've done something not-ideal because I didn't want to get in shit with my staff for doing something that would be better for the patient.

 

I really try to at least be aware of it and reflect on if there is a better way I can balance things out the next time.

 

The culture of my specialty, from what I have seen, is generally much less toxic.

 

I don't know what I'll be like in five or ten or thirty years.  There are definitely psychiatrists that I would love to be like, and some maybe not so much.

 

At the moment, it helps me to focus on why I felt "called" to choose my field in the first place.  I believe in all kinds of sappy things about the universe.  I believe there is something greater in what I'm doing.  I'm okay with how that sounds.  If I lose that part of myself, I'll be in trouble as a human being, not just as a physician.  I know that's not how everyone thinks of medicine, and that's totally okay, but that's what it is for me.  That's what keeps me going.

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I have started clerkship as a junior clerk, I have been rotating in internal med and emergency lately.

It is definitely hard to not cut patients when you have 10 patients waiting for you in the emergency room.

We definitely all want to have the best bedside manners and take time to explain the treatments. But in the next room, there is a 3 month old baby who has unexplained fever.

Even though we don't spend a lot of time with patients, we do make a small difference in their lives! You will feel gratifying when the patients you saw at the emergency or you admitted to internal med, are healthy or are remitting! :)

For senior med students and residents: Is it possible to finish med school without becoming too salty or cynical?

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It is hard to not feel crappy or stressed after working more than 80 hours per week as a resident. There definitely need to be reduction of working hours, but the government is cutting fundings in health care.  -_-

A friend just sent me this.

http://gomerblog.com/2015/08/medical-students-residents/

There's quite some truth in it.

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sleep deprivation is not a good thing - I am one of those residents now at the two year mark of heavy call (1:4 rad call for the past year). It is hard to function well when you are permanently tired.

 

you can see good people just be functionally so tired they are really not themselves. No time to recharge

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Can they finish med school without being jaded? Yes.

 

Residency? Hell no haha

 

And in time you will realize many times patients are cut off because they go on and on about irrelevant things. Aka (and I've seen this) a urologist cutting a pt off for non stop talking about a headache. Go ahead, find a busy person in the corporate world who won't interrupt someone to redirect them when they are talking about irrelevant issues

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Can they finish med school without being jaded? Yes.

 

Residency? Hell no haha

 

And in time you will realize many times patients are cut off because they go on and on about irrelevant things. Aka (and I've seen this) a urologist cutting a pt off for non stop talking about a headache. Go ahead, find a busy person in the corporate world who won't interrupt someone to redirect them when they are talking about irrelevant issues

There's a way to redirect without being rude though. That doesn't take more time.

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Avoiding cynicism entirely is pretty much impossible. Cynicism is mostly a defense mechanism to help deal with the BS that gets thrown around in medicine, and there is a LOT of BS.

 

The key is to get cynical about the proper things. Some parts of medicine are bad but mostly out of your hands - most physicians can do little to improve those situations and being cynical doesn't make those situations worse. Without the ability to fix these aspects of the job, or even the time or energy to process them more maturely, being cynical is a fairly appropriate response!

 

The trouble comes when physicians get cynical about aspects of medicine they can change for the better or, through their cynicism, they make worse. Being cynical about making a difference for patients is a big one. Most students come into medicine with rather high expectations about the potential of medicine to help others. The reality is that, while as a whole medicine does an alright job of helping most people somewhat most of the time, the marginal impact of each one of us is often fairly low. But being cynical about being able to help others only makes that situation worse. Opportunities to do some meaningful good when they do come along get missed. And the day-to-day of simply respecting and appreciating patients gets lost.

 

To keep the cynicism pointed in the right direction, there are definitely some steps that can be taken. Make sure to take time for yourself (and your loved ones) even if it means spending a little less time on your career. Value the opportunities you have to help patients (or when you see others help patients), even if that help is as simple as being friendly with a scared person in a clinic. Lastly, best piece of advice I've gotten so far: if you want to be happy, go where the happy people are.

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There's a difference between cutting off someone because they're just being irrelevant vs. redirection - and this is part of the "art" of medicine.

 

There are definitely days where I feel more jaded than some of my junior days, but I care about my patients. I think it takes someone in my specialty to understand that sometimes you look like you don't care to outsiders, but the "best" thing for the patient is tough. Short term fixes can lead to long term problems.

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It is hard to not feel crappy or stressed after working more than 80 hours per week as a resident. There definitely need to be reduction of working hours, but the government is cutting fundings in health care.  -_-

The problem is then you are looking at an extended residency because you still need the same amount of training. Even if you trim some of the scut work of residency it's still gonna be much longer. So instead of 5 years at 80 hours per week, maybe it's 8 years at 50 hours a week. Believe me, you don't want more years of residency.

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The problem is then you are looking at an extended residency because you still need the same amount of training. Even if you trim some of the scut work of residency it's still gonna be much longer. So instead of 5 years at 80 hours per week, maybe it's 8 years at 50 hours a week. Believe me, you don't want more years of residency.

 

This is not true, especially considering a proficiency based model of training.

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