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Guest fierysweet

Why is it that American premed and med discussion boards are so negative? Has anyone else noticed this? They really make medicine sound incredibly unappealing. The discussions are so adversarial and seem to harp endlessly about the downside of medicine. It's completely different on the Canadian premed forums but I'm wondering about why certain American ones are so negative.


I'm thinking in particular about SDN, but even more about Mommd. Has anyone visited this site? At first I thought it was pretty cool, but now I actually avoid both Mommd and SDN. It seems that all people ever do on there is b*tch and complain. It really makes me wonder why anyone in their right mind would go into medicine at all.


I see posts along the lines of:


"I used to make a million bucks a year as an entrepreneur and now I'm barely making ends meet and working 120 hours a week as an FP and almost getting sued all the time .... AAAAH the glories of medicine".


And then the people on Mommd talking about how they are going back to residency 2 months after having a baby and constantly planning their pregnancies to fit right between 2 and 3 year, or is it better to do it between, 3 and 4th ... Then they spend their residencies pumping their breast milk every hour in the bathroom stall. It just sounds like self-inflicted torture (like why don't you just take a year off or something). It sounds like hell. And for what in the end?


Never mind all the complaining about ungrateful patients, horrible anal, obsessive-compulsive, cutthroat colleagues, huge debt-load, never seeing their families etc., etc. What's the appeal then??


It just seems that the premeds are all gung-ho and idealistic and then things slowly but surely go downhill until you're just completely miserable. Reality seems to hit most around second year. From these discussion boards you would think that all physicians are incredibly jaded, unhappy people with absolutely no lives.


Anyone have any insight as to why this is the case with some of these discussion boards? Is it a function of a different health care system, or is it just that here on this board, we're mostly premeds and still all excited and idealistic? I find these forums really positive, supportive and encouraging. But if I were in the States, man, I don't know if I would've even considered a medical career.


Since I just got into medicine, I've been wondering about these things and having premed doubts ... am I doing the right thing or will I end up miserable like so many members of these boards?

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I have not done any rotations in Canada, but have done all my training in the US. I will do two rotations at UBC the next two months, so maybe the following opinion will change.


A lot of it is hype. A lot of it is true. Insurance puts a damper on things. When you're an ob/gyn attending, working your butt off, and you still have to worry about paying over 120k in malpractice insurance AND constantly worry about getting sued, it's not fun.


I don't know how medical school training is like in Canada. But in the US, things are very hierarchal. It's kind of like a hazing of sorts. Welcome to the club. Rounds are extremely formal. Presentations have to be crystal clear and pristine. I don't know how things are like in Canada, but on Medicine, you always start a daily presentation like the following:


This is a x year old male patient with a history of CHF who presented initially with dyspnea on exertion. Patient is doing well today. Blah blah blah.


Vitals today are stable.


Physical exam is signficant for: improved lung sounds from crackles.


Labs show: xyz


Echo done yesterday showed an ejection fraction of ...


Assessment and plan: In summary, this is a x year old male with a history of CHF who presents with dyspnea on exertion. Likely a CHF exacerbation. Patient is improving after having been diuresed with furosemide...


Plan today is ____.


Be prepared to be interrupted. YOu will be scrutinized every step of your presentation. You must have some thick skin if you're to survive third year. If you go to the clinical rotations part of SDN, you will see people @#%$ and complain about how mean that attending or that resident was. You're right, I don't see that much of it here on this board. Again, I have no idea how med school is like in Canada, maybe it's the same, I don't know.


Also you mention that reality sets in in second year. Don't forget second year right around February, things start getting extremely stressful. Studying for Step I sucks. Then, after you take the test, you maybe have one or two weeks off before beginning third year. For example, my second year ended mid-May. I studied for Step I for four weeks, took a week and a half off, and then third year began at the end of June. From then till now, the only break I had was two weeks at xmas, labor day, and Memorial Day. And then I'm back to beginning fourth year next week. In Canada, with the exception of Mac and Calgary, I think you get a few months off between second and third year. I can tell that would make a HUGE difference.


So this is what I can say. Things are not as bad as people make it seem. Medicine is fun, and after going through third year (and being done today!), I can honestly say I learned a lot and have grown a lot. I feel prepared right now to be an intern, even though I have another year of schooling.


Good luck with your studies. Medicine is not all doom and gloom. There is light at the end of the tunnel.

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Guest wattyjl

this is an interesting discussion - thanks for the input moo.


since i'm also just starting out this fall, i have nothing to input regarding personal experience.


i was thinking though, perhaps some of the negativity is due simply to the fact that people are more apt to discuss displeasure over contentedness. like with voluntary evaluations - people are more likely to talk about how bad something was (e.g. a class) over how good it was. some of this might be due to belief that their input will result in making the class better, but i (cynically perhaps) think it's much more to do with people just wanting to complain and feeling better for it. misery loves company and all.


this doesn't answer why sdn, etc. has become a b1tch-forum, compared to canada.. maybe it's as simple as having good moderators. or a smaller population of posters (less company for the misers). maybe it is to do with differences between medicine in canada and the states, though i can hardly believe the difference is so large...


moo - maybe you can get back to us on your impressions of the differences, after your rotations.

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My friends here tend to @#%$ and complain a lot too.


You bring up a good point of how SDN is a much larger forum than it is here. Hence, inevitably, you will see people paint this horrible picture of medicine.


Also, at least in my school (which is fairly left-wing), I think it's been beat into our heads that the US health care system stinks, that malpractice is ruining our lives (we had a three part lecture series on malpractice this year), and that the current health care system is unsustainable and that we need to move to a system like Canada's. Rarely are the good points of the US system talked about. The debates in our Physician, Patient, and Society course are extremely one-sided and I think this feeds into the bitterness of people.


However, I still feel that, my school at least, has done a good job of tuning us into the realities of medicine. Like you said, people tend to focus on the bad, not the good. A lot of great things happened this year, but one single bad incident can overshadow everything.


This is interesting that you bring this up. I suspect the difference in the two boards have to do with the fact that SDN is a much larger forum, attracting more "trolls" and bitter people. Whereas here, this is a much smaller forum, and the medical community is much smaller, and hence, the anonymity isn't really there.


**I'll also add that during my last rotation (Primary Care), we had a lecture (as well as a few quesitons on our exam), where the lecturer was telling us how horrible drug reps were and how bad we as doctors are for accepting gifts and being influenced by them. Not to mention we had a lecture during first year entitled "No free lunch" where we could if we wanted to sign a pact saying we would not take any lunches or gifts from reps. Never was it mentioned about the potential good that drug companies can do (some drugs on the market today, developed by drug companies have actually made a difference in many patients' lives believe it or not). I'm not about to get into an argument about drug companies and their ethics, but to present only one side of the argument only fosters the feeling that medicine is all about money and that no one is in it for altruistic reasons.


Enough rambling. I got a flight to catch...

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Guest UTMed07
Why is it that American premed and med discussion boards are so negative?
I think the difference is that Canadians view health care differently than Americans. In the US... health care is just another service that you buy. Here it is put up on a pedestal and worshiped-- perhaps even excessively so.


As a group, Canadian docs are more progressive socially. The CMA supports the Canada Health Act... which most US doc would probably characterize as "communist" or "socialized medicine" (said with a sneer). The AMA compared to the CMA is very conservative and has fought single payer state-sponsored medical care vigorously through-out the years.


More generally, I think the US is about money-- the gap between rich and poor is larger. The poor are blamed for their poverty... here the mind set is a bit different. Here it is a bit harder to fall through the cracks... and declaring bankruptcy 'cause of medical bills is almost unheard of. Here legal residents are insured... in the US approximately 40-50 million people have no health insurance.

Never mind all the complaining about ungrateful patients, horrible anal, obsessive-compulsive, cutthroat colleagues, huge debt-load, never seeing their families etc., etc. What's the appeal then??
If you're not the altruistic type... the appeal is financial (despite what is said-- doctors make a good living) and social status.


As for work hours...

I think it is a bit better here. The residents have unions (e.g. PAIRO) and limited hours-- and the rules, based on what I've heard, are usually followed. In the US, where labour laws are more lax... there is more exploitation. Residents are the cheapest doctor one can get... and hospitals want to make money so they squeeze 'em hard.


On Obsessive-compulsive...

I think that is part of being a doctor. You want to get the details right... and getting into med school is harder if you're not the obsessive-compulsive type.


On whining...

Generally, I think Canadian culture (if such a thing exists) demands a greater level of political correctness and sensitivity to the less fortunate and poor.


As for the management... if SDN hasn't changed much recently (I haven't been there for a while), this board has more moderators (per poster) and they work to keep the trolls in check a bit more.

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I can attest to the fact that work hours are routinely broken, for both students and residents.


Hopkins Medicine was put on probation last year because their residents were routinely breaking work rules. Baylor Medicine residents were doing q2 call. At my own institution, things seem a bit better, but although residents are **supposed** to get out at 1pm post-call, they typically stay till 4-5. As a student, on General Surgery, I routinely stayed till 5-6 post call. As my senior surgery resident told me: "Work hours restrictions are for residents, not students." It's this type of attitude that fosters the bitterness you read about on SDN.

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Guest opiedog

Are there any other forums that are worthwhile checking out? I tried Delphi, but either there havent been any new postings for long time, or I have the wrong link.

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Guest fierysweet

Whenever I've spoken to Canadian physicians, I've come out with a really positive impression. Of course, I'm always told that med shcool is a lot of work. But, you know what? So are a lot of things. This was actually one of my interview questions: I was asked how I felt about giving up a 9-5 job for "a lot of work" in medicine. I said that to be successful in any field, you have to work a lot. And that I'm the kind of person who works an above average amount no matter what I'm doing. So I may as well apply that to something I want and something that I enjoy. And I think it's true. If you're that mildly (or not so mildly) obsessive-compulsive type, you're gonna be busting your butt at your job no matter what it is.


I've always received encouragement and positive reviews from Canadian physicians. When I was a teenager, I asked my family doctor about her career, and she said that it was "wonderful". She had four kids. Her husband was a lawyer and she said she much prefers her own job. My current family doctor says she loves her job because she can do whatever she wants:b


When he heard I had been accepted to med school, a physician at my work place said, "you have the world at your hands now". Another Dr., a psychiatrist, said, "well you can't go wrong with medicine".


Wow. They really made me feel that I was making the right choice. So, of course, when I hear all the whining and negativity, I kind of wonder what I'm missing ... or what I'm getting myself into.


But I guess you guys are right, some of it is hype. Some of it is true, but maybe seems a bit exaggerated because it's all concentrated into one discussion.


I also think it's natural, in any profession, to have its members lament how terrible things are sometimes. My mom is an engineer and university prof. She hates professors. She says they're the worst people on earth: arrogant, know-it-alls, narcissistic. Sound familiar? She also thinks engineers are so dull because they have one track minds and can't talk about anything but engineering. Again, sound familiar? Don't get me wrong, my mom LOVES engineering and my brother is being carefully groomed to become an engineer. But there's still a fair dose of complaining. And I have heard similar complaints from other professionals.


I don't really have a conclusion, but I'll stop now because I've written a lot.

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Guest mosquitoba

Interesting topic, thanks for bringing this up fierysweet.


My dad is a physician, and although I think he used to really enjoy his job he now comes home at the end of the day with not much positive to say. It’s either complaints about co-workers, office staff, or demanding patients. He always seems tired, and it seems to me that he lives for the weekends. As I was applying to medical school he seemed to try to be the “voice of reason” or something, constantly reminding me that this was a “sacrifice” and “hard work”… I would most definitely consider myself obsessive-compulsive (I’ve been told so too many times to deny it anyway!;) ) and I don’t mind working hard, but like fierysweet said, I want to work hard at something I enjoy doing!!


After putting all this time, energy and money into applying to medical school and finally being accepted, I’m excited but also a little unsure about whether I’m making the right choice. It seems stupid, as I spent most of March-April convincing my interview committees that I was SURE that medicine was for me. At the time I WAS sure of it, but now a few doubts have crept in. To be honest, the things I usually enjoy doing are the things I excel at. I am not sure whether I will be good at it, or if I’ll find something within medicine I truly enjoy doing.


While I’m still sure of my interest in human biology and my interest in people, I hope that I will enjoy the challenges a career in medicine places before me enough to outweigh all the negative things I’ve heard from family and otherwise. I guess my thing is, while I agree that every profession has its downsides and upsides, I’m not sure if the upsides of medicine will complement my personality. Strangely enough I did think about this a lot while deciding to apply… maybe I’m just getting paranoid! Part of this likely stems from being fed up with research (this is my 5th summer working in a lab job) and sick of thinking purely scientifically in school and at work. For example, I’m really interested in history – I hope medicine can satisfy my other interests, or at least allow me to pursue them!! :)


I think the fact that people here speak so openly is encouraging, and its nice to be able to acknowledge concerns, even when we have spent so much time and energy to get to this point!




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Guest UWOMED2005

That actually seemed pretty balanced and honest to me!


Some people love medicine as a career choice, others not. Sounds like what I get when I poll the doctors I work with.


Where's the problem?

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Guest wattyjl

you're right - there shouldn't be a problem. it only makes sense. 99-100% of people going into medicine are doing so without any intimate knowledge of what practicing it 'means', for them, personally. why shouldn't they be unhappy when they find out it wasn't what they hoped, or when particulars of the career bother them more than they thought it would, etc.


i guess part of the problem is you have to work pretty hard to get in, and once you're in, with a large debt load and lots of specific schooling, it's hard to get out. i'm sure it traps a lot of people.


that's why i find it unfortunate (and stupid, to use my term of preference) that many individuals seem to push themselves toward a medical career with such a narrow view - with blinders on so-to-speak.. i'd bet a large percentage of the 'accepted' are the "i've always wanted to be a doctor" type - who have had their sight so set on medicine from such an earlier age (highschool, below??) that what it is becomes blurred: only the end goal, of becoming "a doctor", is considered. ramifications fall by the wayside. then it is truly random, whether they will be happy with their choice or not.


but of course in the end nobody can say if they're going to like it until they do it, and most won't like it all the time (hopefully more than 50% of the time, but you never know). this worries me too, but it's part of all aspects of life. i try not to think about it too much.

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