Med School Exceptionalism

[chicagoschool]

Having observed many conversations here and elsewhere, it is plain to see that many medical students consider embarking on an MD as exceedingly more 'difficult' than what other people do with their lives. This reaches such an extent that many are advised to hold off on life events and even routine lifestyle choices until after medical training. Simply put, I don't buy it.

 

Frankly, people of all backgrounds do challenging things all the time - often out of necessity. What's more is that there are segments of people wo do these challenging things WHILE in med school, such as raising families or being an Olympic athlete.

 

Obviously I have a lot of respect for my fellow medical students, but sometimes I sense a bit too much 'self-congratulation' in the sense of 'oh wow, we have it SOO hard'. It can get a bit nauseating.

 

(Disclaimer: I don't actually start med school until this fall). There's no particular point to this post, other than needing to get this off my chest.

[A-Stark]

I don't necessarily disagree that much, though I'd say that med students can be fairly cocky and entitled from pretty much the start. Once into clerkship, the former goes away as it is generally impossible to maintain once you spend most days feeling stupid and inadequate. (Note I'm not saying that others go out of their way to make you feel that way, but you quickly appreciate just how much you don't know.)

 

Otherwise I don't think med students have it hard at all during pre-clerkship. If we weren't pass/fail that might not be the case, but either way people complain about everything from exam timing to the occasional writing assignment in lieu of yet another MCQ exam. Clerkship is just like a job (or better yet, an unpaid internship), and the others can range from great (psych, sometimes family) to awful (neurosurgery, trauma/acute general surgery, emerg) to long but usually decent (most internal, sometimes ICU, plastics, ENT). Call is maybe more annoying as a student, especially floor calls which you can't really deal with without reviewing first, though you're not nearly as busy as residents.

 

Anyway it all depends on what you go into. As a student who wants a nice lifestyle in family med or psych or 2+1 emerg, it's not a big deal to suffer through a couple weeks of surgery or medicine wards. For any surgery or internal medicine keeners, you will be working pretty hard in residency.

[NLengr]

I don't necessarily disagree that much, though I'd say that med students can be fairly cocky and entitled from pretty much the start. Once into clerkship, the former goes away as it is generally impossible to maintain once you spend most days feeling stupid and inadequate. (Note I'm not saying that others go out of their way to make you feel that way, but you quickly appreciate just how much you don't know.)

 

Otherwise I don't think med students have it hard at all during pre-clerkship. If we weren't pass/fail that might not be the case, but either way people complain about everything from exam timing to the occasional writing assignment in lieu of yet another MCQ exam. Clerkship is just like a job (or better yet, an unpaid internship), and the others can range from great (psych, sometimes family) to awful (neurosurgery, trauma/acute general surgery, emerg) to long but usually decent (most internal, sometimes ICU, plastics, ENT). Call is maybe more annoying as a student, especially floor calls which you can't really deal with without reviewing first, though you're not nearly as busy as residents.

 

Anyway it all depends on what you go into. As a student who wants a nice lifestyle in family med or psych or 2+1 emerg, it's not a big deal to suffer through a couple weeks of surgery or medicine wards. For any surgery or internal medicine keeners, you will be working pretty hard in residency.

 

Places have the med student getting floor pages? That's seems stupid since they can't do anything about it and it adds an extra step in the chain when you are dealing with floor issues.

 

Pre-clerkship students don't annoy me for whining about difficulty, whati find annoying is the righteousness that some of them project about situations they have never been in, yet clearly, they know better than the people who actually experience them on a regular basis.

[Renin]

Places have the med student getting floor pages? That's seems stupid since they can't do anything about it and it adds an extra step in the chain when you are dealing with floor issues.

 

Pre-clerkship students don't annoy me for whining about difficulty, whati find annoying is the righteousness that some of them project about situations they have never been in, yet clearly, they know better than the people who actually experience them on a regular basis.

 

Med students always have a backup resident when getting floor pages. if it's an emergency, obviously it goes to a resident right away where some decisions can be made STAT. In all other situations, it's a good learning opportunity for the med students, so when they are residents, they know how to handle the same situation without needing a security net.

[A-Stark]

Yeah you do floor call while on core general medicine at Dal. I did it on elective in Ottawa too, and it was even more pointless (they also dont split emerg and floor coverage there which was exhausting). Sometimes it would have been nice to have a helper clerk on call, but everyone's better off with them seeing emerg consults. Thankfully my centre has them do that (you'd be familiar with it ).

[Satsuma]

Luckily for you, those who have gone before you have worked hard so that you may not have to sacrifice as much on your path in medicine.

 

Medical school itself, is not bad at all. Residency can be quite difficult on your life outside of medicine. Consider a 4 year residency in which you are on call 1:4 (that's 24-28 hrs or work in hospital, not going home in that time, and lucky to get a couple of hours sleep, depending on rotation/night - and sometimes you don't even got home on time). That essentially equates to a year of lost sleep.

 

Go ahead and imagine it is reasonable to pursue such a lifestyle while aspiring to be an olympic athlete or parent of the year. But for your average resident, driving home without crashing your car post-call, having the energy to make something other than cereal for dinner on most days and maintaining decent relationships with friends and family who generally don't understand the demands placed upon you, and seeing a bit of sun and breathing some fresh air now and then, is hard enough.

 

Having observed many conversations here and elsewhere, it is plain to see that many medical students consider embarking on an MD as exceedingly more 'difficult' than what other people do with their lives. This reaches such an extent that many are advised to hold off on life events and even routine lifestyle choices until after medical training. Simply put, I don't buy it.

 

Frankly, people of all backgrounds do challenging things all the time - often out of necessity. What's more is that there are segments of people wo do these challenging things WHILE in med school, such as raising families or being an Olympic athlete.

 

Obviously I have a lot of respect for my fellow medical students, but sometimes I sense a bit too much 'self-congratulation' in the sense of 'oh wow, we have it SOO hard'. It can get a bit nauseating.

 

(Disclaimer: I don't actually start med school until this fall). There's no particular point to this post, other than needing to get this off my chest.

[Intrepid86]

Places have the med student getting floor pages? That's seems stupid since they can't do anything about it and it adds an extra step in the chain when you are dealing with floor issues.

 

The purpose is educational. There's never going to be a situation where the hospital (purposefully) relies on a student to do something important.

[A-Stark]

Med students always have a backup resident when getting floor pages. if it's an emergency, obviously it goes to a resident right away where some decisions can be made STAT. In all other situations, it's a good learning opportunity for the med students, so when they are residents, they know how to handle the same situation without needing a security net.

 

True enough, though I do think it's hard to feel really confident about decisions (even minor ones) until it is, actually, your call. I'd say mostly that floor call for clerks ensures that they understand what it's like to be woken in the middle of night repeatedly. It's very satisfying to give a PRN Tylenol order over the phone, and I don't know that all the floor calls I got as a student were always much more useful as learning experiences.

[Intrepid86]

It's very satisfying to give a PRN Tylenol order over the phone

 

I'm sure the novelty wore off quickly.

[A-Stark]

It's not the novelty, but the convenience about being able to resume eating dinner without having to walk to whatever floor the call came from to write an order that should have been done on admission.

[Renin]

I'm sure the novelty wore off quickly.

 

Not much novelty in it. Very convenient though.

[Renin]

But for your average resident, driving home without crashing your car post-call, having the energy to make something other than cereal for dinner on most days and maintaining decent relationships with friends and family who generally don't understand the demands placed upon you, and seeing a bit of sun and breathing some fresh air now and then, is hard enough.

 

I just bought a pair of sunglasses this year because I never had a need for them before - you're never out of the hospital when the sun is in the sky! HAHA.

 

WHAT IS THAT BRIGHT BURNING GLOBE IN THE SKY!!!!?????!!!!

[NLengr]

It's not the novelty, but the convenience about being able to resume eating dinner without having to walk to whatever floor the call came from to write an order that should have been done on admission.

 

My pet peeve is people who don't write prn Tylenol orders on admit (provided there isn't a reason to not give Tylenol). I did a few blocks of medicine subspecialty during my first year of residency and the medicine residents always forgot to write it, resulting in me getting the old 2 am page.

 

In the spots where med students got first call from the floor, could they order anything? Or did they call the resident, explain what wad going on and get the resident to call the floor? If I had to deal with a med student calling, then having to make a second call to the floor and rehashing the info (since I'm not going to trust most med students at my center) at 2 am, I wouldn't be too happy.

[lost__in__space]

I think my first year at UofT was the hardest thing I've ever done. I've been a varsity athlete, studied MRI/quantum physics and have worked a few very demanding jobs (such as hospital research coordinator). Yet the mental effort / tons of time I had to put in studying this past year was really really hard for me.

 

Kudos to people who might think medical school is easy for them, but for me it really felt like a Herculean effort.

[ploughboy]

In the spots where med students got first call from the floor, could they order anything? Or did they call the resident, explain what wad going on and get the resident to call the floor? If I had to deal with a med student calling, then having to make a second call to the floor and rehashing the info (since I'm not going to trust most med students at my center) at 2 am, I wouldn't be too happy.

 

When I was clerking at Western, med students were first call to the floor and their orders were implemented without being cosigned. The only thing we couldn't do was give verbal orders. A very good learning experience, but kind of frightening at the time and very scary in retrospect.

 

They were talking about changing this policy a few years ago, maybe a more recent Western clerk can comment.

[NLengr]

When I was clerking at Western, med students were first call to the floor and their orders were implemented without being cosigned. The only thing we couldn't do was give verbal orders. A very good learning experience, but kind of frightening at the time and very scary in retrospect.

 

They were talking about changing this policy a few years ago, maybe a more recent Western clerk can comment.

 

Holy crap that's crazy dangerous. Most med students don't have near enough experience or knowledge to be doing that.

[future_doc]

I think my first year at UofT was the hardest thing I've ever done. I've been a varsity athlete, studied MRI/quantum physics and have worked a few very demanding jobs (such as hospital research coordinator). Yet the mental effort / tons of time I had to put in studying this past year was really really hard for me.

 

Kudos to people who might think medical school is easy for them, but for me it really felt like a Herculean effort.

 

And I found second year even more demanding.

[A-Stark]

In the spots where med students got first call from the floor, could they order anything? Or did they call the resident, explain what wad going on and get the resident to call the floor? If I had to deal with a med student calling, then having to make a second call to the floor and rehashing the info (since I'm not going to trust most med students at my center) at 2 am, I wouldn't be too happy.

 

We could order stuff like Tylenol/Gravol or a fluid bolus under certain circumstances. This might have changed somewhat more recently so that clerks have less authority. As far as I know the floor called clerks directly about "easy" things. I never got a call about so-and-so's sudden onset dyspnea, though I did once have to assess chest pain in a lady who had it every night, and got the full work up every single night. That was in Ottawa, though, where they have a specific list of limited medications and investigations that clerks can order. In Vancouver, we could write just about anything so long as it said "For Dr Staff" next to it. Generally speaking it was explained that you can order what you want so long as you can expect resident backup. I never pushed the envelope about it, though, and I'm certain the nurses would never do anything that seemed completely out of left field.

 

Holy crap that's crazy dangerous. Most med students don't have near enough experience or knowledge to be doing that.

 

Agreed.

[lost__in__space]

And I found second year even more demanding.

 

Were you at UofT? I was hoping it gets better

[NLengr]

We could order stuff like Tylenol/Gravol or a fluid bolus under certain circumstances. This might have changed somewhat more recently so that clerks have less authority. As far as I know the floor called clerks directly about "easy" things. I never got a call about so-and-so's sudden onset dyspnea, though I did once have to assess chest pain in a lady who had it every night, and got the full work up every single night. That was in Ottawa, though, where they have a specific list of limited medications and investigations that clerks can order. In Vancouver, we could write just about anything so long as it said "For Dr Staff" next to it. Generally speaking it was explained that you can order what you want so long as you can expect resident backup. I never pushed the envelope about it, though, and I'm certain the nurses would never do anything that seemed completely out of left field.

 

 

 

Agreed.

 

At MUN, clerks couldn't order anything. Rightly so.

 

I shudder at the thought of the med students ordering stuff on my current patients. Honestly though, I don't even know at my current center if the clerks can order stuff. I think our nurses phone the resident on call directly. Honestly, I don't even think the nurses know when we have clerks with us (it's not consistent).

[NLengr]

Were you at UofT? I was hoping it gets better

 

You'll learn as you go through med school and residency you keep thinking it'll get better. It never seems to. Good always just seems out of reach.

 

On the plus side, with time you adapt.

 

I'm currently hoping a staff job will make it better. But the pattern seems to suggest otherwise.

[Orcamute]

Having observed many conversations here and elsewhere, it is plain to see that many medical students consider embarking on an MD as exceedingly more 'difficult' than what other people do with their lives. This reaches such an extent that many are advised to hold off on life events and even routine lifestyle choices until after medical training. Simply put, I don't buy it.

 

Frankly, people of all backgrounds do challenging things all the time - often out of necessity. What's more is that there are segments of people wo do these challenging things WHILE in med school, such as raising families or being an Olympic athlete.

 

Obviously I have a lot of respect for my fellow medical students, but sometimes I sense a bit too much 'self-congratulation' in the sense of 'oh wow, we have it SOO hard'. It can get a bit nauseating.

 

(Disclaimer: I don't actually start med school until this fall). There's no particular point to this post, other than needing to get this off my chest.

 

Uh huh..

 

So what is the hidden agenda? You expecting a kid? You getting married?? Training for a bit event??? - Either way, you get what you put into it. As a Medical Professional..it is YOUR responsibility to understand the material. Yes you can go by with just passing all your tests ..but is that what you really want to be known for? NO. You were chosen for a reason, a lot of people would die to be in your shoes..you're not going to just "coast" through, you are going to do your best.

 

What is the hidden agenda?

[ralk]

Uh huh..

 

So what is the hidden agenda? You expecting a kid? You getting married?? Training for a bit event??? - Either way, you get what you put into it. As a Medical Professional..it is YOUR responsibility to understand the material. Yes you can go by with just passing all your tests ..but is that what you really want to be known for? NO. You were chosen for a reason, a lot of people would die to be in your shoes..you're not going to just "coast" through, you are going to do your best.

 

What is the hidden agenda?

 

I must say, your trolling is really improving as of late.

[ellorie]

As a 2015 starting clerkship in September, I am just sitting here quietly horrified

[r-bot]

My take on the OP comes from an analysis of privilege.

 

I'm really proud of some of the things I've done... like writing the mcat over an incredibly busy (work, classes, volunteering, a family death, new relationship) summer and ultimately getting into med. In my case, I was able to work because I wanted to minimize my undergrad debt, but I also lived at home, had no dependents, had a supportive family that valued and enabled my education, and am white and middle class.

 

The result of my hard work is that I have access to a professional degree, one that affords my already privileged self a career that really just perpetuates my privilege. For other people, the same amount of work could result in a high school degree, or a job (any job), the ability to survive, the ability to care for those around them (and so on), depending on their circumstances.

 

I dno, I'll continue to check myself. Pride is fine, but if it's centred around becoming a med student or a physician without examining your challenges and privileges, then it's problematic.