NLengr Posted October 1, 2013 Report Share Posted October 1, 2013 If you just want to suture skin, why not just be an emerg doc? It's just not interesting without the viscera, hollow or solid! Coolness of the surgery is directly proportional to the amount of high powered lasers being fired around. Link to comment Share on other sites More sharing options...
HycrestJIT Posted October 1, 2013 Report Share Posted October 1, 2013 Ha - it is interesting someone is actually arguing for another well known but rarely talked about reason for medicine - people are responding a lot to it with standard examples of money, or dismissing the reason as invalid. Yet this is a reason many do in part go into medicine , and probably is no less valid than many others. For some respect is the most important aspect if at least a minimum level of say finances etc is met. You will meet these people, and they can be quite driven. I've certainly come across them, and there's nothing wrong with it. Based on how the thread has evolved, I can't but but start to consider some well-played trolling. Link to comment Share on other sites More sharing options...
medigeek Posted October 1, 2013 Report Share Posted October 1, 2013 OP, once you see that (besides plastics?) you wouldn't even have a job in these prestigious fields, it isn't much of a concern anymore. Link to comment Share on other sites More sharing options...
youngdad Posted October 4, 2013 Report Share Posted October 4, 2013 A guy goes back to a high school reunion working at a fast food joint. His old school friends are now lawyers, doctors, and bankers. If he feels like he should have gone for a more prestigious job, is that insecurity or just logical thinking. Just wanna be a boss yo No its insecurity. Guy goes back to a high school reunion. His old school friends are now all kinds of professionals, managers, workers, parents. The genuine, down to earth ones are the best to be around and the most memorable whether they are the Prime Minister or a janitor. Lots of other jerks, douches, airheads, and losers are around in all kinds of jobs. Some "prestige" position holders are turds and everyone can see it. They get little respect. Some more "humble" position holders are the best humans around. They get my respect. Its not what you do, it's the way that you do it. Link to comment Share on other sites More sharing options...
Larrivee Posted October 4, 2013 Report Share Posted October 4, 2013 Coolness of the surgery is directly proportional to the amount of high powered lasers being fired around. You must be in urology! Link to comment Share on other sites More sharing options...
Dongzhuo Posted October 4, 2013 Author Report Share Posted October 4, 2013 No its insecurity. Guy goes back to a high school reunion. His old school friends are now all kinds of professionals, managers, workers, parents. The genuine, down to earth ones are the best to be around and the most memorable whether they are the Prime Minister or a janitor. Lots of other jerks, douches, airheads, and losers are around in all kinds of jobs. Some "prestige" position holders are turds and everyone can see it. They get little respect. Some more "humble" position holders are the best humans around. They get my respect. Its not what you do, it's the way that you do it. Sorry but whether it's fair or not pc or whatever but people in low rungs in society are just not respected in the common sense of the word. One does not respect a janitor the same they respect a supreme Court justice. One does not respect an elementary teacher the same they do a neurosurgeon. The latter in both cases instills, in most people, a certain sense of awe. Link to comment Share on other sites More sharing options...
Exocytosis Posted October 4, 2013 Report Share Posted October 4, 2013 One does not respect an elementary teacher the same they do a neurosurgeon. I'd totally have more respect for the teacher. I mean, it's cool that you fix brains and all. But could you spend 6 hours a day in a room with 20-30 children, all the while trying to teach them stuff they couldn't possibly care less about, and not throw any of them (or yourself) out a window? I couldn't. Link to comment Share on other sites More sharing options...
TheBoss Posted October 4, 2013 Report Share Posted October 4, 2013 Optimistically we'd say that people will respect others for good virtues rather than desirable job, but realistically a lot of people really do pay more attention to your job, similarly to how people's perceptions of others are influenced by physical attractiveness. I'm not saying anyone here individually cares about other people's jobs, but that doesn't change how the general public behaves. Link to comment Share on other sites More sharing options...
hamham Posted October 4, 2013 Report Share Posted October 4, 2013 I'd totally have more respect for the teacher. I mean, it's cool that you fix brains and all. But could you spend 6 hours a day in a room with 20-30 children, all the while trying to teach them stuff they couldn't possibly care less about, and not throw any of them (or yourself) out a window? I couldn't. LOL! You can't deal with kids, but can you fix brains? If not, I don't see why you have more respect for the teacher... I have to agree with TheBoss here. In the eyes of the myopic public, a neurosurgeon is usually more well-respected than a teacher. Link to comment Share on other sites More sharing options...
medigeek Posted October 4, 2013 Report Share Posted October 4, 2013 I'd totally have more respect for the teacher. I mean, it's cool that you fix brains and all. But could you spend 6 hours a day in a room with 20-30 children, all the while trying to teach them stuff they couldn't possibly care less about, and not throw any of them (or yourself) out a window? I couldn't. You mean 6 hours minus an hour of lunch and 30 minutes of recess daily? your statement is pretty ridiculous, how about a 6 hour operation where one tiny mistake will either kill the patient or leave them permenantly disabled? I'd take coming to school at 8:30 and going home at 3pm over the former in terms of difficulty . Link to comment Share on other sites More sharing options...
Anne Posted October 4, 2013 Report Share Posted October 4, 2013 Hey, I can understand that you feel that way. I am in M3 and doing a longitudinal clerkship in Sioux Lookout, ON and servicing far north reserves as part of that. There is an incredibly and unusually large scope here because they service a catchment of >30,000 without any specialists at all except one general surgeon and one onsite radiologist (off site radiology too). In my first month of clerkship I have been first assist on surgeries that I have never even read about (FM does surgical assist and they pass it off to students), I have gotten to deliver babies and scrub in for emergent sections (they deliver so many babies here it is unbelievable), manage complex inpatients that in any other place in Canada would definitely be managed by IM, and done many an interesting ER shift. All anesthesia is also FM based. There is also a lot of psychiatry here (minus a psychiatrist) and a medical withdrawl unit covered by FM. First, if you are feeling as though it is not challenging, perhaps you would like a broader scope like this? Second, I am finding myself falling more in love with family medicine, but often I (as well as friends in my class) have experienced similar things to what you have said. In fact, I won this award for research at a conference last year and an IM resident from U of C came up to congratulate me and asked me what I was thinking of specializing in. When I said not completely sure but thinking about family, he said, "I think you can probably do better than the salvation army of medicine." That really hurt my feelings, so I can understand how you feel when it feels like others might not respect you. I have had some great specialist mentors and great generalist mentors. The two things I always ask preceptors are would you choose it again, and give me a piece of advice you wish you learned early in your career. Some of the answers have made me feel more at peace with some of the downsides of family that you wrote. One person told me that studies have actually looked at who goes into rural generalist practice, and the single biggest predictor is ones capacity to deal with uncertainty- above intelligence, above talent, above grades. This was also highlighted in a plenary speech at the SRPC meeting about why there are a shortage of rural physicians. Case and point two ER shifts I have been on in the past month the CBC machine was broken so getting one had a turn around time of 6 hours. Even more extreme, Dr.'s cover northern communities by phone and I actually heard a physician attempting to administer some sort of EGDT to a septic patient through instructions given over the phone to a nurse without having ANY investigations available. We have been doing a lot of simulation training and in the middle of a sim code or other crisis situation my fav preceptor will often throw in the line "we don't got that," to emphasize how important it is in rural medicine to do what you can with what you have. My main hobby is woodworking. I am only mentioning this because I saw that you said you like "doing stuff with your hands." I think rural family medicine has an element of procedures and make shift procedures (we always seem to be literally making devices from other devices) so maybe that would appeal to you the way it does to me. There are not RT's or all the devices etc. that are in larger centres so you really need to know how to work all the equipment and make stuff. An internist I worked with told me if he could do it again, he would do family. His piece of advice was that, "No one ever tells you medicine gets easy, it takes a while, but eventually you master all the knowledge you need if you are committed to learning it and then all you're left with is the patients. Choose a type of medicine based on the type of patient encounters you like or don't like. I like to make people feel comfortable and happy. You know what makes patients feel good, when the family doctor who they've known for 30 years comes to see them in the hospital. In spite of whatever I do for them that's what makes them happy and I will never have that relationship with patients. No one will have the relationship with patients family doctors can have." Another doctor I worked with said she wished that when she finished residency someone told her that your practice changes with you. She had always looked at this doctor she worked with at the end of his career in awe as she perceived that he did so much more for his patients than she did and made many less referrals. His advice to her was, "Be patient it takes time, I've known these families for 40 years." In that same practice I learned a ton about preventative medicine. I was amazed at how much medicine is Canada is based on people being sick as opposed to intervening before that. Using EMRs to pull out patients based on various risk factors can be a powerful tool in decreasing morbidity and mortality. They used a set of risk factors to identify pts. with increased chance of AAA and did bedside ultrasound screening and found 3 AAA before pts ever presented with emergent symptoms. They also ran group counseling as a physician team and even got referrals from the high-school of students that were not doing well in school. Since the program started the high-school has seen a dramatic decrease in drop-out rates and increase in graduation. Since income and social status are the biggest predictors of morbidity and mortality in Canada I think that is a great achievement even if it is difficult to quantify. In fact, if you actually look at what determines health most of it isn't even medicine at all. I think it is kinda cool that family has the chameleon ability to advocate and adopt some of these determinants into daily practice. A radiologist who has been a wonderful mentor to me told me that though they like radiology (was in neurosurg. switched to rads because didn't end up liking it as much as they originally thought) they admire the autonomy the generalists have to not be attached to a hospital and the freedom to direct how things run and ultimately have many careers in one. From doing coroner work, to rural or city practice, hospitalist, being involved with the hospital or having a private clinic. These are all true stories and situations of people who have inspired me to see family medicine as something great, but don't get me wrong I still feel bad that people would think of me as the salvation army of medicine. One of my friends who has more confidence than I could ever dream of actually has a license plate on a sports car he bought after paying off his lone that says, "JUST A GP." I am sorry that you wish you chose differently though. Best of luck. It has been a long time since I last posted on this forum. I am currently a family medicine resident, and while residency life is relaxing and pleasant in general, and jobs are plentiful in the field, I believe there is a reason why many shy away from the field. If I could choose all over again, I would stay far away from the field. Here is why: Your peers don`t respect you Everyone who gets accepted to medical school, by and large, are type A personality types (myself included). We all want to be the best of the best, neurosurgeons, cardiologists, plastic surgeons, you name it- family doctors just do not measure up to that. Often times you strike up a conversation with other residents, and when they find out you`re in family medicine, they say ``We definitely need you guys...we need good family doctors for sure`` with an arrogant air. When you`re a family doctor, be prepared for specialists to feel superior to you when talking (despite how unjustified it may be). Your patients don`t respect you In my experience, patients only rarely come to you for pressing medical concerns. They usually come to you to get something very routine done. For example, getting their medications refilled, annual physical, PAP smears, warts frozen off, getting a work note etc. That`s a significant amount of your practice. They know and you know it doesn`t take a mental giant to do that. And when big problems come up- it`s time for referral to the ``smart ones`. It often times feels as though you`re their homeroom teacher, while the specialists are the ones teaching calculus, physics, and english literature. The public doesn`t respect you I realize that the public by which I mean your friends, acquaintances etc are often in awe when a person gets into medicine. That`s because of their potential to be a trauma surgeon or something prestigious. Once they find out you`re in family medicine, the wow factor and prestige is gone instantly. I have, some time back, gone on dates with a girl who was a starbucks barista, who asked me ``why family``- with the clear question of - why that and not something greater. The unfulfilled potential will forever haunt you. Family medicine doesn`t respect itself Recently friends have posted an article, written by a family doctor- you may have seen it, entitled ``Are you going to specialize, or just a gp``. I find self defending articles about respect and being a ``specialist in the person`` and ``specialist in general practice`` quite embarrassing actually. Insecurity seems to abound amongst family practitioners You don`t respect yourself I don`t truly mean this, but had to go along with the previous headings (lol). I is difficult to be a generalist. The field is just too broad, and it is impossible to know everything. In trying to know everything about everything, you end up knowing nothing. Specialists will always know much more than you in every given subject. Also, since specialists all have their own little area, you, the GP will be left with the scraps. Namely random presenting complaints that no one will ever know like random tingling sensations on a patch of skin or flushing ear wax. Link to comment Share on other sites More sharing options...
NLengr Posted October 4, 2013 Report Share Posted October 4, 2013 You must be in urology! Or I got a thing for lasers. Link to comment Share on other sites More sharing options...
aaronjw Posted October 4, 2013 Report Share Posted October 4, 2013 LOL! You can't deal with kids, but can you fix brains? If not, I don't see why you have more respect for the teacher... I have to agree with TheBoss here. In the eyes of the myopic public, a neurosurgeon is usually more well-respected than a teacher. Until... http://www.youtube.com/watch?v=rNnzi4NcKKY Link to comment Share on other sites More sharing options...
aaronjw Posted October 4, 2013 Report Share Posted October 4, 2013 The bigger problem is not the perceived importance from the general public but your own ego driven perception of self importance. My father in law was a fairly renowned engineer who at the top of his career was a Canadian representative to the UN at a number of conferences. You'd never know it though. He was just a northern boy who spent more time talking about his family, friends, and sports than he did his career. His career was his job, his family was his life. Now if you have an empty life and deeply rooted self esteem issues then I can see some of you'd be wrapped up in the outward perception of your career or potential career and the income earned. Link to comment Share on other sites More sharing options...
Exocytosis Posted October 4, 2013 Report Share Posted October 4, 2013 your statement is pretty ridiculous, how about a 6 hour operation where one tiny mistake will either kill the patient or leave them permenantly disabled? I'd take coming to school at 8:30 and going home at 3pm over the former in terms of difficulty . Dude, have you ever worked with kids? Sure the hours are better, but I'd take removing brain tumor over teaching a bunch of 5th graders math any day. Link to comment Share on other sites More sharing options...
rmorelan Posted October 4, 2013 Report Share Posted October 4, 2013 Sure, some people are driven by the pursuit of prestige and esteem. Others by their families, or by the quest for knowledge, and others aren't driven at all. The OP stated that he dislikes the choice he made because family is a less prestigious field, among other reasons. That is perfectly fine; he has his own reasons and we have no right to tell him that they are wrong. It is his next course of action that determines his outcome. He could choose to stay a family doctor and stew in his regret, which I am sure he will do given what he's said, or he can try to get into another residency. If I were him, I'd try damned hard to do the latter - harder than I tried. and he can switch - I mean you run into people all the time with GPs and then proceeded to follow it up with something else. Actually sounds like a pretty awesome combination really. Link to comment Share on other sites More sharing options...
rmorelan Posted October 4, 2013 Report Share Posted October 4, 2013 It gets harder nowadays given any retraining beyond what you see in the second round is always tied to some sort of indentured servitude. Plus he'll have to work for a year before he can apply to re-enter(I'm considering it). So, not as easy as you make it sound, but not as hard as I make it sound either. Interesting - wasn't sure on the all the details. So you work for a year and you can reapply? To what round of carms would that be? Or does even talking about things in those terms even make sense etc Link to comment Share on other sites More sharing options...
rmorelan Posted October 4, 2013 Report Share Posted October 4, 2013 At least in Ontario they force you to work for a year before you can apply for reentry. Any attempt to negotiate an earlier start with the robot that operates the phone lines will be met with consternation (reminiscent of dealing with Bell tech support). Then the details get vague - you fill out a few forms and send them in the mail. It appears to be a process separate from the match. ok so how do you figure out where you can apply to then - or does that question even really make sense? Ha - I mean the second residency has to be funded somehow. Seem odd they wouldn't somehow merge CARMS into it somehow. Link to comment Share on other sites More sharing options...
rmorelan Posted October 4, 2013 Report Share Posted October 4, 2013 I think you just put down your intended specialty, they see if there's a need anywhere, then they farm it around to programs and if they get a bite then its on. how delightfully haphazard. You are going through this right now? Sounds painful and of course I hope it works out for you! Link to comment Share on other sites More sharing options...
rmorelan Posted October 4, 2013 Report Share Posted October 4, 2013 I'm not yet a year out so its off-limits as of yet. did they give you any reason, other than the government really doesn't want you to do this, for forcing the one year cool off period on you? I mean really what is the point. Link to comment Share on other sites More sharing options...
Jochi1543 Posted October 4, 2013 Report Share Posted October 4, 2013 The only "critical thinking" some patients do is read what Jenny Mcarthy has to say about vaccinations or what someone on Youtube posted from their parents' basement. They're mostly unable to help themselves without a basic education of and understanding of critical thinking. We had a presentation about health literacy, and it's frightening how difficult it is for some people to understand what we might consider pretty simple information. It's not just complex medical terms, either. Literacy alone is already a big challenge, apparently. I'm always battling how to explain things to a patient without it coming off as if I'm talking down to them, because I know I personally get quite irked as a patient when a physician who doesn't know my occupation is talking to me about "poop" or "belly pains." But you can't assume anything, even if your patient is educated - the other day I was talking to a teacher about the cognitive decline that her parent was experiencing and got a hunch that I wasn't really getting my point across. Turns out, she had never heard the word "cognitive" and had no idea what I was saying. Link to comment Share on other sites More sharing options...
medigeek Posted October 4, 2013 Report Share Posted October 4, 2013 Dude, have you ever worked with kids? Sure the hours are better, but I'd take removing brain tumor over teaching a bunch of 5th graders math any day. Come back after you perform a cranial operation at 3am on someone who's dying and been shot in the head... then compare that to teaching math to kids. And yes i have worked with kids. Link to comment Share on other sites More sharing options...
medigeek Posted October 4, 2013 Report Share Posted October 4, 2013 We had a presentation about health literacy, and it's frightening how difficult it is for some people to understand what we might consider pretty simple information. It's not just complex medical terms, either. Literacy alone is already a big challenge, apparently. I'm always battling how to explain things to a patient without it coming off as if I'm talking down to them, because I know I personally get quite irked as a patient when a physician who doesn't know my occupation is talking to me about "poop" or "belly pains." But you can't assume anything, even if your patient is educated - the other day I was talking to a teacher about the cognitive decline that her parent was experiencing and got a hunch that I wasn't really getting my point across. Turns out, she had never heard the word "cognitive" and had no idea what I was saying. Health literacy is one thing but self-diagnosing in any sense is stupid. Even if you're a physician yourself. Very basic things are one thing, but coming up with a "rare" and complex diagnosis is often due to paranoia and impaired judgement (same goes for diagnosing family members, etc.) Link to comment Share on other sites More sharing options...
rmorelan Posted October 4, 2013 Report Share Posted October 4, 2013 Come back after you perform a cranial operation at 3am on someone who's dying and been shot in the head... then compare that to teaching math to kids. And yes i have worked with kids. actually was a high school teacher for a year - computer science - and it can certainly be stressful I guess, but not potentially panic inducing. Link to comment Share on other sites More sharing options...
medigeek Posted October 4, 2013 Report Share Posted October 4, 2013 actually was a high school teacher for a year - computer science - and it can certainly be stressful I guess, but not potentially panic inducing. I feel like being a teacher really depends on you... I remember a couple elementary school teachers who just didn't really care about teaching the students and seemed like they were having a very relaxed and easy time. Even in high school I had a couple teachers like that. Also had a few who do their job of teaching/marking and never seem stressed. In contrast, some teachers were always stressed out over the smallest things, always snapping over every little thing, those people would be stressed in any field Link to comment Share on other sites More sharing options...
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