The past few weeks, I have had the opportunity to work with a number of inner city patients. I wanted to share a interaction that has been on my mind.
The man had been brought in drunk the night before after being found on the side of the road. It isn't clear whether he was attacked or whether he simply passed out. My team had been consulted because of suspected spinal chord injuries.
As I proceeded with my interview, the patient asked me if I was going to be a doctor. He then proceeded to tell me I would be well off, asking "What will you make when you're done, like 70 grand?" I smiled and said, "Something like that," embarrassed to tell him that he had underestimated my future income by about 50%.
As part of the curriculum, I recently read an article about the "hidden curriculum" of medical school. The article argued that many virtues that are sought after by medical admissions boards are extinguished by a hidden curriculum of exhausting hours, jaded attendings, and constant criticism. Of note, one of the problems it cited was a development of a sense of privilage among medical students. In other words, medical students are leaving school feeling that they deserve a good income, prestige and long vacations.
The comment caught me off gaurd because, after spending the last 6 years in school with 6 left to go, I feel like I deserve SOMETHING for all my hard work. After all, practicality has to fit into the equation.
Yet, after these past couple weeks, I wonder. I CHOSE a training program with exhausting hours, and I CHOOSE to stay in it each day. I can expect this choice to be rewarded by a comfortable income. In contrast, many of my patients work longer, more exausting hours than I. After 15 hours of monotonous work, they may return home to briefly rest and be with their family before starting all over again the next day. Their is often no hope of changing this pattern.
I am not saying that I think my time and efforts shouldn't be rewarded, but I guess I am seeing it a bit differently, perhaps more like I did two years ago when I started. In short, I think maybe we SHOULD be leaving medical school with a sense of privilage, but a different kind of privilage: the privilage to go to medical school, to be part of a culture where success and self-determination are the expectations, and to walk with patients in their most vulnerable and difficult moments.
And with that, I will get off of my soap box. Thanks for reading.
4 comments:
I sent you a reply to this blog through your e-mail (too long for a blog comment).
Great insight. The world would certainly be a better place if everyone stopped the facade of believing that they were more important, or that their lives counted for more than others. Everyone has something great to contribute to this world!
I agree with you up to a certain point. However, I expect to see a follow up to this post when you're a resident. All I can say is that residency is freaking hard, and it's Jeremy, not me, doing it. And honestly, as shallow as it seems, there are some days when the idea of making a little bit more money is what helps me make it through the day. Like I said, shallow, but Jeremy really hasn't been around this week, or the past 10 weeks for that matter.
But I also agree with you that you choose to go to med school and subsequent training. And it is a privilege. How many applications do med schools get each year, and they have to weed through those and accept around 100? It's nice that my husband has a steady career ahead of him (and that you have a good career ahead of you).
I don't know if I totally agree with your comment about other people working longer hours and harder jobs. I think being a doctor is a demanding chore. I've seen what working for 30+ hours straight does to Jeremy, and it's not pretty. Not to mention that there are times when the boys don't see Jeremy for two or three days.
There's my soap box. Sorry! I just love discussing stuff! Wish we could hang out and talk about it some more!
this is actually jeremy,
I don't think i have to remind you of the places you have to put your hand (or fingers) the bodily fluids that get splashed in your face. The malpractice you have to deal with. the pounds of paperwork you have to do every day. The calls you put in. The uptight coworkers you put up with. The amount of stress being medically and legally in control of another wo/mans life. The delayed emancipation you suffer after 8-12 years of medical school+residency+specialty+fellowship+postdoc. I am just about to take my 3rd step of boards, and frankly I'm tired of taking boards. I have to take yearly prite exams and pass three mock-oral boards. Then I have to pass psychiatry and neurology boards and an official oral boards. Then you have to get umpteen cme credits and re-certify every ten years. The cost of actually getting your liscence is insane. Then on top of it all you have to pay back all of your student loans which have been frantically acruing while you have been participating in all of the above. They also take out somewhere around 30% of your gross income off the top as taxes.
Now, I too am not so cognitively emersed in the financial incentives-- but to put that much time in, one must be enumerated. I can't think of too many people who would do a job like that for peanuts. People that work as long and hard as doctors are pulling in overtime, and aren't sitting to bad. i wouldn't be too caught up in a drunk and homeless mans projective identification. They feel like loosers, and they want you to feel guilty for your success. Besides, I hope you make much more than $140,000.
jeremy
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