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Is Medicine Right For Me?

 



The Case For a Medical Career

by Livia Picariello and Jason Choi

Pursuing a career in medicine has many benefits such as, salary, autonomy, and helping others. Doctors have the opportunity to build a close relationship with patients in their care, this is not a common benefit for most career fields. The decision could have been set before they started college or after a previous career choice was not right. There is always a group of premedical students that are not completely sure about their choice. This article will help provide a better understanding of what medical students can expect. Through this article one will understand the job expectations for both a medical student and a physician.

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Benefits
Becoming a physician has many advantages.
One gains respect in the sense of being rewarded for improving and saving lives of others and from the community and people that they are involved with helping. Their help is seen through all of their contributions and efforts for others' lives [1].
Another benefit to being a doctor is the potential income that can be made. Salaries do vary with experience, specialties, and the setting that the doctor is involved with [2].
For example, general practitioners could earn an average salary of around $190,000 and a specialist could earn on average around $340,000.
Employment of physicians and surgeons is projected to grow up to 14 percent in 2016. Job availability is expected to increase for all physicians.
The highest increase of physician specialties to be available will be are hospitalist, pediatrics, obstetric-gynecology, hematology-oncology, and family practice. The Bureau of Labor statistics has projected that there will be a shortage of up to 200,000 physicians by 2020. Due to the high demand, going into practice can be a good choice.
There is also the most job diversity available for physicians. A physician has the widest variety of specialties and subspecialties to choose from compared to any other career [3].
For example, a physician can practice internal medicine with a subspecialty in oncology or family practitioner with a subspecialty in gynecology, oncology, or adolescent medicine. There is a wide variety for the doctor to chose from with flexibility.

Medical School
Medical school is difficult and requires a lot of work. A medical student is expected to complete the correct course work and be prepared to handle working with patients. Medical students are trained to take care of a persons health needs. The training begins in the classroom [4]. A first year medical student can expect to take gross anatomy, biochemistry, microscopic anatomy, human embryology, behavioral medicine, molecular biology, human genetics, medical neuroscience, medical ethics and humanities, physiology, and physical diagnosis [1]. A second year medical student is expected to take more classes, such as microbiology and immunology, pathology and laboratory medicine, clinical correlation, pharmacology, advanced physical diagnosis and introduction to clinical medicine and physical diagnosis, but not as many as the first year. These basic courses during the first two years of medical school provide the foundation for the third year clinical rotations and build a more well-rounded student [4]. The basic sciences courses will help one to understand how to better care for a patient during rotations and how to develop the skills needed when entering residency [4].

Residency
Residency is an important step in the process of becoming a physician. Residency offers new physicians different specialties to perfect and practice, preparing them for the rest of their medical career. Most residency programs will offer benefits for the practicing physician after schooling. For example, The Mayo Clinic offers, a variety of different insurance plan coverages, short term disability coverage (which can be up to three months), three weeks of vacation time, and free meals while working [5]. Paying through residency can be difficult if not receiving benefits that are needed to survive and be self dependent. According to Housestaff Stipends Nationwide (2012) [6], The amounts earned in residency will depend on the post years after medical school. For example, first post year medical school students earn on average about $48,000 and fifth post year medical school earn on average about $57,000 [1].

After Residency
It is important for a rising physician to finish their residency program with the specialty they feel is right for them. The right specialty and/or subspecialty can fit ones own personal needs and better fulfill their career choice in the medical profession. Many doctors that are unsatisfied with their career choice could be unhappy because they have chosen the wrong specialty. For example, if a physician is working in a specialty that they are unhappy with, the patients may not receive the full the benefits. Also the amount of cognitive and procedural work spent and the hours put in can help determine the right specialty. Having the right specialty can have a big effect on how much control one will really have on their lifestyle as a physician. Having a controllable versus an uncontrollable lifestyle is one of the biggest influencing factors in choosing a specialty. Personal time available, control on weekly work hours, and the amount of on-call hours are all determining factors. For example, Ophthalmologist have more flexible lifestyles of about 54 hour working weeks, where general surgeons have longer working weeks [1].

Support
Help can be provided for medical students throughout the entire process. Many medical schools have programs that provide help on choosing a specialty based on strengths and interests. Different programs such as "Strong Vocational Interest Inventor: Gough Medical Subspecialty Scales," can be used to help make a decisions on what is the best fit. Help can also be found through others who maybe encountered during medical school, residency, and internships [1].
There are limits imposed on physicians in residency that can help a new physician from getting fully burned out before their career starts. The Accreditation Council for Graduate Medical Education set up restrictions that a resident to only be allowed to work no more then 80 hours, three consecutive on call nights, or 24 consecutive hours in a single shift [7]. The government even allows students to defer payments during residency for up to three years without interest [8].

Summary
Going to medical school is a decision that needs to be well thought out in advance, but the outcomes out weigh everything in the end. There is a lot of work that goes into working through medical school and residency. One will be provided with a lot more options available after finishing school and residency programs. Medical school classes will prepare one to be able to handle and fully understand how the human body works and opportunities to practice before residency programs start. Residency programs use the skill sets perviously learned in medical school and during clinical rotations to allow one to practice as a doctor. Residency programs are paid to help pay off debts from medical school and understand full responsibilities of being a practicing doctor. After residency, one will be fully prepared to practice on their own in a specialty and field of their choice. Attending a medical school will provide a healthy lifestyle, including all the benefits.


The Case Against A Medical Career

by Livia Picariello and Losmeiya Huang

Students often times will enter medical professions without fully understanding what they are getting themselves into. There is not much research done by most premedical students before considering what is expected of them in medical school. This article will discuss different options concerning to going to medical school and the effects that it will have. The article will review a different perspective on disadvantages, statistics, surveys and various other issues regarding to medical school. The idea of this article is to provide more information on both sides of going to medical school. Understanding on some of the challenges of going to medical school and if it is the right choice for one’s self. 

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Challenges

Being a physician can be very time consuming. Medical school takes up a lot of time and has very high tuition costs. Even after being a physician, one will have long work hours and will not have as much time spend with family and friends. It can become very stressful for a person working through the process of working towards medical school, being in medical school, entering residency and moving towards a full time working physician. As a doctor, one has the ability to help save lives, yet this does not come without high stress levels. There are risks of making a mistake or a problem arising with a patient, such as death or more advanced illness. Most reported cases of stress were caused by an uncontrollable outcome. For example, 73 percent of new doctors in cardiac arrest teams found cardiopulmonary resuscitation (CPR) to be stressful [1]. Some physicians even find it to be difficult to talk about different CPR options, such as ‘do not resuscitate’ forms. Lawsuits for malpractice are another challenge that a physician will have to handle and can cause serious damage to their reputation. Also, the majority of malpractice cases end in favor to the plaintiff [2]. 

Costs 

Paying for medical school can become very expensive for a student. The average cost for medical school per year can range depending on where one goes. The cost of public schooling is about $29,000 and private is about $47,000 a year, for just the tuition. After the entire medical process, including medical school, living expenses throughout school and residency, residency and with interest accumulated, repayment costs from loans could add up to as much as $600,000 [3]. Loans, scholarships and grants available help get students through school, but accumulate interest and increase the repayment costs later on. Almost 86 percent of students carry educational debt after medical school and in the past 20 years tuition has increased 165 percent for public schools and 312 percent for private schools [3]. Paying for schooling is not the only cost that students are faced with, and they also have to worry about extra education expenses, such as books and other supplies needed [4]. Students need to pay for living and personal expenses while in school, such as housing, food and travel costs [4]. Working to help lower schooling and personal costs takes time away from studying. Most students need to work and end up with more stress to stay on track and keep up with medical demands.   

Premedical Students

Being a premedical student can be undesirable, stereotyped, frustrating, and cause anxiety provoked experiences [5]. The premed work load puts too much pressure on the student. The work load does not allow for much time to do anything besides studying, which can cause difficulties for a student to relax [5]. Studies that were conducted on premedical students in the San Francisco area showed how many students do not fully understand what they may be getting themselves into. For example, about 98 percent said they felt they would be able to heal patients and are not worried about business issues. About 95 percent feel their work will be more intellectually satisfying and fun. 83 percent were not worried about the duties they would have to do. The premedical curriculum can be a lot to endure.

According to the American Medical College Application Service (MSAR), students need to take general chemistry, organic chemistry, biology, biochemistry, physics, math courses, and english [6]. These are all required to take on top of what is required for the undergraduate degree. Relationships and extracurricular activities may suffer a bit due to the over load of studying. With the work load one needs to maintain a high GPA for the science courses [7]. Some medical school will screen GPA’s if they do not meet the averages [7]. Organic chemistry is one of the main courses that throws students off their premedical track. Statistics show that almost 78 percent of students dropped due to that course and by senior year almost two-thirds of all dropped out of the premedical path due to the over competitive environment [7]. On top of worrying about one’s undergraduate degree, one also needs to prep for the MCAT exam, fill out applications and prepare for possible interviews [4]. The application process takes about 18 months, which includes preliminaries and secondaries, letters of recommendations, resumes, and fees [4]. After all the time put in, there are about 43,000 applications submitted overall, about 31,000, where only about 19,000 are accepted [4]. 

Burn Out

Many medical students still wonder if they made the right choice [5]. They feel unsatisfied and that there could have been something else more suitable for them [5]. A study shows that many medical students become dissatisfied by their third year of medical school and will stay that way even after they have graduated. For example, about 30 percent of doctors will have sleep problems and 40 percent feel they are always analyzing how well they preform [8]. By the fourth year, many are more stressed out then the average population and experience an increase of alcohol consumption [9]. Suicide rates have been found to be extremely higher in females in the field then males in the general medical student population [10]. 

Once one gets into medical school, one will still need to take examinations. After the second and fourth year of medical school and completion of residency, one will need to take the United States Medical Licensing Examination before one is able to obtain their full Medical Degree [9]. During medical school, one will be on call, have clerkships during third year and be involved in medical projects outside of school and clinical work [9]. Once the student starts to work with patients, they will be faced with ethical issues, which may not always have a clear answer on how to handle them. Some ethical issues could include, giving inferior medication for economic reasons, patient’s family interests could conflict with the doctors’, or HIV patients could provide conflicts between public and private heath [11]. 

Doctor Dilemmas

Many doctors report being unhappy due to being overworked, not being paid well and being expected to meet unrealistic demands on occasion. Many doctors would not take the medical path again if they had the option and would not recommend it to their children to pursue [12]. They feel the problems they face is not worth the hassle or loss of autonomy [12]. The happiest doctors are said to be younger then 35 and older than 75, they have to much pressure and patients sometimes expect their physicians to perform miracles [2]. The health care system causes physicians to have high costs for malpractice insurance and HMO’s cause problems for how the doctor is able to care for the patient effectively [2]. 

Location, specialties, patient demographics, and technology are all aspects that affect physicians’ satisfaction with their career choice [13]. Most patients may not have readily available internet access to stay in contact with their doctor, and the location of practice affects the physicians satisfaction with their career choice, because the area may not be ideal to them or fit their own personal needs [13]. Many doctors are not able to keep up the diversity that is increasing and may not be fluent in another prominent language other then English. There are found to be more burnout reports by female physicians then males. Women have to deal more with the healthcare bureaucracy and on average earn about $22,000 less. Physicians also face problems within their personal lives because they are not always able to keep up the demands of what they are expected to do for their family and relationships. Females have higher divorce rates then males would have in certain specialty areas of practice. For example, surgeons and psychiatrists have higher divorce rates then some other specialties [14].

Summary

Medical school is very time consuming and one needs to be consistent in their studying to stay on track. The work needed to get to medical school is very challenging and time consuming. Preparing for medical school is very stressful and once one gets in the stress levels increase. One has to fulfill the requirements expected and pass exams with high scores before applying to medical schools. The costs of attending medical school can be very expensive and using various payment options can cause increased debt afterwards. Once in medical school students are expected to complete courses and do clinical rotations in the hospitals to reinforce learning. Medical students and doctors have high burn out rates, where they get worn out really fast from all the expectations and problems they face. Many doctors feel pressure and that they need to do better as a physician for their patients. Doctors are faced with ethical issues and problems that are not always easy to solve. Patients expect for doctors to be able to do anything and do not like it when a doctor is unable to explain or fulfill a request of theirs. Becoming a doctor is very difficult and may not always be the right choice for everyone.


References

The Case For A Medical Career:

[1] Association of American Medical Colleges 

 [2] Salaries of Specialties

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[3] Specialties and Subspecialties

 [4] Education

 [5] Mayo Clinic

 [6] AAMC Housestaff Stipends

 [7] Resident Hours

[8] AMA

 

The Case Against a Medical Career:

[1] Stress

 [2] Zuger, Abigail. "Dissatisfaction with Medical Practice." The New England Journal of Medicine 350 (2004): 69-75.

 [3] Tuition Costs

 [4] Association of American Medical Colleges

 [5] Premedical Sress

 [6] Requirements

 [7] Barr, Donald A., Maria E. Gonzalez, and Stanley F. Wanat. "The Leaky Pipeline: Factors Associated With Early Decline in Interest in Premedical Studies Among Underrepresented Minority Undergraduate Students." Academic Medicine 83 (2008): 503-11. 

 [8] Buddeberg-Fischer, Barbara, Richard Klaghofer, Martina Stamm, Johannes Siegrist, and Claus Buddeberg. "Work stress and reduced health in young physicians: prospective  evidence from Swiss residents." International Archives of Occupancy and Enviornmental Health (2008).

 [9] Medical Testing

 

 [10] Schernhammer, ES, and GA Colditz. "Suicide Rates Among Physicians: A Quantitative and Gender Assessment (Meta-Analysis)." American Journal of Psychiatry (2004): 2295.

 [11] Ethical Issues

 [12] Ethical Issues

 [13] Doctor Dilemmas

 [14]McMurray, Julia E., Mark Linzer, Thomas R. Konrad, Jeffrey Douglas, Richard Shugerman, and Kathleen Nelson. "The Work Lives of Women Physicians: Results from the Physician Work Life Study." Journal of General Internal Medicine 15 (2000): 372-80. 

 

 

Contact PCPR

General Contact:
Vy Tran

Mailing Address:

Premedical Career Pathway Research 
PO Box 19456
Stanford, CA 94309 

Phone/Fax: 626-487-6797

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