“Look at every path closely and deliberately, then ask ourselves this crucial question: Does this path have a heart? If it does, then the path is good. If it doesn't, it is of no use.” ~Carlos Castaneda

Wednesday, April 11, 2007

The beatings will continue until the morale improves ...

“If your actions inspire others to dream more, learn more, do more and become more, you are a leader.”
~John Quincy Adams

As I have written previously, and it is confirmed in one of the forums on the Student Doctor Forums, medical students these days are soft. I say this half in jest, but it does have some truth; otherwise, it would not make so many upset. From “my perspective” medical students and sometimes residents are not here to learn. They feel that we, the attendings, are making things to give them busy work. We are just giving you more paperwork to fill out, another dictation to do, or another patient to see. There is no medical relevance to anything you are asked to do, no education to be had. Everything must have some teaching value otherwise it is a waste of their time. They would rather study for the shelf exam which definitely correlates more with patient care that actual patient care.

This past week we have a medical student on service who is here to learn. She is a fourth year and this is her last rotation. She could cruse the rest of the way. That’s what most others do. “I am on month away from being a doctor, I have matched, why should I work so hard?” Hey, I am not knocking that mentality, it’s “senioritis.” We have all had it. What make her rotation interesting is she actually wants to learn. HOLY SHIT BATMAN, a medical student who want to learn about what we are doing. Yeah, we get the orthowanabes but they don’t count. Usually, those not going into ortho are really here to just have another elective. We are a surgical elective and we don’t require much of them. But, she actually wants to learn. Hmm, go figure. Isn’t this why we went to medical school or may be it was to be rich?

Why would this surprise me? Well, it is the interest. It makes me want to spend the extra time teaching. The extra time explaining why we do this or that. It makes me think. It reminds me why I am in academics. Sometimes all the other factors that many medical students and residents don’t see and these things can get you down. To have all the pressures of the powers that be and the top have uninterested residents and medical students as well will just frustrate you. (uurgh)

From the attending side, you are being pulled at multiple levels. From the upper level, administration of the hospital wants you to operate more and bring in more “business.” Residents want you to let them run free to operate and make decisions, as well as, get home at a reasonable hour; they don’t want to spend too many hours in the hospital, “we do want a life.” There are patient obligations. Patients call the office wanting to be seen right away for their acute intoeing consult. Other physicians want you to be available for consults so alleviate their fears of an acute case of “I can’t diagnose the cause of your pain” syndrome. Your partners want you to see more patients and operate more so that there will be more revenue for the practice as a whole. And if you are in a big university, the head of the university and/or medical school may have an interest in what you do. This makes your ultimate goal of patient care a little difficult at times. How can you dedicate your life to the education of the future medical providers without being disenchanted?

It is when a young physician reminds you how interesting medicine is and what good we can do for patients. You are reminded about the differences you make in patients life everyday. This may be an idealistic view but reminds me of why I am here. I want people to aspire to be better, to understand disease processes, and find cures. I want to change the world. Ok, that was a bit much, but I do want to make a difference. So, the way I chose to do it is by one patient, one medical student, and one resident at a time. I will continue to try to spread the little knowledge I have with the hope that someday they will do the same.

"Courage doesn't always roar. Sometimes courage is the quiet voice at the end of the day saying, 'I will try again tomorrow'."
~Mary Anne Radmacher

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