Tag: motivation

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Why Are You In Medicine?

I was recently interviewed on a podcast (Surviving Medicine) and was asked the simple question, ‘why are you in medicine?’. In retrospect, that’s the exact question I silently ask myself in frustration and exhaustion a little bit too often while I’m in the hospital. In those moments I recognize that I feel burnt out. In those moments if someone told me that I had to repeat intern year in order to finish residency I would probably quit medicine altogether.

So much of our job as medical students, residents, fellows, and attending physicians are out of our control. Even when we are able to treat our patients appropriately we are faced with the simple fact that many of our patients might simply not follow our recommendations. But you know what? That’s okay. We can’t control everything and acknowledging that is the first step. What we can control is how those external forces make us feel. You are in control of your own emotions and your personal sense of job satisfaction.

Residency trains physicians in how to treat patients and develop into well-rounded doctors. Sometimes however we lose focus on why we went into medicine in the first place. The truth of the matter is that the day to day struggles and frustrations weigh heavily on our professional and personal lives during training and those stressors likely won’t abate upon graduation to the next level of professional development. The stressors of medical school compared to residency are different but the same. The stressors of residency to fellowship or our first job as an attending physician are different but the same. Residents today more than ever need to train themselves in how to perceive job satisfaction in order to find personal enjoyment in their day to day life as a physician and in doing so help combat professional burnout. We must not lose sight of the forest for the trees.

Thinking back to the original question I was asked on the podcast, “why are you in medicine?”, I tried thinking of my favorite aspects of my job. Things like teaching my medical students and interns, presenting interesting cases at conference, learning how to manage and treat the basics of internal medicine, and the time I spend with my patients.

As any patient could tell you doctors don’t spend much time with their patients. Unfortunately it’s one more aspect that I feel is out of my control. I wish I could spend more time at bedside with my patients and it’s one of the most frustrating aspects of medicine today. However the simple fact of the matter is that our day is packed to the brim and we can only spend so much time at bedside. But those small moments of my day are my favorite. That inseparable bond between patient and physician. Being able to tell a patient and their family in their time of need that I hear them and I’m listening and that we will figure this out together. To explain a diagnosis and why they haven’t felt well over the past few weeks. Or to console a grieving family when my sympathy is all I can offer them.

Today I reminded myself why I went into medicine and it was invigorating. I even went back and read my personal statements from medical school and residency because I wanted to remember the version of me that applied with eyes wide open. I’m not that same person but the passion that drove me to apply to medical school in the first place is the same passion that pushes me each and every day in the hospital. It’s the same passion that motivates me to do my personal best for each and every one of my patients day in and day out. It’s the same passion that helped me remember why I love my job.

I leave you with the same question that helped center me, “why are you in medicine?“.

This blog post was originally featured on KevinMD, social media’s leading physician voice.

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Medical Training Doesn’t Get Easier. You Just Get Stronger

I don’t think I’m ready for my second year of residency. As second years we have to cover the PCU (progressive care unit),  a step down unit in between the general medicine floors and the medical ICU (intensive care unit). We have to cover all of the rapid responses, situations in which patients are unstable and look like they are in impending doom, as well as codes for the entire hospital, situations when the patient is literally dead already and we have to work to bring them back. On top of that, our general responsibilities on the medicine floor services go from doing most of the grunt work to leading the decision making and overseeing and teaching our intern and medical students. None of this was in the medical school brochures. But you know what, neither was everything I’ve learned intern year of residency. Or in my third or fourth year of medical school during clinical rotations.

As I’ve progressed through my medical training I’ve found that the written curriculum is just as vast as the hidden curriculum. The learning curve is steep and it’s terrifying. I still encounter situations on the day to day basis that I have never dealt with before. And you know what? I’m still standing and so are my patients.

So to the recent medical school graduates waiting to start residency on July 1st: trust your instincts. It’s going to be difficult and there is nothing you can do to prepare for it. Read up if you want but don’t go nuts preparing for the unknown of residency. Have faith that, at times, you will feel inadequate, anxious, terrified, and not quite ready. Take solace that you are not alone in experiencing those emotions. It is normal and you will be okay.

Because you’re never fully ready for the challenges that lie ahead. You just have to be ready enough.

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The Medical Student’s Guide to Clinical Rotations

With my third year of medical school coming to a close, here is what I wish I did differently, wish I knew beforehand, or figured out along the way during my core clinical rotations. Its nothing groundbreaking and you may have heard this before but it can’t hurt to hear it again.

Hold yourself accountable for the welfare of your patient
During your clinical rotations it is surprisingly easy to be lazy. But once you graduate medical school it will be your responsibility to care for the patients. Sure, as a resident you have a safety net to fall back on but at the end of the day the goal is to become self-sufficient. The more patients that you see in medical school the more prepared you will be for residency. So do a quick search on UpToDate for differentials on your patient’s chief complaint, think about which lab tests to order, and find the best treatment options. It’s also good practice for step 2 CS! So start holding yourself accountable for the welfare of your patients instead of waiting for that day to come.

Take onus of your medical education- be aggressive, take the initiative, and anticipate your next move
Don’t wait for someone to ask you if you would like to perform a physical exam task or a specific procedure. Be aggressive and take the initiative by asking your resident if you can do it. When you interview a patient and anticipate that they will need a urinalysis go get a clean catch cup for your patient- don’t wait for someone to tell you its okay for basic things like that. If the patient’s vitals aren’t hooked up to the monitor then attach the EKG leads, pulse ox, and blood pressure cuff and record the vitals. Do you need practice placing IV’s? Go speak with the nursing staff and find out if anyone needs blood drawn. They will be happy to oblige you with work. At the end of the day you are paying the hospital to be there so you might as well get your money’s worth. Be decisive and take your education into your own hands.

SCUT work- some clinically useful task
As a medical student nothing is above your pay grade. Especially since, again you are literally paying them to be there. So don’t feel neglected or insulted if your resident has you do what seems to be menial labor. Some SCUT work is fun- like drawing blood from a patient or performing a paracentesis. Other SCUT work is not- like transporting patients or copying, faxing, and delivering paperwork. But its all necessary. If you weren’t doing it then your resident would be.

Learn from your mistakes
I make a fool of myself on a daily basis. I’ve missed easy diagnoses, forgotten to ask rudimentary questions, and I’ve been sprayed by just about every bodily fluid imaginable. All of these mistakes can wear on your confidence but you are expected to make mistakes as a medical student- its how you learn. Simply never make that same mistake twice and move on. Better yet, learn from your colleagues’ and your residents’ mistakes. For instance, always wear a face shield and a mask when you drain an abscess. You’ll thank me later.

Again, at the end of the day you’re paying them to be there so you might as well get your money’s worth and make the best of your clinical experience. As always, I’d be happy to address any specific concerns you may have- just shoot me a message or leave a comment. Happy studying!