Choosing Medicine for the right reasons.

We recently received an article in which a 15-year-old medical school aspirant expressed the reasons that led to her choosing medicine as a career.It is always heart warming to see enthusiasm and passion for this profession, and I am sure that our young author has a very bright future in medicine.After reading this delightful piece of creativity, I was forced to rethink what had led to my decision to pursue medicine, and how have my perceptions changed over the past eight years since then.

To be honest my decision to choose medicine was a combination of personal circumstances and an aptitude for the subject. But I will focus on how my expectations have changed over the years. I will name a few of my assumptions and then reiterate how these have changed over the years. All in the hope that the coming generation can make an informed decision about their career.

Medicine is tough!

Then– all my sources then pressed on the fact that studying medicine is tough. My life would have significant stresses and I would have to deal with them on a regular basis.

Now– I believe there was some truth behind this. But I have lately realized that medicine itself is the most fun subject to read and understand, but practicing medicine entails a lot of sacrifices on the personal front. It is the lifestyle that is tough rather than the subject itself.

Your life is “set” as soon as you make it into medical school!

Then– I felt that I was standing on the bank of the river, and I would cross it as soon as I entered medical school.

Now– I have realized that getting into medical school was not crossing the river, it was taking the plunge. I have faced countless currents that have tried to drown me since then, and have felt a sense of achievement after conquering each one of them.

It is a noble profession!

Then– I sincerely believed that every patient I see would be filled with gratitude and keep me on a pedestal. I would have a place in society second to none.

Now– Medicine has become highly professionalized, and the majority of patients see it as a job. There is significantly lesser appreciation of the personal sacrifices, because the present culture disregards it as your “job” and presumes that you are getting paid to do it.

People want instant results!

Then– I was well aware that there will be things that I would be able to change, and there would be things that would be beyond my control. I was at peace with this and aimed to improve the quality of my patient’s lives even if I couldn’t cure them.

Now– you will see patients with chronic debilitating illnesses, and you will feel helpless while struggling to make their life better. Moreover, a small minority of patients may blame you for their misery and seek second or even third opinions. It is understandable but leaves you with a sense of dissatisfaction.

You are constantly learning. (I should rather say always Testing !)

Then– this is one of the best aspects of medicine and makes it challenging and exciting all through your career.

Now– while learning is imperative, there are systems to check that you are keeping up with the standards of the profession. It means that you are constantly preparing for some form of a test, and your years of hard work depend on the outcome of this test. This is regardless of your stage of training.

The professional ladder!

Then– I knew that it would be years before I would be able to take independent decisions about my patient’s care. I understood the responsibility and agreed that this is an essential part of the learning process.

Now– junior doctors have to face the wrath of the so-called “VIP” patients. They insist that solely the attending physicians should handle their care. It is reasonable to seek care from an experienced physician when required. There are several procedures and basic health care issues that can be handled by the junior doctors, depriving them of this hampers their confidence and their education.

I would save lives!

Then– this notion is secondary to dramatization of the profession in various TV programs. These programs are loosely based on facts and create an image far from reality. There is a crash call every 10 minutes; the physician stays in the hospital for days at a stretch and his every action leads to a dramatic scene involving a patient whose life he changes.

Now– about 30% of your job would be talking to patients in the clinic, solving their issues and diagnosing their conditions. Another 30 percent of your time would be spent taking care of your inpatients in the hospital. 10 percent of your time would be spent doing procedures like central lines, pleural drains, crash calls for physicians and various surgeries for surgical specialties. Notice that we are left with a huge chunk of 30 percent- this is the time spent doing paperwork. You would be surprised how important documentation is in day-to-day practice. It is this paperwork that keeps you safe from litigation and keeps a track of all healthcare interventions for your patient.

The Hospital would be my second home!

Then– long shifts at the hospital would make it very difficult for me to have a social life, and would hamper my personal relations.

Now– you don’t mind doing the long shifts because you have fallen in love with your profession by the time you are ready to practice it. There are strict rules in place for working hours, and you are not allowed to work beyond a certain point. This time limit is vital for patient safety, and you are replaced by a colleague when your shift ends- you handover your jobs and responsibilities in detail. The handover is a vital part of the day, and the basic idea should be to make sure your colleague understands your patients as well as you do.

Show me the money!

Then– I would have a comfortable life, I wouldn’t be rolling in money but I would have enough to sustain myself comfortably.

Now– I wrote this particular segment for people who have chosen this profession after they have searched for the highest paying jobs on the Internet. Remember that there is a humungous amount of effort required to reach the stage where you start making a decent amount of money. With the same amount of effort, in any other profession you would comfortably make thrice as much money. If you have made this choice for the money, prepare to be disappointed.

Medicine is a long process!

Then– Rome wasn’t built in a day!

Now – Rome definitely wasn’t built in a day!

The idea behind this article is not to discourage anyone from choosing medicine but to help you make an informed decision. People who become doctors for the right reasons find it much easier to cope and end up becoming way more successful than the rest.

Acknowledgements-  Ms Akriti Keswani for her lovely article and Mr Apurv Sinha, MBBS MRCS FRCS(Trauma and Orth) for valuable input on the topic.