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> you can't become a doc for love of the profession, because it's a profession you can't test drive oh, I don't know about that. It's like a 6 week community c

> you can't become a doc for love of the profession, because it's a profession you can't test drive oh, I don't know about that. It's like a 6 week community college course to become an EMT. There's a test drive for you. There are 2 year programs that will get you a nursing license. You can get a taste of the medical career path without going the full MD route. Maybe not as accessible as coding, but it is accessible. As my kids are just now graduating HS, this is something I try to drill into them. College can be like an assembly line that spits you out saddled with the equivalent of a 30 year mortgage, trained for a job space that you literally have no idea if you'll even want to do ... or it can be like a Baskin Robins of careers, and you can try every last one of them until you find what you really like. passion and knowledge of self are everything. the rest is a commodity.

arkades 8y ago
> It's like a 6 week community college course to become an EMT. There's a test drive for you. There are 2 year programs that will get you a nursing license. EMT and nurse aren’t “mini doctors,” any more than doing video game QA is “mini programming.” It gets you near the profession, it doesn’t put you into the shoes. I don’t know how to articulate this. The job that requires about eight years of post-grad training, including four of them as heavily supervised on-the-job training with slowly increasing responsibilities for 80-100 hrs/week, is wildly different than the job that you can start doing in six weeks. Working in the same setting as a physician is no more “test driving” what it’s like to be a doc than being a secretary at a hedge fund is test driving what it’s like to be a hedge fund manager.
- sizzle 8y ago
  What about shadowing a doctor in high school? You literally follow them around all day and get a taste of what they do.
  - arkades 8y ago
    The thing is, the salient bits of being a doctor have to do with the thought process going on in their head, the stresses of responsibility and decision-making, and all the considerations they weigh with each patient. It's just not an "observable" thing. Docs don't really start sharing their internal processes with you until you're in the second half of med school, and even then not commonly. From the outside, it just looks like... guy in a white coat, often at a computer, making pronouncements. And then doing paperwork, which largely consists of documentation to prove to the government and insurers you did everything they decided should have been done for that patient and if not, why not. The combination of accountability and lack of autonomy is a leading cause of physician burnout and, again, is all internal. The other part it leaves out is the hours. "What do I do with this patient?" is a very different thought process at hours one, eleven, and eighteen respectively, of what should have been a twelve hour shift. One hospital I know of has its trauma/SICU surgeons do 5 days on and 5 days off where they pull 12 hour shifts daily, and they're on call every night. But trauma/SICU doesn't really sleep, so these folks are making critical care decisions at hour one-hundred-and-twenty, of which maybe eight hours involved sleep. All of these things occur in the internal landscape. Shadowing is ... not effective. Most med students have done clinical research, shadowed doctors, volunteered in hospitals, etc. Back in the day, I did hospital volunteerism, clinical research, hospital QI, and I worked in health insurance. I'd seen medicine from pretty much every vantage point before I second-careered into being a physician. And every senior med student and resident and physician will tell you, "holy shit, I had absolutely no idea what it would be like." Even the occasional nurse that decides to go to med school, who most commonly think they're halfway to being docs already, will say "omg, I had no idea how much I didn't know, and how much you guys have to do." We had two in my med school class back in the day. When we were in didactics, they were shocked by how much docs had to know. When we got to clerkships (the second half of med school, where you work in hospitals) they were floored by how much was involved in being a physician that simply wasn't visible to nurses. And that's... you know, nurses. Folks who work in our vicinity on a daily basis.
    - sizzle 8y ago
      Thank you for the eye opening insight, my significant other was accepted to med school in the states and she/we are double minded on her pursuing the field of medicine due to the dismal work life balance you mentioned, considering she has a science masters and works a 9-5 in medical research. She didn't have the undergraduate grades and did masters + high MCAT score to finally get in at 30 years old. Given the current state of medicine in the states, you touched upon the topic of insurance companies. The endless paperwork seems to be a side effect of physicians being beholden to insurance companies to supply a steady stream of patients that afford an income that will offset the steep debt and decades of opportunity cost spent in school. This seems unique to America from what I can tell and is only getting worse, along with what I'm told regarding physicians (MD/DO) competing with nurse practioners and physician assistant, government oversight, etc over area of practice. Finally, the topic of burnout and physician abuse (lack of sleep, working overtime and being on call), is truly disgusting. This was a tough read, previously posted on HN: https://ericlevi.com/2017/05/13/the-dark-side-of-doctoring/ https://ericlevi.com/2017/05/13/the-dark-side-of-doctoring/ I sincerely hope you and all overworked physicians take care of mental health and avoid burnout. I think private practice and limited hours for certain lower specialties might be the answer for my significant other if we plan on starting a family anytime soon.
  - matheusmoreira 8y ago
    > You literally follow them around all day and get a taste of what they do. And then you go home while they stay behind on call...

arkades 8y ago

> It's like a 6 week community college course to become an EMT. There's a test drive for you. There are 2 year programs that will get you a nursing license. EMT and nurse aren’t “mini doctors,” any more than doing video game QA is “mini programming.” It gets you near the profession, it doesn’t put you into the shoes. I don’t know how to articulate this. The job that requires about eight years of post-grad training, including four of them as heavily supervised on-the-job training with slowly increasing responsibilities for 80-100 hrs/week, is wildly different than the job that you can start doing in six weeks. Working in the same setting as a physician is no more “test driving” what it’s like to be a doc than being a secretary at a hedge fund is test driving what it’s like to be a hedge fund manager.

sizzle 8y ago
What about shadowing a doctor in high school? You literally follow them around all day and get a taste of what they do.
- arkades 8y ago
  The thing is, the salient bits of being a doctor have to do with the thought process going on in their head, the stresses of responsibility and decision-making, and all the considerations they weigh with each patient. It's just not an "observable" thing. Docs don't really start sharing their internal processes with you until you're in the second half of med school, and even then not commonly. From the outside, it just looks like... guy in a white coat, often at a computer, making pronouncements. And then doing paperwork, which largely consists of documentation to prove to the government and insurers you did everything they decided should have been done for that patient and if not, why not. The combination of accountability and lack of autonomy is a leading cause of physician burnout and, again, is all internal. The other part it leaves out is the hours. "What do I do with this patient?" is a very different thought process at hours one, eleven, and eighteen respectively, of what should have been a twelve hour shift. One hospital I know of has its trauma/SICU surgeons do 5 days on and 5 days off where they pull 12 hour shifts daily, and they're on call every night. But trauma/SICU doesn't really sleep, so these folks are making critical care decisions at hour one-hundred-and-twenty, of which maybe eight hours involved sleep. All of these things occur in the internal landscape. Shadowing is ... not effective. Most med students have done clinical research, shadowed doctors, volunteered in hospitals, etc. Back in the day, I did hospital volunteerism, clinical research, hospital QI, and I worked in health insurance. I'd seen medicine from pretty much every vantage point before I second-careered into being a physician. And every senior med student and resident and physician will tell you, "holy shit, I had absolutely no idea what it would be like." Even the occasional nurse that decides to go to med school, who most commonly think they're halfway to being docs already, will say "omg, I had no idea how much I didn't know, and how much you guys have to do." We had two in my med school class back in the day. When we were in didactics, they were shocked by how much docs had to know. When we got to clerkships (the second half of med school, where you work in hospitals) they were floored by how much was involved in being a physician that simply wasn't visible to nurses. And that's... you know, nurses. Folks who work in our vicinity on a daily basis.
  - sizzle 8y ago
    Thank you for the eye opening insight, my significant other was accepted to med school in the states and she/we are double minded on her pursuing the field of medicine due to the dismal work life balance you mentioned, considering she has a science masters and works a 9-5 in medical research. She didn't have the undergraduate grades and did masters + high MCAT score to finally get in at 30 years old. Given the current state of medicine in the states, you touched upon the topic of insurance companies. The endless paperwork seems to be a side effect of physicians being beholden to insurance companies to supply a steady stream of patients that afford an income that will offset the steep debt and decades of opportunity cost spent in school. This seems unique to America from what I can tell and is only getting worse, along with what I'm told regarding physicians (MD/DO) competing with nurse practioners and physician assistant, government oversight, etc over area of practice. Finally, the topic of burnout and physician abuse (lack of sleep, working overtime and being on call), is truly disgusting. This was a tough read, previously posted on HN: https://ericlevi.com/2017/05/13/the-dark-side-of-doctoring/ https://ericlevi.com/2017/05/13/the-dark-side-of-doctoring/ I sincerely hope you and all overworked physicians take care of mental health and avoid burnout. I think private practice and limited hours for certain lower specialties might be the answer for my significant other if we plan on starting a family anytime soon.
- matheusmoreira 8y ago
  > You literally follow them around all day and get a taste of what they do. And then you go home while they stay behind on call...