Most of my medical training up to this point has been just a ton of studying. Getting 4-4.5 hours of sleep to study, go to class, stress out, learn some more, cross my fingers hoping I'll remember those things, day in and out for about a year and a half.
I'm not really obsessed with being #1 in my class or anything, but I'm sort of happy my work ethic has put me above the mean of my class on most exams, or at least as competitive as they are. My class works very hard, and they're so involved in so many things while I more or less started as my 2nd year began, for a lot of reasons though.
For me, it seems like what residency programs and your medical school want to see out of you is hard numbers on exams and your performance as well as all your evals. And being one-dimensional is rewarded in a career like this.
I guess I'm lucky right now being single and starting the most important year of my training so far: clinical rotations. Clinical grades and USMLE Step 1 are "why you're at medical school" and they matter the most generally speaking, but some types of residency programs want to see your Step 2 score too and I think that is becoming more common.
The trend just seems to be that everything is becoming more competitive, even surgery, which I just found out the past year. General surgery is not awesome for the social life and a lot of students in the past (I think 1990s) opted for more lifestyle friendly specialties, and while I haven't seen the most recent numbers on people not matching into surgery or such, I have heard from MS4s interviewing that getting into a good surgery program is becoming more competitive and someone in particular said in particular he hadn't met anyone at his g-surg interviews who made less than 245 on their Step 1.
Continuing, don't think "IM isn't competitive, so I don't have to work that hard." Or "My scores/CV is average for people going into g-surg." The "top tier" programs are going to be taking the applicants with the higher step scores and more research, even though it can be a field seen as "less competitive" like IM or pediatrics. Just do you best! And give up some of your social life?
This is when I start the bulk of my post:
I don't want to disuade anyone from entering medicine: it's such a rewarding field and an exciting field with so much learning and so many people eager to teach you and see you succeed. You will touch lives, ease fear, deliver babies, be the among the faces patients see when they fall under anesthesia and when they wake, you'll be there to see parents smile at their newborns, and see children just be their awesome playful selves, happy as can be after their recovery. You'll get cards from patients full of thanks because they've gotten their health and life back.
You'll be a teacher to patients, peers, and others in the community. You'll be trusted, confided in, and work your hardest for your patients.
But you'll also be in a system where you have to really adapt to challenges that come up all the time, not have a lot of sleep/time off, and probably be facing more and more oversight from the government.
You'll be overworked by overworked people working in and overworked/overburdened system where the work never ends and gets complicated unnecessarily, you'll probably have personality differences and feel dumb, be put on the spot, be disgruntled at, and you'll probably have second thoughts about your career. (But don't give up!)
Also, I think medicine isn't really regarded as highly as I think it used to be, looking back at sentiments from the 1950s/earlier decades: I heard a joke once: "What's worse: a doctor or a lawyer? Punchline: a doctor, because they prolong your suffering."
A little bit acerbic! But it does add a little bit of salt to the wound as I think medicine is kind of losing its charm among the general US populace with doctors being seen as going in it "for the money."
I guess to stay sane in this kind of career, you should just:
1. Get used to snap-judgment by people not in medicine
2. Stay positive and happy and be sure you choose a specialty you love
3. Become active in politics and an advocate for your patients and your field, because if you just sit around doing nothing, a bunch of non-docs/outsiders in Congress will make a lot of decisions for you
4. Balance your lifestyle (a running theme in this here Texan blog!)
Anyway, Happy New Year, everyone. Keep in touch with the realities in the field of medicine, but also stay positive!
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