Wednesday, October 7, 2009

I need your help if you are not an MD. What are your preconceptions as to how a doctor is trained? Any myths? Anything you've wondered about?

I am surveying non-doctors to see what they think about how a doctor is trained. Do you have any idea how that happens? What do you think happens? Have you wondered about it? Is it shrouded in mystery? Do you have extra admiration for MDs due to this process? Please make comments to let me know your opinion and you might make it into my next book.

(Disclaimer: If you make a comment, you are giving me permission to use it in a book. If you don't want me to use your comment, don't make one.)

Thanks for your help!


I've already had a few comments that didn't address my question, so I will add this: Everyone knows the kind of qualifications it requires for an MD-college degree with pre-med classes/MCAT, 4 years of med school, and minimum 3 years of residency training.

My question is, when you picture in your mind what a med student has to do to learn what is required to practice medicine, how do you see that happening? This relates to course work, learning how to examine patients, "practicing" on patients, etc...Are there any myths, pre-conceptions (i.e. doctors are all intelligent [not saying that this is true BTW, just an example of what many people assume]), movies that bias you? Have you ever wondered about the rituals that occur to create a med student? It is not straightforward like: you go to class, you learn anatomy, you learn pathology/microbiology/pharmacology, and suddenly you can be someone's doctor. Have you ever wondered what it is really like? Do you think you know what it is like bc you have a friend/relative who is an MD? If so, I want to hear what you think you know.



  1. Goodness, there are lots of assumptions hiding in your questions!

    The training process for a doctor is not in the least bit mysterious -- though that may be because I was an academic.

    Let's see: I suppose a BS as an undergrad degree; med school, internship and residency (tacking on specialization requirements).

    I admire anyone who is dedicated to helping others, as well as anyone who goes for a goal.

    Recently, though, I've grown very tired of listening to doctors gripe about the time they've invested, their student loans, etc.

    Choices, we all make them. I spent a considerable amount of time in grad school, never had the promise of big bucks -- but it sure was exactly what I wanted to be doing, so it never occured to me to complain.

    Wow. Now that that is out of my system, I should say that having a good medical team has enhanced the quality of my life, no mean achievement, that. It seems that having a bit of an attitude is necessary to be able to pull off the amazing stuff youse guys do.

  2. is your goal to convince the public that doctors deserve the money they make? you could tell the public that you had to stick pins in your eyes to become a doctor and they still won't think you deserve to be paid any more than the next person.

  3. Man, anonymous you are really cynical. My goal is to find out what people's preconceptions are of how you train a doctor and then demystify it. I am not sure where your harsh comments come from, but feel free to discuss your difficult dr experience that has made you respond in such a negative manner to what I perceived as an innocent question.

    Bianca, thank you for commenting. However, you didn't answer my question(s), and I'm wondering if perhaps I am not asking the question correctly? You say that the training of a doctor is not in the least bit mysterious. Why? Do you think that your training as an academic is the same? I'd like you to write down what you perceive as how a doctor gets trained. I want to know what is in your (and other non MDs) head as to what you picture as the process of MD training. Include rumor, stereotype, myths, movies (i.e. gross anatomy), etc...Thank you for taking the time to comment

  4. I imagine that doctors in training put in long hours to acquire scientific knowledge but that they should spend more time on bedside manner. Maybe they already do take courses in how to talk to patients, answer questions, visit a hospital room without looking like they're dying to make a run for it, but I'm not aware of it. And male doctors are still yelling at nurses in front of patients, which really pisses me off. Not sure if I answered your question at all, but my perception of how a doctor gets trained is that the training does not include how to deal with their fellow human beings.

  5. Thank you Jane. This is exactly the kind of thing I am looking for. You have essentially asked: "Do doctors take courses or other means of learning good bedside manner? If so, they are not effective." and you've said, "...doctors put in long hours to acquire scientific knowledge." This is very helpful, and could make it into my book.

  6. As a medical school aspirant, I find this topic an interesting one. Since I'm considering a rather massive career change, I've done a fair amount of research on what medical training is like. Therefore, my preconceptions may be more realistic than others.

    To my way of thinking, there are at least four things which I expect to experience on the road to becoming a physician:

    1. Abuse by residents and attendings. Most everything I've heard about medical training includes a mention of the mistreatment of students by those further advanced in the process. I'm sure that a degree of skepticism is in order here, but I fully expect to be forced to endure some of this as part of clinical rotations and residency. My personal feeling is that stressing students is good, but the various shades of unprofessionalism that are frequently present are not.

    2. Volume of information. I studied physics and mathematics as an undergraduate which are conceptually based. My perception is that medicine will place a lesser emphasis upon concepts and a greater one upon the breadth of knowledge required in order to complete my training.

    3. Time commitment. My undergraduate studies were required a relatively complete time-commitment for me, probably because I approached school as if it were my job. Granted, I had a rather difficult program and was considerably older than the tradiational college student (I was 26 when I started). I expect the pre-clinical years to require the same level of time commitment. In the clinical setting, I tend to think that the same thing will be expected, with the added twist of a loss of independence. Whereas during the first two years, I'll be relatively free to set my schedule, rotation schedules will be dictated by others.

    4. Uncertainty. There are many unknowns in the training process. If I get in the first year I apply, I'll matriculate in August 2012. I don't know where I'll be living, since it will depend upon which school I attend. I also don't know where I'll be living during internship and residency. Same goes if I'm able to do a fellowship. Even as a single and fairly unattached adult, spending 10 years without a home sounds a little rough.

    One final thing that concerns me is whether my desire to be a physician will wane during the training process. Sacrifices that I'll have to make along with whatever healthcare changes that occur under the banner of reform will most definitely exact a toll upon a desire to practice medicine. It's natural to worry about whether a commitment to being a doctor will be stamped out by all of the bad things in medicine.

    I'll close with one final statement. I read something a while ago about the motivations on becoming a physician. The author said a desire to help others was both a reason TO become a physician and a reason NOT TO become a physician. His reasoning was that individuals that are motivated by a desire to serve others easily make the best physicians, but are also the most likely to be discouraged and disheartened by the bad things in medicine.

    Hope I've given you some insight into how an individual on the outside looking in sees what his future might be like if he pursues medicine.

  7. Obviously the first thing you need is a way to pay for a very long and expensive education...
    You would need to graduate college first with a bachelor's degree and have good enough grades to be accepted into med school. Then you need to be able to score well enough on the MCAT to get in. Then you would need to pass the USMLE (United States Medical Licensing Examination) Step 1 in order to get through to the third year. Then Step 2 in your fourth year.
    All this to say that there is going to be an awful lot of studying and tests before you get close to practicing medicine. Then after you have finished working long hours in residency (making only about $44,000 a year) you can take USMLE Step 3. Depending on your chosen specialty this could all take about three more years after graduation.
    All told at least ten years of training. And if "anonymous" thinks doctors should get paid the same as some random person sitting next them, then that explains the ignorance of the process that is prevalent.
    I am not a doctor (and don't play one on TV ;-) but I have trained many on health IT systems over the years, and I find that most physicians generally want to help other people. They are usually smart enough to have chosen from many different fields and what draws them to medicine is the ability to make a difference with their lives.

  8. George, pre-med student - fantastic. Keep up the good work. Your comments are super helpful. I may end up incorporating some of them into my book. Brian, thanks for the support! But this isn't an ego trip, really (cc: anonymous), I am trying to sort out what people think about the training of an MD. So far George is closest, not surprisingly. I'm really interested to see what other people think. Thanks guys.

  9. I know it is a little off topic, but I want to address George's points directly: (1) Mistreatment depends on the student, the resident and the attending. It can be that way, but it can be a great collaboration too. (2) Perception is somewhat accurate for first 2 years, but in reality, the concepts are the most important things. As one med school t-shirt said, "I've forgotten more than you'll ever know." Many of the specifics fall away, but the critical concepts remain. (3) Exactly opposite of what you said. Pre-clinical years were the easiest. We went out frequently, and i watched a ton of TV. You learn when you need to buckle down and when to goof off. In the clinical years there isn't that free time and freedom of time. (4) True. I got a house with a picket fence in residency because I craved stability. I was tired of being a gypsy. (5) The healthcare system issues won't faze you in residency. If you want to quit during residency it won't be for those reasons. That will happen when you begin to practice post residency...(final statement) True. BUT it is up to those (like me) who still motivated by their patients to keep at it, find a balance, and do right by their patients no matter what the evil system throws our way.

  10. Dr. Brenner... you *really* need to examine your questions! You are loaded down with the knowledge of what you want to hear.

    I mean, just for starters, how do you expect people to know their own misconceptions, stereotypes, etc.?

    What you really want, it seems, is a fiction of your own making (under the guise of research -- a terrible trend).

  11. Bianca: I fully admit I am biased since I am an MD. That why I want to know what (non medical) people have in their head as to what the process is of training a doctor. What questions would you suggest to find out what I want to know-which is what image people have in their minds?

    I never used the word misconception. I used stereotypes, and even used the examples of movies like "gross anatomy" as an image some people might have.

    Your comment is harsh and not at all what I have intended. I think I have made my point clear. You have a right to your opinion, but if you don't contribute beyond criticism you are just wasting space on my comments.

  12. Dr. Brenner,

    I appreciated your response. As I've been planning my steps into the medical profession, I've tried really hard to get an accurate impression of what it's actually like. Unlike the traditional pre-med student, I already have a well-paying, established career that I would be giving up to go into medicine (assuming I'm accepted to medical school). For someone in my position, a frank discussion of our presuppositions about medical training - like the one you've initiated - would be an invaluable asset. Thanks again.