On Becoming a Physician

In August of 2008, I made a decision, perhaps a foolish one. I decided to show up for matriculation to medical school. For better or worse, I stuck it out-- in part scared into sticking with it because of the massive amount of debt that I rapidly accumulated-- and am now less than six months from graduation. Now, I don't want you to get the idea that I resent or regret my decision. I am happy and proud of my accomplishment but I don't know that I would have made the same decision knowing exactly what went into becoming a full fledged physician. Despite being 6 months away from being allowed to append "M.D." to my name after 3.5 years, I still have 3-7 years of training ahead of me. Thank God for ignorance: it makes us do great things that we would otherwise avoid.

When I started medical school, I was haughty. I thought to myself: "pshah, I'm smart. I can handle it." I, in my naivety, could not conceive of the sheer quantity of information I had to learn, much less the rapidity with which I had to assimilate it for testing purposes. Needless to say, I struggled a bit to keep up with the Jones'. I'm not ashamed to say that I was not at the top of the class or that I was responsible for making the top half of the class possible. I was overwhelmed that first year. I had never developed good study habits up to that point, relying more on the seat of my pants, which were wearing thin at this point-- perhaps to the point of showing off my underoos; my undergraduate studies focused more on the thought process than on the assimilation of data; I was ill prepared. It was a good lesson in humility. After 2 semesters' worth of graduate level biochemistry, a semester's worth of epidemiology, a semester's worth of genetics, 2 semesters' worth graduate level human anatomy all condensed into 4 months, I had survived my first semester. 25 hours of classroom a week and countless hours of studying, I had made it.

I learned over the next 3 semesters how to study better and become, not a academic leader but brought myself to the point of respectability. I whined and complained, as I am want to do, at the time about how much work I had and how medical school was usurping my life. In retrospect, I had the life. I took to "home schooling", giving up on going to lectures-- the lectures were more like Death by Powerpoint-- and just reading the powerpoints and lecture notes on my own time. It worked pretty well, in my opinion. Then came "Crunch Month". This is that point in a medical students life where everything is in the balance. This is the lead-up to the ultimate test: USMLE Step 1, the great equalizer, the Smith & Wesson for medical students. I have never dedicated myself to any task the way I did during crunch month. For 30+ days I read my review books for 8 hours a day; I did hundreds of practice questions a day for another three hours; I grew a beard; I forewent (is that a word?) grocery shopping (At one point, I asked my roommate to buy me some groceries. He thought I was ridiculous at the time and I think he was somewhat annoyed at this request. A year later when he went through the same ordeal, he apologized for thinking I was ridiculous as he was running low on food.) Time off was scheduled in half days, 6 half days over the course of the month. The test was seven and a half hours long. I survived it and did quite well actually but I came out with severely impaired social skills.

I had a month off to re-acclimate myself to society and then I was out of the frying pan and into the fire that is 3rd year of medical school. I don't know that I can do justice here to the 3rd year but it is a truly strange experience, I'd imagine it's like having only read about Morocco and then being sent to Morocco as a tour guide and being expected to know everything there is to know about Morocco but no one really wants to know what you know about Morocco, they just want to know if you know it and pretend like you need to know it and have the responsibilities of a tour guide... if that makes any sense. But let me summarize 3rd year for you in the most relatable sense:

• about 60-70 hours a week carried over 50 weeks (3000-3500 hours) 
• averaging 4 days off a month 
• work days starting at 5-7am
• working 98 hours/wk at times
• 30 hour in-house call
• Studying for exams outside of clinical duties
  

I could go on but I don't want it to seem like I'm complaining. So I'll stop there, for now.

So what's my point in this seemingly interminable rambling? Well, other than a little complain/bragging and back patting, I want you to understand what goes into making a physician (but mostly bragging). Not for my sake but yours. I recently read an announcement of an acquaintance of mine talking about how after 650 clinical hours she had completed her training to become a nurse practitioner, albeit those hours don't include the hours logged towards her RN or working as an RN. I don't say this to belittle NPs; they're smart people and essential for the future of health care. But, I want you to understand what you're dealing with when you deal with a physician: A master of his domain

So next time you or some one you know says, "That doctor doesn't know anything!" or "That doctor has his head up his butt!"Ask yourself, could you do it? If so, come back in 8 years when you're done with your training.