Stumbled across these two blog posts which present a wonderful contrast of opinions on views of medical school. I encourage anyone reading this post to read those two, but then to pay particular attention to the comments; they're just as revealing as the posts themselves. Some people love their time in medical school, approaching every aspect with unbridled enthusiasm. Some people hate their time in medical school, grudgingly dragging themselves through every aspect.
Of course most people fall somewhere into the middle with a lean towards one side or the other, but I there are more than a few people decidedly on one end or the other.
I'm definitely in the latter category. Ok, I don't hate medical school, certainly not 100% of the time, but I'm frustrated with my experiences in medical school far more often than I've been happy or even satisfied with them. The second post linked almost perfectly explains why I feel this way: I got into medicine to connect with people in a meaningful way and, ideally, to have lasting, positive impact on their health and/or lives in general. Yet, medical school more often than not pushes me in the opposite direction.
Meaningful contact with other people - even simple human interaction like normal people do each and every day - is secondary and often discouraged. Much of the health care system, including a good portion under the control of physicians, does not seem designed to provide adequate care, let alone excellent care. As the lowest person on the totem pole, you have no choice but to go along with what I consider substandard or fractured care. I can hate it all I want, but not only do I have to put up with this system, I have to advance and at times defend that system.
Let me be clear - the care is substandard, but the medicine is usually (though not always) fine. And that gets to the heart of the divide in viewpoints on medical school. For me, medicine is the means to an end. I want to help people, but don't particularly care how as long as it's effective. Good medical care can have an incredibly beneficial effect on a person's life, but getting the medicine right is only the first step in getting good care. It's necessary, but not sufficient.
Yet for some physicians or physicians-to-be, the medicine isn't means to an end, it's an end itself. For those who love the medicine, I imagine medical school is great, it's very much focused on acquiring and refining medical knowledge. For those of us who are very much patient-focused, learning about the medicine at the expense of forgetting about the patients is not a worthwhile trade-off, even if it is (hopefully) a temporary one.
This is not to suggest that people who love medical school are not going to care about their patients. It's a spectrum - some people who love the medicine are keenly devoted to the well-being of their patients, while others couldn't care less about their patients' ultimate well-being, with most falling somewhere in the middle. Likewise, those who are less-than-impressed by medical school are not guaranteed to be good with patient care - there are lots of reasons to dislike medical school and a desire for greater focus on patients is only one of them.
I will fully admit though that I get more than a little concerned about my ever-happy-with-medicine classmates, though I generally think they'll make good physicians, and the crux of that concern is that they're might not be seeing the faults or flaws in the current system. Calling medicine broken is a bit hyperbolic, but the further I get into it, the less hyperbole I see in that statement. There are some serious, deep issues in the medical professional that are going to take a long, concerted effort to change. I can't see those issues and not get upset that part of my training involves being forced to entrench those issues further, so to see people go through that process happily makes me worried that they'll be part of the next group of physicians fighting to keep the system broken...
If this whole post makes me sound like a pessimist, I want to stress that my frustration comes from a very deep-seated optimism. I dislike much of the current system of both medicine and medical education because it could be so much better and I believe we can make it better. I see so many colleagues with the intelligence and compassion to make productive changes; there's no shortage of ability. Yet, there may be a shortage of will. The more people with power who are happy with the status quo - and in medicine, people with power often means physicians - the more likely the status quo is going to stick around. In that sense, a few more dissatisfied medical students wouldn't be so bad...
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