What does it take to become a doctor?
Today's students and residents grapple with a new and changing world
Medical school. Of all the words associated with education, those two probably evoke the most intense imagery. Tough to get into. Even tougher to get through. Classes with cadavers. Mind-bending mountains of memorization. All-nighters. And debt. Lots of debt.
Today's medical school experience has much in common with experiences of generations past, when these stereotypes were forged. Students still need to be intelligent, dedicated, and idealistic to get through the door. Once they're in, they work like sled dogs for four years and like sled dogs with M.D. degrees for three or more years after they graduate. But as technologies evolve, social norms change, and state education funds start to erode, important differences emerge.
Here's how medicine today looks through the eyes of three in the thick of it.
First year: From dream to reality
Chris Vu is on his way.
Four years ago, when Vu decided to switch his undergraduate studies from engineering to pre-med, medical school seemed an almost impossible dream. Now, with the first year behind him, it is a sometimes-seemingly-impossible reality instead, one flirting with the upper limits of how much the human mind — and 24 hours — can hold. Anatomy, microbiology, neuroscience, physiology, pathology, pharmacology ... The list seems endless.
Double lattés helped Chris Vu survive the seemingly endless study sessions of his first year of medical school.
"You're so bombarded with information that when all is said and done, you struggle to find out what you really know," Vu says. "There are so many things. How much have I really learned so far? I really appreciate what physicians and faculty have told me — that in your third and fourth year, it all comes back."
The highlight of the year for him, as it is for many first-year medical students, was the gross anatomy class. "It was probably one of the coolest experiences I've ever had in my life," he says. "Everyone appreciated the opportunity to see how we're all put together. It was really interesting to see up close how layered we are — all the skin, fat, and muscle — before you get to the really interesting stuff."
Less exciting were the brain-busting basic-science classes that followed. "You're learning receptors and neuro-transmitters and genetics," he says. "Yes, they're interesting. Yes, they're required. Yes, they're important. But is this the thrill of medicine? You're still stuck in a classroom in a chair for four hours a day, looking at a PowerPoint presentation."
Or not. Like many of his classmates, Vu occasionally watched taped lectures at home over the Internet rather than trekking into campus to catch them live. "You can sit at the computer in boxers and eat breakfast," he says. The technology also allowed him to watch the lectures at his own pace and on his own schedule as well as review them for exams. It also, he admits, left him more time for things like snowboarding and golf. "That's definitely an awesome tool," he says.
Vu enjoyed the Tuesday sessions he and his classmates spent with master tutors, off-campus physicians who gave students a taste of real-world medicine. "We learned in a small-group format, which helped us feel more comfortable asking questions and gave us an opportunity to think like physicians," he says. Less "real-world" was the Physician and Patient (PAP) class, in which students practice patient interviews with actors. He found it tough to take the class seriously — after all, the patient wasn't really sick, and he wasn't really a doctor. But he admits the class did provide some valuable practice for the day when he will finally sit down with a real patient. "It takes the edge off," he says.
One of the challenges for Vu has been accepting the trade-offs medical school requires. Friends from college have been settling down, getting married, taking well-paying jobs, buying new cars. Meanwhile, he's going deeper into debt than he cares to think about — by the time he's done, he figures he'll have $150,000 in loans — all for the opportunity to work long hours at a starting job with pay comparable to what he got working as a landscaper.
"It's such a long process to get somewhere," he says. "I know I like medicine. I know I will enjoy it. I knew I would be intellectually stimulated by the education. It's more like, 'Am I going to be wasting a large chunk of my youth?' Doctors are respected; it's a good field. But it's 10 years out of your life."
For now, he's looking forward to his second year — and even more to years three and four, when he'll get to work with real patients in real clinical settings.
"I really want to learn, to put everything together, to think, to understand how it applies to everything else," he says. "I just want to get by these, the first and second years, and get to medicine."