Standards are dropping....

It's official folks, I will be starting medical school in three short weeks............Wow, I think I just shit my pants....I graduated from college 2.5 years ago, I can't even remember what it's like to sit in lecture (although I recall it's somewhat unpleasant), and the drugs did not help my learning abilities.

So in a nutshell, the next few weeks are going to be some combination of tough/depressing/neurotic/confusing/embarrassing/inebriated, will involve clueless 22-25 year olds, dead bodies, and me.....clearly a situation with promise of comedy, ripe for parody.

Thankfully, I'm going to a school I'm pretty excited about, which sadly, is located in a city I'm depressed about. The institution felt right from the moment I joined the backrow kids in a sample lecture; amidst the carnage of med school, they somehow found time to pay daily homage to the NY Times crossword puzzle, stalk love interests on Facebook, and throw paper airplanes at the front row kids, all while following an epically boring Ph.D lecturing about pharmacology. I got the impression that a lazy man cannot only survive at my medical school, but possibly thrive.

Which is exactly what I aspire to be in medical school. I spent my first few years as a medical student trying to talk the talk, walk the walk. I sat in the front row, had my colored pencils at ready for organic chemistry, and was contagiously neurotic. Perfect pre-med right? Except I wasn't. Definitely a case of square peg, round hole. Because I inevitably was always 10 minutes late to class, I always screwed up weeks of results in lab because I was spaced when we were getting instructions, and sometimes the relationship between the hours I studied and the score I achieved was decidedly inverse. After 2.5 years out of the game, I have embraced my square peg nature, perhaps a little too much.

Whatever the case, I'm entering medical school with expectations and goals that may be somewhat different from the average student.

1.) P=MD -> Pass equals MD. As in, if I get a 61% on a test, I studied too hard, because as long as I pass my classes, the USMLE, and don't piss off my attendings too much during clinical rotations, I can pass Go and collect $200 at some residency, somewhere in the US. I know, I know what you're thinking, "Oh my god, I never want this guy to be my doctor." A very healthy fear, Darwin has served you well. But hopefully that fear is a reflection of me and not so much the strategy of P=MD. I've heard the pre-clinical years have a good deal of bullshit thrown in (Krebs Cycle and pKa's anyone?), which you thankfully will probably never need to know. In theory, if you can pass your USMLE, you have an ample understanding of the material. Plus, with the extra free time I may have pissed away for that Honors score, I can enjoy what's left of my twenties.

2.) Boundaries, Boundaries, I said BOUNDARIES you crazy motherfuckers!
If you've ever been around doctors for an extended period, you start to realize as a community, they're pretty damn weird (I know, it's rich coming from me, but takes one to know one, right). But seriously, what kind of person decides whether they're 18 what they're going to do with life? And then pursues that with the sort of bloodthirsty rancor many pre-meds exhibit. Sounds like a great way to select for some malignant personalities. Moreover, I get the impression a lot of physicians started their training thinking, "Well, I'll get through college, and then I'll power through med school, and bust ass in residency, and then I'll have time to chill by the pool with my hot mamma/pappa and a stack of the Benjamins." Except, it doesn't always seem to work out that way. Because after you spend the majority of your twenties working, a time when your identity is still shifting and malleable, you might find out that's who you've become. After short-changing relationships with parents/siblings/spouses and making no time for interests outside of medicine, it may be your life. Which is why I think a fair number of doctors have malignant personalities (angry, cocky, mean, self-absorbed, God-complex, etc.). Call me crazy, but in a profession where your most personal of functions, the right to shit, eat, and sleep in peace are encroached upon (welcome to surgery rotation, where as medschoolhell beautifully points out, you're not the med student, but the retractor bitch), you need to make a stand for yourself, and how far you are willing to subsume yourself to your studies/job. So in medical school, I hope that when it comes time to choose between calling my parents or studying for that high pass on the test, I call my folks every damn time. I'll let you know how it works out.

3. Exit strategy anyone?
The American healthcare system is broken. That's not my opinion, that's not conjecture, it's a god damn fact. Talk to anyone on the front lines of medicine who doesn't have their head in the sand. And it needs fixing. Hopefully the solution will come around in the next few year, and hopefully, it will be one amicable to doctors. But what if it isn't? What if a profession that has seen declining reimbursements, increasing work hours, and skyrocketing educational tuition gets worse? Is it still worth it? Do you love your patients that much? Can you get out if you're carrying $250,00 in debt? I don't know, these are very troubling questions to ponder. So at every stage of my med school career, I'll be reading the papers, following the blogs, hey maybe even watching a little C-Span to figure out how things are looking. And if they get real bad, I may decide to get the hell out of clinical medicine. Because while I want to touch lives, and do good in medicine, I'm not going to martyr myself. I've seen too many unhappy doctors to want that for my life.


Some of my friends hear me bitch constantly about medical school, and they say, "Why do you want to go then?" And the truth is a

a.) I love to bitch about things....come on, it's kind of fun

b.) It's a great profession that comes with a pretty high price tag.

Who wouldn't want to save lives and get paid well for it? Sounds like a win-win, right? Except the more I learned about it, the more I realize it is a tough profession to enter. The work can be boring, dirty, and downright depressing. The pay could ultimately be shitty on a per hour basis. And the training can really, really suck a big one.

So that all gives me pause, but it still seems worth a shot. Hell, I can always drop out if I really hate it. And how is it going to get better if people don't bitch, and then do something about it. Which I plan to. I think physicians need to become more engaged in political issues, need to take an active role in administration at every level of healthcare, and need to address the lifestyle issue, so ultimately, medicine can be a people-friendly career instead of a meat-grinder.

It's always going to be a daunting endeavor. Taking care of the sick and the dying was never going to be fluffy bunnies and daisies in the springtime, but I think it could suck a whole lot less. Again, I'll let you know how it goes. Stay tuned for more.....