My dd is a premed/bioengineering student (junior)who is interested in medical school.
Given all that has been mentioned PA school looks really good to me right now as far as length of time spent on training and costs of education, as well as the work/life balance.
- Just because she is the one person physically on the floor does not mean that she is the be all and end all. She has supervising MDs (residents/attending physicians) that she is supposed to contact for anything more than an emergency laxative (slight sarcasm). I directly supervise residents, I am legally liable for any decisions they make. You bet I want to know what those decisions are, and I want to know before there are irreversible consequences. If she is handling significant issues on her own as an intern, please tell me which hospital she is at so I don't ever go there.
- Regarding saving lives, short of doing the Heimlich maneuver or doing an emergency open cardiac massage in a cardiac arrest (not an interns job BTW), no one saves a life of the patient on their own in the hospital. I don't count being the one to push the "code blue" button as 'saving a life.' Yes, it takes a village.
- I certainly hope she is not telling you details about the 'lives' she saved as that would be a HIPPA violation.
- A surgeon who removes a ruptured appendix likely saved that persons life. Ditto the anesthesiologist that was in on the case. That is not something we preen about, it's our job.
Sorry for the hijack. This glorification of an interns work is quite erroneous and misplaced. And yes, I was an intern back in the day when every other day 30+ hours was routine and we were told not to bother the resident unless it was a true emergency.
I saw the above numerous times with my daughter’s med school friends and it was certainly my daughter’s experience. D went to medical school having had a great deal of exposure to orthopedic surgery and thought she would go that direction. Her surgical and orthopedics rotations went very well. ER was also on the short list. You could have knocked me over with a feather when after her final rotation, obstetrics and gynecology, her father and I received a phone call from her telling us she had found “her people”. She had really thought about her personality and skill set and while she could have made other areas work, ob/gyn was clearly the best fit. She is starting her third year of residency and while sleep deprived and a bit beaten up, she likes her peers, the training, and feels she made the right choice. Crossed fingers it ends up being what she wants it to be.
FWIW, my dermatologist is a great person and I am sure worked long and hard for her success. She has sun damaged patients like yours truly but the majority of her practice consists of patients who pay for expensive treatments out of pocket. She works four days a week with no weekend hours. I have seen her nanny bring her children in at lunch time to visit. Even with such a fine example of a dream medical practice D had no interest in dermatology. Interesting, the whole “fit” thing.
^^^This times 1000.
Multiple surveys and studies have found that the biggest driver in specialty choice is personality fit, not income, not educational debt, not work-life balance.
http://www.amednews.com/article/20130311/profession/130319978/4/
There’s a whole list of peer-reviewed journal articles available in PubMed that supports this.
And D1's experience has been very similar to Elleneast's D's experience. D1 entered med school thinking of radiation oncology (physics degree w/ 4 years of particle beam research, spent 4 months shadowing rad onc in med school) or orthopedic surgery (spent a full year shadowing an ortho in med school, assisted in ortho surgery on a weekly basis for a year, learned to suture left handed because the surgeon was a lefty, did surgical research with first author publications and multiple national surgical conferences, did surgical sub-Is), but in the end chose another specialty she felt was better suited to her personality. And just about every time I talk with her, she tells me how glad she is that she chose her current field, despite the crappy hours and rotating shifts and sleep deprivation.
I am starting to see the same happening with D2. And D2's friends. (Not just her med school friends, but her high school friends who are now in med school--so kids I've known for a long time.)All so helpful. Thank you!
Anybody see the comments from the guy who is a resident on HONY today? Pretty sobering.
My sister a professor of OBGYN. From a lifestyle POV, this isn’t a great specialty as you never age out of overnight call. She LOVES her work, her team, her hospital, her students, her patients. It’s been such a wonderful path for her.
Several years ago, I went on a date with an ER doc who worked something like 6 24-hour shifts per month. He was incredibly happy with this schedule.
Yes, I read it. I felt badly for the young doctor. He looked so tired. My daughter has had some very rough days but likes the people she works with and feels supported. She knew residency was going to be demanding and while she could not have imagined how much stress she would feel prior to diving in, she is slugging through it.
For the uninitiated, doschicos referred to a wonderful website called Humans of New York on which Brandon Stanton posts photographs and interviews with random New Yorkers each day. He has a real gift for getting people to open up. Generally the site reconfirms the basic good of people but as the parent of a resident, today it saddened me. The young doc has dealt with a lot and his points about stress are not off base. Are we allowed to link? http://www.humansofnewyork.com/
Hanna, I am so happy to read about your sister.
I asked my DD about interns being responsible for the entire floor. She agreed that I was right, she had talked of having multiple pagers and being the #1 contact for multiple floors/areas and that she may have also felt very much alone; however there was always a 3rd or 4th year chief around or even an attending. They were sleeping and the trick is to wake them when needed, not too often, but never too infrequently! So, an intern could be ‘in charge’ but they are certainly supervised and have full back up available. Yes, they are the ones to ask for the supervision, but one time not asking soon enough would be the only lesson needing to avoid that error in the future!
It is interesting how many Ob-Gyns and their relatives are on this thread!
@Hanna said “My sister a professor of OBGYN. From a lifestyle POV, this isn’t a great specialty as you never age out of overnight call. She LOVES her work, her team, her hospital, her students, her patients. It’s been such a wonderful path for her.”
The way Ob-Gyns handle the desire to “age out of overnight call” when they reach a certain point in their lives and careers is to drop obstetrics. They don’t make a profit on most obstetric patients, their high malpractice insurance premiums are mostly due to the OB part of their practice, and the crazy call nights are mostly OB related.
Can’t find an OB? It is partially due to older Ob-Gyn’s deciding to only practice Gyn as they get older.
(Another spouse of an Ob-Gyn here.)
And one would think that if a first year resident thought a patient was going to die…that would be one of THE reasons for waking the attending or senior resident, right?
My sister’s field of research and teaching is all OB, so she won’t be going anywhere. Her home is the labor & delivery floor. She works at a public hospital and has no private practice, so she doesn’t have to think about profits or insurance premiums. This is her calling.
The sad truth is that on some floors (like critical care/MICU) there are patients who are expected to die, who have been sent there to die. It may not be an event an intern would wake the attending for since there’s nothing anyone can do to prevent it.
Guess what- in nonteaching hospitals there may be NO physician around on the floors. In teaching and other hospitals the nursing staff really runs things at night- thank goodness. They’re the ones who let the doctor know of things that need attention. Good physicians, including interns, listen to their hints- should we…? questions et al.
Yes to many who are expected to die are in the hospital.
The intern may be carrying the beeper(s) but the nursing staff in teaching (and other) hospitals know what to do to be sure things get done right. So many stories I can tell. The interns usually can thank the nurse for alerting them to situations needing doctor’s orders.
Quality of life- defined differently by everyone. My quality of life would have been terrible if I had had to do a dermatologist’s job. Imagine not enjoying your work. Call nights are part of getting to do what you like to do days. And, yes, getting older makes it harder to put in the hours, have interrupted sleep…
What some people abhor others thrive doing. OP- your D will figure things out. Medicine is only one of many paths to feed the mind and soul.
Any first year resident should be listening hard to what the nurses say - they (the residents) are not at the point of being “all that” quite yet.
Even physicians with many years of private practice experience should listen to nurses- that doesn’t mean always doing what they say, however. It also helps to explain unusual plans, changes from the usual… A lot easier if people know why they are doing things.
Agreed–my H said one of the most important things he learned rotating as a resident was make friends with the nurses as soon as possible and listen to their advice!
I know many physicians complain about being hamstrung by administrative and insurance issues.
My nephew is currently in medical school, and the entire extended family is incredibly proud of him. There is something about the prestige that being a doctor commands. It makes our whole family feel like we are smarter. I don’t care if that sounds weird, it is the truth.
Nephew is in his mid 30s. For one thing, I think cause he’d had some life experience before being accepted to med school, it influences his perspective. He doesn’t want to take orders the rest of his career. He started as a respitory therapist but felt he wanted more. I feel there I something to be said for wanting to reach your potential. There must be a certain drive and focus and ability to do the necessary work required to become a doctor. For many, life gets in the way or sidetracks us and we deal with missed potentia, regretl and “what might have been.” (yes, speaking of myself).
It always seems to me a doctor has lots of perks, they are admired, command authority, are respected; their words carry weight and I’m not just talking about on the job. I think many people do not see that there is a down side to being a doctor.
H is a doctor and comes from a family of doctors. I think if the OP’s daughter really desires this, she can find a way to make it work. I can’t remember now if the OP is concerned about her work/life balance or her daughter is?
Anyway, if work/life balance is important, she can steer herself in that direction if she plans in advance. She can pick a specialty that is more 9-5 and work as a salaried employee rather than a partner. She can avoid surgery if she doesn’t want to get up at 4 AM. She should avoid OB and all super specialties. You don’t want to be the one super specialist in a 100 mile radius if you expect to have any reliable weekend time!
H’s sister is a super specialist. There are maybe 5-7 hospitals in the country that could use her as a full time employee. As a consequence, she commutes 2+ hours to work part time at one. At a closer hospital, she goes in once a week and is swamped, just swamped, by people who travel hours to see her. Her H is an ER doc. That would be fine if he had a regular schedule but he rotates between days, evenings, and nights. That’s just how his partnership works. It makes child care very difficult.
My D1 was considering medicine, saw this family saga unfolding, and decided to become a nurse instead. She has an RN after just 4 years of college and is happy. She will likely get a NP degree sometime in the next few years but will work first to see where she wants to go.
H is a radiologist. He was in a practice for 17 years that was fine at first, but then began to change. Several docs left to go to Kaiser because they were tired of running a business. H left and we moved far so he could work strictly at a hospital (and it’s one he’s worked at before). He’s much happier being an employee. A good friend of his is also a radiologist but has a neuro-interventional subspecialty that gets him called in at all hours. He doesn’t mind. The friend’s wife was a doctor and gave it up to raise their kids and take care of everything her H couldn’t cover since he was being called in so much.
So, it comes down to choices. I’m sure if the OP’s daughter wants to be doctor she can make it work, even if she has several years of training that are difficult to mesh with family life. At least there are rules about training hours now.