<p>Is medicine worth it? It depends. If you go into the field with realistic expectations it is worth it. All our friends who have kids in medical school did not push their kids and did not discourage them either. So far, we have a psychiatrist in Wisconsin (in his second year of practice) who has plans on opening his own bar someday, LOL. We have an opthalmologist in Palm Beach who is enjoying his practice. We have a surgical residence who is very committed to medicine. After all, he got into medical school after two tries. We have a couple who are M1s this year. One of them told his mom jokingly-"Mom, there is no turning back now, because I owe so much money already". He wants to be a pediatric surgeon. The other M1 is going to his parents' old country to fulfill his papers for his MPH, which he started when he did not get in to med school last year. He is all excited to be an MD-MPH in the future. These kids all came from medical families so they kow more or less what is in store for them in the future. It might not be anything like their parents' but still they are in it for the long haul and for good reasons.</p>
<p>I know plenty of internists, family practitioners who don't have the social skills that they should have and are out there practicing their specialties - they may possess the medical expertise to diagnose and treat a disease - but bedside manner, no way.</p>
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I know plenty of internists, family practitioners who don't have the social skills that they should have and are out there practicing their specialties - they may possess the medical expertise to diagnose and treat a disease - but bedside manner, no way.
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<p>So, what you're saying is that they should've gone into pathology ;)</p>
<p>I artfully manipulated a conversation wth my neighbor into a discussion of our topic (Hey, doc. Whattya think of this computer post?). He reiterated many of the concerns shared by the docs on CC except the financial ones as it applies to him personally. He , at this point, does not feel any of the $ stressors and doesn't see any in his immediate future. </p>
<p>He is a Family Practice Physician and I think has been out in practice 11 years. He is an employee of a healthcare system and works in a larger satellite clinic in a "good " part of town. I believe he went straight there after his residency. He feels he has great autonomy, but not unlimited autonomy, over his patients and his patient loads and how he "treats" his patients . He feels because of his popularity (my word) he can "control" for what he wants to do and what he wants his practice to look like by selection of new patients and the services he chooses to provide. He says little changes can over time make big differences in the quality of a family practice.</p>
<p>He knows my D very well and has had many great talks with her. I have asked him to have another long talk with her when she is home Easter. He says he was never seriously pulled by the lure of big-time research (or academic medicine) after his first foray lead him to the conclusion that his UG mentor was brilliant but completely insane (harnessing the electrical impulses in a cell to work as the 0's and 1's in a bio computer- I know I said that wrong, but it was something like that). His pull was always (and still is) to direct patient care.</p>
<p>He responded to my reading of several of the negative posts urging highly gifted , highly ambitious students to stay away from medicine and seek other vocatons with "I know I can work less and make more money. That was true when I started, too. I could work less now and make the same money but I stay on top of my readings, keep current. I want to constantly tweak my practice for better patient care and a better practice, a practice I like better. I find that exciting. I do feel that the mechanism of what we charge for, how we charge, and how we get paid for our services is faulty. As long as we stay bound to insurors there will be constant pressure to bring costs down because the whole insurance concept is flawed. It doesn't work now and won't work into the future." (Obviously paraphrased by me. This dude is plenty smart and I'm sure I haven't done what he said justice. Just thought I'd share.</p>
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He responded to my reading of several of the negative posts urging highly gifted , highly ambitious students to stay away from medicine and seek other vocatons with "I know I can work less and make more money. That was true when I started, too. I could work less now and make the same money but I stay on top of my readings, keep current. I want to constantly tweak my practice for better patient care and a better practice, a practice I like better. I find that exciting.
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<p>That doesn't really address the fundamental fact that front-line clinicians who PRACTICE medicine, in general, are not the innovators - the movers and the shakers who introduce the new technologies. Medicine, a conservative institution, is almost by definition the opposite of ambition (wanting macro, scalable impact).</p>
<p>^^^^^ That's exactly what I was going to say... the response dodged the initial question.</p>
<p>Maybe he's just not a macro kinda guy. His stated excitement was in finding ways of improving patient care to HIS patients, enjoying his practice more. Maybe he is more small-grain focused. Maybe the question is more one of what does ambitious mean to a M.D. ?</p>
<p>Edit: But I didn't ask him if he considered himself ambitious. I'm pretty sure he's brilliant. Not much doubt there (according to his peers, and both D and I). I know he values his autonomy (control over his practice) to some degree. That's 2 of 3. ;)</p>
<p>Now I have myself wondering, what does ambitious mean when it is used in reference to a kid who is contemplating medical school? What are some elements that an ambitious kid would have that a not so ambitious kid wouldn't? Maybe I've been misunderstanding y'all when you use the word. Is ambition money, global reputation, Nobel Prizes? I consider my one personal data point very ambitious but her "ambition" (as I understand it, but hey- I've been wrong before) is to be the best, to make a difference, to work with the best, to stretch the knowledge envelope, to share what she knows as a teacher and mentor but (again as I understand her, what the hell do I know) the respect of her peers and enough $ to live a very comfortable life do have a place in her plans. In some of those ways she IS more macro than my neighbor, so does that mean she is more "ambitious"? (Not rhetorical.)</p>
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Now I have myself wondering, what does ambitious mean
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<p>You're right it can mean several different things but in the context of intellectual and ambitious students it would generally mean that they want to be the "movers and shakers." That may, or may not, involve money depending on what the area is although for most of these types it's safe to say that money is only a secondary motivation not the primary one. </p>
<p>Almost by definition, practicing medicine is a position where one needs to be a follower and not a leader. For a private practice one has room to be the king of their own castle in that regard, but in terms of the overall picture and field as a whole it's not particularly conducive to someone wanting to be intellectually ambitious and a mover and shaker. I think that's what the comments about "ambition" mean and why some are saying that a career in medicine may be incompatible with those that are 'ambitious' in that regard. </p>
<p>In my own experience, this factor often applies to high flying business and investment types who often are subject to the snide remarks of "oh they're only in it for the money" but in reality many of these folks don't care about the money that much... it's the ability to be in a position of influence and being a "mover and shaker" that they really enjoy. More often than not the snide remarks about making a lot of money are more the result of the jealousy of the one making the remark than any truth about the subject just wanting a lot of $$$. I mean look at someone like Warren Buffet (now the richest man in the world)... it's safe to say he was never in it for the money.</p>
<p>I think the word "ambitious" does bear some examination. One could argue that simply aspiring to be a MD is ambitious. If I go up to my dad and tell him I want to be a neurosurgeon, he's not going to reply, "I wish you'd be more ambitious, son."</p>
<p>The percentage of people publishing in Science or winning Nobel Prizes is small. Most successful post-docs and PI's spend their lives doing research that has tenuous clinical correlations at best. Currently, I'm a research fellow in a lab at the NIH that deals with the CFTR ion channel mutated in people with cystic fibrosis. However, the words "cystic fibrosis" never comes up because our research is so far away from any clinical applications. Going into research to "cure a disease" is highly idealistic (but very ambitious I guess ;)). </p>
<p>You guys say that the tweaking curm's doctor does is not innovation, but guess what a post doc spends most of his time doing? Getting a Western blot to work. Redoing experiments. Pipetting. Modifying a protocol. Is that what you would call "innovation" or "ambition?" Even if he becomes one of the lucky ones to attain PI status, he will spend much of his time managing a lab and writing grants rather than designing experiments.</p>
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pathologists. It is a field that was always easy for doctors with limited language skills, such as some of the earlier foreign doctors, as well as those who did not want to "meet the public.
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A friend of mine from college days became a pathologist. I believe he went into that field because he considered it to entail more 'science' versus some other medical practices that might be more rote (from the doctor's perspective). Meanwhile, his GF who graduated med school with him was going to become what she called a 'real doctor' where she'd interact with patients (who could talk). She was just teasing my friend who had absolutely no social problems at all.</p>
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I think the word "ambitious" does bear some examination. One could argue that simply aspiring to be a MD is ambitious. If I go up to my dad and tell him I want to be a neurosurgeon, he's not going to reply, "I wish you'd be more ambitious, son."
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</p>
<p>Of course, there's no question that's "ambitious" but I think the original comment was in a different context that...</p>
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front-line clinicians who PRACTICE medicine, in general, are not the innovators - the movers and the shakers who introduce the new technologies
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</p>
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The percentage of people publishing in Science or winning Nobel Prizes is small. Most successful post-docs and PI's spend their lives doing research that has tenuous clinical correlations at best. [...] Going into research to "cure a disease" is highly idealistic (but very ambitious I guess ).
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<p>True, but of course not all research is human disease research either and even if one doesn't cure the disease in question there's still a lot more freedom to innovate in the field, develop new techniques and shape the direction of field.</p>
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You guys say that the tweaking curm's doctor does is not innovation, but guess what a post doc spends most of his time doing? Getting a Western blot to work. Redoing experiments. Pipetting. Modifying a protocol. Is that what you would call "innovation" or "ambition?" Even if he becomes one of the lucky ones to attain PI status, he will spend much of his time managing a lab and writing grants rather than designing experiments.
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</p>
<p>That's all true and there's no question that the path to becoming a PI is a cut-through business... but I think it's safe to say that one still does have much more ability and freedom over what they do and what they innovate, with much more ability to influence the field as a whole. Even if one doesn't cure X disease they can still make major breakthroughs, develop new techniques, etc. </p>
<p>Also, not going to med school doesn't automatically mean eventually becoming a post-doc either. I know one of these types that would fit the "movers and shakers" and "intellectual ambition" labels and after a science PhD they went off and worked for a global consulting firm to learn the ropes of business and before too long I wouldn't be surprised to see them as a VP at a pharma or other scientific research firm...</p>
<p>My, my, my...what rarified air we breathe here on College Confidential! ;) Its similar to the high school student who is concerned that he/she "only" has a 2300 SAT score. On this thread we are discussing whether medicine is intellectual and ambitious enough for some students; whether $150,000 - $200,000 a year is adequate compensation; and whether real movers and shakers should go into medicine. I can only think of a few jobs that make more money, have more prestige, are filled with students with more ambition.. oh, I take that back, I can't think of any... I love this quote! ;)
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I think the word "ambitious" does bear some examination. One could argue that simply aspiring to be a MD is ambitious. If I go up to my dad and tell him I want to be a neurosurgeon, he's not going to reply, "I wish you'd be more ambitious, son."
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I'm chuckling....</p>
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My, my, my...what rarified air we breathe here on College Confidential! Its similar to the high school student who is concerned that he/she "only" has a 2300 SAT score. On this thread we are discussing whether medicine is intellectual and ambitious enough for some students; whether $150,000 - $200,000 a year is adequate compensation; and whether real movers and shakers should go into medicine.
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</p>
<p>I don't think anyone has come close to suggesting that going into medicine is not an ambitious career. People have simply been commenting that there are many different types of ambitious personalities and that a career in medicine perhaps isn't particularly compatible with all of them. </p>
<p>Your attempt at brushing it all off is certainly noted but it would be rather dangerous for anyone contemplating entering med school to do the same. There are serious issues facing the field at the moment from a variety of angles and I think this thread is simply attempting to have an open discussion and debate about those issues that will most certainly effect anyone entering the profession.</p>
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I don't think anyone has come close to suggesting that going into medicine is not an ambitious career. People have simply been commenting that there are many different types of ambitious personalities and that a career in medicine perhaps isn't particularly compatible with all of them.
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Would that include this post by afan?
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Overall, going forward, medicine will be nothing special, but a perfectly reasonable career for the not too ambitious, not too independent, and not excessively bright, solid student who can limit debt along the way.
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<p>Or this one by afan, quoted and agreed to by susan4</p>
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Is this the best career you can find? Depends. What are your talents? If you are creative, brilliant, and ambitious - not the career for you. </p>
<p>If you are conventional, traditional, very comfortable with authority, and not too concerned about accomplishment and autonomy- could be fine.
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</p>
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I think the word "ambitious" does bear some examination. One could argue that simply aspiring to be a MD is ambitious. If I go up to my dad and tell him I want to be a neurosurgeon, he's not going to reply, "I wish you'd be more ambitious, son."
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</p>
<p>Well, that's assuming the dad isn't a venture capitalist or a scientist truly passionate about pursuing truth. I think you need to distinguish between ambition to advance within a preordained system, versus ambition to step outside and fundamentally alter a system.</p>
<p>As to these comments...</p>
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You guys say that the tweaking curm's doctor does is not innovation, but guess what a post doc spends most of his time doing? Getting a Western blot to work. Redoing experiments. Pipetting. Modifying a protocol. Is that what you would call "innovation" or "ambition?" Even if he becomes one of the lucky ones to attain PI status, he will spend much of his time managing a lab and writing grants rather than designing experiments.
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</p>
<p>You ignore the larger picture. That practicing doctor will never have the opportunity for macro impact. Your post doc will if he's good enough. Well, that's why you have to be supremely confident of your talents, and why I mentioned that many of my peers who were uncertain about their ability to make those experiments work, their ability to discover or invent a paradigm-shifting technological platform, choose to go the MD/PhD route because they like that stability, even though intellectually it's a sacrifice.</p>
<p>I'm sorry. I have some trouble accepting that the posts I quoted fit your description.
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People have simply been commenting that there are many different types of ambitious personalities and that a career in medicine perhaps isn't particularly compatible with all of them.
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<p>My D's life is her own to live. If she suddenly decided to become a venture capitalist I would remind her of two things :
1) You don't have any capital to venture which means you have to sell your soul to someone who does.
2) You have a soul that doesn't need selling. </p>
<p>I know there are many exceptions and there must be wonderful, erudite, community service oriented venture capitalists somewhere (but on this thread there aren't any ambitious, exceedingly bright, innovative, mover and shaker physicians so maybe not?) but I haven't met them. The ones I have met have enjoyed the thrill, the chase, the game. But none of them have been particularly great folks and their "juniors" and underlings have always looked miserable to me. Anyway, making money from having money without producing anything of value is not exactly my idea of a life well lived. It must be for some folks.</p>
<p>Continued...</p>
<p>You waste away some of your most intellectually fertile years devoting 80-100 hours a week during residency instead of thinking about innovation. Some people enjoy it. Others don't.</p>
<p>I would take a look at this Daniel DiLorenzo as an example of ultimately having to make a choice between the clinical and the entrepreneurial side: <a href="http://www.scctv.net/ei/ei_27_dilorenzo.asx">http://www.scctv.net/ei/ei_27_dilorenzo.asx</a>"</p>
<p>"I was trying to do both at the same time for a while. Filing patents, speaking with potential investors, speaking with potential recruits for the company. Ultimately it became clear that to do a good job at both was impossible. You could do one, but the other would have to be put on the back burner, and so at the end of the 2004 academic year I took leave from my neurosurgical residency."</p>
<p>It's to those with my second definition of ambition, if you're certain and passionate, I advise against the MD. It's certainly less risky, but a much longer route.</p>
<p>To add in response to the comment above: Nobody is saying there aren't any physicians that are like that. There are. It's just medicine is a less risky, but longer route, that diverges from the primary effort if that's really what you want to do - macro, scalable change. Again, that's why I said MD/PhD is an option many of my colleagues who aren't so devoted or risk-taking choose.</p>