Some of my: Inventions | Magazine interviews | Sheds | Favorite ER memories

Information for people contemplating
a career in emergency medicine and
other medical specialties

By Kevin Pezzi, MD

“The tragedy is that everyone thinks they already have goals. But what they really have are hopes and wishes.”
— Brian Tracy in The Power of Discipline

You want to become a doctor. I want to help you achieve your goal.

I don't think that you will find anyone more qualified than I am to help you become a doctor, because I did it, against all odds. In sixth grade, my teacher said that I was "slow," and I struggled my first two years of high school. I felt lucky to receive Ds in some classes that I should have flunked.

Then everything changed. I earned virtually all As my last two years of high school and throughout college. My college GPA and MCAT scores were so high that I was the one person my medical school accepted per year with only three years of college. I did so well in medical school that I was elected to Alpha Omega Alpha (the med school equivalent of Phi Beta Kappa) after my second year, and graduated in the top 1% of my class.

Studying to become an ER doctor?
Future ER doctor?

I was such a shoo-in for an ER residency position (the most coveted residency at that time) that I was offered an under-the-table deal because they wanted to ensure that no other hospital lured me away. The director of my residency program once commented that I was the smartest resident they ever had, and one of my former bosses told me that I was the smartest doctor he ever met. Aren't these implausible accolades for someone who once was a class dunce?

I was not born with that aptitude. I learned how to expand every facet of brainpower from intelligence to creativity, and I can show you how to do the same thing. You will learn more from me than you could from people who were born on third base, yet act as if they just hit a triple. Being dealt four aces doesn't necessarily make one a great poker player.

I achieved this intellectual metamorphosis from dunce to doctor without any tutors, prep courses, or much help from my family. If I can do it, you can, too, because you're probably brighter than I was. The problem is that 99.99% of teachers succeed only in making their students more knowledgeable, not more intelligent or creative. "Slow" kids like me usually fumble through the system and emerge from it without anyone doing anything to materially augment their brainpower. Hidebound by centuries of antiquated teaching methods, today's teachers cannot transform "slow" kids into ones who ace medical school, like I did. Hence, it frustrates me when I hear politicians and teachers' unions suggesting that the primary way to improve education is to increase funding for it. Hogwash.

Although I was trained as an emergency room doctor, most of my advice is applicable to other medical and surgical specialties as well as other careers requiring superb intelligence or creativity.

In addition to presenting tips to enhance your academic success, I will give you an insider's view of what it is like to be an ER doctor. You will learn the pros and cons of a career in emergency medicine while you are being educated, entertained, and often surprised by a very candid doctor who never pulls a punch.

I spent years developing a similar site, www.ERbook.net, which also focuses on emergency rooms and ER as a career. That site needs an aesthetic makeover, but its extensive question and answer pages provide information that you won't find elsewhere. I will post all new topics on this site in its question and answer section. I am willing to answer questions that I have not previously addressed, but please first check both sites to see if I already discussed that matter.

I firmly believe that since I overcame many obstacles yet succeeded, you can do it, too. If you read some of the difficulties I faced (here and here), it will erase any doubts you may have about whether you can become a doctor or other professional in a challenging career. You can, and with my help, you will.

I helped many people succeed, such as a struggling student depressed about his abysmal grades that seemed to shatter his dreams of becoming a doctor. He is now a brilliant medical student. Another person was trapped in a dead-end job, convinced she didn't have The Right Stuff to become a doctor. With my help, she did; she is now a professor at the medical school I attended (Wayne State), and she is chair of her department at a hospital in the Detroit Medical Center. I gave yet another person the boost she needed. She is now a neuroradiologist, medical school professor, and president of a prestigious medical organization. Note the pattern: not only did I help them, but I helped them become outstanding.

If you want to wear a white coat and earn the right to be called a doctor, the time to start is now. Ready? Let's go.

“Who are we to worry about, or compare ourselves to, others’ dreams when we can't even execute on our own?”
Michael Lazerow

“Too many of us are not living our dreams because we are living our fears.”
Les Brown

“Build your own dreams, or someone else will hire you to build theirs.”
Farrah Gray

“The best time to plant a tree was 20 years ago. The second best time is now.”
Chinese Proverb

“Nothing in the world can take the place of persistence. Talent will not; nothing is more common than unsuccessful men with talent. Genius will not; unrewarded genius is almost a proverb. Education will not; the world is full of educated derelicts. Persistence and determination alone are omnipotent. The slogan "press on" has solved and always will solve the problems of the human race.”
Calvin Coolidge, President of the United States 1923 – 1929

“As we look ahead into the next century, leaders will be those who empower others.”
Bill Gates

Notes:

  1. This is the personality trait that most often predicts success: conscientiousness. If you don't have it, you won't be a good doctor, no matter how smart you are or how much you know. Here's a true story that illustrates conscientiousness.
  2. Personality outsmarts intelligence at school: Conscientiousness and openness key to learning
  3. Grit better than GRE for predicting grad student success
  4. If you want to become a doctor, what I'm holding should scare the living daylights out of you: an amazingly thick brochure of the 11th annual Non-Clinical Careers for Physicians conference. Now ask yourself: if being a doctor is such a desirable profession, why on Earth is there a demand for an expensive course that teaches ways to escape clinical medicine?
  5. How Being a Doctor Became the Most Miserable Profession: Nine of 10 doctors discourage others from joining the profession, and 300 physicians commit suicide every year. When did it get this bad?
    Comment: In 1980, my older brother presciently realized that medicine was bound to become a very noxious profession, so he warned me to not go into it. I didn't listen, making the single greatest mistake of my life. Unfortunately, medical school admissions committees are just as foolish as many applicants in assuming they should become doctors if they like science, excel in it, aren't allergic to hard work, and can't think of anything better to do. Wrong! Medicine can be a fabulous profession for some people, but when you're young, it isn't easy to predict what you'll be like when you mature.

    Secondly, the optimism of youth blinds medical students and wannabes into thinking they will magically escape the myriad drawbacks of medicine, such as ones presented in that brilliant article and ones I presented in the past few decades, but figuratively closing your eyes and hoping for the best won't deliver it. To dodge problems, you must focus on them and intelligently plan ways to circumvent them.
  6. More Than Half of General Surgery Residents Think About Quitting
    Comment: Mentioning the drawbacks of medical careers and how most doctors eventually regret choosing them is essential so students make the best possible career choices for themselves and society. While being a doctor is often very stressful (except for the cushy specialties), the rewards can be priceless.

    I saved many lives as an ER doc. I vividly recall one “save” because I went out of my way and risked my future to save the life of a young black man I knew I couldn't bill. I left the ER (and my malpractice coverage) to run upstairs for his code, which was being botched by the residents responsible for his care. At that facility, a teaching hospital, ER doctors covered the ER only and were supposed to stay there, which I typically did because it was usually so busy I had no other choice.

    But one uncharacteristically slow night I heard a code called overhead and decided to go even though I realized I could have been sued for everything I had and would ever earn had the patient not lived, and I knew the dismal odds: 85% of patients who code in hospitals die. Knowing this, American doctors don't step outside the scope of their practice and malpractice coverage to save lives they have no responsibility for.

    On the street, Good Samaritan laws give some protection to doctors who go out of their way to help, but that'd be a tough sell in a hospital in which I took over a code the residents were running. The second I entered the room, both residents said “Dr. Pezzi!,” clearly surprised and happy to see me. A somewhat officious (but just doing her job) nurse asked me to spell my name during the code, which she wrote in the medical record detailing the code—thus I knew I'd be named in the lawsuit if the patient died. Families often understand the death of elderly folks but are hopping mad when young people die, so I was treading on very risky waters.

    I've never heard of another doc exposing himself to so much potential liability with nothing to gain, but I put that patient's welfare ahead of my own—and I feel very good about that, and also about turning that into a teachable moment because the residents were making a mistake they didn't realize, so if the patient died (which he would have, had I not arrived), they would have learned nothing and chalked up the death to being just another one in that miserable 85% statistic.

    With odds like that against me, and with leaving the ER being so medicolegally risky, the “save” was all the more gratifying. Other occupations don't give people equal chances to save lives, so before you reject medicine, consider what you're giving up. Not only did I save his life, but also the lives of the children he likely had afterward, and the lives of their children, and on and on. Ten thousand years from now, many people will likely have lived but wouldn't have had I not saved the life of their predecessor.

    In medical school I was taught to treat every patient like a sibling. I didn't always do that, but I did in this case, and I'm darn proud of it. You'd be, too.

    “To do more for the world than the world does for you — that is success.”
    Henry Ford

    I relish the “saves” but rue the ones I couldn't, such as my Dad who was murdered and dumped in a swamp, or a classmate executed by her husband, who reportedly spaced shots to her head by 20 to 30 seconds so the relatively wimpy .22 bullets gave her enough time to suffer horribly—and she did indeed, as she stumbled out of her home to drop dead in her driveway less than a year after marrying him.
  7. Sell Yourself, No one Else Will
    Comment: This commendable LinkedIn article is applicable to life in general, not just business careers. One quibble: the author, Bryan Lovgren, seems not to appreciate the benefits of what he terms “a self-deprecating mentality.” There's real-world and scientific evidence that the optimal catalyst for success is appearing to the world as if you have a big head but secretly doubting your ability so you wake up every day with a fire in your belly compelling you to do something great to prove your worth. You can go a step further and utilize social rejection, which is incomparably effective.

    Had I not possessed a self-deprecating mentality, I likely wouldn't have become a doctor and surely would not have graduated in the top 1% of my class, nor would I have subsequently accomplished goals that make medical school seem like a walk in the park. Once I can reveal the inventions I have up my sleeve, their benefits to billions of people now and forever will underscore the upside to thinking so little of yourself it fuels a perpetual quest to improve.

    The complacency of narcissists stems from inflated self-assessments that undermines the incentive to prove themselves because in their minds, they have nothing to prove: they think they're great, so there's no need to do anything more to justify it. Parenthetically, that is one reason why narcissists often excel only in careers in which appearance (not just physical appearance) is key, such as politics or the myriad silver-tongued talking heads on television who often have high IQs but achieve almost nothing tangible.

    Henry Ford said, “Don't find fault, find a remedy; anybody can complain.” It is so easy for TV's talking heads, and other functional idiots in general, to complain about others, but inherent in their criticisms is tacit boasting they have better ideas and solutions. If so, where are they? None of the narcissists on TV have a plan better than mine: a way to give more to those who receive benefits from government while draining less from taxpayers, simultaneously strengthening the social glue that binds us together: rich, poor, and in-between. I was tired of the malignant divisiveness that increasingly fractures America, so I did something about it.
  8. Humiliation tops list of mistreatment toward med students
    Comment: I somehow escaped that, but I witnessed other classmates being humiliated, such as when a professor of surgery would routinely take us—third-year medical students at the time—into a hospital meeting room, close the door, and grill us with one question after another. If anyone paused before responding, didn't know their stuff, or couldn't express it in grammatically correct sentences and paragraphs without saying “um ”or “uh,” they'd be sharply criticized and sometimes subjected to The Mother of All Humiliations: when the surgery prof would SLAM his fist on the table so hard it shook, and with his neck veins popping out further than I'd ever seen, he'd SCREAM in their faces, “You're too dumb to be a doctor!”

    And you know what? He was correct; some med students are indeed too dumb or too lazy to be doctors. He was also wise enough to realize that public humiliation is the best motivator, with research now substantiating its efficacy. Painful? Yes, but not nearly as painful as when those students become doctors who know too little and put too many people into the grave too soon.

    As a medical student, I worked 7 days per week, every day of the year, from early morning until late night, studying, studying, and more studying. I didn't waste half the day, as students reportedly do now, frittering away time on social media; I put my nose to the grindstone and worked hard because I knew patients would one day count on me to keep them alive. The surgery professor knew that, too. People who want to slough off should go into something like politics, where they can bamboozle voters into thinking they have bright ideas when all they have is charm and Hollywood looks. And ego.

    The docs with marginal mental qualifications—say, the ones who graduated in the bottom half of their class—should be turned into nurses or PAs.
  9. More than 70% of young oncologists in Europe suffer symptoms of burnout
  10. 'I've Had It With Medicine!' 16 Options for Second Careers
    Comment: Make that 17: inventing. :-) I can't prematurely disclose what game-changing ideas I have up my sleeve just to appease skeptics and small-minded folks imbued with a crab mentality who don't think there will ever be another Steve Jobs, but when my prototyped and proven inventions are marketed, I will succeed in helping billions of people now and in the future in addition to making my investors fabulously wealthy.

    My LinkedIn tagline has the seemingly audacious claim that my big ideas “could make my investors richer than Bill Gates and Warren Buffett combined.” That seems like a pipe dream, and had someone told me five years ago that I'd soon have ideas that valuable, I would have laughed. But after decades of trying to come up with even a single big idea, I quickly had a small flood of them, some of which do things that seem utterly impossible, yet I know how to make them practical and easy to produce and use.

    I will enrich my investors while saving consumers a boatload of money. To understand how that's possible, history gives other precedents for how significant innovations can create vast fortunes while benefiting consumers. My inventions will make people happier, healthier, and more attractive; they'll save time and energy, and give more pleasure than you ever thought possible.

    I never intended to address drug addiction, but as a fortuitous side effect of one of my inventions (not its primary application), some people addicted to drugs or at risk for that will instead use my product so they could, if they wished, experience rapturous pleasure every waking minute of their lives, without harming their health or society, as the repercussions of drug abuse do. Yup, I turned even a frigging side effect into a miracle!
    The moral of the story is that if you truly want to help people, as most people say when they want to become doctors, you might do enormously more by not practicing clinical medicine. The catch is that there's a well-worn path to becoming a doc. It's arduous, but the road map is clear: just follow the directions and — presto! — you'll arrive at your destination if you have The Right Stuff: enough mental horsepower and figurative gas in your tank.

    Unfortunately, the path is much less clear on how to become an inventor with moonshot ideas that pan out. Going from dunce to doctor, as I once did (see above) was a breeze compared with the difficulty of morphing from a doctor to an inventor with ideas that solve some of mankind's most pressing problems and help companies leapfrog ahead of their competition.

    In this and my other ER site, I gave various tips for augmenting intelligence, most of which are easy though not always quick. Many of my serendipitously discovered tips for boosting creativity are even easier (though so abstruse virtually no one knows them), but some of them require sacrifices few people would endure. The latter are the ones likely most responsible for my big ideas, but without such breakthroughs, you can still make a decent living and help people by inventing. So before you commit to a medical career, consider inventing. Had someone given me that advice when I was young, they would have done me a huge favor.