Why is medicine such a demanding career?
The never-ending stress of being an ER doctor
The joys of being an ER doc
Q: Why is it so hard to become a doctor? Most people who start out to become doctors never make it. Why?
Answer by Kevin Pezzi, MD: The ultimate reason why society makes it so difficult to become a doctor is because most members of society want the brightest possible people taking care of them. People are used to dealing with inept mechanics, builders, cooks, bureaucrats, salespeople, and weathermen, but not doctors—from whom perfection is usually demanded.
In regard to your question about the alarming attrition rate, there are many factors. Here are some of them:
- Many courses required for premedical students (such as chemistry, organic chemistry, and genetics) are significantly more challenging than other college courses.
- Many premed students do not have a realistic idea of their aptitude, and they switch to a different career path when they realize they're not doctor material.
- Many premed students are wise enough to know that being a doctor is not the grand and glorious job it's reputed to be. However, please keep this in mind: While being an ER doctor is probably more stressful than you imagine (hence why I tend to emphasize those factors), a career in emergency medicine is also vastly more rewarding than you likely realize. Saving lives is arguably the most important and rewarding job in the world. As an ER doctor, no other medical specialty will give you so many opportunities to help so many people in so many ways. Working in the ER is generally exciting, and you'll make more money than an average doctor. You will also receive some priceless rewards. For example, I've received thank-you cards from adorable children, and beautiful women have given me such cards in addition to hugs that seemed to go on forever (my free Love & Lust in the ER book presents some of these stories). I received a free restaurant meal, courtesy of a gorgeous waitress whose life I once saved. I also had the world's nicest automobile dealer give me a car for as long as I wanted it, in addition to lavishing me with a truckload of presents. I've had patients write letters to the hospital administration so complimentary that I still get a warm glow when I think of them years later. These perks of being an ER doctor show that people are genuinely grateful for the care they receive in emergency departments.
- Some premed students become pregnant (or get someone pregnant), and then realize that the demands of parenthood are challenging enough without the superimposed burden of medical school and residency.
- Some premed students do well in college but flub the MCAT exam.
It takes a lot of mettle to become a doctor. It is not just a matter of brainpower, although that is required, too. It takes almost superhuman dedication to endure the many years of training in college, medical school, and residency. Personally, I do not think it is worth it. I began my training with exuberant optimism and a singular focus, and that carried me well beyond the point at which individuals with more common sense realized that life doesn't have to be so hard. Yes, a medical career can be very rewarding, but remember that you will pay a high price for that reward. If nothing else, you'll spend a decade of your life cloistered away from your friends and family. Most likely, you will need to postpone marriage and childbirth—and if you do not postpone the latter, you're shortchanging your children.
Even if you are not fazed by the daily hassles of being a doctor (long hours, numerous committee meetings, the constant need to study, the hassles of dealing with insurance companies, lawyers, bureaucrats, and dingbat hospital administrators), you will likely feel a never-ending sense of uneasiness about the fact that people's lives are in your hands. If a waitress makes a mistake, she will probably just perfunctorily say “sorry” and still get her 15% tip. If a judge makes a mistake, he is immune to the consequences and never needs to apologize. But if a doctor makes a mistake, people can die. That fact is unnerving, even for well-trained doctors. One of my prior bosses was a very knowledgeable and highly trained ER doc, but he confided that he became so worried hours before every shift that he was nauseous. I've been that way, too. In time, the pressure usually fades somewhat, but does not entirely go away. Being a doctor is an awesome responsibility. I suppose it is not so bad if you are in a low-octane specialty like dermatology or allergy/immunology, but if you are an ER doc you're going to feel the pressure—and the day you stop feeling it is the day you should get the heck out of the emergency room.
See a related topic: How ER doctors can combat burnout
UPDATE: Medicine just became a much more desirable profession, thanks to the economic crash that devastated our economy in 2008. The profession of medicine offers one thing—job security—that is nice in good times but as precious as gold in bad times. I needn't remind you that things are bad now, and almost certain to get much worse (if you doubt that, read this). When times change, it is important to change with the times. I've used a lot of ink warning students in the past about the drawbacks of a medical career, and all of those reasons were quite valid. The cons are still there, but the list of pros just mushroomed in importance thanks to the inherent job security in most medical careers. Good luck trying to find another career that offers comparable job security.