Rapid Responses to:
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Rapid Responses: Rapid Responses published:
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Medicine: you get to make a difference
- David A King (26 November 2008)
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a Career You Will Not Regret
- Antoine Kass-Iliyya (27 November 2008)
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Yes, I Would Advise Medicine as a Career!
- William Notcutt (6 December 2008)
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Ask to your self if you want to do it
- Hammad Akram (7 December 2008)
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David A King, FY2 Doctor St James Hospital, Leeds, LS9 7TF
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Relative job security, good pay, respect from the general public: there are still many good reasons to become a doctor despite the more cynical views of many members of our profession. However, more than anything else, I prefer to quote the words of the eminent British neurosurgeon, Henry Marsh, when people ask me whether they should study medicine. During the acclaimed BBC documentary "Life in their Hands" he was shown working long, often stressful hours whilst having to overcome the many limitations imposed by NHS practice. "Is it worth it?" he reflected at one point during the programme. "Well a lot of people go home from work and wonder whether they have made a difference. At least I don't have that problem." That, for me, remains a good enough reason to want to be a doctor. Competing interests: None declared |
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Antoine Kass-Iliyya, ST1 General Surgery Friarage Hospital, Northallerton, DL6 1JG
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I think medicine is a great fulfilling career, it requires a good knowledge of a fairly vast and intricate science, acquisition of multiple skills, applying the knowledge and the skills that are constantly refined and practiced in helping patients, which can be extremely rewarding, and personally fulfilling. I think to be happy you have to feel good about yourself, and being a doctor does not fall short of achieving the latter. Nothing can be more satisfying for a civilised human being than employing his intelligence, skills, and efforts in helping other fellow human beings, let alone the respect, the job stability, the financial security, and the social status being a doctor brings. Having said that there are some disadvantages of being a doctor which I believe cannot outweigh the advantages no matter how numerous they are. Difficulties of being a doctor in General: 1) Guilt and Worry: Worried doctors might suffer sleepless nights in wonder of whether there was anything they could have done better or whether they were negligent or failed to pick up an important clue or symptom. 2) Mistakes: Doctors are human beings, and they are bound to make mistakes, which can be as serious as costing a life, therefore; it is their duty to ensure that they are 100% vigilant and keeping their mind on the job (no matter how difficult their circumstances are), otherwise they are risking their patients’ lives by delivering suboptimal care. 3) Frustration: It can be frustrating sometimes not to reach a conclusive diagnosis (i.e. no organic cause identifiable) or not to be able to cure the patient (i.e. metastatic cancer, parkinson’s, MS, MND, CF, etc…) 4) Social life: Most doctors in their training years are on the move, which makes it difficult to settle in one place, and even more difficult to build long term friends and relationships, and if they choose a competitive specialty their career demands may supersede and overwhelm their social needs. 5) Maintaining knowledge: being a successful doctor means maintaining a good level of knowledge to support his/her decisions during his/her daily work, which requires constant reading as a routine practice, this means that the doctor’s job does not end at 5 o’clock, but far beyond that. 6) Patient’s expectations: Doctors are frequently stressed when they face very high or sometimes false public expectations, which make room for patients’ dissatisfaction, complaints, and litigations. (At the end doctors cannot perform miracles) 7) Offensive/ rude patients: Every now and again doctors can encounter an offensive alcoholic patient, an angry frustrated patient who is not getting immediate care, a dissatisfied patient who has been waiting a long time to get his scan or operation done, and unhappy relatives who are not content with management plans or standards of care. 8) Litigation: Doctors are always prone to litigations for a variety of reasons (chaperon issues, poor documentation, improper communications, neglect, prescribing errors, etc…); hence there are bodies that support doctors in these situations (MDU, MPS, etc…) Difficulties of being a junior doctor: 1) Boring/paper work: Taking bloods, inserting IV cannulas, filling request forms, writing referrals, writing prescription charts, etc.. 2) Hierarchy system: Sometimes junior doctors have to handle the stress of speaking to an angry senior for an advice or a patient review, or the stress of persuading the busy consultant radiologist to perform an urgent CT scan. also junior doctors are often required to be up to date and able to answer all the senior’s questions regarding ward patients 3) Career development: Junior doctors have to ensure that their CV is developing as they go along, be it a tough exam they have to pass, an expensive course they have to attend, or a looming deadline they have to deliver on, and if they fail to show a good progress they may not be promoted or they might not be able to secure a training post. 4) Extra / long unsociable hours: Given the humane nature of the profession, junior doctors rarely finish work on time, it is not uncommon for a junior doctor to be attending to a sick patient when s/he is supposed to be at home eating his/her pizza and drinking his/her glass of wine, and doctors rarely keep a log book to claim all the extra hours they work. Being on night shift can be depressing and lonely time, as much as being on call during weekends. Difficulties of being a Consultant: (consultant surgeon for instance): 1) Time pressure: Operating consultants are required to finish their list at the right time to avoid any unnecessary cancellations and patients/relatives disappointments, and this can be particularly difficult if they are required to train their junior registrar or SHO simultaneously. 2) responsibility: Consultants take the bigger share of responsibility for any mortality or morbidity occurring in patients under their care which sometimes means consultants having to attend in court or answer to a complaint filed by patients or their relatives, equally so, consultants sometimes make a very difficult decisions regarding patients care, like deciding on the resuscitation status after discussion with patients, or deciding on withholding active treatment, 3) Emergencies: In cases of extreme emergencies consultant surgeons can be called in the middle of the night to perform an emergency operation, 4) Personal life: Many specialties require long hours of hard work and devotion, as well as participation in national and international academic work, which can prevent consultants from spending a much required time with their families 5) Maintaining efficiency: Consultants are required to maintain their knowledge and skills up to date, to ensure a service of high quality, minimal complications and steady quantity. Having said that very few doctors regret their choice of career, and very few doctors are made redundant or left medicine, and even the ones who do so, I believe they do it because they realise that they chose a medical career for all the wrong reasons. Competing interests: None declared |
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William Notcutt, Consultant in Anaesthesia and Pain Medicine James Paget University Hopsital, Greta Yarmouth NR31 6LA
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I enjoyed this thought provoking article. I am an inveterate promoter of medicine. I teach and encourage and try to enthuse school students as well as those in medical school. When talking to prospective medical students applying to University I always tell them that I look for the element of "passion" to become a doctor. I often see it at interview and later. Somewhere though , many do lose this enthusiasm. Medicine is fascinating, rewarding as well as fun and all the patients who had waited an hour to see me at my pain clinic which ran late the other night , were pleasant and appreciative of my time with them. When anaesthetising a young woman recently she commented on the way in which we were chatting and laughing with her, which was very different from the minimal communication going on in the ward. Why do others not find pleasure, interest and reward in their practice? Over time I have observed that there are many doctors who lose interest in medicine as a subject and in patients as people to meet. Some see it as a 9-5 job. Others become negative to all and sundry and constantly moan although this is rarely about clinical activity. Whilst my generation worked far longer hours than the current one yet the dissatisfaction with the career seems to be in the latter. I feel this is something that needs exploring, challenging etc. I don't know what can be done and I hope we can find a way to encourage those who are losing interest younger ( I have a vested interest at my time of life). Willy Notcutt Consultant in Anaesthesia and Pain Medicine Great Yarmouth Competing interests: A happy doctor |
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Hammad Akram, Epidemiologist 2 OCCHD
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Medicine is one of the most respectable profession in the history of mankind. But one has to consider few things before going for it. You should ask yourself "DO U REALLY WANT TO BE A PHYSICIAN?" what were your DEFAULT area of interest since your childhood e.g some people are good in artistic work, some are good at technical stuff.. So you are the person who can guess what is best for you. After deciding that medicine is your choice who have to keep this thing in mind that Medicine is not a field where there is a full stop..its an evolving field and it requires more hard work than most of the other professions, you get the reward and a big one in terms of finances and respect but you get it a bit late, with lots of hard work & exams/boards. But at the end of the day if your really wanted to do it you ll' love it.... Hammad Akram M.D, M.P.H Competing interests: None declared |
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