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Views & Reviews Live from Liverpool

Would you advise anyone to become a doctor?

BMJ 2008; 337 doi: https://doi.org/10.1136/bmj.a2739 (Published 25 November 2008) Cite this as: BMJ 2008;337:a2739

Rapid Response:

a Career You Will Not Regret

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

Competing interests: No competing interests

27 November 2008
Antoine Kass-Iliyya
ST1 General Surgery
Friarage Hospital, Northallerton, DL6 1JG