Friday, 15 January 2016

Careers

I would like to warn you ahead of time, oh kind reader, that this is a very selfish post.  I am writing this simply because I'm feeling lazy at the moment.  There will be no stupid patient stories here, no self-deprecation (ok, maybe a little), and no idiotic antivaccine lunatics to make fun of.  Instead I'm writing this as a response to one of my readers who emailed me with a question that I've been asked numerous times.  So rather than a simple return email, I'm writing this in case I ever get asked again.  That way I can just point the reader to this blog post and not have to write the same crap all over again.  So if you have no interest in a career in healthcare (hence the title), go ahead and click here for some stupid "fail" videos.  God damn it, I hate using "fail" as a noun.  It makes me feel dirty.  Ick.  "Fail" is a verb, people!

Ellie (yes, her actual real name™) is a sophomore in high school and emailed me a few days ago with a series of questions.  She is considering medical school but doesn't want to endure the years of education.  So she reconsidered with . . . you know, she can tell her story better than I can.  Take it away, Ellie!
Hi Doc! My name is Ellie (The same one that commented on your blog about vaccines :p).  I’m a sophomore in high school and since about 6th grade I’ve been considering a job in healthcare.  However, I’m really afraid I don’t have what it takes to be in healthcare.  I’ve thought about being a surgeon, but I couldn’t do 12+ years of school.  I’ve thought about being an EMT, but their pay is less than many other in a healthcare field.  I’ve thought about being a nurse, but I’m afraid I’m not compassionate enough.

You’ve written lots on your blog about how you’ve always wanted to be a doctor, but how did you know that you would be right for the job?  What kind of people should go into the healthcare field and what kind of traits do healthcare workers need?

Part of why I’m interested in healthcare is I want to help people.  I’m definitely not the most selfless person, but when I have the skills, I love to help people.  I always get this warm and fuzzy feeling when I help other students who don’t understand the lesson and I’m sure that would translate to healthcare.

Lastly, what kind of jobs would you suggest for teenagers looking to join the medical field (if you can think of any).

Thank you so much,
Ellie
And before anyone asks, yes she gave me permission to use her real name.  No really, she did, and that's her real name.  I didn't change it or anything.  Honest!

Anyway, those are excellent questions, Ellie (still her real name™).  Let me see if I can answer them with some semblance of a logical order.

Whatever job you select, it should be something you love, and if you truly love it, you should pursue it however necessary.  Do you love the idea of being a surgeon?  Does the thought of being anything else make you feel as sad as everyone in the theatre felt towards the end of Inside Out (seriously, if you haven't seen that movie, go see it)?  If the answers to these questions are "yes", then nothing should stop you, even 12+ years of school/medical training.  If you settle for anything less, you will never forgive yourself.  Just like you should never settle on a partner, you should never settle on a career.

Nursing is an excellent option, and though you may not think you are terribly compassionate now, you would probably surprise yourself.  You obviously enjoy helping people, and there is really no career out there like nursing when it comes to helping.  Sure, doctors get most of the credit.  But it's the nurses who are always there, always checking on people, changing bed linens, cleaning bedpans, helping people sit up, fetching water, going for pain pills.  Ok, perhaps that doesn't sound very glamorous, but trust me, when you need help in the hospital, who are you going to ask?  A doctor?  Ha!  The best response you're likely to get from a doctor is, "Let me find your nurse".  Nurses are by and large extraordinary people doing extraordinary things, and I consider myself lucky that people choose that career.

How did I know medicine would be right for me?  I didn't.  It was a gamble, a calculated risk.  There was always a possibility that I would graduate from medical school, start my surgical training, and realise, God damn it, I hate this shit.  There were people in my medical school class who dropped out for various reasons, and I knew several people that quit in the middle of surgical training.  Medicine probably is not for everyone, surgery certainly so.  So who is right for it?  What attributes should people have to go into medicine?
  1. Ethics - You'll sometimes have to make difficult decisions, even life-and-death decisions.  If your moral fibre is not strong, you should not be here,
  2. Judgment - See #1
  3. Intelligence - You don't need to be the smartest person in the world, but there's a lot to learn.  Dummies need not apply and should probably stick to law.  Just kidding, lawyer friends.
  4. Endurance - Long hours, overtime, and little sleep is the norm.  If you need a solid 8 hours of sleep per night, you should probably look elsewhere.
As for jobs that a young person seeking a career in medicine should pursue, the tendency is to volunteer at a hospital.  If I were interviewing candidates for medical school, my response to that would be, "YAAAAAAAAAWN".  Not that volunteering at a hospital isn't useful or educational for everyone involved, it's just BORING.  Every prospective medical student has seemingly done their time as a hospital volunteer.  So if that's what you'd like to do, it's probably fine.  It'll most likely get you by.  But if you really want to stand out from the herd (and trust me, you do) then do something different.  I volunteered reading books onto tape for blind students and at a free park clinic for the homeless.  Both jobs were extremely rewarding, and they stimulated many conversations with interviewers.

There are tons of options out there for teenagers looking to do something.  Volunteer at a soup kitchen or homeless shelter.  Pitch in at a shelter for battered spouses.  Clean up the roadway.  Read books to the elderly at a senior center.  You'll probably be surprised just how satisfying those jobs can be.

I hope that answers your questions sufficiently.  Now if you'll excuse me, I'd like to get back to writing my next Daily Beast article.  Hmm, now that I think about it, it doesn't seem like I'm actually that lazy after all.  Good.

25 comments:

  1. "Dummies need not apply and should probably stick to law."

    Ouch.

    But I'm sure you would agree Doc, that somehow there is always that one person who manages to get through law/medical school and still has no semblance of real knowledge...

    ReplyDelete
    Replies
    1. Yeah I know, it was a joke. A rather harsh one, I'll admit.

      I was expecting this comment. You are correct, there are always people in every medical school class who make you wonder how they got in.

      Delete
    2. Worse still, neurosurgeons.

      Delete
    3. I should also mention that SisBastard, whom I adore, is a lawyer. I do understand that not all of you lawyers are terrible people. ;)

      Delete
  2. "Dummies need not apply and should probably stick to law."

    Ouch.

    But I'm sure you would agree Doc, that somehow there is always that one person who manages to get through law/medical school and still has no semblance of real knowledge...

    ReplyDelete
  3. If you're in a community that has a volunteer fire department, ask if they have a cadet program.

    I agree that most EMTs aren't paid what they are worth. it is also among the least glamorous parts of the medical field - despite that they show on Chicago EMS or whatever the medical side of that group of shows is called.

    it does seem to be on the busiest end of helping people, though. - and if you train through a fire department, you usually get the training for free.

    ReplyDelete
  4. hi there. I received my EMT cert a few years ago in Omaha, Nebraska. I thought it would give me an advantage when I go to medical school in a year or so. from what I've found, EMT jobs are very difficult to come by. almost all of them are through the fire department and you must first be hired on as a firefighter. in my opinion, it's definitely worth sticking to it through paramedic training. not sure if that's the case elsewhere. love your blog, doc (:

    ReplyDelete
  5. Bit offended with the nurses bit we do much more than clean and fetch which is a very minor part of the job. Nusrses are also the ones doing all the obs noticing when something is wrong with the patient and giving advice to the doctors. We take blood, give medication, run IVs and as a midwife as well monitor pregnancy and deliver babies.

    ReplyDelete
    Replies
    1. It seems like you missed the part about nurses being extraordinary people doing extraordinary things?

      Delete
    2. I caught that nice comment about nurses being extraordinary, but was also a little stung that your examples of what we do were limited to "...checking on people, changing bed linens, cleaning bedpans, helping people sit up, fetching water, going for pain pills." Wow. If that was all I did, I would need no more training than a high school diploma. My masters degree would be a waste of paper.

      Delete
    3. Well, to be fair, you only covered the portions of the job that can be performed by a CNA rather than an RN.

      Nurse epidemiologists exist, for example. Far more interesting (to me anyway) than dealing with vomiting or crapping.

      But yes, nurses are extraordinary. Now, why are female nurses paid less on average than their male peers in the US? It's one profession where women far outnumber men and I would expect there to be no significant difference in their salaries, but I'd be wrong.

      http://www.bls.gov/opub/reports/cps/highlights-of-womens-earnings-in-2013.pdf (page 13/76: registered nurses)

      This may not apply where you are, Doc. I find it very upsetting.

      Delete
    4. My apologies if that's the way it read. I certainly meant no disrespect whatsoever. I (obviously) fully understand all the responsibilities that nurses have, the most important of which is to be our eyes and ears when we aren't there.

      Nurses are my heroes. Full stop.

      Delete
    5. Mine too...my primary care provider is a nurse! (APN). Of course, I have great doctors too :)

      Delete
  6. Job-shadowing or internships are great for young people to find out if an occupation might be right for them. I mentioned in an earlier blog comment that my husband is a veterinarian. He has tons of students wanting to spend time at his clinic. Many who apply, have a very idealized ideas about what a vet does. They are unaware of the smells, maggots and bugs, snapping and biting animals, mundane jobs, terrile hours, and sometimes sadness that can be a part of everyday practice. My favorite intern was a girl who faithfully showed up everyday, all summer, and did everything she was asked. She took notes, seemed interested, and always had a smile on her face. At the end of the summer, she went off to her fall studies. We received a beautiful house plant with a sincere thank you note. At the bottom, it said, "If you need to contact me, I will be at Juan's College of Cosmetology." She found out what she needed to know.

    ReplyDelete
    Replies
    1. I loved working with a mixed practice vet: small animal and large - farm calls are the best (even when they're the worst)! I went into research and in the end, I think I made out better financially than I would have as a veterinarian.

      I ♥ my veterinarian and can't imagine him not in practice. He's not allowed to retire, sell the practice or die. Nope. Not without my say-so!
      (。◕‿◕。)

      And engineers - I ♥ engineers too.

      Wednesday

      Delete
    2. Learning isn't just figuring out what's right for you...it's figuring out what's *not* right too.

      Delete
  7. As a recent, unwilling consumer of healthcare services since Sept. 23, here are a few of my observations.

    1. I never wanted to be involved in any aspect of medicine. Beside the whole, "ew" factor, there's the fact I can't stand anybody's blood but my own. This doesn't mean I lack compassion, it just means I exercise my compassion in less "ew"-y, bloody ways.

    2. If it hadn't been for an off duty EMT up a phone pole scrambling down that pole and knocking me down because I stood up with part of a fibula sticking in the earth, and something of a gusher going off about knee level (first time I'd ever heard the term, "popliteal artery"), I wouldn't be here writing this little missive.

    3. It also didn't occur to me in September that it wouldn't be until November before I could wipe my own ass. NEVER underestimate the power of wiping your own ass. NEVER underestimate the gratitude of a person who can't wipe their own ass for the people who do. Then there are transfers for surgery, they smile when you come out of surgery, the skeptical look they give the tray of food waiting for you. Then there are the more important things like making sure you get the right drugs in the right doses at the right time. Or, keeping track of your blood pressure and knowing when your normally low blood pressure is now too low and you need another unit of blood. A good nurse is fantastic. A bad nurse is fatal.

    4. A doctor and a mess of nurses put my popliteal artery back together. I wasn't conscious for that part, but I've talked with the vascular surgeon a bunch since then. I've also talked with the orthopedist, and the plastic surgeon since then (that's right, folks, plastics is responsible for more than bad boob jobs - they do things like take a cheese grater over your thigh so that you have enough skin to close your lower leg). There are a huge variety of specialties out there should you go the doctor route.

    And, if you want to practice medicine without a license, get involved in the insurance industry.

    Look, I'm an outsider. I love Doc's blog, but that's as close as I like to get to medicine. As an outsider, I'm appreciative of all of my recent caregivers, including my PCP who's helping me coordinate pt and the like without giving me a look that says he saw that one coming. Here's what I see - I see somebody remarkably young trying to make a decision that she should not be making at this time. Right now, your decisions should keep options open, and not closing them down. You're saying that you have an interest in medicine - great! Keep all options in medicine open for as long as possible. 12 years of school seems extreme from where you are now. It won't seem that extreme when you're a few years older. As for the expense - there's ways to pay for school, and things are changing when it comes to payments for school beyond high school. Don't let expense deter you until it actually deters you.

    Glad you want to get into medicine because you want to help. 15 surgeries later, you are the kind of doctor/nurse/orderly that patients actually like, and make a miserable situation just a little less miserable.

    ReplyDelete
    Replies
    1. In general, the older you get, the less extreme 12 years of ANYTHING sounds.

      especially once you've got 12 years of a few things neatly behind you.

      Delete
  8. For Ellie....
    Maybe look into the dental field?
    I personally had similar concerns (interested in healthcare but not in too much schooling, want to help people, want a science research component but at the same time human interaction, want decent pay, etc...) and ended up applying for dental hygiene. I'm halfway through my 3 years of schooling, average 30$/hour where I live (can make around 40$+ per hour if I move somewhere else), decent job market, can help people and there are programs like dentists without borders if ever I really want to get into the volunteering spirit, etc...Downsides? Starting pay is meh, slightly difficult to be hired full time (at least where I live...but easy to work at two clinics and just pick the hours you need), can cause muscle problems longterm, etc...
    Not saying that program is necessarily for you, but my point is just to expand your search. There are MANY different options when it comes to the health field, so you'll probably be able to find something that's right for you :)

    ReplyDelete
  9. I disnt know you had a sister, Doc! You've only mentioned a brother before. Does she know about your opinion on lawyers? To paraphrase you, "fucking soulless assholes, every last one of them" (or something along those lines, I'm too lazy to check).

    But I agree for the most part. I think defense attorneys are worse than prosecutors, since it's their job to keep the scumbags out of prison.

    ReplyDelete
    Replies
    1. "I think defense attorneys are worse than prosecutors, since it's their job to keep the scumbags out of prison." You'll think this right up until the time you are accused of a crime you didn't commit. You're like people who hate the police until someone attacks them, or people who hat doctors until they get sick.

      Professionals by and large ignore this feature in the people they have to deal with, but sometimes it's hard.

      Delete
  10. Hey Doc,

    Thought you might find this interesting/massively frustrating:
    http://www.theaustralian.com.au/subscribe/news/1/index.html?sourceCode=TAWEB_MRE170_a_FBK&mode=premium&dest=http://www.theaustralian.com.au/higher-education/opinion/wollongong-should-never-have-accepted-judy-wilymans-thesis/news-story/304956bbe891402206dbbbccfa02e340&memtype=anonymous

    Apologies in advance for the tension headache it'll cause.

    -G

    ReplyDelete
  11. I love my job as a pharmacist. I knew being a doctor or a dentist wasn't for me because I couldn't stand the thought of hurting somebody even it is to help them.

    Thus, pharmacy comes as an alternative option for me. I get to interact with patients and teach them how to use their medical devices like asthma inhalers, nasal sprays, insulin pens and how to take their medicines. You still get to help them in a way.

    Besides, if you get tired of being a clinical / community pharmacist, there is always an option to work in the enforcement area or research etc.

    There's no end to what you can do once you pick a job you love.

    Peace out.

    ReplyDelete
  12. DIETITIAN!

    It's awesome. I get to read charts and talk to people...while actually not being in charge of their care, life or death, or touching anyone. It's perfect. Downsides include total lack of decent salary, and no one (especially doctors!) read my notes or care about my thoughts and impressions. Oh well, I get paid either way and can't kill anyone.

    ReplyDelete
  13. Ellie, what about going for nursing? It's a 4 year bachelor's program, if you decide you don't like it you still have a bachelor's of science degree(which is very useful in fields outside of medicine) and if you decide you want to, you can go on to become a nurse practitioner! They're the kinds of doctors you see when you go to the take care clinic at Walgreens or planned parenthood. They diagnose, and can prescribe medications, and it takes waaaay less schooling than going on and becoming a doctor. It gives you a chance to reevaluate your life choices without making a 12 year commitment.

    ReplyDelete

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