The summer is right around the corner and the transition of medical students and residents are upon us. For some medical students their time is spent getting in some extra rotations so they can finish a little earlier. Others choose to do some research in order to gain brownie points later on (like it really matters). A few take some time to enjoy their last chance at freedom. They, by pure luck, seem to realize that this may be the last chance of fun in their lives. The truth of the matter is that residency will end all their memories of what real life was all about. As bad as they thought medical school was, residency is worse. Less sleep, more stress and very little money will make them suffer like they never suffered before.
Those residents who are finishing up in their programs are excited because they are about to finally start their lives and be real members of a productive society. They believe the hard days are over and it’s a gravy train with biscuit wheels from here on in. I am here to tell those newly minted clinicians that your suffering doesn’t just end and in fact will continue in today’s healthcare climate. The good news is at least you have a light at the end of the tunnel. You have something to look forward to. You will finally get a real salary and make some real money. You will finally get a modicum of respect. Your dream of becoming a doctor, no matter how delusional it may be, is still a dream and still fun to think about. There are no more hurdles of training to go through and after an initial steep learning curve you realize that you are on autopilot for the rest of your career. Hooray! But you will still suffer. No longer do you have attendings to pimp you but instead you now have the government to audit you. No longer do you have a chief resident to torture you but you will have an administrator demand you see more patients for less money. No longer do you have tests that keep you up studying all night but you have the managed care companies trying to cut your pay. Here is the difference. Before, in residency and medical school, you knew it would end. Now that you are out there on your own, you’ll realize that it won’t. The finality of that distinction is what makes a lot of doctors burn out and want to quit.
I am sorry to sound so cynical but I am not trying to be. This is reality. You may ask if there is a chance things will change. Is there a light at the end of the tunnel? Well, that depends on you. No, there will never be an end to suffering. This job, just like in life, will always have it. There are always problems. You have them. The system has them. Each patient has them. The first step in surviving this career is to accept that. Your day will start with problems and end with problems. The key is not to get lost in them. Sometimes you even have to welcome this suffering and even surrender to it. Who knows, it may expand who you are and become your teacher? Yes, suffering can become your teacher. But if you constantly worry about the suffering and try to become “problem free” then you are doomed. It will never happen. A critical piece in becoming an authentic doctor is being able to accept this fact (a Buddhist Noble Truth). The ultimate goal is to transcend past this suffering. If you do that you may just find some peace and happiness. It is possible. It’s just not easy.