Bush

Adam Bush

Morean

English 1201

4-12-2020

Is the Heath Care Profession Right for You?

Hundreds of thousands of people each year graduate high school and know they want to

pursue a career in medicine, but they have no idea what route they should take in order to

completely fulfill their wishes. They also have not investigated or heard of those who are

already in the profession and wish they would have changed their route of study. People may

think they want to practice medicine for several reasons. They may have a soft spot for sick

children or want to be a world-renowned doctor who may find the cure to cancer which took the

life of their grandmother. They may be infatuated with the human body and want to learn more.

There are many reasons why someone may want to be a part of the health care industry;

however, when they take a step back and look at the hundreds of options before them, they often

become intimidated and overwhelmed, maybe even forgetting the historical facts of physician

burnout and unhappiness. There are many career choices in the medical field, but due to its high

burnout rate and unhappiness amongst its professionals, it is important to consider several facts

that contribute to its challenging profession, and many would argue that this career path is

intended for a select few.

Historically, medical doctors and nurses have been held to a high regard. They are

known to be professionals that are well educated, kind, and compassionate. Over the years, the

medical career has changed, keeping many from entering it at all, and making others already
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deeply involved, wishing they would have chosen an entirely different career. Those that enter

the medical field may envision medicine and the schooling to be what it was years ago. They

begin the schooling with a false perception of what the career entails (apprentice). Still others

complete medical school, begin residency, and switch specialties. As a matter of fact, an

astounding thirty nine percent of residents transfer to another medical specialty and forty eight

percent of residents leave the program entirely (Beckers). What contributes to this change of

heart? Could it be that people believe they have the drive to achieve a goal that they were never

equipped for?

The one thing that all health care providers have in common is their desire to make

patients well. Doctors and nurses who love their profession tend to be better at their job.

Therefore, it is very important to determine what type of job you will enjoy for the rest of your

working career. According to Medscape Physician Lifestyle and Happiness Report 2020,

physicians will spend on average upwards of sixty hours a week at work (Martin 17). This is by

far above the average time spent at work per week among all professions. Working this many

hours requires a sacrifice of time that must come from somewhere else in your life. Daily,

doctors give up time with their own families or their own hobbies in order to help others. An

essential step that cannot be skipped when selecting a medical profession is deciding what

medical specialty fits your personality. All people’s brains are wired differently so it is important

to find a specialty that works well with the way you think and the interests that you have. An

astounding fact showed that only forty four percent of neurologists and critical care providers are

happy outside work while sixty percent of rheumatology doctors are happy outside of work

(Martin 3). It is concerning that someone who is providing such crucial care to human life may

be leading an unhappy life outside of work which most certainly affects their work habits.
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There are three types of physicians: managers, fixers, and diagnosticians (Keller 2). The

first type of physician is a manager. Some examples of managers are primary care doctors and

family medicine physicians. Managers tend to look at the big picture. They have much less

knowledge in specific specialties, but they know the main idea of every specialty. These doctors’

job are to treat minor illness and send severely ill patients to specialists. Many of us have

firsthand experience in being referred to a specialist. Oftentimes, when an individual breaks a

bone they go to their family doctor who will assess the injury, order an x-ray, and refer the

patient to an orthopedic specialist. The bone specialist will then take the proper course of action

in order to get the patient back to their normal state. Sometimes the patient will need surgery to

repair the bone so he or she will be sent to an orthopedic surgeon or possibly even a hand, hip,

sports medicine surgeon, etc. These types of doctors must be ready and alert. They need to have

a clear mind in order to consider causes for symptoms that patients may be presenting. These are

needed physicians, yet with the current burnout rates and decline in morale, patients access to

care is being limited as physicians either leave clinical responsibilities or cut back on their hours

(Heath).

The second type of doctors are fixers. This type of person is typically a surgeon of some

kind. “Surgeons tend to describe their roles in terms of ‘fixing’ specific problems” (Keller 2).

Fixers like to have immediate solutions to the problem. Cardiothoracic surgeons perform heart

transplants on people whose hearts have failed. The patient comes out of surgery with a new,

working heart. Fixers also value working with their hands rather than prescribing medicine or

physical therapy, but this does not mean a surgeon will not prescribe their patient medication and

physical therapy before surgery to try to prevent resorting to the most invasive treatment option.

To maximize the effectiveness of the procedure, surgeons will use additional techniques after
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surgery. A patient may be referred to physical therapy for an amount of time or even to an

inpatient rehabilitation facility. These are all responsibilities of a medical physician. Each

responsibility must be made with a clear mind and with the patient’s best interest in mind. When

someone in this type of specialty comes unhappy to work it can unintentionally affect their

quality of work. The largest threat to physician-patient interaction, is the physician no longer

being there due to cutting back hours or sadly, even suicide (Heath)

The third and final type of doctor is the diagnostician. Radiologists and emergency

medicine doctors are diagnosticians. They see images and patients and their job is to determine

what is wrong with them. These doctors have large amounts of stress because all the treatment

following their encounter with the patient stems from the diagnostician’s diagnosis. Emergency

medicine is only for a certain type of person, and it is possibly one of the most difficult

specialties. If a patient comes in with a chronic runny nose, they need to be able to dig deeper

into the issue and not just dismiss the patient with a prescription for allergy medicine. If the

doctor finds out from the patient’s history that he or she has been having headaches and a salty/

metallic taste in their mouth as well as the runny nose the doctor would need to rush the patient

to surgery. The seemingly harmless headaches and fluke salty taste in the mouth seem

meaningless to the patient, but the doctor would be able to diagnose the patient with

cerebrospinal fluid rhinorrhea. This is a condition where fluid in the brain is leaking out into the

nasal canal and mouth. Cerebrospinal fluid rhinorrhea will be fatal if caught too late. The stress

encountered by these types of physicians leads to massive burnout. Over the years, there has

been less patient interaction with the increase of technology. Patients make appointments over

the phone and may even get results over the internet. This decreases patient-physician interaction

causing a lessening relationship which may allow a medical provider to better know and
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understand his or her patient. Without this better relationship, the physician can be confronted

with undue stress in making medical decisions without fully knowing a patient(Heath).

One of the most influential factors when deciding what medical specialty, you will pursue

is the education required to practice that type of medicine. The more common avenue that people

choose is the nursing route. The schooling varies from 2-4 years post high school graduation.

This schooling is typically rigorous but manageable. One professor my sister had in nursing

school stated, “Nursing school is like drinking from a firehose”. You are inundated with a lot of

information in a short amount of time. Even with clinical studies where nursing students have

direct contact with patients and practice in several areas of focus, the burnout/drop-out rate is

high. According to Bio Med Central (BMC) Nursing, the number of dropouts differ in different

countries. “The intention to leave nursing education or the nursing profession is associated with

determinants of study burnout, job satisfaction, organizational commitment, job demands and

work engagement” (Bakker). There is a great need for nurses, therefore, it is important that those

who begin the education complete it and are then happy with their choice of career. As argued,

the medical profession needs to be taken seriously, and many aspects of it must be considered

before beginning the training it requires. “The shortage of nursing professionals is a growing

concern,” according to the Commission Health workforce. It “acknowledges that there is a

significant employee turnover in some field of health care due to demanding working

conditions” (Bakker). This means that those that make it to graduation will have no problem

finding a job in the nursing field as the demand for them is high.

The other common route many people take leads to becoming a medical doctor, MD.

This training is some of the most difficult and stressful in the world. The first step to becoming

an MD is to earn a bachelor’s degree from an accredited college. Within your bachelors’ degree
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you will be required to take several medical school pre-requisites. These pre-requisites are very

important to your education. They consist of several biology, chemistry, anatomy, and

psychology classes. It is here that some decide they no longer want to continue their education

after the four years, and they make an early career plan change. For those that continue to hang-

on to their aspiration, their next step is to be accepted into a medical school. This is perhaps the

hardest point in a doctor’s career. Medical schools are competitive and require a high, grade

point average in your bachelor’s degree. Medical schools also require you to take the Medical

College Admission Test (MCAT). This is like the ACT’s big brother. The ACT is used by

colleges when accepting high school graduates. The MCAT is used for accepting bachelor

program graduates into medical school. Medical schools also like to see letters of

recommendation from credible sources. If a medical school is considering a possible applicant to

accept, they will call them in for an interview. After going through this tough process, you may

still be denied entrance. Only about one third of medical school applicants get accepted. If you

are rejected, you will have to wait until the following year and apply once again, hopefully this

time with a stronger resume and higher MCAT score. Consider the emotional trauma that ensues;

students have gone to great lengths to get to this point and have spent hours in textbooks and

medical facilities. They must make the grave decision to wait another year for testing or make a

turn in the choice of career. The argument continues, “Should all who think they are interested

in medicine truly pursue the field?”

After being selected, individuals will have four more years of education where they will

learn and master heaps of information about the human body and medicine. During medical

school, students will take a series of exams that must be passed in order to legally practice

medicine. Students will take United States Medical Licensing Exam 1 (USMLE 1) at the end of
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their second year of medical school. Students will take step 2 and 3 in the second half of their

medical school education. Only a small portion of students do not pass this first USMLE test. At

this point, pause to think about the considerable amount of stress this puts on the student. They

are at a point of no return in their schooling, yet they are not seeing the ‘light at the end of the

tunnel’ as they have more hurdles to overcome. Burnout has already started due to the amount of

stress this testing generates. Ninety-four percent of students pass the USMLE leaving a six

percent of students wondering their path of direction (Wolf). Should all those interested in

medicine pursue a degree in the medical field, especially that of a physician which requires

extreme academic rigor?

After completing eight years of formal schooling, students have a plethora of knowledge

in the field of medicine. Students will lean on the information they learned to choose what

specialty they pursue. This information is not enough. Even though you may love trauma surgery

and neurology, the information you learned in med school will not be sufficient to make decision

between trauma surgery and neurology. This is where you must consider several aspects of your

life. Residency is the next step for the medical school student. Here you will receive intense

schooling in your area of medical interest. If you are interested in how the digestive system

works, you may gear your training towards gastroenterology. Those interested in the heart

receive the training to become a cardiac specialist. Each of these medical avenues have different

demands placed on a doctor. You must decide the demands you are willing to accommodate and

those that do not seem to fit well with the lifestyle you may want for you and a future family.

One of the considerations a future doctor needs to make is what kind of interaction they

enjoy with patients. Family medicine doctors typically have long and deep relationships with

their patients. Family medicine doctors often see babies the day they are born and continue to see
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them from time to time until they are an adult. Many people find this aspect of the job very

attractive. On the other hand, some people prefer minimal patient interaction. Radiologist for

example, spend much less time conversing with the patient than family medicine practitioners.

These are the two ends of the spectrum, but there is an in between and this is where the majority

of physicians choose their career. Surgeons often spend one to three days a week in the clinic

where they diagnose patients and discuss treatment options. The other days during the week are

spent in the operating room. Patient interaction is a huge part of being a doctor. Therefore, it is

important to discover what type and how much interaction you want with patients in order to

become the best doctor possible and provide your patients the best care. According to MedScape,

nineteen percent of physicians in the Millennial generation are as unhappy in their profession to

call themselves depressed. This increases to twenty three percent for Generation X and the Baby

Boomer generations (Martin 2). We can generalize that the longer in the medical profession, the

more unhappy you become. I think most would agree that they want to be happy in their career

as many hours of your life are spent there. It is especially important that those caring for the

health of mankind are happy in the profession. Not all are suited for a career in medicine.

When selecting a career in the medical field it is important to consider the hours you want

to work. When you are newly hired, you will most likely be required to work the night shift.

Several specialties such as trauma surgery and obstetrics have long unpredictable hours.

Obstetric doctors are always on call and at the ready to rush to the hospital and deliver a baby.

Some people may love to deliver babies, but the thought of being called to duty in the middle of

the night is something that makes them reconsider their choice of career paths. These people may

want to instead consider working as a pediatrician in an office or as a dermatologist. Working

long hours is a difficult hurdle that every doctor manages, but hours outside your zone of
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comfort could lead to dissatisfaction with your career. Medical personal cannot perform if they

are not at their best. Working shifts that are not satisfying may result in a doctor that is not

working at his or her peak performance.

Salary is another aspect of the medical field that can vary from specialty to specialty, yet

doctors that enter the field for their care of humankind, do not choose a specialty for the income

it will generate. Those that do soon find that the money earned by some of the top specialists are

also the specialists that have the highest rates of unhappiness. It is a common misconception that

doctors enter the field out of greed. Some believe that doctors care about their pockets more than

they do their patients. On BestMedicalSpecialities.com charts and graphs are shown that

compare doctor to teacher salaries. They compare the amount of time spent in the education

environment and the workplace itself to the compensation in salary that each of these

professionals receive. Surprisingly, teachers make a few pennies more per hour than the average

medical physician (Best 1). For those that simply enter the profession for the money they make,

soon find this adds to their unhappiness when they calculate the hours spent in the field to the

income.

After considering the above personality and income factors, a medical school graduate

will choose a specialty and apply for residency. Residency is a three to seven-year experience

that you must complete in order to practice medicine completely unsupervised. Future doctors

will apply through the electronic residency application service or ERAS. This allows students to

apply at various hospitals while the hospitals then get to choose the students that they would like

to join their staff in caring for patients. After residency, you are qualified to practice

independently, however, many physicians will choose to yet further their education by selecting

a subspecialty and gaining their fellowship. The percentage of doctors continuing education to
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receive a fellowship, depends on the type of degree the medical doctor currently holds. This

continued education that is often encouraged, can cause additional financial stress on the

household as well as time sacrifice. When finances and time become lost commodity in a

family, satisfaction with marriage decreases. “Seventeen percent of medical doctors rate their

marriage as being fair or poor” (Martin).

The process of becoming a doctor could be described as ‘Survival of the Fittest’. The

smartest and best students rise to the top and attend Ivy league schools like Harvard Med,

Stanford, Johns Hopkins, and Cornell. The weak students get eaten alive and end up having to

drop out or attend a less reputable school. This is a sad truth. Some people want to be doctors

more than anything but struggle to get through the schooling. The students that work extremely

hard and squeeze through the training often become the best doctors, but those that do not make

it to the top deal with emotional struggles.

Not all who are interested in medicine should pursue a career in the field. There are

several factors to take into consideration, and none of the factors are quick and easy to decide

upon. There are as many specialties in the medical field as there are factors to consider when

choosing a path of training. It would be beneficial for a person considering medical school to

investigate types of doctors and maybe even shadowing several to determine interest level. All

types of medical providers are needed and thankfully there are all types of people with all types

of interests. The schooling is long and tedious. The time spent is laborious and sacrificial.

Choose a career that drives you to grow in your field, enjoy your work every day, and one where

healing and helping people is front and center of your reason for coming to work. The medical

profession is not for everyone, and those that enter it should carefully determine if they should

enter it. Lives depend on it, and your happiness may be determined by it.
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Works Cited

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Jubal, Dr. Kevin, director. How to Choose a Specialty. Med School Insiders, May 2019,
www.youtube.com/watch?v=yQLD_HZPBwM.
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fits-your-medical-specialty.html.
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