October 05, 2014

The Top Five Things I Wish I Had Known Before Applying to Medical School

Now I realize this post has nothing to do with nutrition, food or healing. But it is something that I have wanted to discuss for a long time because this is an issue close to my heart. I wish someone had discussed these things with me before I entered medicine.  Now don't get me wrong, medicine is a great profession and on most days I am grateful for what I do. However, I often wonder if, had I known what medicine was really like, would I have done it all again? The answer is is that I am honestly not sure. There are a lot of downsides to medicine that people don't seem to talk about, and it is not until you are already so entrenched in your training that these issues become apparent.

Television and the media do a great job of making medicine look like a glorious career. Now I am sure it is no shock to you that the medical TV shows are far from reality. But do you realize how far from reality? And I am not just talking about sex in the call rooms (trust me if we ever make it there we are using these rooms to sneak in a few precious minutes of sleep before that pager goes off again). But I am talking about everything else. Those lunches the residents always seem to have time for in the cafeteria… not so much. We are lucky if we get a few minutes to sit down and eat, and it is usually while still working or attending an educational lecture. All the time spent in the viewing room watching other surgeons operate. No sir. There are way too many other patients to look after, either on the ward or in the operating room. The way all of the residents are able to attend each others' weddings or birthdays. Sorry, but one or more of you needs to be at the hospital at all hours.
I hope you are starting to get the idea… So with that in mind I have put together The Top 5 Things I Wish I Had Known Before Applying to Medical School.

1. You May Not Get a Job

Yep that's right friends. But wait, don't we have a doctor shortage? Yes, yes we do. But jobs are not determined based on long wait times and inability to find a family doctor. No, jobs are decided on a political basis. This is especially true for any specialty that relies on procedures or operating room (OR) time. You have to wait 1-2 years for your knee replacement surgery? Don't blame the lack of doctors (trust me there are a ton of orthopaedic residents completing fellowship after fellowship just waiting until a job opens up). Blame the limited OR times that are available to these doctors, and thus limiting the procedures they can do. Now this may be more of an issue for us here in Canada where surgeons don't have the option of opening their own private operating rooms. I am not sure if it is the same in the US or other places. 
But this is a harsh reality that many physicians are facing as they near the end of their training. And then, even if you are lucky enough to find a position, it will not likely be in the city of your choice. This becomes extremely important when you have family or significant others involved. Ideally your partner is in a position to move with you, but unfortunately I know that this is not always the case. I have seen relationships end when a physician has to move to a more remote location simply to find work. I am fortunate in that rheumatology is one of the few internal medicine specialities that still has many job openings in Canada. And hopefully this will still be true when I finish my fellowship in two years. My fingers are crossed. 

2. You Will Always Have Homework 

I cannot even imagine what a home-work free life would be like. Totally free evenings and weekends? That is a foreign concept. As residents we always have work to do when we get home from the hospital. Studying makes up a big proportion of this, but working on presentations and research also takes up a large chunk of time. I can only imagine the workouts I would do, friends I would see, outings I would take if I didn't have this never ending homework. Life would be amazing. Unfortunately, this obligation to do work outside of the hospital never really ends. The focus just changes overtime. Once we become staff we have lab work to follow up on, patient letters to write, committees to sit on etc etc. And since medicine is always evolving, there will always be reading to do. Now, don't get me wrong, I actually really enjoy reading and learning (yes I know, nerd) but I just wish it didn't take away from the other things that I love to do, and often have to let slide (i.e. exercise, time with friends or family).

3. You Will Have to Sacrifice Your Own Health

Residents in general are some of the un-healthiest people I know. It is a terrible irony that we council our patients about making healthy lifestyle choices, when the truth is that most residents are not able to make these choices themselves. You all know that eating healthy is extremely important to me, so I make it a priority to make my own meals and eat well. I am the rarity. In fact, I am known as the girl who always brings her own food because it is so unusual. Most residents rely on cafeteria food for survival, and on our 24 hour shifts turn to the sugar laden peanut butter and Digestive Cookies that are found free on the wards for sustenance. We typically work between 60 to over 100 hours per week, and this just includes the time we actually spend in the hospital. This does not include the after hours work we put in doing homework, studying, working on research, presentations etc etc. As you can imagine this does not leave a lot of time for anything else like exercise, sleep, grocery shopping and preparing meals. It is easy to see why so many residents neglect these other aspects of their lives. Especially those with families or other personal obligations. I am very fortunate in this regard and so I have been able to maintain a fairly reasonable work-life balance, but I make exercise and nutrition a priority. Because of this I have had to make sacrifices in other areas of my life.

4. You Will Have to Miss out on Many Important Events 

I cannot tell you how many birthdays, family dinners, weddings etc I have missed because I am not able to get the time off of work. As a resident you are expected to be on call (where you work 24 hours in a row) on average 7 times per month. And on some rotations you are not allowed to take vacation time, at all. In fact last year I had to miss Erik's brothers' wedding because I was not allowed to take vacation on the rotation I was on. Now many people could not imagine this happening in any other work environment. Miss a family wedding? No way! But as a resident we have very little flexibility in our schedule, and the administration often seems to turn a blind eye when it comes to our lives outside the hospital. I am not trying to sound bitter, but as a group of hard working, highly intelligent adults, it gets very frustrating continually being treated like children. We often have to beg and plead for things that other professionals automatically get. Now this changes once we become staff, but it takes years and years as a resident to make it to that point.

5. Patient's Often Don't Listen to Your Advice 

I can't tell you how many times we tell patients to change their habits with our words falling on deaf ears. Now if you have found your way to my blog chances are you actually take great pride in your health and so this doesn't pertain to you. But you are the minority. So many hospital admissions could be avoided if people were willing to make changes to improve their health: quitting smoking, cutting down on alcohol consumption, exercising more, changing eating habits… The fact is that most people are just not willing to make these changes and this can become extremely frustrating as a physician. You know what needs to happen to help your patients, but they are preventing you from helping them. I take such great pride in my own health that it is very difficult for me to watch others take theirs for granted. This is something I have been dealing with throughout residency, and will continue to do so, I am sure, for the rest of my career.

Well there you have it everyone! The Top 5 Things I Wish I Had Known Before Applying to Medical School. I would love to know what you thought of this post. Did you know any or all of this? Does any of this surprise you? I would love to hear your feedback. And if you have any questions please let me know.



  1. GREAT blog. I cannot believe more people do not check into the REAL LIFE of the medical field or if they are so taken by the IDEA of being a doctor they lose all sensitivity to what the medical field is really like and like so many things once caught up in the web just keep going with the flow not knowing how to untangle oneself from the time and investment already involved. Anyone who can look objectively at the REALITY of the profession would surely want a better way.

  2. Wow Erin, this is eye opening. I have several friends who went through this but they had no concept of being healthy so I didn't even think about how hard it must be for you to cook your own food, etc. I thoughy I had it bad with a full time job and kids but guess I should keep my mouth shut now :-) Good for you though to go through with it and I hope you are able to get through to some people to change their lives. Chances are they'll still listen to you more than many others because you'll have that Dr. designation, and I know you'll use it to the best of your abilities!

    1. Thanks for reading Michele! And don't sell yourself short... being a mother is a full time job all on its own so I can only imagine how busy you are!

  3. I had no idea on a couple of these. So enjoy your blog.