For What It’s Worth

Although like many medical students I began my professional training only months after the end of college, I believe in the value of medical schools welcoming (or even actively recruiting) older students who have established themselves in areas outside of medicine. In particular, I greatly admire the men and women who come to medicine having already found lifelong partners, started families, or achieved success in other careers. The process of training physicians requires great maturity at the outset, but it also necessarily involves personal change and challenge to our egos and senses of self along the long and winding road. Where, as we muddle our way through the books and anxiety and sleepless nights, do we find our centers? I count myself lucky to have befriended and found good role models in fellow students whose ages are matched well by an increased maturity, self-awareness, and steadfastness against the tendency to lose self-control and courtesy so often experienced by immature physicians (of any age or level of training).

It may be true that recruiting older students (as a criteria) is not a sufficient means of acquiring students with greater maturity before the onset of medical training, just as recruiting minority students does not necessarily encourage the recognition of value in diversity and cultural differences. Rather, if I were ever in the position of recruiting students, I would look much favorably on those who have achieved or are achieving the “developmental milestones” of adulthood:

1) Greater self-confidence resulting from success in prior employment or an ambitious project unrelated to medicine.

2) Happiness in companionship, marriage, and family.

Perhaps the most important aspect would be that such successes are not connected to medicine. Why this requirement? Because the medical profession can all too often dominate the physician’s sense of self-identity. As medical students, we see ourselves as being devotees to a worthy cause, and we should be given respect and recognition for our self-sacrifice. As physicians, we measure our self-worth (and those of our colleagues) by our demonstrations of clinical skill and success. As we move through our professional training, making personal sacrifices along the way, we as medical students might hope that our excess cost in time, personal pursuit, and interpersonal interaction with friends and loved ones will end with our graduate medical training (e.g. residency and fellowship). There must be a light at the end of the tunnel. However, the increases in salaries are not accompanied by a sudden relief in stressors and professional commitments: if anything, the commitments increase (whether in private practice or academic medicine), and the stressors are just better compensated monetarily.

Is this reason for despair? I don’t think so. However, it does give one pause to reflect:

1) Am I putting off my life during my medical training?

2) What exactly will get better after my medical training is done?

3) What am I missing out on?

Medical training is intense and demanding. However, I do think that there is a choice in viewing one’s contribution as either self-sacrifice or dedication. A few months into my first year of medical school, I identified happiness as a necessary prerequisite to being a successful physician-in-training. More than a year later, I couldn’t agree more: in order to deal with the stresses and challenges of our training and future profession, we need to have happiness in our lives unrelated to medicine. These sources of happiness keep us human, centered, and well-rounded.

The great physicians of the distant past were often more than doctors: they were ministers, mayors, shopkeepers, husbands, fathers, and community leaders. In more recent decades (the time of training of many elder physicians today), a blind self-sacrificial approach to medical training was the norm. Would it be surprising if many of these physicians are reluctant to retire, and thus, lose their primary means of self-validation?

People find great, self-enriching happiness in many different things. For me (and many of my classmates), one source of great happiness is that found in love shared with another person. As my recent engagement marks entry into a new stage of life, I find myself paradoxically more energized, focused, and committed to my professional commitments. True happiness is not a distraction: it makes us greater, better, and more than we were before. The medical profession requires us to be just that – greater, better, and more – for the benefit of our patients and for our own sustenance. Another way of looking at it is this: medicine is a profession centered around giving and sharing – compassion, knowledge, and care. An empty shell has nothing to share, while one filled does. In gaining more in our lives outside medicine, we have more to give.

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