| | The prestige thing is important to consider carefully. The average doctor works pretty crazy hours unless you really go out of your way to find some cush job with good hours like working in some 9-5 urgent care somewhere or something like that, most of which won't pay that well, at least at doctor money goes (though it would still be a lot from any ordinary point of view).
So, assuming you work the standard 60-80+ hours per week at a doctor, consider that you will not have much time for anything but that. Thus, as you will spend nearly all of your waking time around techs, secretaries, nurses, midlevels, other doctors, administrators and patients, you must consider that circle when assessing prestige and what prestige means and its context.
In this case, the context of your prestige as a member of a group of doctors, as you are in that group, and your level of value will be judged against where you fall in that herd. Everyone will very rapidly figure out how you measure up regarding the things they care about, and they care about the following things:
1) Ability: since you will be judged among doctors, your level of ability will relative to them, and they are a generally impressive group, obviously, so shining in that club is not easy. Everyone will very rapidly figure out if you are smart and capable, as this is the real world, not some test, and patient outcomes depend on you knowing what you are doing. People will die more often if you don't have command of the core knowledge of medicine. That rapidly gets noticed by everyone, administrators, your medical director(s), nurses, patients, families, and your colleagues. Unless you have lots of ability, in the medical world you won't have prestige. Thus, better study or get out, as without a really thorough and fluent knowledge of the core aspects of medicine, bad things will occur, everyone will know it, and you will rapidly gain the reputation of being a poor doctor. Given that you will be spending 60-80+ hours with people who then think of youy as a poor doctor, there will be no thrill of prestige just because you have an MD after your name, I promise you, and there will be much internal stress unless you are the sort of rare person who can suck and not care. I know doctors who appear to fall into that category: their capacity to handle and/or ignore that internal dissonance is amazing to me.
2) Caring: you will also be judged on whether or not you care about patients and medicine. The patients and families and nurses will all very rapidly figure out if you really are engaged, if your heart is really in it, if you really give a damn. If you don't, you will feel the dark stares instantly, feel the bad reactions from families and patients immediately, day after day, interaction after interaction. You will count the complaints as they pile up, mark your time by the visits to your administrator's offices for conversations related to everything that goes badly because of this, and likely finally get sued, as patient sue doctors who they don't feel care about them. This is not a test: this is real life, and your real life as a doctor who doesn't care about medicine will likely suck. Lawsuits ruin lives, marriages, careers. All your not very hard work will crumble due to not giving it the attention that patient care deserves. Just as the rewards of being a doctor are great, so the penalties for failure are pretty severe. Working 12-16+ hours days doing something really hard and stressful that you also really don't care about leads to burnout, drug and alcohol addiction, serious marital problems, depression, illness, and even death. I see this all the time in my colleagues who should have done something else.
3) Friendliness: seems related to caring, but I know doctors that care and aren't particularly friendly. Friendly doctors do better. They still have to have the other things, but if you are really nice to work with you will do better, and you are much less likely to be friendly if you are constantly barraged by complaints, if you are aware that everyone around you doesn't feel you know what you are doing, if you are being sued, if patients respond badly to your bad care, and if you yourself feel like a fraud, which you will feel like if you don't know what you are doing, and you would be right.
In short, if you are not a caring, well-educated, smart, kind, able, skilled, engaged physician, you will not have prestige during 60-80+ hours of your waking life, and, in fact, will have the reverse. You will paradoxically be very low on the prestige list, below that of good nurses, below that of good techs, below that of even really helpful janitors and even below that of good administrators. You will be looked at like we look at all the doctors that don't know what they are doing and don't care: we feel they are a dangerous waste of time and brain power who shouldn't be allowed near patients.
Your imagined notion that somehow when you come home to crash after a long day that the prestige you get at home and from your family will compensate for that: it won't. If you are miserable all day long, your spouse will know it and feel it when you get home. There is nothing attractive about that, nothing sexy about it, nothing that makes a partner happy. If they are the sort of superficial person who would care about the fact that you are a doctor who makes good money and cares little about whether or not you are actually happy: don't marrry that person. When you crash and burn, which you likely will, they will take you for what you are worth and skip off to the next sucker. I see this on a regular basis and could list doctor after doctor this has happened to. If they are actually a decent, loving person who really cares about you, then their good heart will break when they see what working like a dog at something you don't really care about does to you: don't do that to them, as it is not fair. It is just tragic.
I will tell you a story that my father told me. He endured a really brutal residency back in the days when they were even harder than they are now in a totally malignant New England hospital that will go unmentioned. They worked 100+ hour weeks. They slept little. They were hazed mercilessly. Luckily, my father loves medicine, but is till totally sucked having to work that hard in that environment for that long. A week from the end of this brutal three-year residency they were all sitting around doing charts when one of the residents that had seemed even more miserable than the rest of them got a phone call. He picked up the phone listened for a minute, said nothing, put down the phone, took off his white coat and stethescope and started walking out the door. The other residents asked him where he was going. He simply said, "My mother has died and I was only doing this for her. Now I don't have to do this anymore," walked out the door and never practiced medicine again. Seven years of misery for nothing.
Again, either figure out how to love it or don't do it. It is that simple and straightforward. It is basically guaranteed that if you don't heed this advice bad things will occur, both in your life and in the lives of your patients, as very soon the decisions will be yours, the responsibility will be yours, and the risks and rewards will be yours. Don't ignore that risks part as you are all focused on the rewards of meeting your family's expectations, as the risks aren't worth that. Medicine is a high-stakes game, and you better not walk up to the table if you don't intend to win and aren't willing to do what it takes, as what you lose when you lose will blow your mind.
Back to the A&P point: are you 100% certain you never crossed it? Interested in the priesthood and monkhood and the like, hanging out on obscure internet forums about hardcore practice, agonizing about dharma pursuits and having career dysfunction: totally certain you aren't having some Dark Night stuff mixed into your very confused career motivations?
Could try to do what I did: I spent a year in India (or Thailand or Burma or some place like that) doing volunteer medical service along with taking breaks to do serious meditation retreats in good monasteries. That year gave me lots of medical cred, also gave me lots of motivation to learn to care for people well, as the need was so staggering that it would be really hard for even the most uncompassionate idiot to not feel the impetus to do something, as well as solved my Dark Night problem and allowed me to get back to my career path with a much more galvanized and inspired vision of how great it would be to really know how to care for people and make a difference in the world. I also learned a ton about all sorts of diseases that we don't see here much and learned a whole lot about myself. I was inspired by doctors like Dr Jack Prager who started the street clinic that I worked in in Calcutta called Calcutta Rescue, and by the difference that all that training made in your capacity to make a real difference in people's lives. That growth helped tremendously, and when I came back a bit wiser and more mature to medical training it made all the difference. |