Becoming a Doctor- A Spoonful of Sugar or a Taste of Your Own Medicine?

One of the more common questions I get in life is whether I would choose medicine again. Once a year I give a lecture at a high school pre-medicine club with 30+ students wanting to know if they should become a doctor. Before I answer that question let me tell you my journey.

Why I Became a Doctor?

I was never one of those “gifted genius children”. Just now it took me 3 tries and spell check to figure out how to spell genius. Finally that squiggly red line went away. I went to a public school, didn’t pass the test to get into “spectrum”, the class where the “gifted genius children” went, and only did slightly better than average in several subjects on my grade school national tests. I remember getting in the 99% percentile in math, top 90% in science and 50-70% in reading and writing.

Most of my patients call me “Doogie Howser” because of my baby face. I’m far from it. I did just take an IQ test and scored a 138. I was happy with my score, but it was below “genius level”.

In the 6th grade I got a B+ in my favorite subject, math. I got the lowest GPA of any of my siblings that first quarter of school. I decided I wasn’t going to get any more B’s. My next B+ didn’t come until my sophomore year of college. I got a B- my Senior year too. I was more interested in dating Kelsey at that point than studying. Plus, I had already got into med school.

In the 7th grade my Dad offered me $1000 if I got straight A’s every quarter. I still remember my Mom handing me an envelope with 10 crisp $100 bills in it at the end of the year. It happened again in the 8th, 10th, 11th, and 12th grades. I wasn’t a genius. I just wanted the $1000 every year. Maybe that does make me a genius.

At some point early in elementary school my Dad told me I should become a doctor. I don’t remember making any conscious decision to do it, but becoming a doctor was always in my mind as the thing I should do.

Try Before You Buy

I worked as an orthodontic assistant for a year in high school. I actually really liked the job. Jim Dart was my boss. He was a great guy. He taught me how to develop x-ray films in a dark room. I got to put on the color bands and mix the cement for the braces. Also I got to use the squirty hose that you always want to use at the dentist office. I thought maybe I should become an orthodontist. Jim Dart told me to go to medical school instead.

What I knew about medicine before going to medical school was what I saw from my 30 second sports physicals each year. The doctor‘s job seemed easy enough.

How to Become a Doctor- Taking the MCAT and Applying to Med School

I did ok on the MCAT. My score was better than most medical school matriculates. That combined with my 3.86 GPA from BYU and I figured I was a shoe in for med school. I mostly applied to schools with good football and basketball programs. I didn’t care much about how the med schools ranked on national lists.

The first year I applied I interviewed at four medical schools: University of Washington, University of Kentucky, Texas A&M, and the University of Texas in Houston. I figured I would get into all of them. The University of Utah sent me a letter telling me to get lost. Besides beating my alma mater in football for the last 9 years that is another reason for me to dislike Utah.

I was on the waitlist at the four schools up until the day school started in August. My bags were packed, but I stayed put. My dream of getting into med school was shattered, and I was devastated. I talked to counselors and mentors about what I should do. My options included getting a PhD and becoming a professor, doing something totally different like home construction, or reapplying to med school. A friend asked me, “What do you call a doctor who doesn’t get into med school…? A dentist,” he replied. I started shadowing dentists again thinking that was my new calling.

Eventually I decided I was going to reapply to med school. I postponed graduation for a year and enrolled in classes to finish off another major. The next year The Medical College of Wisconsin accepted me. I left BYU with majors in Spanish & Biology, a minor in Chemistry, and the love of my life (for whom I sacrificed and got a B-). Despite not getting into med school the first year I applied life was good.

White Coat Ceremony

The first week of medical school we had the traditional White Coat Ceremony. All of the other students were really excited about it. I pretended to be excited too. In reality I had no idea what it was. It wasn’t until after the ceremony that someone told me that doctors wore white coats.

Don’t touch your doctors white coat. It probably hasn’t been washed in a few weeks. It’s a cesspool for germs. The tradition of the white coat is one that I would be happy for medicine to forget. I have 4 white coats in my closet. I haven’t worn one in 8 years.

What Type of Doctor are you Going to Be?

“A rich one” was my typical reply before I started medical school. People asked me this question all the time. My mother-in-law started to worry about my priorities in life when I gave her “a rich one” response.” The truth was I was trying to cover for not knowing there were multiple types of doctors. In my mind there were three types of doctors: family doctors who’s only job was to do sports physicals, cardiologists whose only job was to fix heart attacks, and surgeons. They just fixed broken bones. Fortunately/unfortunately that was the extent of my medical knowledge growing up. I went to a doctor to get shots, sports physicals, fix my broken arms, and once I saw a cardiologist visiting my Grandpa in the hospital.

After getting into med school I found out that the question “What type of doctor are you going to be?” was quite a complicated question. It turns out there are over 120 specialities in medicine with new specialities popping up every year.

Getting into some of the speciality fields has become increasingly difficult. I wasn’t aware of this going into medical school, but you can’t just choose your specialty and expect to get it. The competition is increasingly intense for some of the popular, high paying, or lifestyle fields. Interventional Radiology, Orthopedic Surgery, and Plastic Surgery were the most competitive fields to get into in 2018.

The Match

The Match is the most exciting time of your med school career. After putting in four grueling years of study and work The Match decides what type of doctor you will be and where you will go for residency. I think this is where The Hunger Games author got their idea for the “Reaping Ceremony”.

After my 3rd year of medical school I applied to become an orthopedic surgeon. I knew going in that it was a competitive field, but I had reasonably competitive scores. For The Match each medical student interviews around the country at residency programs in their desired field. The student ranks which programs they like in order (1-10 or however many places they interview) and the residency programs do the same with the residents they interview (1-100 or however many students they interview). They plug everything into a computer system and try to match the students and programs rank lists. Most students will get one of their top three picks. Some students are offered as tributes to The Scramble.

The Scramble.

I interviewed at 10 programs and had over a 95% chance of getting a job. I fell into the 5%. It was a devastating realization that I was going to be a doctor without a job. With my $350,000 of med school debt I was ashamed and embarrassed. What do you call a doctor who doesn’t get into residency…? Dental school wasn’t looking like a bad option after all.

After getting a call that I didn’t match I entered The Scramble. Any student who doesn’t match (about 5-10 at most schools) scramble for any residency position left across the country. For most of us this was in a field not of our choosing. The residency programs who didn’t fill their spots are desperate to get any sucker who is foolish enough to change their life’s dreams and choose a field in medicine they had never thought of or prepared for.

The morning of The Scramble I faxed my resume to as many programs as I could. Their were two residency spots in orthopedics open across the country; one spot at Yale (surprisingly) and one in the Carolinas somewhere. After faxing your resume you wait for the programs to call you. The orthopedic spots filled quickly. I wasn’t chosen.

I got a call from the University of Michigan offering me a one year internship in general surgery. General surgery wasn’t what I wanted to do. This was just a one year position though. Maybe it would allow me to re-evaluate my life.

When they called me I asked if I could talk it over with my wife and call them back in a few minutes. The program director said, “No, but I’ll wait on the line for you.” I looked at Kelsey. We both shrugged our shoulders not knowing what the right answer was. I got back on the phone and with as much excitement as I could muster said, “I’d love to take the position.”

Surgery Internship

I got physically nauseous as I woke up at 4:30am each morning of my intern year. I typically got home each day around 8:30pm. The norm was to spend 80-100 hours per week at the hospital. I always clocked 80 hours per week. Never more. Nationally the resident work hour restrictions cap the workweek at 80 hours. I wasn’t there to cause problems. Older surgeons still called us “weak” for only working 80 hour weeks. “Back when we trained we didn’t have work hour restrictions” we were often reminded.

I’m not afraid of hard work. However, I am opposed to abuse, ridicule, and a cruel work environment. Many of my fellow residents I viewed as normal, nice people. Some had become so messed up by the system that they were shells of humans. The few who yelled, swore, and ridiculed incessantly made life miserable for the rest of us. In a profession where kindness should be viewed as the supernal quality, there is sure a lack of it, especially during training.

In a system which demanded perfection, mistakes or setbacks inevitably happened which were beyond our control. The 70 year old obese diabetic who has smoked their whole life will unfortunately end up having surgical complications at some point. Interns were the whipping boys.

As an intern I took upon myself the “battered spouse” or “abused child” role. I was too afraid to speak up about the injustices occurring because of fear of retaliation. I lowered my head and continued working, along with the majority of my fellow interns.

Each month of my intern year I got 2 full days off. I was also given two 24 hour periods of time off when I switched from day shift to night shift or vice versa. One of my days off early in internship I went golfing. The chief residents told me that I always needed to have my pager on me and so I took it with me to the course. 9 or 10 holes into my round I got a page. Despite having a cell phone I ended my round and drove home before I called back. I was too afraid I would get yelled at for being on the golf course even though it was my day off.

After that I found that it was easiest not to go golfing at all. It wasn’t until I matched in Emergency Medicine that I decided to pick up my sticks again.

Emergency Medicine

By the first part of September (only two months into my intern year) I needed to either reapply to orthopedic surgery, general surgery, or choose another career. I dreaded the prospect of going through the match again. That day on the golf course helped solidify my thoughts. After months of prayer and what I consider divine revelation, I had the thought I should do emergency medicine. I didn’t know much about it as I had never worked in the ER during medical school. I told Kelsey my decision. Surprisingly she had come to the same conclusion. Neither of us doubt there was some divine intervention in our decision. I sent in my application, not knowing exactly what being an ER doctor would be like.

I applied to 20 ER programs and got 20 interview offers. This was a shock given that I had applied to 90 orthopedic programs and got 10 interview offers. I used up all of my three weeks of vacation that year to go around the country and interview for jobs.

After switching to emergency medicine I was viewed as inferior by many of my surgery colleagues. “Don’t become a triage doctor” one surgeon told me. “It is amazing how little you have come to think of yourself” another surgeon said. In both instances I just smiled and laughed at their own arrogance. My fellow interns applauded my decision and were happy for me. Three additional interns I was with that year switched out of general surgery. Two went to anesthesia and one into PM&R.

The Re-Match

In March of that year I matched into my first choice on my rank list, the Emergency Medicine program at Michigan State in Grand Rapids. I was ecstatic.

My last shift of internship was a night shift. I drove home at 8:00am and we left for Grand Rapids by 8:05am. I don’t recall a happier day in my whole life.

Residency

I only have great things to say about residency in Emergency Medicine. The physicians I worked with were incredible teachers and treated me like a human being. It was stark difference to the reality of my intern year. Maybe it was because I was in a different residency program. More likely it was because I was in a different field of medicine.

I was nervous initially about emergency medicine. I thought I would miss being in the OR. While at The University of Michigan one surgeon gave me great advice: “If you can imagine yourself doing anything in life but surgery, do it. If you can only see yourself being a surgeon and nothing else will make you satisfied in life, be a surgeon.” In my mind the choice was clear. Although I missed the OR it wasn’t my life’s passion.

Residency and Divorce

Programs love telling medical students how many of their residents end up getting divorced. On the interview trail for residency one the of things that I was frequently quoted was how high a residency programs divorce rate was. Some residencies wore it as a badge of honor that their residents worked so hard and were so bitter about life that their divorce rate was higher than the national average. I steered away from these programs. Others were drawn to them.

In reality the divorce rate in medicine is below the national average. Only 23% of male physicians end up divorced while 40% of female physicians get divorced. I was a little surprised by that number given what I had been quoted during my whole training. Overall that is a great reflection on the field.

My marriage thrived during residency. I owe that to Kelsey. She felt the pain of job as much as I did, even though my day to day specifics she didn’t know. She was fortunate to find great friends everywhere we went and had great co-workers to help her out while I was at the hospital.

Becoming a Doctor- Would I Choose Medicine Again?

Looking back at life the good times always seem to stand out for me over the bad. Medical school, internship, and residency training was very tough. Just getting into medical school seems nearly impossible these days.

I have now spent more time as a practicing physician than I did in residency. My work is demanding mentally, physically, and emotionally. If I make a mistake then a patient may be harmed or even die. Sometimes I lose sleep at night thinking about patients and the decisions I made to treat them. I often lose sleep because my body has a difficulty time adjusting to the constant switching between day, evening, and night schedules.

Lawsuits are a constant worry. I would say I worry about me being kind to patients much more than I worry about them being kind to me. My daily prayers are filled with petitions to be charitable, kind, and patient to the patients I treat. I am kind by nature I’d say, but the demands of my job often make things feel rushed and impersonable. Health care has become a “hospitality field” where the patient’s desire often trumps what is medically necessary or appropriate. Battling those competing demands is difficult.

The pay is great. I’m respected in the community because of my profession. I am able to provide for my family and support my wife and children at home. That sounds very archaic but it is important to me. There is a moment almost every day at work that I feel that I am making a difference in someone’s life. That is the most rewarding part of my job.

Should you go into medicine? I don’t know. I hope that you’d have a little more insight into the field than I did when I started. Obtaining that insight is very difficult. Even in the middle of med school I still had no idea what it was like to be a doctor and I was doing it. Would I go into medicine again? I would…maybe.

About the Author

I am a husband, father, ER doctor, and an avid golfer.  With a handicap of 3.2 I have a fairly legitimate claim to be among the Top 100 Physician Golfers in the United States.  You can read more about my story on my about page. Feel free to contact me or follow my sites on social media