Beware: The article I’m about to recommend has a bitter tone, but it’s important for those who are considering the medical field to hear all perspectives. Plus, many of the issues this anonymous writer brings up – understaffing, corporate medicine, twisted financial incentives, lack of fulfillment – are on point.
Here’s the piece.
This time of year, when residency and medical school interview processes are revving up, many of us feel overwhelmed. Here’s a brief but thoughtful piece I’ve saved over the years; it’s about balance. As you consider your future career choices, it’s worth thinking about issues the author covers like clarifying what brings you joy, considering your goals while understanding they will change, and defining balance for yourself.
In this day and age, one can choose a traditionally tough specialty but work in a practice setting that allows for some autonomy and flexibility. But you need to know what you want, and you need to give yourself the room to explore those goals in order to guide yourself in the right direction.
A survey of 80,000+ physicians estimated that women make 25 percent less than their male counterparts over a 40-year career, according to a New York Times article. The troubling findings were published in a paper in Health Affairs. Of note, factors like specialty, type of practice, and patient volume were controlled for. Had they not been, one of the authors said, the discrepancy would have doubled. The salary gap starts at the beginning of women’s careers and then only worsens.
According to the Times article, the pay gap is wider among healthcare practitioners than among those in computer and engineering jobs. Considering that, women pre-meds who are on the fence about a career as a doctor have every right to seriously consider another profession…
While my career has been a good one until now, I’m increasingly worried about the field of emergency medicine. See my October 21 blog on the current dearth of emergency medicine jobs. The American College of Emergency Physicians (ACEP) recently published a report on the future of the field’s workforce, concluding that there will be nearly 10,000 too many emergency physicians by 2030.
Dr. Thomas Cook published a piece recently called A Few Feasible Solutions to EM’s Workforce Crisis. He demonstrates a healthy skepticism for the possible solutions that ACEP proposed. See his piece here.
In the meantime, corporate emergency medicine is depleting some physicians. A group has even considered unionizing.
In addition, burnout has been a big problem for the field – even before the pandemic.
Medical students, as great as the specialty of emergency medicine is in many ways, I would be remiss if I didn’t tell you to consider these issues seriously when making a decision about your future field.
As you interview now for medical school, dental school, residency, or fellowship, it’s important to think about what will make you happy in the next phase of your career.
When I was a medical student applying for emergency medicine residency programs, a well-meaning dean gave me some bad advice. I was determining the order of my rank list and was particularly concerned about one program that had an excellent reputation but was in a city I didn’t like. The dean told me, “You’ll be so busy during residency it won’t matter where you live.” Luckily, the advice rubbed me the wrong way, and I wholeheartedly disregarded it. Where you live for your training is as important as the quality of your training program. The reasons are several-fold:
1. Training is time-consuming, and you want to be in a city you can enjoy fully when you’re able to blow off steam.
2. Training is stressful, and you want to be in a city where you have social support.
3. Training is not completed in a vacuum. Your personal life continues. If you’re single, you may meet someone and end up staying in the city where you’ve trained for the rest of your life. If you’re in a long-term relationship, you may decide to have children (or already have them); down the road you might not want to relocate your family.
Not everyone gets the opportunity to train at an institution in a city s/he likes. But prioritizing your contentment will increase your opportunity for well-being and career longevity.
Dr. Finkel is a graduate of Stanford University and Harvard Medical School. On completing her residency at Harvard, she was asked to stay on as faculty at Harvard Medical School and spent five years teaching at the world-renowned Massachusetts General Hospital. She was appointed to the Assistant Residency Director position for the Harvard Affiliated Emergency Medicine Residency where she reviewed countless applications, personal statements and resumes. Read more
