Want to learn all the behind the scenes at the ER? Cool, you’ve come to the right blog post. This will be an ongoing series that may turn into a podcast, details to come. There are a lot of misconceptions that people have about the medical world, and the hope I have is to dispel some of those, offer some questions you can ask yourself to see what kind of a doctor you need to see for your current ailment, and hopefully enable those who don’t know what goes on behind the ER doors to have a bit more patience if not sympathy for what these doctors do to help them out. That being said, just like any field of work, there are rotten apples and you should always advocate for yourself for the best medical care.
Today’s post is going to focus on the training that goes in to becoming a doctor. Most doctors get their undergrad from a somewhat to very competitive University to hopefully make their Medical school application be a bit more competitive. They can major in any field of study as long as they also meet a rigorous pre-med course schedule. Most doctors opt to go for Biology, Chemistry, Biochemistry, physics, and a heavy load of math and statistics. It can also include psychology and sociology. Sometime in their last year (usually fourth year) of undergrad education, they begin to study for the MCAT– the test required to get into Medical School. They higher your score, the better your chances of getting accepted. Though there is a doctor shortage, it is still competitive to get into a Medical school. Some students opt to go to a Caribbean Medical school because they are less competitive on acceptance, but they will find after four years of training that it’s going to be exponentially more difficult and competitive for them to land a residency position in the US. There are a number of reasons for the doctor shortage, but one of them is that we don’t want to make medical school less rigorous. We want it to be competitive to help ensure the best care.
So after four years of Undergrad science-based study, they now go on to Medical school to get roughly two years of intellectual study and lab work and then spend the last about two years of Medical School with the majority of their study being hands on, in the hospital. All the while still studying for annual Step tests. After their third year they apply for a residency position. They select their desired residency, but are placed into a match based system, where their preferred residency will hopefully line up with the residency’s preferences. “Match-day” is in March. It is a much anticipated day full of anxiety as these medical students discover where the next 3-7+ years of training could take them.
I helped put my husband through undergrad while working full time as a teacher and working on my Masters in education. After he graduated, I was due with our first baby. Because he was in the national guard it made sense for me to quit my job rather than find expensive child care. I stayed home with my son while he finished his undergrad and went to drill weekends once a month. The budget was tight and stressful, but we made it work. We utilized government help and paid a meager rent to my in laws while we stayed in their nice home. After graduation Andy was pleased to be accepted into nearly every Texas medical school (I honestly don’t think he tried any where else). We chose to stay in Houston due to already having a family and needing the affordable place to live. It was a whirlwind of four years. His schedule was mostly Mon-Fri but included over nights at time and over 12 hours between class and rotational on hand study in the hospital depending on the field he was currently studying. After experience in anesthesia, surgery, and Emergency Medicine, he decided that Emergency Medicine fit his personality, life style, and skills the best.
When Military Match day arrived in December, we were pleased and excited that we got our second choice, which in reflection, should have been our first choice, but we admittedly picked the residency in Texas first because it’s what we knew. Medical school was tough. Knowing that we still had so many years ahead of us was very daunting and sometimes emotionally exhausting. We had our first kid before medical school and our second during the middle of his first year. He was able to come to the hospital the day I induced, but had to head back to the hospital the very next day. Luckily my mom was able to fly out and help me through that. We had our third child, a girl, during his third year of medical school and our final child during the first year of his residency training. Maybe we were a little nuts, but we had both had careers before this medical training and didn’t want to put off having a family.
Though medical school was challenging, residency was that much more challenging. My husband worked six out of every seven days with a schedule that was unpredictable and always changing. The majority of his shifts were swing shifts, which is a shift that starts during the day and ends in the middle of the night. He also had a fair share of night shifts and only a couple of day shifts every month. These constant shift in schedule as well as the weird hours really messes up your circadian rhythm. Because he was working an average of 6 days a week it was impossible to ever catch up on the poor-quality and shortened hours of sleep. Most residencies include time doing their chosen field of medicine and a few months “off-service” where they will be focusing on a related, but different field of medicine. This helps them work more effectively with their peers in those fields as well as builds a more well-rounded education that will help them in tight situations.
Let’s talk about compensation. When my husband was in medical school I was selling some of our belongings that we no longer needed. A man drove across Houston to pick one of our items up and saw me mowing the lawn as he pulled up. I can’t remember how he found out, but he knew my husband was in medical school. He said to me, ” Why don’t you just hire someone to mow your lawn, isn’t your husband a doctor?” Well, first of all, he wasn’t a doctor yet, just a student wanting to become a doctor and secondly, doctors don’t start making money until they are in residency and even then it’s a barely livable wage. When they graduate residency, their income usually increases exponentially, unless they are military, then it is a very comfortable income, but about a third of what their civilian peers make. By the way, I still mow my own lawn even though my husband has finished residency. While we make a good deal more, we still have to carefully budget our money. We spend most of our travel money to go see family since we live so far away from them, mostly due to the fact that my husband is military.
Leave a comment to know what other aspect of “behind the scenes” you’d like to know. The next post I plan to write will be “reasons you should and should NOT head to the ER, saving yourself time and money.”