Life vs Medicine

Family comes first for some who have finished residency

Bridging Gaps in Approach to Work, Life

Hiring a Young Gun

The generation and gender shifts in medicine: an exploratory survey of internal medicine physicians
(odd one out article: In this one, it is shown that there is not much difference between the Baby Boomer generation, and Generation X, and no significant gender differences. However, in my post I am mostly wondering about my generation, Generation Y.)

On my last medical school interview, my interviewer asked me what I thought about women in medicine. I told him that I think that it is a good thing to have women doctors, because I think it’s good to have a diverse population of doctors to treat the diverse population of patients. There have certainly been times when I have preferred to have a female doctor, especially when I was child.  However, I can’t really say anything about the larger implications for the field of medicine, and it remains to be see what the overall impact of women in medicine is going to be, and whether it will be positive or negative. He seemed content with my answer, and didn’t say much more on the topic. I half-wish I’d asked him what he thought.

Medicine really is changing. Doctors are changing. There are more women doctors, and women doctors are more likely to work part-time. The new men doctors are also wanting to cut back. Women still do a large share of the housework and childrearing, and men are less content to put work and being a provider ahead of actually getting to know their children. As a generation, Generation Y really values their leisure time, their families, their life. And though we want to be Doctors, this does not negate those traits. This leads to fewer and fewer  doctors who are willing to put in long, hard hours into being a doctor. It’s not that we don’t value medicine. No, we are still eager and we still think this is a noble calling and we want to help people. We just also want to play with our children, and maybe have a hobby or two, and maintain happy relationships with our spouses (who are more likely than before to also be doctors, now that both genders are in the field).

How much will this hurt the patient? How much is medicine going to have to change to accommodate our new expectations? I know for sure that I am not willing to work insane hours throughout my career, and that depending on how demanding my field ends up being, I can see myself switching to part time for a few years and then switching back to full time. Is it wrong that I have taken a spot in medical school? Should spots be preferentially given to people who are more likely to work more hours? Well, what about the MD/PhD students? Trained as doctors but often only spending 20% of their time being doctors and 80% doing research?

Part of the problem is that it is hard to predict who will give the most of themselves into being a doctor. But part of the problem is also, does it matter? Children need to be raised, research needs to be done (aside:  I admit to often being frustrated about the resource divide between what goes into basic science research and what goes into public health and policy, but I’m seeing a trend toward valuing public health as a discipline so steps are being made in the right direction), and doctors deserve to be happy, fulfilled people just like the rest of the population. And medical students in the US pay for their own education, not the government (and therefore the population, ie, future patients), so does the public get to have a say in who is trained? What about as a purely hypothetical, ethical discussion? Is it right to train doctors who will work fewer hours? Is it right to rely on foreign medical physicians to fill the gaps? They may be equally competent, sometimes better, but every doctor that comes to the US from another country, is a doctor missing from that country, and many countries suffer quite seriously from brain drain (I could be accused of contributing to that particular problem).

On the individual, personal level, I want to say it’s all fine. I want to say that it’s okay and in fact right, for my generation of Doctors to work fewer hours because we want to, to share patients with colleagues instead of having to come in during odd, unpredictable hours because we’re tied to a particular patient. I want to say that it’s wonderful that women are about half of the new physician work force, even if they’re more likely to work part-time. Maybe this is the right way to do it, and the previous generations of doctors, with their housewives who ran the home while they were gone most of the time, were the ones who were doing it wrong. Or maybe these are all right ways to do it. Or maybe these are all wrong ways.

Maybe there is no right way.

I’m only a second year medical student, so no doubt I will look back on this someday and think, How naive and ignorant I was back then! But this is what has been going through my mind for a while now, and I’ve yet to come to any conclusions.