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What medical students are asking
What Medical
Students
Are Asking
n April 1990 at the invitation of Dr. Howard R. Horn, I spoke at an initiation banquet of the incoming members of the Alpha Omega Alpha (AOA) Honor Medical Society at the University of Tennessee College of Medicine in Memphis. When asked what topic I would speak about, I asked Dr. Horn to ask the AOA inductees to provide me with some questions to discuss. The following request was sent to each of the 25 AOA recipients: “During your 3+ years in medical school have there been some questions that have continued to recur in your mind and that you have had difficulty in answering? For example, when I was in medical school I had a terribly difficult time in deciding which subspecialty to choose. How does one decide? Can you provide 3 questions that keep recurring in your mind ?” Fourteen of the 25 students responded and 42 questions were submitted. Similar questions were submitted by several students. An attempt wasmade to retain the wording of the questions as submitted. They are arranged under 7 general topics. Choosing the appropriateprofessional careerpath: Should that path be the academic or the purely practice one? What are the rewards and shortcomings of the various career paths? Should I be a specialist or a generalist? Does primary care really have a future? If a specialist, which specialty? What are the important factors to consider in selecting a specialty? How can I select a specialty that requires prolonged training or pursue an academic position when I have so many loans (for schooling) to repay? Should I compromise my career goals for the sake of “my significant other”? Which professional path will allow me adequate time to pursue my nonmedical interests? Does the prestigious AOA honor obligate me to pursue a career that might fulfill the expectations of others (friends, family and advisors) rather than one that would make me most happy? Balancing family and professional li& Can I be both an excellent physician and an excellent parent? How much of one’s life should be devoted to medicine and does it make one a lesser physician to consider family more important than medicine? How does one best balance family life and professional life? How does one prevent professional “burn out”? Public image ofphysicians: How do physicians improve the deteriorating image held of them by the community? Are physicians responsible for their declining reputations? How do we mend the dwindling trust that patients once had in their physicians? Role of government in medicine: What will be the future role of government in medicine with regard to physician compensation? Is socialized medicine (if administered by medical personnel) such a bad idea? How should physicians address the problem of increasing numbers of indigent patients? Medical ethics: What are ethically acceptable reasons for a physician to refuse to treat a patient? How can the conflicts between expensive new technology, cost-effective medicine and quality of life be resolved? As technology to prolong life becomes more abundant, how will the distribution of this technology to individual patients be decided? HOW do we
I
1260
THE AMERICAN
JOURNAL
OF CARDIOLOGY
VOLUME
68
NOVEMBER
1, 1991
“ration” health care dollars? With ever increasing malpractice premiums, what future legal/medical changes will occur to ensure both plentiful and competent prenatal care? Medical education: Is present medical education successful enough in developing traits such as patience, compassion and understanding of human behavior or is too much emphasis put on attempting to expose students to the entire breadth of the ever-expanding medical science data base? How often do I or my classmates trade places in our mind’s eye even for an instant with those whom we are treating? Should we make an effort to do more of thii or is this emotionally self-destructive and counterproductive to the job we must perform? Will drastic changes in the way medical students are trained occur in the future? How are students going to be able to afford medical education in the future considering increasing tuition, more difficulty in obtaining student loans, stricter loan repayment schedules, etc.? How can the traditional medical student education be made a more progressive and less harmfully rigorous experience? Will computers play an ever widening role in medical education? Should basic research be a requirement of students in medical school? Miscellaneous: How successful are marriages between 2 physicians? How does one maintain the “to-serve-humanity” idealism in the face of long hours, hard work and, at times, an atmosphere of cynicism? Are the long hours expended by house officers in internship and residency training programs detrimental or necessary to excellent training? Why do certain groups of physicians (i.e., surgeons vs internists) continually “backbite and bad-mouth” each other? What areas of medicine will make the most significant advances over the next 20 years? Many good questions. Few good answers.
William
Clifford
Roberts,
MD
Editor in Chief
FROM
THE EDITOR
1261
Students
Are Asking
n April 1990 at the invitation of Dr. Howard R. Horn, I spoke at an initiation banquet of the incoming members of the Alpha Omega Alpha (AOA) Honor Medical Society at the University of Tennessee College of Medicine in Memphis. When asked what topic I would speak about, I asked Dr. Horn to ask the AOA inductees to provide me with some questions to discuss. The following request was sent to each of the 25 AOA recipients: “During your 3+ years in medical school have there been some questions that have continued to recur in your mind and that you have had difficulty in answering? For example, when I was in medical school I had a terribly difficult time in deciding which subspecialty to choose. How does one decide? Can you provide 3 questions that keep recurring in your mind ?” Fourteen of the 25 students responded and 42 questions were submitted. Similar questions were submitted by several students. An attempt wasmade to retain the wording of the questions as submitted. They are arranged under 7 general topics. Choosing the appropriateprofessional careerpath: Should that path be the academic or the purely practice one? What are the rewards and shortcomings of the various career paths? Should I be a specialist or a generalist? Does primary care really have a future? If a specialist, which specialty? What are the important factors to consider in selecting a specialty? How can I select a specialty that requires prolonged training or pursue an academic position when I have so many loans (for schooling) to repay? Should I compromise my career goals for the sake of “my significant other”? Which professional path will allow me adequate time to pursue my nonmedical interests? Does the prestigious AOA honor obligate me to pursue a career that might fulfill the expectations of others (friends, family and advisors) rather than one that would make me most happy? Balancing family and professional li& Can I be both an excellent physician and an excellent parent? How much of one’s life should be devoted to medicine and does it make one a lesser physician to consider family more important than medicine? How does one best balance family life and professional life? How does one prevent professional “burn out”? Public image ofphysicians: How do physicians improve the deteriorating image held of them by the community? Are physicians responsible for their declining reputations? How do we mend the dwindling trust that patients once had in their physicians? Role of government in medicine: What will be the future role of government in medicine with regard to physician compensation? Is socialized medicine (if administered by medical personnel) such a bad idea? How should physicians address the problem of increasing numbers of indigent patients? Medical ethics: What are ethically acceptable reasons for a physician to refuse to treat a patient? How can the conflicts between expensive new technology, cost-effective medicine and quality of life be resolved? As technology to prolong life becomes more abundant, how will the distribution of this technology to individual patients be decided? HOW do we
I
1260
THE AMERICAN
JOURNAL
OF CARDIOLOGY
VOLUME
68
NOVEMBER
1, 1991
“ration” health care dollars? With ever increasing malpractice premiums, what future legal/medical changes will occur to ensure both plentiful and competent prenatal care? Medical education: Is present medical education successful enough in developing traits such as patience, compassion and understanding of human behavior or is too much emphasis put on attempting to expose students to the entire breadth of the ever-expanding medical science data base? How often do I or my classmates trade places in our mind’s eye even for an instant with those whom we are treating? Should we make an effort to do more of thii or is this emotionally self-destructive and counterproductive to the job we must perform? Will drastic changes in the way medical students are trained occur in the future? How are students going to be able to afford medical education in the future considering increasing tuition, more difficulty in obtaining student loans, stricter loan repayment schedules, etc.? How can the traditional medical student education be made a more progressive and less harmfully rigorous experience? Will computers play an ever widening role in medical education? Should basic research be a requirement of students in medical school? Miscellaneous: How successful are marriages between 2 physicians? How does one maintain the “to-serve-humanity” idealism in the face of long hours, hard work and, at times, an atmosphere of cynicism? Are the long hours expended by house officers in internship and residency training programs detrimental or necessary to excellent training? Why do certain groups of physicians (i.e., surgeons vs internists) continually “backbite and bad-mouth” each other? What areas of medicine will make the most significant advances over the next 20 years? Many good questions. Few good answers.
William
Clifford
Roberts,
MD
Editor in Chief
FROM
THE EDITOR
1261