A Day in the Life of a Physician

Doctors can pursue many career paths, including private practice, university-hospital work, or a job with a health maintenance organization. The first lets you be your own boss. The second offers you the opportunity to divide your work between treatment, research and instruction, in varying proportions. The third means you work for a large corporation, which provides you with patients and handles most of the administrative and business tasks that physicians in private practice have to handle on their own. Doctors can also work in inner-city clinics or in rural areas, where shortages of doctors exist. Doctors can be general practitioners or they can specialize in internal medicine, cardiology, endocrinology, neurology, oncology, sports medicine, or one of the many other specialties. Medicine is a very rewarding profession, but it is hard work. Doctors are often exhilarated when they know they have helped someone get well and devastated when they lose a patient. It is a job that can prey upon you physically and mentally. Since the average patient is not a doctor, physicians must not only be able to communicate difficult, often painful information to those in their care, but also they must learn how to interpret their patients’ needs. They must relate to their patients as people and not reduce them to just the illness that needs to be treated. One element of this is collaborating with their patients to determine the best course of treatment for them as individuals. This requires patience, empathy, and compassion. “Compassion,” said one doctor, “is absolutely necessary.”

Paying Your Dues

In college, enroll in a premed program. Volunteer to work at your local hospital or with the emergency medical services. During your last year of college, apply for medical school and take the MCAT. The four-year program at medical school encompasses clinical work and book learning, with two years in the classroom and two in the clinical setting. Some of the usual courses are pathology, pharmacology, neuroanatomy, biochemistry, physiology, histology (the anatomy of tissues), and gross anatomy (cadaver class). Clinical study takes place at local hospitals or medical practices. Students are expected to offer diagnoses and suggest courses of treatment in real-life situations, although an MD/instructor makes the final decisions. In standard programs, students enter clinical clerkships in their third year and, in their fourth year, they can choose among various elective subspecialties. Students also spend the fourth year applying for internships. After four years, students sit for the USMLE (the medical boards), and those who pass receive their medical degrees. A three-year internship and residency are next, although many specialties require a longer training commitment. A medical education is never truly complete. New challenges and breakthroughs change the medical landscape at an alarming clip. Nevertheless, those initial years of med school have an enormous impact. One doctor we spoke to could name instructors who still influenced his work, more than thirty years after he earned his degree.

Present and Future

Not even the elimination of disease would eliminate society’s need for specialists in the working of the human body. The first physician, Hippocrates, began with this motto: “First do no harm,” a credo doctors still live by today (physicians are asked to take the “Hippocratic oath” which affirms this belief among others). With the institution of formalized training and strict professional certification, physicians gained more respect and were more widely used in the modern world. The medical profession is undergoing a downsizing process similar to that of many other industries. Medical schools are placing a greater emphasis on general knowledge, although there is still a need for specialists. The growth of managed care has increased the demand for obstetricians, pediatricians, and family practitioners who can treat a wide variety of ailments and look after the health of a large number of patients. Medical schools themselves are getting smaller, and some states have closed down entire medical programs for lack of funds.

Quality of Life

PRESENT AND FUTURE

Residents work long hours and are expected to put their classroom experience into practice right away. Doctors must quickly learn the difference between books and people. Interns and residents work under the supervision of other doctors. Although resident’s hours have traditionally been very long, hospitals have recently begun reducing the schedules of their young doctors. After satisfying residency requirements, a doctor can strike out on her own as a full-fledged medical practitioner. Wherever you work, you’ll spend much of your salary paying off student debt, which can exceed $100,000.

FIVE YEARS OUT

In private practice, a full partnership usually comes after five years. You have a vested interest in attracting and keeping patients. In addition to your clinical responsibilities, you will have the management duties that come with running any business. University-hospital based physicians may work their way up the faculty ladder, devote more time to clinical work, or spend their days in the lab conducting research. Doctors at HMOs can look forward to some vested interest in their organization.

TEN YEARS OUT

Experienced doctors, whether general practitioners or a specialists, command very high salaries. A thriving private practice is demanding but lucrative. Medical instructors at major universities often earn more than the university’s president. With the boom in managed health care, doctors at HMOs can expect similar rewards in exchange for accepting certain restrictions on their professional autonomy.