Inside Doctoring: Stages and Outcomes in the Professional Development of Physicians

By Robert H. Coombs; D. Scott May et al. | Go to book overview

Rebelling Against Big Brother

Mark B. Wenneker

Remember those first days of medical school in Amphitheater C? As we gazed over the eager faces, we all knew who would become the surgeons, the researchers, and the family practitioners. Did any of us suspect then that our class would produce eight anesthesiologists, 10 radiologists, 14 ophthalmologists, and one of the lowest percentages of general internists and surgeons in the history of Harvard Medical School? I certainly didn't. What makes us so different? Maybe it's the $30,000 debt that many of us have incurred, but surely business school was an easier way to make a buck. I think that behind these statistics lies a deeper meaning about how we wish to incorporate medicine into our lives.

There was a time in the not-so-distant past when graduation from medical school was like a marriage ceremony. Our medical forefathers (we have few foremothers) took their vows to devote their lives to medicine, for better or for worse, for richer or for . . . well, till death did they part. Residents--as the word suggests-- resided in the hospital. Salaries were minimal, but who needed money when food and clothes were free and one didn't need an accountant to calculate a debt repayment schedule? There was even a time when hospitals forbade their residents to marry. After all, that would be bigamy.

Some may say that times have changed. Yet, a few months ago as I was flipping through the pages of the Boston Globe, I happened upon Ann Landers' column, which included a letter from a "concerned mother" whose son, Jay, was an intern under stress. Poor Jay was so exhausted that he could no longer make clinical decisions. Worse, his mother was terribly worried. Knowing how fair and open-minded Ann is, I looked forward to a gentle but scathing critique of the medical training process and a discussion of

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