Holy shit, I've been doing this for 5 years. Look at my first post, that was over 5 years ago and before I was even in med school. I was applying to med school; a doe-eyed premed, full of hopes and dreams, and fresh out of college. And look at me now, applying to residency, a weary-eyed soon-to-be doctor, filled with realities and not enough sleep for dreams, or fully coherent thoughts, still fresh out of college (right? right?!?! I can still party right? I'm cool, right? Say it! Say it!!). So let's highlight the differences between me now and me 5 years ago.
1) Let's start with the most pressing for any hopeful premeds. Primary care blows. I sort of figured I wanted to have a long-term relationship with my patients, doing primary care in an underserved area, stomping out diseases with a tongue depressor and deep thought. I'm going to listen to my patient. Fucking listen to her. That's what I'm going to do, fuck yeah!
Primary care sucks. I don't mean people who do primary care sucks, I mean the way primary care physicians are treated sucks. Every specialty has it's own brand of suck, but something about primary care, particularly outpatient, feels like you are standing there in your white coat, trying to listen to your patient, acting dignified and thoughtful, like a good doctor should, while monkeys surround you and fling poop at your face and laugh at you. Fifteen minute visits, gatekeeper status, hyper-specialized docs keeping you out of the loop are the poop on your face. The insurance companies are doing the flinging.
All of the underserved, long-term relationship, sword of justice stuff is superfluous to my new found love of hyperspecialization. Everyone with a brain tumor is under-served. I still like all that stuff, it is just mostly irrelevant in my world, and takes a back seat until I can breathe on the other end of residency.
2) I have confidence. As you can tell by my first post and the subsequent ones about interviews that I wasn't really sure how this whole thing would go. Med school has a 58% rejection rate the last time I checked. Residency is virtually guaranteed. I didn't know how I would do in med school, on my board exams, with extra-curriculars, etc. I now trust in the system. They let me in because they thought that I would be fine, and I was. "Med school is the narrowest hoop, and once through that, you will do just fine and get a residency" that's the basic idea and it is pretty much true.
3) I have chest hair.
4) I am jaded. Not jaded, that's not quite right, hardened, calloused. I try very hard not to be jaded, but hardened for sure. I've watched people die, I've pumped on their chest while they die, I've had my patients die. That's never great, but the weird thing is just how used to it you get. Not to mention all of the gross shit I've done or seen or been asked to do and just been like, "yeah ok whatever". As in "Stick my finger in that guy's butt? Yeah ok whatever."
Ways I am the same:
1) I still want to be a doctor. I want to be a totally different kind of doctor, but I love this profession so much. We love to bitch about it and prove how much more hardcore we are than all the other professionals, but truthfully, we get paid a more than decent salary to go around thinking about how the body goes wrong and fixing people. We can get jaded and bitch about the paperwork and the insurance companies (for good reason), but there are so many opportunities to more or less switch careers to teaching, or admin, or writing or even a different kind of doctor if it gets bad. Worst comes to worst, it becomes like every other job, we do it for pay and can't wait to get home to our real passion. Boo hoo for us.
2) I want a cat. I wanted a cat then, I want a cat now, I still don't have a cat and probably will never get one. Seems like a lot of work. A tattoo is in the same boat. The same boat as the cat. Which makes it some sort of strange boat with a cat and a tattoo and wanted by me, but only, like, sorta.