Yesterday in class, our overarching discussion topic was normative behavior. We defined this term and tried to apply it to our understanding of the way our college campus functions, as well as to medicine. One of the points brought up was that by interacting with the gay community, Dr. Verghese himself would be seen as an "outlier" of sorts with respect to most everyone else, who preferred not to talk about AIDS and treated it as a "taboo" topic. This brought up the idea that physicians actually face various risks in medicine - physical, in terms of acquiring an infectious disease from a patient; emotional, in terms of the weight of having to deal with such emotionally heavy issues as losing a patient; and social, in terms of caring for a group of people who society have deemed as "outcasts." The last of these three can be seen throughout history, with diseases like leprosy and AIDS (which has often been referred to as the modern-day leprosy).
The emotional risks of being a physician are particularly important to consider. Often, the stress of work becomes too much for neurosurgeons or ER doctors to handle, and it is not uncommon to hear stories of physicians facing burnout and attempting to deal with it in various ways (some often destructive, such as self-medicating or becoming addicted to alcohol). I personally have heard stories of pediatric oncologists becoming depressed and contemplating suicide because of the young children they treat with terminal illnesses who cannot be saved. Even in specialties that are not always so high-stakes, no doctor ever forgets the first patient that they lost. It is something that stays with them and weighs upon their conscience for years and years to come. Thus, in this respect, I and my peers have chosen a difficult path. However, to me, the rewards outweigh the risks, and I'm fully prepared to face challenges along the way.
From that point, our discussion deviated from the risks doctors face to whether we, as students, are effectively prepared by our training to deal with them in the future. One of my classmates raised the question of whether our current education teaches us how to effectively and constructively deal with stress. When that deviated into a discussion about the various sociological and psychological concepts that we are required to know for the new MCAT, the professor asked us whether we believed it was really important for us to have to know the details of every theory in order to be a good physician. In response, one of my classmates argued that it isn't so much knowing the specific theories themselves as expanding our worldview and developing the critical thinking skills that are necessary to becoming a well-rounded and excellent physician. I agree with that - it's not really going to be essential for us as practicing physicians to know the difference between the nativist and interactionist theories of language acquisition, for example. However, having at least a passing knowledge of such concepts helps us understand human behavior and society on a larger scale, and that's definitely important to medical practice. On that note, I feel that the way this is tested on the MCAT is not necessarily indicative of one's true understanding of these concepts. Test scores are great and all, but on their own, they're really not indicative of a student's ability to be a good physician. They have to be complemented by other aspects of the application, like the personal statement or interview, where the student has a chance to really demonstrate their level of knowledge and thoughtfulness in considering the issues that are important to medicine today, like health disparities or the effect of racial stereotyping on the care that patients receive. These are not topics that can be assessed accurately by a multiple-choice exam, but are still essential and thus must be addressed in some other way.
