There is a very insightful blog post in the THE from a final year med student at the Karolinska. He writes:
However, there were also negative aspects of medicine that made me question my career choice. For instance, I quickly realised that clinical decisions are heavily based on protocols and algorithms, leaving little room for individual reasoning. Moreover, the time with the patients seemed to be very limited, and the conversations almost always followed the same patterns. The monotonous work was in deep contrast to the adventurous job I had imagined.
To remain motivated, I had to answer the sensitive question that I had not previously addressed: what role, if any, do I want to have within this field?
These are pretty pertinent and sharp insights. His solution is to try and pursue research as well as clinical practice, but this too has its own drawbacks. It is the comments about protocols and how much medical practice is so time constrained, that chime with my dissatisfaction with so much NHS practice (and it is getting worse). Reminds me of Paul Seabright’s comments in his book, The Company of Strangers,
‘It is both an admirable and melancholy fact that training and and the standardisation of working methods are designed to reduce the impact of personal idiosyncrasy on the job’
If medicine is to keep attracting the best, medical jobs need to radically change; and those of us used to the old world, need to map out a new one and appreciate that talent in not infinite. But one of his lines is a good starting point for all students: what role, if any, do I want to have within this field?