An email I received from a second year med student

Posted with permission:

Dr. Parkinson:

What can I expect when I graduate? It’s a bit silly to wonder that now, considering I should be cramming away for finals and the USMLE Step 1, but after stumbling across your site I had to ask.  I’m an Indian born, Canadian raised future physician attending medical school in the American south (Georgia).

Every time I turn on the news or step outside the comfort of the local coffee shop, I’m constantly reminded about the gross dissociation between the ideal perception I have of medicine and the reality.  I applied to medical school to help alleviate the pain and suffering of those in need.  Why is it then, whenever I turn on CNN or head over to the New York Times, that I see headlines that insist physicians are doing the exact opposite?

“The cost of health care is too high”
“the uninsured number in the tens of millions”
“people cant decide between paying their health or the electric bill”.

Is this what I should expect once I have the letters MD beside my name?  What can I do as an individual to address just one aspect of this enormous problem?  I read your philosophy, and I’m a bit torn.  I completely agree that reform is needed, but I’m not sure that it begins at how physicians are compensated.

I spend a lot of time talking about which residencies my peers are interested and find that only a tiny fraction of them look to primary care.  I wish I could say I’m considering primary care, but that would be a flat out lie.  This isn’t because I think primary care is any less valuable, but with student loans that rival my parents mortgage, primary care is a non-starter.  Does this seem reasonable? Without the weight of student loans shackling us to the pursuit of high paying specialties rather than those that are needed, how can we expect the current crop of medical students to take a future as a family practitioner, pediatrician etc. seriously?

Have you considered the cost of medical education as a factor?  Is mine a valid concern?

Just a few thoughts, and some random questions.

Sunny Sambhara

p.s. I realize there were many questions in there, but I’m hoping you can draw out the gist of my concern, mainly, should we address the cost of medical education when we look at addressing the soaring cost of health care?

These are the issues med students face. This is why they’re not going into primary care. This is why there is a physician shortage and, keep in mind, nearly 95% of them think this way and are not going into primary care.

So what do we do about it? It’s a crisis and will seriously affect the quality of care we receive in the US until we fix this problem.