ndab Ah Yes, Medical School: A Sense of Entitlement

Thursday, December 18, 2003

A Sense of Entitlement

Now that finals are over (pass, baby, it’s all about the pass), I feel a need to vent on something one of the heads of our cardio/renal/respiratory block said as a grand finale on the final day of lecture. He got up in front of everyone and went off on this grandiose speech, talking about the virtues of medicine and all this fuzzy crap. That alone would have made for a rather benign and quasi-inspiring speech. Yet, if that were the case, I’d have nothing to be pissed off about. To conclude his speech, the doctor began discussing the notion of entitlement. He seemed rather worked up about this topic and how we, as doctors, are only entitled to taking care of our patients and learning everything we can for their sake. In a dramatic pose, he concluded, “You are entitled to NOTHING else,” and he stormed off to a rousing ovation. I’m sure it didn’t quite go down like that, but that is the gist of what was going on.

The subtext of these comments was very clear: after spending eight weeks of listening to or reading what must have been hundreds (thousands?) of complaints from anal premeds (they may technically be medical students, but they’re not fooling anyone) about the class, this doctor felt the need to give a quick lecture on what we are really entitled to. He felt that students were complaining about the most ridiculous things – if lecture notes weren’t posted a week in advance, if someone didn’t appreciate a non-offensive joke that was made in class, etc – and that we should stop being such pussies, sack up and learn to deal with these minor inconveniences and just learn everything we can, blah blah blah. He mentioned how the clerical people work all night to prepare copies of notes for us and about how everyone is working so hard on our behalf. On that point, I think he is absolutely right. There are individuals in our class who probably gripe about the most asinine things and come across as whiny little bitches who want to be spoon-fed everything, and if I had to listen to them all the time I’d want to impart a lesson regarding entitlement, too.

However, now that the doctor has brought up the topic of entitlement, I feel a need to respond (to whom, you ask? To my loyal readers, of course!). Before I begin, I should note that I have never complained about anything to official medical school people, much less the moronic stuff that people in our class complain about. In fact, my only conversation with this doctor went as follows:

Me: Wouldn’t mitral regurgitation have a diastolic murmur that starts in the beginning of diastole and not an end-diastolic murmur?
--I point to the screen--
Doctor: Umm, EDM stands for early diastolic murmur.
(Needless to say, I did not make much of any impression with this guy.)

All that aside, the doctor’s argument is fundamentally flawed. Yes, when I am a practicing doctor, I am only entitled to learning all there is to know to treat my patients. That is a noble statement that I hope to fulfill during my career. However, I am not a doctor. I can’t even pretend to be one. I can’t really even take a freaking blood pressure right. Given that, I am going to go off bitching as medical student paying tuition to support this guy's salary, be forewarned, because as a medical STUDENT who is paying a fee for a service, my sense of entitlement is not as he perceives it to be:

First let me say that I understand that this is a new curriculum where things aren’t totally set. Lecture notes might not be ready far in advanced because they are being made for the first time in this format. There is some fudging of the schedule now and then. Some of the lectures or labs might not be all that useful or clear. I’m ok with all this – it’s all brand new, so there’s bound to be mistakes. And in this facet of the game, I think they’re doing a pretty good job of things overall.

However, as a medical student paying thousands of dollars in tuition to this university, I feel like I am entitled certain things. For example, two weeks before this last set of exams, neither I nor anyone else in my class had any clue how we were going to be evaluated. Take home finals? Anatomy practical? Three hour in class test? Clinical skills test? All we got was a shrug from the professors and a hint of interdepartmental squabbling as to what is the most important thing to test us on (the anatomy guys literally had verbal arguments with the block chairs about including an anatomy test after our whopping three sessions of anatomy over eight weeks). Umm, guys? You’ve had six fucking years to figure this out. This isn’t one lecture or one lab. This is the entire evaluation system on which it is decided whether we ultimately graduate, what residency we go off to, etc., and it’d be nice if we had a clue about what we should be focusing on before we went into it. Do I spend my time trying to learn the anatomy that was so poorly presented in the first place? Do I try to make sense of the many heart sounds? Should I learn how to do a complete physical on my own to make up for the pathetic attempt they made to teach us? I wasn’t sure, and they didn’t really elucidate it all until about a week before the exam. I’m not paying thousands of dollars so that they can loaf on something this basic and fundamental to the medical education process and leave everyone of us just wondering how to spend our time.

A sense of entitlement?
You’re damn right.

Last week I had a chance to view the schedule for the next block. To my dismay, it turns out that I will be in school from 10-5, Monday through Friday. The problem, you wonder? Well, part of my decision to choose a medical school hinged on whether the given school provided a more flexible schedule that would allow for outside pursuits. This meant so much to me that I asked our lady in charge of the new curriculum TWICE (once during the revisit day, and once via email) to confirm that the schedule at our school would follow the lesser classtime/more independent learning plan that most medical schools are leaning towards. Both times she assured me that this was the case, and our schedule for the first two blocks lived up to it (mostly). However, this new schedule demonstrates to me that she really has no say in the matter – the block chairs can do whatever the hell they want, and because of that I am going to be in school all day, every day rather than being able to pursue the “extra” things that got me into medical school in the first place. This is especially unnerving because the word is that the block after this one has super hardcore chairs that will see this and have no problem extending school from 8-5. I specifically wanted to avoid this, as I do not learn best being in class all day – there is a fundamental split in medical schools in this regard, and I made a point to avoid the ones that teach this way. I’m mad at this because I could be having a guaranteed independent learning schedule at a certain school in Boston right about now, and I honestly believe that is where I would be if I knew that our schedule was turning out to be this way. This amounts to them blatantly lying to me. Twice. Needless to say, I am less than thrilled.

A sense of entitlement?
You’re damn right.

Have you ever had to sit in lecture and observe what is going on, only to realize that the people up there talking to you have no idea what you know or any clue of how their talk has anything to do with what we are learning? I would say that, on average, two to three lectures per week fit in this category. Now I said before that I am ok with things being a little rocky since it is a new curriculum, yadda yadda yadda. But at some point you have just got to wonder whether they really have ANY clue what the fuck is going on. They’ve had six fucking years to get their act together, and I do not get the impression they really have it. The odd part is that the new curriculum cut out some lectures, etc., but for the most part just rearranged lectures that were already being given in a different order so we see pathology the first year. So then why the hell, after six years of planning, is this so complicated? Why do we have hours of our lives taken away by someone talking about esoteric research thing that is totally irrelevant to what we are supposed to be learning? Why do we not get a schedule for the following week sometimes? Is it because they don’t even know themselves what the hell we are doing the next week? It sure as shit seems that way. Why is the poor office worker up late at night Xeroxing for us, as the doctor so dramatically portrayed in his grand speech? Because he and the other people in charge of our education don’t have THEIR fucking act together in the first place, and any complaints they receive from us are in essence a reflection of their own failure to demonstrate that they can plan an eight week class with six years of notice. For my thousands of dollars, I do not expect perfection or anything even close to it, but I do expect a certain basic level of organization or structure.

A sense of entitlement?
You’re damn right.

Ahh I feel much better.
The funny thing is, I think they are doing a great job overall - but just because you are a self-proclaimed brilliant doctor does mean you can get up on stage and demean us on a groundless and flawed argument.