New M.D.

The Long Path of Medical Training

By Lauren Eckstein, M.D.

I recently had the pleasure of treating a 16-year-old boy for congenital nasolacrimal duct obstruction. Because of the division of clinical responsibilities, I rarely have the opportunity to treat "pediatric" patients. Most children seek care at The Children's Hospital of Philadelphia (CHOP). By contrast, adults are seen in the Hospital of the University of Pennsylvania system. As I don't provide clinical coverage for CHOP, taking care of this young man was a unique and quite interesting experience.

He Wants to Be A Physician

While I completed my preoperative paperwork and marked the operative site, I engaged him in light conversation. He had just a year remaining in high school and was looking forward to going away for college following graduation. He also revealed to me that he was planning to pursue a career in medicine — he wanted to become a cardiothoracic surgeon. Of course I thought this was a great idea, and I lent him my approval (for whatever it might be worth) as well as my encouragement.

The surgery later that afternoon was successful and the patient has done well postoperatively with resolution of his epiphora. However, I continue to worry about him. Not because of any concerns I have for his clinical status; I expect that he will continue to have an uneventful recovery and will realize an excellent clinical outcome. Rather, I worry about him because of the difficulty and the duration of the path that lies before him.

I am very happy with my career as a physician and satisfied with the choices that have brought me to this position. Medicine is a wonderful profession, engendering tremendous pride and generating unmatched fulfillment that I believe I could not find in any other pursuit.

However, a medical career — mine included — is not without its difficulties. Among numerous other challenges we face, is enduring the incomparable length of the training process. Few college students (and likely even fewer high school students) are aware of the time commitment required when they first set out to become a physician.

Years of Training Await Him

For many young people, exposure to medical training in such pop-culture outlets as movies and television shows may have imparted a sense of the frequent, extreme physical demands of the training regimen, but few realize the number of years they will spend "in school" to achieve their goal: I am now in my sixteenth year of post-secondary education, and I have at least one more year of formalized training ahead of me. While I spent a few years during this time earning my graduate degree, the total length of my training program is not unusual.

Indeed, many of my contemporaries in medicine have spent as much time, or longer, in their respective education. Unfortunately, many are also resentful of the opportunities lost and sacrifices made during the long training program. Although, like me, they are generally happy with their choice to become physicians, most state that they would have liked to have known how many years of education they were committing themselves to when they first decided to embark upon a medical career.

How, then, do we encourage and nurture a youth interested in becoming a physician while also informing him or her about the difficulties of the career path without simultaneously dampening their enthusiasm? There are probably no simple answers to this question.

A frank discussion of the steps necessary to achieve their goal is probably advised, but the realities of this process must be set in context. With rare exception, the years I have spent in training have been wonderful; in point of fact, some of the best times of my life have occurred during internship and fellowship.

The Rewards Are Worth It

If given the opportunity, I would not alter my early decision to pursue a career in medicine, as doing so would cause me to forfeit the many inspiring and irreplaceable experiences I have had as a physician.

Indeed, sharing these incredible narratives and moving stories with students interested in becoming doctors may be the "best medicine." It seems to have worked well with my patient. OM