10 Things Medical School Doesn’t Prepare You For

IN A NUTSHELL:

• No. 1 response is business skills
• Doctors wish handling death was taught
• Managing emotions, ethical practices also lacking

Medical school is the time in your life when you are stressed out, exhausted, and wondering what you got yourself into.

However, medical school is tough for a reason. One of its purposes is to weed out those who are not 100 percent invested in becoming a doctor and it teaches you the skills and stamina to be the best doctor you can be. 

But that does not mean medical school prepares you for everything. In fact, there are many lessons it leaves out.

1. How to manage a business: According to medical professionals, the most common response as to what medical school doesn’t teach you is business skills. Becoming a doctor is more than just caring for people’s health, it means being an entrepreneur as well. In 2018, the American Medical Association reported that 45.9 percent of doctors owned a practice and a whopping 65 percent of surgical sub-specialists did as well. 

Dr. Michelle Lee is a board-certified plastic surgeon who studied at Harvard.

“I am currently in private practice. Seeing patients and treating patients are the easiest part of my job. When physicians start private practices, they become the head of a million-dollar corporation and have to learn all the tools of running that corporation on their own,” said Lee. 

2. Managing emotions: The statistics are grim. In a survey conducted by the American Foundation for Suicide Prevention, 28 percent of residents said they’ve experienced a major depressive episode and 23 percent of interns said they’ve had suicidal thoughts. 

Many medical professionals believe that medical school doesn’t train them for the high-stress environment of residency and beyond.  Dr. Jennifer Hunt is the Chairperson of Pathology at the University of Arkansas for Medical Sciences and Leadership Coach.

“We didn’t learn resilience. Nobody taught us to develop the skill of bouncing back after failing. In fact, we only learned to perfect perfection. And then you go out in practice and there are no more multiple-choice tests or pass/fail grades. Every failure felt like the end of the world. We never learned to fall up,” said Hunt. 

3. How to handle death: Having a patient die is never easy, even if you know it’s a part of life. Dr. Boingoc Mary Dinh, with WellSpan Good Samaritan Hospital in Pennsylvania, said  medical school didn’t prepare her for losing her first patient. 

“When I started residency. I felt incredibly distraught when I pronounced my first patient as deceased and filled out [the] death certification and death note,” said Dinh.

Though she said she’s grown to accept that death is a natural part of life, she wishes her education offered students guidance on how to handle it. 

“[Medical school] doesn’t prepare you for taking care of a patient day in and out for a week, only to have them die abruptly due to something you couldn’t control. It doesn’t prepare you to walk up to a dead body whom you bonded with and talked to and shared laughs with and pronounce their time of death. Medical school doesn’t prepare you for that kind of emotional trauma day in and day out,” said Dinh.

4. How to communicate: Several doctors said they did not feel like medical school taught them how to speak with their patients, particularly the loved ones of a sick or dying patient. “Medical school doesn’t prepare you to talk with families about taking their loved one off life support because their mom or dad or sister is completely brain dead. Med school doesn’t prepare you to have these tough conversations or the emotional injury we deal with every day,” said Dinh.

5. How to teach your patients about a healthy lifestyle: Basic information on weight and nutrition is something some doctors say medical school leaves out. “[I] only had [a] two-hour lesson about My Plate, the USDA’s nutrition guide, during our whole med school time. We also didn’t learn about functional or integrative medicine. We had very little knowledge about supplements or nutraceuticals, which is so key as many of our patients want to know about natural treatments,” said Dr. Carrie Lam.

6. How to handle student debt: It goes without saying: medical school is expensive. A medical degree costs anywhere from $150,000 up to $250,000. Dr. Leif Dahleen wishes school better prepared students to handle all the debt they will have once they enter the working world.

“Medical school did not teach me anything about personal finance, student loan debt management, or the business of medical practice. With the average indebted medical school graduate carrying a loan balance of about $200,000, which will generally only increase during residency and fellowship, some basic personal finance education would have been valuable,” said Dahleen.

7. How to understand pain: Dr. Amy Baxter, CEO of Pain Care Labs, said the nature of pain was something her medical school didn’t spend a lot of time focusing on. “I was woefully underprepared on the nature of pain, although to be fair we have learned so much about how the brain processes pain in the past decade. My 1990 Emory Medical School medical education can only be held responsible for not laying a good enough foundation,” she said. Instead, Baxter said that her medical school education emphasized too much on medications instead of understanding potentially better solutions such as physical therapy, psychology, nutrition or exercise.

8. How to silence your inner critic: Medical school is tough and breeds a culture of competition and over-achievement, which can cause feelings of inadequacy or defeat. As a doctor and leadership coach, Hunt knows this all too well. “We didn’t learn to contain and control our inner critic. We learned the opposite. To let it run wild, full of aggressive criticism and mean comments. Sometimes this was even bolstered by reality, and real live mean comments. But we never learned to keep that inner critic in check,” she said.

9. How to be an ethical doctor: Dr. Joe Volpe, of Austin Diagnostic Clinic, said that while medical school teaches you how to practice medicine, it doesn’t always tell you the ethical aspects of your job, such as what’s right or wrong or what’s the best option during a moral dilemma. “I think that teaching and understanding the basics and theory would be good for doctors. They would be better at applying ethics to clinical situations. End-of-life decisions, to treat or not to treat, vaccination costs versus care, and keep in the hospital or discharge are just a few examples,” said Volpe.

10. How to handle smells: Let’s face it, being a medical professional is a very odorous job—from patients who are unable to practice personal hygiene to the smell of necrotizing flesh. “I have developed a pretty strong stomach over the years but will occasionally get thrown by a particularly badly infected wound. Trying to hold a normal conversation with a patient like that without openly reacting to the smell is one of the biggest challenges going,” said Dr. Alexander Trevatt. 

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