Medicine used to be a calling

By Arne Vainio, M.D.
News From Indian Country April 2012
 
“Medicine used to be a calling. I don’t think that’s necessarily true anymore.” This is a statement made to me at a conference by someone who has been a physician for many years and is close to retiring.

He started medical school in the 1950’s and was in class when almost all medical students were men and many of them smoked in the classroom. Residency was brutal and they used to call doctors in training residents because they more or less lived in the hospital and had to be available around the clock with almost no time off. Residents were at the mercy of the attending physicians and were often treated disrespectfully and given the worst jobs. Family life took a back seat to medical training and residency paid very little. Building a practice was a long process and house calls were common.

Things have changed since then, but medicine is still a difficult path to follow and the time required of a medical student or a resident is still overwhelming.
Even getting into medical school is difficult. I have been working with med students and residents since I completed my residency in 1997. I also see quite a few students who are hoping to get into medical school and come to spend time with me seeing patients.
 
Some of them are just looking for a letter of recommendation and I can generally spot them from a mile away. They spend a day or so with me, ask for a letter and I never hear from them again. But every once in a while I see a student who really does want to go into medicine for what I consider to be the right reasons.

A family practice doctor makes a good living, but this isn’t a good way to become rich. At least, not from a financial standpoint. Most medical students will end up with many tens of thousands of dollars in student loan debt by the time they get their degree and this happened to me.

That having been said, most doctors don’t have trouble finding work. I constantly get offers to work in beautiful locations all over the country with promises of less on call time, more money and more family time.

I do know doctors who have gone into medicine because they thought it was mostly a good income. I’ve known doctors who have quit medicine after a few years because this can be a difficult life. Death is a part of life and being with families when someone is dying never gets any easier. Addiction and all the blaming and heartache that come with it cause lots of strife. The paperwork is endless.
 
But there are rewards. I get to watch young families grow and get to be a part of watching a baby I delivered start kindergarten and go on to school. I get to see kids I worked with when they were in their teens enter college and start careers. I see elders in the process of passing their wisdom on to their families and often on to me.

Jared came to spend time with me a year or so ago and he came to the clinic often. In addition, he worked with our diabetes programs and helped with screening events in the community. He has been a pharmaceutical rep for years and understands the business side of medicine.

He came to me last week to ask for a letter of reference for medical school. He is married and has two children and is working full time. He has been studying hard for the MCAT (Medical College Admission Test) and will be taking that in a few weeks.  This is a full day standardized exam that tests critical thinking, problem solving, writing skills and knowledge of scientific principles and concepts.  Chemistry, physics, molecular biology, cell biology, biochemistry, mathematics, physiology and organic chemistry are among the subjects tested.
 
For a class of 50 students, the school he is applying to gets well over a thousand applications. This means his MCAT scores have to be high, his written personal statement has to be outstanding, his grades have to be very high and his letters of recommendation have to be strong. His past employment, community service, extracurricular activities and even where he lives figure into whether he will get an interview or not. Getting an interview doesn’t guarantee a place in the class and applicants to medical school are competing against the best of the best.

Once in medical school, the coursework is overwhelming. A full course load in college is 12-16 credits per quarter. Medical school can easily be double that and every instructor expects you to be the number one student.

Medicine is a difficult and often lonely path to walk and only someone who has been through medical school can understand the commitment and discipline it takes to complete this journey. Medical school never really stops and I have to recertify my American Board of Family Practice credentials every seven years. This is also a standardized test that covers all of medicine. Studying for that happens constantly and every 3 years I need to report at least 150 hours of continuing medical education in addition to self assessment modules and chart reviews.

Is it worth it?

Absolutely. I’m living a dream I never even knew I had until I was 30.

Jared was sitting in front of me in my office and was fully aware of all of this.

“Doctor Vainio, I’ve been a part of medicine for several years as a pharmaceutical rep, but now I’ve seen the other side of medicine. I want to do what you do. I see myself in ten years sitting in this office or in a small practice somewhere in rural Minnesota. Ever since I’ve seen what being a doctor means, I know it’s all I’ve ever wanted to do.”

I looked over his personal statement and his grades. Both are impressive and he does have his heart in the right place. He does want to go into medicine for the right reasons.

We’ve been short two doctors for quite awhile and this has put an extra burden on the doctors we do have. Our hospital practice is busy and we’ve been trying for months to attract good doctors to join us. The doctors we have at Min-No-Aya-Win are dedicated and are there because they care about our community. This also goes for our Nurse Practitioners, Physician’s Assistant, Nurse Midwife, Nurses, lab, x-ray and everyone else in our health care system.
 
This is a great place to work and Fond du Lac has worked hard to continually develop new programs. I went into my recruiting mode and as I shook Jared’s hand I invited him to apply for a position as one of our doctors in 7 or 8 years. We’ve been looking for someone like him.

Is medicine still a calling?

Ask your doctor at your next visit. Ask the nurse and the person who draws your blood. Medicine is a way of life and I get to work with caring and competent people every single day.

It’s the life I was called for.
 
Arne Vainio, M.D. is an enrolled member of the Mille Lacs Band of Ojibwe and is a family practice physician on the Fond du Lac reservation in Cloquet, Minnesota. He can be contacted at This email address is being protected from spambots. You need JavaScript enabled to view it.
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