Times are changing: curmudgeon def.--crusty, ill-tempered old man.
Article Type: Editorial
Subject: Medical education (Management)
Medical education (Technology application)
Medical education (Analysis)
Life style (Analysis)
Medicine (Practice)
Medicine (Analysis)
Authors: Brick, James E.
Brick, John F.
Pub Date: 07/01/2012
Publication: Name: West Virginia Medical Journal Publisher: West Virginia State Medical Association Audience: Academic Format: Magazine/Journal Subject: Health Copyright: COPYRIGHT 2012 West Virginia State Medical Association ISSN: 0043-3284
Issue: Date: July-August, 2012 Source Volume: 108 Source Issue: 4
Topic: Event Code: 200 Management dynamics Computer Subject: Company business management; Technology application
Geographic: Geographic Scope: United States Geographic Code: 1USA United States
Accession Number: 310150676
Full Text: We all see medicine changing all around us. Some of these changes are instantaneous and some take a while. In the thirty odd years since we finished medical school things have changed in ways we could never imagine. Almost all of this was witnessed from our billets here in Morgantown where we've been fortunate enough to be perched for almost all of that time. Of course, the new technology we've seen come on line is incredible! We remember the first CT scanner in northern WV, the year we were interns in Morgantown--1977. Fortunately or rather despite all the new "stuff" our "Art" and the patients haven't changed all that much...both still require a caring and available Doctor.

One of the best things about our kind of jobs, as we've come to realize in the last few years, is we get to talk to medical students and residents--quite a bit. We bet we've "been around" well over 3000 of them in the last three decades. They are a very bright lot; you'd be surprised what you can learn from them, if you just listen. This last few weeks in one of our offices, one of us talked to several students that told us something we'd never heard until the last couple of years. They now, it seems, are worried about how long it will take them to finish their residencies. It seems they don't want to put their lives on hold any longer than necessary.. .and they are worried about work hours during residency and after they finish. Now this latest group we talked to were women, but we've been hearing the same thing from the men. By the way, about half the class are women at WVU--definitely a good thing.

But something else is changing here. On a level much more profound than the technological things we always seem to talk about in pieces from places like this. To begin with, the residents and students themselves have changed. We think they are smarter than we were. At least 'book smart.' Every year their entrance exam scores go up. And they certainly have more debt than many of us did. The average WVU medical student now graduates owing $152,000 , we think we owed $5000 when we finished. Students now openly admit that potential future income modifies their post graduate training choices, and who can blame them with the debt they have?

They also come from a different background than us. These kids likely grew up without a parent in the house that could remember the great depression. Very few of them are in the first generation of their family to go to college.

They are probably smarter than us in other ways too. There is a lot of talk about "Generation X" or "Generation whatever" but these kids grew up in a different environment that we did. We're not sure what that means, but some of these kids talk about "lifestyle", a term we never heard in the context of Medicine from faculty, house staff or students till a few years ago. When they enter training, they now have nationally mandated limits on the numbers of hours they work and in some instances how many patients they can care for. For the first time we are hearing from newly finished house staff that the hours they must work are too long in private practice.

We thought the "lifestyle" we had as house officers and students was pretty good 30 years ago, some of us think of it as the most fun we ever had, but we probably didn't know any better. We don't believe Dr. Flink would have recognized that term "lifestyle". He told us we could go home when the patients had been taken care of.

James E. Brick, MD

EB Flink Professor and

Chairman of Medicine

John F. Brick, MD

Professor and Chairman of Neurology

WVU School of Medicine
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