this blog goes to 11.

my thoughts have been occupied recently with the following: now that i am not the lowliest of of medical types (the hierarchy goes something like this starting from the bottom--3rd year med students, interns/first-year residents, 4th year med students, upper-level residents, fellows, attendings. 3rd years are lower than interns because they can't really do anything useful to anyone (except possibly themselves, which means learning). interns are good because they know a little and can do all the things that "need" to be done by an MD for whatever reason, likely legal, but in all reality could be completed by a trained monkey. 4th year med students are higher because they know some stuff, and can do some stuff, largely to help decrease the workload on residents. this makes them feel good because for the first time in their medical careers they appear to be useful and sought after, their work seems important and meaningful, and others actually listen to and care about what they think. attendings are super nice to 4th years, especially at the start of the year, since many of them start out on rotations in which they hope to eventually be residents. the result is that they get treated like upper-level residents--that is, work fewer hours, do the exciting parts of procedures, do far less paper work, and have lower amounts of inane responsibilities (eg, paperwork) which allows them to focus on what it actually means to be a doctor in these sense of what we all thought it meant to be a doctor, until we actually became doctors (that is, residents) and realized that its far more prosaic and onerus that we thought it would be. part of why they get treated so well is so that these feckless students do realize how much it can actually suck to be a resident. this is partly how i got duped into choosing surgery as my first career (i have since rectified that action)).

anyhow, that is not what has been on my mind, but rather, what i want to know, or what i have been trying to do is see how med student a becomes like intern b, who becomes like resident c, who become like attending. the path of any one person is not as interesting to me is what type of med student becomes what type of resident, and so on, to attending level. i have exposure to people above and below me, and people at my level of training, so what i want to do is take co-intern x and see that he is like med student z, and also like attending y. in this exploration or theory or whatever, they are all the same person, it's just that the student is the inchoate version of the attending. i want to see if one can determine a set traits or personality characteristics in a resident and extrapolate that into what sort of attending they will be by finding and matching-up those same traits in an attending.

there are vastly divergent styles of practicing as a physician, even in the same field. and i wonder if personality traits are what drive the medical behavior of doctors. are the timed, reserved folks those who order every possible test just to rule-out disease x, even though they think the chances are negligible? are the parsimonius testers arrogant fucktards who think they know everything?

stay tuned, i'm on the case.