1. How colossally broken the U.S. healthcare system is. How monumentally undereducated/misguided about health/medicine/ethics the people legislating healthcare are. How desperately most physicians avoid thinking about the problem; indeed; how many actively contribute to it in order to chase “patient satisfaction”, the end-all-be-all these days in the highly political hospital world. How mercilessly this hurts patients, particularly the underserved. 2. How uninvested most patients are in their own health. How lazily most people would rather take a pill to control their obesity or cholesterol instead of watching less TV and getting up to go do some exercise. How massively undereducated people are about basic nutrition facts that didn’t have to be explained to their ancestors just a few generations ago. 3. How uncertain the practice of “the standard of care” is. How traditionally defined practices that legitimately may negatively affect patient care still survive. “This is how I was taught” is something I’ve heard way too often. How forcefully evidence-based medicine struggles to make the rounds, as many have relatively little experience analyzing a study and how it should or should not affect their practice. How tremendously difficult it really is to actually prove something of clinical value, namely due to the fact that ethically, experimentation on humans is seen as horrifyingly unethical…but at a certain point, you have to wonder if it’s not just as unethical to keep up practices that we’re not really sure are beneficial to the patient. 4. How minimally the process of educating a clinician has changed to adapt to modern times. Indeed, one wonders if we aren’t going backwards somewhat. How ancient the system is, expecting every medical student to take the same courses/rotations for three years and then somehow differentiate themselves into the 145 different medical specialties. This originates from a time when it was legitimately possible to know just about everything in the field of medicine with enough time/study. How favoring the system is to subservience, now that we have the hierarchy of attending physician, fellow, resident, medical student. How frightening it is that we emphasize memorizing and spewing out answers on tests instead of looking at ways to test actual clinical competence. How poorly the art of the physical exam is taught, in favor of far more expensive tests and imaging. All that said, I still love what I do. There is much I would change if I had the power, but simply put, I do not; nor, I suspect, will I ever. So I do what good I can, when I can, where I can. We’ll see if any of this changes in the years to come. 5. It isnt what I regret learning; it is what I regret not learning. 1. That death is cruel, fickle, and unjust; 2. That families often have no idea of medical limitations; 3. That physicians are often afraid to address points # 1 and # 2, or dont have the skill set to do so; 4. That every death consumes a bit of one's heart and soul. Doing this for some time, it is clear that end of life care - death and dying - doesnt get easier, it gets harder and harder. 6. Since the big philosophy things have been covered, let me cast my vote for embryology. Almost a complete waste of time. And certainly could be replaced with something else far more useful. It's like classical Latin. It may have, at a few places, some actual identifiable connection to what you need to know to practice medicine, but those (few) things are FAR more efficiently learned on their own, instead of trying to learn Latin.* Wow, so that's the reason cleft palate is so common! But you can take all facts like that and put them all into just a single one-hour lecture. Maybe 30 minutes. By that time you'll be down to syndromes you'll never likely see. SBH *Benjamin Franklin actually noted that about Latin in the mid 18th century, and it took the university educational system in most of the world 200 years to catch up with him. If Franklin had ever gone to medical school, he'd have said the same thing about embryology. 7. 90% of what we treat, we can't cure. Even with the vast knowledge that mankind has generated in science we are still so far away from dealing effectively with chronic diseases and life threatening ailments. 8. Realizing how human doctors are, after all (self included). That we are prone to the same fallibilities and frailties of our wards, the same errors of judgement that patients make, the same emotional turmoil that the sick and their dear ones go through. That we make mistakes when tired, are distracted by our lives outside the hospital and are simply irritated by some patients. That we cling on to absent hope or dream up impossible doomsdays and never know why. That we bleed when cut, faint when hungry and are cases when sick. That we are the worst patients to have. 9. That doctors are not angels. Not just that they cannot save you all the time, but also that even at a top medical school, a significant number of the students do not have the dedication and ethos that this profession requires. I know it's hard to give your 100% all the time, but I think when it comes to people's lives, that's what is required. In medicine, your 'bad day' could ruin someone's life. I entered medical school by trying to emulate my grandpa who decided to leave his top hospital position and work in a rural area for 40 years and treat patients regardless of whether they had money to pay him or not (apparently he accepted live chicken as the visit fee on a few occasions). Not to say he was an angel, no, but certainly he was not the norm at my medical school. I left medical school thinking, man, if I get into ER with a serious condition, I would not want 40% of my former classmates to be the doctor in charge. Simply because they don't care enough. There are many wonderful doctors out there, but you cant just close your eyes and pick a doctor, you must be vigilant. It is unfortunately pretty hard to tell how good a doctor is by a layman. That's what I regret learning, because it makes it hard for me to trust doctors I don't know, and trust is a big part of treatment. 10. If Dental school counts: The worst thing I learned was that no one really knows anything. It's guessing when you drill the tooth, it's guessing when you excavate, it's guessing when you apply the filling, and it's guessing when you tell the patient that "you're all done" The only thing you can be sure of is when you extract the tooth... there'd be no question that the tooth is out 11. One thing I regret learning in medical school is how time should be managed well. When I was in college, I am not the type of student who spends time on studying, my pre-med course was not that demanding so, I was kind of relaxed. When I entered med school, I get to spend my hours on studying and I regret that I have to learn it here rather than learning it before. Now, I'm under pressure because I'm still adjusting. 12. No regrets, since all critical statements are true but have nothing to do with med school but are the result of the system in which we operate. As for doubts and insecurity about dying, this has to do with the mostly western denial that death is an integral part of live. Immortality has not yet been realized. 13. What I have is not really regret but rather more of a "spoiler". After medical school, one sees through the illusion of medical care. We don't always know what we are dealing with from one patient to the next. We rely on statistical probability to make diagnoses and guide treatment. In the practice of medicine, there is no magic, there are no guarantees and not all the time will everything be "just fine". 14. Doctors are humans with halos. There do exist shenanigans and misfortune has it that, they make the rest believe that it is they who own the profession. I would like to narrate an incident off syllabus that had completely changed my perception towards the field. This scenario took place in February 2011. India. My sophomore year at Med. School. Our institution is located in a town (a rural area turned) and hence, our patients. It was our first time experiencing the hospital environment. We were posted to the Dept. of Internal Medicine as a part of our Clinical Rotation schedule. We were in for an orientation lecture. The professor we were to face was one one ranking short of securing an admit into Cardiology. He was known for his ocean of knowledge, both on and off Medicine. I find knowledge intimidating, but what followed was what had changed my perception. We were thirty students who were posted. Our professor took turns with us while we introduced ourselves to him. After an array of personal Qs and once we were finished on them, he took to the most important one, "Who has chosen Medicine with a motive to serve the unaffordable?" The very being my motive, I instantly shot my hand up. I was soon to realize that I was the only one and his direct stare into my eyes was what made it obvious. He quipped to saying, well, more like spelling, "YOU ARE F-O-O-L-I-S-H!" I was startled beyond comprehension. I managed a smile, and I do not know how. I have gotten to know later, that a patient in casualty had passed away because he refused to deal with the referred case owing to the personal dispute he was in with the other doctor who was the first to attend the deceased. And, there was an instance when I had bluntly told one of our senior residents from E.N.T to his face, "I'm ashamed that I am in our field when I come across those like you." Also were follow-ups outside when I have crossed paths with the most shenanigan doctors, who, ironically happen to be the most renowned. That, dear world, is The Ugly Apron-Stethoscope Love Story! 15. I'd love to answer "nothing" as even the saddest or ethically challenging or disturbing experiences have all been contributory to me as being human and humane. If I had to pick one experience, I do regret witnessing a late term abortion. Not meant to be a political statement but at that stage in my training, I knew I would never have to perform one and since then I have never been able to wash away the mental image. 16. My big sis (gynaecologist, India) often says that 90% of what she learned in med school has been of no use to her in her practice. She feels that the curriculum is outdated and students are taught a lot of things that are irrelevant in practice while the important things are glossed over. I must get her to post an answer here. 17. I have to preface this statement with the fact that I didn’t really “learn this in medical school” as much as I learned it on my own while a medical student: The power of the orthodoxy. There are so many things which we now know to be untrue, and can scientifically demonstrate to be untrue, that are still taught, and pushed to the public. Dietary Cholesterol: Most of the cholesterol we eat is esterified (a kind of chemical modification) this cholesterol is very poorly absorbed by our gut - the end result is there ends up being little, if any, correlation between dietary cholesterol and blood cholesterol. (This was solved decades ago on a physiologic basis and has mostly been overlooked) Calorie Counting: A calorie is not a calorie. If you consume a given amount of calories from fat, or from carbohydrates they have dramatically different impacts on your body. When you consume carbs you trigger an insulin response. (Long story short) Insulin is the storage hormone and tells your body to store those carbs as fast as it can. You have a limited space for the storage of carbs so your body converts it into fat (VLDL and LDL) both of which are small particles and are the primary triggers of Atherosclerosis (what leads to the majority of strokes and heart attacks). If you consume ONLY fat in that context you do not trigger insulin and therefore dont have to deal with the consequences of your liver producing toxic fat particles (Small LDL) Exercise: I’d bet youve been told you exercise to burn calories. This is a half-truth at best. You can go online and calculate your body’s BEE (basal energy expenditure) this is the calories required to simply exist, you need to keep your cells in the right state with respect to electrolyte balance and also keep your body out of thermal equilibrium (you need to stay at 98ish degrees Fahrenheit). What youre really doing when you exercise is burning down your body’s store of glucose. The “average” 70kg male (154lbs male - dont ask me why this was the standard) has roughly 1800kcal of glucose stored in their body, 800 in the liver 1000 in the muscle. When you exercise your muscle, as lazy as it is, preferentially burns the glucose right there. So as you exercise you “drain your fuel tank”. If you consume glucose after that then it can freely enter the muscle without triggering further insulin and subsequent VLDL,LDL creation as above. That being said, this is all basic metabolism. I can talk all day about critical care, surgical management, optimal nutrition, and stress management but that’s another thing entirely. 18. I regret "learning" how to talk to people like they are disease. I regret "learning" to be excited when I saw a cool diagnosis, regardless of what it meant for the patient. And I regret "learning" to think of myself as better than everyone else. 19. "Regret learning" is such an oxymoron. Learning itself is a positive experience. How could learning anything cause any regret? The answers people have given here mention some or the other "fault" with the system, but how is learning about the fault a regretful thing? It is the first step in the solution of the problem. You may say that you regret having spent time and effort on something that is not very useful to you in your real life, but then how would you know it is or isn't useful unless you've learnt it in the first place! There are no regrets in learning anything, everything has some or the other use. 20. 1-) The education is not as I expected. I thought we go rotations and learn stuff about diseases and pathology and physiology about it in the second year, but instead we learnt histology. Histology is not fun. 2-) How easily things could/can go wrong. After you see the microorganism causing diseases, one small enzyme regulating a whole process and how fragile that enzyme is formed, and a hormone regulating our LIVES, you think we are fine only accidentally For example, did you know that both male and female internal genital organs develop in a fetus and one of them regress later? It is not just XX and XY. And did you know that all of mammal fetuses look alike for a while? Some suggest with the existence of some specific substances in the fetus at that time, a human could give birth to some other mammal. But I cannot say anything scientific about its accuracy. Let all of these aside, look up the dimensions of hypophysis gland. Of course it is not some kind of 'fun fact' or something unexpected, but didn't you expect something different? 3-) The other thing was the thin line between life and death, perfection and nothingness. Go to anatomy laboratory and see the bones, then go to physiology class to learn a fascinating mechanism. 4-) Vitamin D. In primary school, they told us that Vit D makes bones. You would think it wouldn't let a bone absorbed, but no... It was not that simple 5-) The rate of idiopathic diseases. What About You ?? Source
