What is it like becoming a physician?

A recent thread asked why people didn’t become physicians and some of the comments made me curious.

What is it like becoming a physician, from entry into pre-med to being fully certified in one’s specialty?

Positive and negative, anecdotal and systemic info welcome.
First-hand accounts preferred but second-hand ones also welcome.

One of my sister’s sons recently became a physician. He said that not having to take classes any more is WONDERFUL.

My niece is somewhat disillusioned after practicing for a number of years now. She also had staggering loan debt from her education.

PreMed fun honestly.

Med school first two years just memorize and regurgitate. Hope that the parts that stick and the parts you need overlap to some degree. None of the feeling of mastery, of having been able to think critically, that college offered.

Next two are the clinical years. Feeling pretty inadequate and dumb much of the time.

First year of residency (aka internship year) the most stressful year of my life. Being idiot enough to have started a family that year and then my wife getting significantly ill postpartum did not help. Rest of residency feeling some actual sense of knowing what you are doing.

After that practice, now over two decades into it, a blast. They pay me to do this?

I remember feeling guilty a lot of the time when I was in Med school. For example, if I decided to just goof off on a Saturday (instead of staying locked in my room memorizing stuff that looked like this or this), I’d start to think that I was already letting down my future patients. Or that I was abusing the privilege (and luck) that I had by having been accepted into med school in the first place.

Still, though, med school was a blast. I had terrific classmates and made a lot of great friends. The knowledge content, as demanding as it was, was quite often extremely interesting and intellectually stimulating (to this day, I remain awed by the ‘wisdom of the body’). And, frankly, as a virile young man (who lived on the only ‘male floor’ of a twelve story dormitory for nursing students), being a med student had its advantages.

As a resident (i.e. after finishing med school but still training to become a specialist), the overriding issue was fatigue; chronic fatigue. At the beginning, it was actually kinda fun to be up all night, running around, ‘saving lives’. But, doing that every third night, week after week, month after month, for years, took its toll. There were a number of times that I felt like crying - I was so, so tired yet had no option but to carry on (and show up again the next day to do it all over again). I don’t think I’ve ever been quite the same.

Being a resident was also when I learned about people. I mean you wouldn’t believe what goes on out there, ‘next door’. As a front line doc, you see people at their best, and at their worst. Every day you get to see the full gamut - from frustrating and aggravating, to humbling and inspiring. And, of course, there’s the “there but for the grace of God go I”. So many sad, horrible things. I counted my blessings (and continue to do so to the present).

One other point. You get a lot of ‘power’ as a physician. And, as a resident, within the confines of your hospital, you run the show. That leads to that guilt thing again: I could never get over the strange feeling I had, almost a sensation of paradox when I would be in charge of the cardiac arrest team at 4:45 PM, deciding who would live and who would die, and when to “give up” and 'let Nature take its course, and when to pull out all stops. At those times, I was in a position of almost supreme power. Yet, at 6 o’clock, when I’d put on a pair of old jeans and a tee shirt and leave the hospital, I’d just be one more face on the street. Another guy on the sidewalk. Nobody acknowledged me, no one deferred to me. I was nobody special. Just another guy in the line at McDonald’s. A very strange, almost surreal transition.

Why do medical residents work so much? Combining inexperience and fatigue must lead to an increase in errors.

Karl, how did you make the most of your position as a med student/resident/physician as a virile young man? Just casually mention it and no more? As a single lawyer, this is relevant to my interests.