Is It Ever Too Late to Become a Doctor?

I cannot imagine retiring and being like, yeah, I want to go to med school for my retirement. Hi everybody and welcome to the podcast. This is Generations MD. My name is Stephanie and I'm joined here by my colleague Dr. Sarah Davis, who's also my mother. Um, so recently I just posted the TikTok of you in the '90s of you and all your friends. So I made this TikTok of me being like, mom, what was medical school like in the '90s? And then it went to a bunch of pictures of you and all your med school friends. But you sent me a bunch of pictures of you guys and there was none of you guys like studying. It was all of you guys partying.

Well, who's going to take a picture of studying?

Yeah, but I'm like, it just, you know, just looks like you guys are just having fun.

Well, okay, you look like you guys were trying to be doctors. That's what you guys did back then is just, just partied it up all the time. Okay, remember we didn't— well, most of the events that we did, there are no pictures of because we— you had to bring a camera if you wanted to take a picture of something. So it's not like you guys that you have a camera with you 24 hours a day, 7 days a week. We had to like remember to bring our camera. We had to load it with film, maybe have, you know, batteries for the flash, all kinds of stuff like that. So the only time we did it was like special occasions. So we had in there pictures of like our med school formal, the White Knights Ball. And then we had, like you saw there, we had pictures of this luau. You probably saw a bunch of those. We had, you know, Hawaiian shirts or whatever. And then we had a '70s party. So we were all dressed up.

That was you with the afro, right?

Well, that actually— Oh, there was a different party that you had to wear an afro for? No, that picture was taken at Anne's wedding because I was wearing like the, uh, my bridesmaid's dress. It was obviously near the end of the evening, and for some reason somebody had that, uh, wig with them, so I put it on and posed for a picture.

Hmm, okay. I don't know if that's appropriate. I don't know if I added it into the—

Hopefully not. I mean, it was all a long time ago. Um, But yeah, so lots of regular stuff. There's just no pictures of even our regular parties. We'd finish a test and go to the jigger. You guys were partying more than what I saw is what you're telling me. Right. There were a few pictures in there that were from the yearbook. I did not recall, but we did have a yearbook every year apparently. Hmm. Do you guys have a yearbook?

I don't believe we have a yearbook, no.

I feel like we would know about that.

There's no yearbook committee. I think I would be a part of the yearbook committee if there was one.

So yeah, yeah, I mean, again, I guess you don't really need that kind of stuff now. Um, but I, I found my yearbook and I went through and found some of the pictures from the yearbook, and there were a couple of pictures in there of like, you know, people studying or in study rooms. And then I think there's some stuff of like people eating pizza in anatomy labs. Eating pizza in anatomy labs Yeah, you know, you get hungry, you're in there for a long time.

I definitely got the formaldehyde munchies though, for sure.

Is that a thing, the formaldehyde munchies?

Yeah, like it's— the smell makes you starving.

Oh, okay, I did not know. You didn't know this?

We definitely have talked about this before.

Oh, that smell is so disgusting.

It's awful. And it's not during— it's not while I'm in the lab, but then after, then it's just like immediately immediate hunger, but also unclear. It's because I was like, you know, standing for a long time.

I think you're standing there for hours and you're not eating or drinking.

But different from like being in the OR or something for hours and kind of, you know, standing over an alive person.

Like, it's just being over a dead person. Yeah, it makes you so hungry. Okay, I don't know, there's something, something, uh, some deep psychological problem there.

Anyway, on that note Um, but yeah, the—

I, it, uh, that was fun. You posted those pictures, the, uh, but, and it was— and I had all those pictures from our 30th reunion. I had gathered all those pictures and I had used all those to make a slideshow, but then the slideshow didn't really go over all that well.

Oh, so they didn't make the cut?

Well, it was— we had technical issues, so it wasn't—

that's classic boomer action right there. You guys couldn't figure out the PowerPoint, and that is totally not true.

I asked for the AV guy to help. Okay, it's okay. What, what else? So third year, still chugging along, going okay?

Yeah, I experienced the first time I think ever in my career today where I was like one step above somebody else. Like, we had a college student shadowing today. And, um, it was interesting because, you know, this whole time, especially, you know, I shadowed a little in college, and then really first years and second years are kind of the same, you know, like in regards to the hierarchy. And, you know, same thing, you know, beginning of third year, whatever. Um, but, you know, I'm at— still at the bottom of the totem pole. Med students, then the interns, then the upper residents, then the fellows, then the attending. So at the very bottom of the, of the totem pole there. And it's a lot of it is kind of just looking to the people above you kind of for some direction on what to do, like where to be, when to be where and stuff. So, um, and you know, when nobody is giving you that guidance, it can be kind of hard to be like, what am I supposed to be doing right now? Am I doing the right thing? And, um, there is a kid that was with us today and, uh, I mean, it was a really— it was a short day, not much going on. And then the attending left and I knew that like that he just left. He— I knew he wasn't going to come back just because of that's how the workflow goes. But obviously the student that was shadowing doesn't know that.

So no one's like disappears. Yeah, yeah.

So then he's just in the workroom, nothing's really happening, there's not a ton of patients to see. And, you know, just the little thing of just being like, hey, like, by the way, just so you're aware of the situation of what's happening, like, I don't know if he— what he told you, but I, I don't think he's gonna come back, so like you can probably just leave, or, you know, whatever. So I think just being at the stage I'm in now, like, it kind of felt good to be able to do that to somebody else, you know.

Yeah, well, and that was nice of you because you could have like pranked him or, you know, done something mean, but you chose to be nice.

Well, I don't think anyone like intentionally— it like, I can see it now from, you know, other people's perspectives. Like, people aren't intentionally not like dismissing, or a lot of times not like dismissing students, or, um, you know, like giving them, like looping them into what's going on. They're— everyone's just kind of in their own zone, just kind of doing what they're going about their day, you kind of just forget that there's this other person that's there that doesn't know what's going on.

Yeah, well, and when you're the attending, I mean, you come in and then you round and then you're just like, okay, I'm out of here. And, um, and now you've been doing it long enough, like, you understand, like, that that's what happens, you know, after rounds, that nothing else is gonna happen. But yeah, if you're a college student, you have no idea, right? Is this attending gonna pop back in at any time? Yeah.

Like what's the expectation for me is really hard. And you know, sometimes not, sometimes no one really knows that, but I think just looping people into what's going on is helpful. I remember when I was shadowing in college, I got to shadow at this a decent number of times at the Academic Center near Clemson in Greenville. And there was, I remember on pediatrics, they were doing walking rounds and I, remember walking around and, you know, I have no idea what they're talking about at all. I'm just like standing there just kind of being like, yeah, yeah. And I thought it was a resident, but looking back, it might have been a medical student that like really brought me aside and was just kind of explaining to me everything that was happening and really took some time to do that. And that really stuck with me.

Like, that's so nice. Yeah. Oh, that's nice. Well, yeah, maybe you can do that for somebody sometime.

Yeah, I mean, it definitely, it meant a lot. It's also kind of crazy, like, how much, you know, being on rounds at that stage when I, it was like a foreign language to me, and now, like, seeing somebody, you know, seeing a college student now and seeing them being like, nothing, you know, this is so foreign to me, and just seeing, like, how much I've learned.

I know, that was kind of fun to see how far you've come. It's funny too how you, like, you didn't know if that person was a med student or a resident or anything else. Like, when you're a college student, you're just looking, there's just a bunch of people and they're all way ahead of you. You know, you don't even really know what the ranking or the hierarchy is of all those people.

Yeah, yeah, exactly.

Uh, well, that's, uh, that's cool. I'm glad you got to— you know, it's also nice not to just be the most clueless one in the group.

Yeah, yeah.

So did you hear about this woman who is starting her family medicine residency and, um, She is, she's 71 right now and she's gonna turn 72 years old like a week after starting residency.

Right, I heard about this. I kind of saw it, but I was not clear. I didn't really read much into it.

Yeah, yeah, it's, I mean, it really is crazy. Okay, so she, and you know, when people first hear this, they get a little bit up in arms because, people are like, did she take up a spot in medical school for somebody else who's going to have like 50 more years or 40 more years of practice? Um, but she didn't. She went to a Caribbean medical school, so she did not take up a spot in a U.S. medical school.

Um, but now she's doing residency, and now she's doing residency.

And so her daughter is a meteorologist on I don't know, some— I think like some sort of national channel. I don't really— I don't, I don't know who she is, but, um, but she said that the whole family never thought that she was actually going to do a residency. They just thought she wanted to get her medical degree. The story is that she was a neonatal nurse practitioner for decades and decades, and she had always wanted to go to medical school, but she never— she just did not have the chance. She had, she had gotten married and she had a family. And then, then like just when those kids were like starting to get old enough and then she was going to apply and then she ended up getting divorced, then she had remarried and having more children. And her last child was born when she was 49 years old. Oh, wow. Right. Which is just like That is just nuts to me. Um, yeah, yeah. So with all of those things going on, she just didn't have time to go to med school. And so then she finally said— but her, her whole thing was she just really wanted to know kind of what she was missing as a nurse practitioner, or like she just wanted to know more about all of the fundamentals of medicine. And so even all the way along, she was taking lots of other classes. She took more advanced classes in anatomy and, and lots of other things kind of all through the years. She was really studying and learning extra, which was probably really helpful because then by the time she was, you know, applying to med school, she had— I mean, it— she had some of that information, um, and again had been studying. But I mean, crazy. Took, took the MCAT, I guess. Don't know how she did on it, but, um, took the MCAT, applied, went to medical school. And the whole story too is that her husband— she says, you know, well, what do you want to do? You know, here they're in their 60s, whatever. And he says, I want to travel. And she says, well, I want to go to med school, so I'll go in the Caribbean and then you can visit me and travel around.

Well, okay, so I cannot imagine retiring and being like, yeah, I want to go to med school for my retirement.

Yeah, said nobody ever except for this person. Yeah. And so, I mean, I think all of that, I mean, it's weird, but you're like, okay, like, whatever, you just want to learn. Sure, you just want to learn. And I had a patient one time who was in her 70s and was getting her PhD in something, and, um, Like, okay, that's, that's interesting. You want, you want to do that. But residency, that's a whole different thing.

Well, also, it's, it just changes the difference between, you know, learn— you, you go from learner to practitioner, and now like you are in charge. As a medical student, you know, you're, you're, your job is learner. So it's just like now, I mean you know, that there's 70-year-olds who are practicing and there, yeah, exactly.

Except there's a real difference between something that you have been doing for decades. It's not that hard because you've been doing it for so long and, you know, you know how to do it well. I mean, it's like, okay, yeah, there are older people who drive cars, but if you were learning to drive in your 70s, like, that would be a lot harder than if you you know, hadn't, you know, different than you've been driving forever and ever.

So, so is the residency program that accepted her international, or is it in the US?

It's here. It's a family medicine program here. Um, and so, yeah, I do. I just, I have so many questions about it, and I just, I just cannot imagine being in your 70s. And also, you know, doing the math there, okay, she's going to be 70 75 when she finishes. Like, you start a practice at age 75?

Yeah, yeah. I mean, no.

And, um, but like, imagine like doing— being on call all night long and running to codes and just like everything that your body physically has to do during residency. I just can't imagine doing it that age. And you know, who— again, I don't know anything about this residency program. I would kind of love to hear like how it all goes, but you have to think that her co-residents are probably not thrilled.

Yeah, I mean, that's the thing is like you can't— like you— I don't know, I guess I'm trying to like put this in a— in some sort of perspective, but it's just like, you— yeah, you, you can't just— you're all— you guys have to end up doing equal work, and everyone's gonna have to do the work. So, you know, it's just different, you know, if something happens and you can't work, or like something, you know, like you can make accommodations for people, but like it's at the cost of other people. So it's like, where's the— where's the line there? And then is it good for anyone's health?

Right, right. Yeah, I mean, like I said, it's totally— it's totally different. And that's, um, like when you are up all night, it's— it's hard enough because you're learning new things. I mean, again, later on you, you can't— I mean, nobody wants to stay up all night, but when you stay up all night and then you're working all through the night or part of the next day or whatever, when you've been doing something for a long time, it's not nearly as hard to do. When you're learning new stuff, that is very difficult, um, which is one of the reasons that residency is so hard. But also If you were— if you have the brain of a 70-something-year-old and you are sleep deprived and then taking care of patients on stuff that you have just learned, it just seems like a recipe for disaster.

Yeah, I don't know. Yeah, I know.

And all—

I, I don't know exactly how call works for the residents that I'm working with now, but I do know that Overnight on some of the floors, there's only one intern per like, oh, like 80 patients or something. Yes. And so I'm like, if she's the one intern that has to be there, like, I don't know, it's— I don't know.

And yeah, that's how it was on call for us. We were the only residents in the hospital. It's a smaller hospital, but still we had to take care of all the patients on the floor and all the admissions that came in through the emergency room. Yeah. And so So you'd be down in the emergency room and you were working up a patient and then you get a call from the floor. Somebody's having some issue and you'd have to run up there and take care of them and run back down. And it was— I don't know. And again, when there's a code, you'd be just— we were the code team.

Yeah.

We'd be dead asleep and the code pager would go off and you'd have to just jump up and run to the ICU or whatever floor the code was happening on. I don't know. I mean, I can't imagine myself doing that now at 58.

I'm 25 and that is exhaust—

that sounds exhausting.

Yeah, right?

Yeah, she's 3 times your age.

Yeah. And I don't know, I'm trying to find a silver lining with the whole thing. I think the med school thing though, I, I— and the— you talking about that older woman that got a PhD, I mean, I do think like And just the story of that she was a nurse practitioner and like she wanted to see what she was missing out on and like fill in those gaps and, and learn. I think that that is cool. I think it's like, okay, like how can I expand my knowledge? And, and also it's like, I guess when, if you're, you are somebody who really always wants to do something and you wanna do something meaningful. Then with the latter years of your life, then I think going to school is a cool thing to do. Medical school, that sounds like a bit much, but I don't know, learning something. Yeah, for your brain too.

Yeah, I'm sure it is. It— yeah, it just kind of all goes back to like, it's all fine when it's just about you and it's not hurting anybody else. When other people are involved, your team, your patients that's when you have to go, hmm, I'm not, I'm not so sure about this. Yeah, but I don't know, we'll, we'll see what happens. Um, I'll be— it'd be interesting to see if she just like quits after a month or if 3 years from now we're hearing that she's looking for a job.

Yeah, uh, but I know I wish her the best and with— for her health and everyone involved.

I know, I certainly—

That's my statement.

That's your story and you're sticking to it. Uh, yeah, I definitely don't have any envy about the whole thing.

You wouldn't go back to medical school?

I would not.

Freshen up a little bit?

Uh, you know, with you being in med school, that's close enough for me. And I do sometimes have dreams, which is a normal thing. You know, you'd sometimes have those dreams that like you're still in high school and you haven't finished a test or something. But since you've been in med school, I've had a lot more of those kind of dreams where I've got to go back, I've got to do this or that. And yeah, I mean, it's just truly a nightmare. And it's always that thing in the dream where you're like, wait a second, I'm a doctor. Why do I have to do these rotations? I'm already a doctor. And then you just get really confused.

If you could go back and do one rotation, you know, in a specialty that's not your specialty, if you had to go back and do one, which one would you do?

Um, that, that actually would be kind of fun. In fact, sometimes I've even thought about it, like I would love to do derm, uh, have a whole month of derm. Um, I've even thought sometimes I was like, I wonder if I could just rotate with one of my dermatology colleagues and just shadow them.

Yeah, just because you like, just because there's, I mean, derm is a big just because you want to learn some more, or—

Yeah, yeah, I just like to— yeah, just be seeing it from their perspective. Um, I think that would be— I think that would be kind of cool, and it would help me more in my practice. Um, trying to think of anything else I'd want to do. Most everything else is pretty painful. Um, I definitely will never go back to surgery.

No, not going to go back to the OR.

I will not step foot in the OR no matter how much you paid me. Um, although, I mean, even doing like an orthopedic clinic, that would not be the end of the world.

I mean, that, that's like the same thing, you know, that's just seeing some sports, seeing some MSK injuries. That's not different from what you do.

Yeah, now that, that's true, that wouldn't be different. Hmm, it's like, yeah, some stuff like I, I did the radiology rotation, um But now I just feel like most of that stuff I'm just too far gone from. Uh, it's, it's funny, patients do this all the time to me. They'll bring in their disc from their CT scan and they'll be like, oh, here, did you want to look at these images? I'm like, no, I do not. I have no idea what I'm looking at.

I think it's important. I feel like it is important to be able to look at I mean, once you get to outpatient, then that's one thing. But I don't know, I feel like it's important to be able to have some sort of understanding of what's going on.

It is. And it's— I mean, it is cool. Well, and, and of course you used to do that in the hospital. You'd go into the, the, the film room. I don't know what it's called now.

We don't have a room, we just pull it up on Epic.

Well, where— but where do the radiologists hang out? Where's their secret, like, cave?

Oh, I don't know actually.

Oh, it's probably at their house, honestly.

Maybe. I have no idea. No, they're there somewhere. I don't know.

They're hiding. Well, I mean, the interventional radiologists are doing something.

Well, that's a whole thing. But I mean, they don't work on the weekends. They're just— well, they're just—

and of course not, they're just chilling.

They have a cushiony job. But, uh, but But they're needed. They're very much needed.

Yeah, they are. Um, but, but I did enjoy like going in there. Um, I mean, I used to go in there when I was a resident a lot and just like look at the films with them and have them tell me stuff. And that is, that's actually really helpful. And they get really excited when you come in there because they're lonely and sad. And, uh, and then you come in there and say, oh yeah, you know, can you tell me about this case or something. They're like, oh yeah, yeah, yeah, let me put these films up. And they talk about them.

So, you know what people don't do enough now in the hospital is to talk to people face to face because you just message people on Epic. So you're just messaging. And then, I don't know, my current attending, there's been a couple times when he has gone down and like brought the whole team to go talk to somebody face to face. And you end up getting way more like done in a minute just talking to somebody than just messaging back and forth, back and forth. Also, people are just more likely to— I don't know, like, it just, it's more efficient and people are— the communication is just better.

Well, you can hear in their voice like what, what they're thinking and how, how serious they think something is. You just get, you get so much more nuance when you actually talk to people. But doctors don't like to talk to people. I think that is well established. I heard something like 70% of doctors are introverts, which, hmm, I wouldn't doubt.

That's interesting. That's so— that's very interesting because I feel like I was going to say most of my class is extroverted, but it's probably just because I'm interacting with the extroverted people.

It's just your group of friends, but it's still a lot of people.

I mean, not even just my group of friends, but, you know, people I'm with on rotations and people like That's, that's surprising to me, honestly.

Go to any doctor function where you've got a bunch of doctors, like at a networking event. It is the most painful event of your life. You go in there and they, they stand in their little groups and they only talk to all the people that they already know. So you've got like a group of surgeons.

I feel like this is just any other event. People do that anyway.

No, no, no, no. Because then you'll have like the marketing people and the administrative staff, and those people are walking around, they're introducing people to people. You can have a conversation with them. It's just, it's super easy. And the doctor stuff is just like, it's just like pulling teeth to, you know, okay, what do you do? Like, tell me about your practice. Where are you? What kind of patients do you like to, you know, what, you know, what's your patient population, blah, blah, blah. And And it is, it's just, it's a painful event. Now, if you already are friends with them, then it's fine. It's the meeting people that is hard. But that's what I'm talking about with that getting people to actually pick up the phone and talk to you about a case. I mean, it happens to me all the time where I'll text somebody and I'll say, "Hey, can you give me a call so I can tell you about this patient?" And oh my God, it is like, you can tell that they've just been like, oh God, I gotta call this doctor. I don't want to call her, but I'll call her. Dude, in 30 seconds I'm going to tell you everything you need to know to see this patient tomorrow, and then it's going to be much easier when you actually see the patient because I've explained the whole reason and why they're coming there and, you know, giving you some inside scoop. I'm telling you, this is going to be more efficient for you. But they just hate it. They don't want to call you.

Yeah, and I mean, that's just gotten worse and worse with Epic messaging and all of that stuff, like consults and everything. It's just like, you don't— I don't see any consult services people. Like, the only time I would run into somebody today, like, we were seeing a patient and then we were walking out and then there was the psychiatry team just happened to be there, and then they ran into each other and got to discuss the case. But I mean, I've only seen like their notes dropped in the chart. Like, I don't, I don't know what they Like, I don't talk to them at all.

Oh God, that's so bad. Mm-hmm. I mean, we had to meet up with each other over the physical chart because sometimes you wanted to write your note, but pulmonary was writing their note and they had the chart. So you were waiting for them to finish with the chart so that you could have the chart and write your note.

That's, yeah, that must have taken so long. And they must have been so bad, the notes.

The notes? Oh yeah, they were terrible.

I mean, there's some consult services that still have some bad gensurg awful notes, but like, but I mean, in general, I mean, it's a lot easier. But now you just have the copying of the note over and over.

Right, right. A bunch of extraneous information. Yeah. Yeah, that was. But yeah, I mean, at least then sometimes you were there and, you know, pop around and say, oh, oh, pulmonary. Okay. You saw him. What'd you think? And it really, you know, it was very helpful. I mean, I suppose in my outpatient practice, I don't see anybody for sure. In fact, there's so many doctors that I have been referring to for years and years, and I have no idea what they even look like, which is kind of funny. But so I guess it's not that much different, but I do talk to them on the phone. When they'll call me back. Don't be afraid to pick up the phone and call somebody.

That is right on, right on, right on. You heard it here from Generations MD. You heard it here from the boomer.

I'm not a boomer, I'm Gen X. It's totally different.

On that note, thanks guys for listening. Um, you can find us on Instagram @generations.md and TikTok. Mine is @generations.md and my mom's is Dr. Davis PGY30. And if you have any questions or interested in being a guest on the podcast, you can email us at askgenerations.md@gmail.com and we will talk to you guys soon.

Bye.

Bye.