Someone in the medical blogosphere wrote a post a few months ago about "why we do it." What is it that made us decide to become doctors? If anyone reading this knows the post I refer to, please send me the link.

My question to the people who ask, 'why we do it,' is "why do you care?" That is not to say I'm surprised that you care. Everyone seems to care. I've been getting asked the question about why I became a doctor almost monthly going on six years now. What causes my sympathetic nervous system to activate and my blood pressure to rise is not so much that people ask about your motivations for becoming a doctor, but rather that everyone seems to have some preconceived notion of what the "right" reasons to be a doctor are. It's not enough that we give up a decade of our lives in order to devote a career to preventing and curing disease, we have to be doing it for the right reasons. If you're doing it for the sake of others great, carry on. If you're doing it for you're own ego, you should be doing something else.

Why does nobody ask the same question of plumbers, or auto mechanics? Nobody would expect that a plumber or an auto mechanic went into their chosen profession because they love pipes, or because they want to improve the functioning of the world's cars. They do it because it's a job and it pays the rent - which is perfectly reasonable. Nobody asked them for a personal statement when they applied to plumbing school, or to prove that being a plumber is more rewarding than anything else they could be doing. And this is the way it should be because it's none of anyone else's god damn business how personally fulfilling one finds one's own profession to be.

It so happens that I find the practice of medicine to be highly rewarding in many ways. It also sucks ass in many ways. Before applying to medical school, I did a rough cost-benefit analysis of the many ways in medicine was likely to be rewarding versus the many ways in which it was likely to suck ass. I concluded that it would probably be marginally more rewarding than sucking and this line of reasoning has brought me to where I am today. Plus, I have severe allergic rhinitis and the relatively hypoallergenic environment of the hospital helps with that.

A study published this month's issue of Patient Education and Counseling found increased rates of nervousness among female medical students and corresponding decreased clinical performance. Summer Johnson comments on the study at bioethics.net. Does anyone think that women make inferior doctors? Of course not. But, apparently, they are not evaluated as highly as their male counterparts. This study confirms my long held belief that clinical evaluations of medical students are completely bogus. They are probably useful for identifying the very small subset of students who have serious problems interacting with patients in order to prevent them from graduating. But, for the most part, they are highly subjective and mostly meaningless. It took me until about the end of my third year to figure it out but, in medical school you are evaluated much more highly for being consistently and confidently wrong than you are for being tentative but on the right track. And, if someone pats you on the back enough times for guessing at a diagnosis and a reasonable plan, you eventually start to believe that that's what good medicine is.