Dr. I. Dealist floats down the hallway with delicate, yet powerful grace. Her crisp white coat, showcases the beautiful blue font of her embroidered name with the all-important "M.D." initials after it. She's earned it, and she's a wonderful doctor. Patients love her, staff love her, she loves life, but most of all, she loves being a doctor. "Thank you for saving my life", a pudgy, cute 75-year old woman says, as she gives her a tray of rich, chocolate brownies. "Thank you", she says humbly, but proudly, as she hugs her patient. Dr. Dealist's days are filled with funny characters, helping people and saving lives. She knows everything about the townsfolk. She knows that Mr. Jones dog just had knee surgery and he sometimes forgets to take his insulin. She knows that Mrs. Brown is expecting her fourth child any day, and she'll be there by her side. She's a respected and important part of the community.

At the end of the day Dr. I. Dealist returns home to her two wonderful children, (all children of the month at their school). That morning she'd also washed the team's soccer uniforms and baked cookies for their teacher. Her gorgeous George Clooney-look-alike husband, breezes in and kisses her cheek. She serves lentil loaf, artichokes and home baked bread for their healthy family meal. After helping her kids with their homework, she tucks them into bed and has a glass of wine with her husband. Wearing the expensive French lingerie her husband bought for her (they can afford it) they tuck themselves into bed for a night of intimacy. She will awake the next morning, refreshed, charged and excited for another day after a breakfast of espresso and croissants. What a life!

Down the street, Dr. R. Eality is not having the best of days. After having only 4 hours sleep she's got to get the kids up, get them dressed and off to school in less than 30 minutes. Toast and pop-tarts in the car is breakfast for this family. If, the car starts they'll probably be about 15 minutes late for school. She's been driving this car since she was a second year resident, and it's in need of a little TLC. Her husband works from home and has luckily prepared the kids lunch before he disappears off to work on his computer. The dishes pile up in the sink and will be done when there is time.

Dr. Eality arrives in the office to two grumpy patients, who have waited 20 minutes for her to arrive. "Great, it's Ms. Harris", what a wonderful start to the day, she says. Ms. Harris is the most obnoxious patient she can imagine, she doesn't take her advice, won't take her medicine, but comes back time and time again with the same complaints. Add to that the fact that she would rather tip her hairstylist $20 than pay her $15 co-pay. Dr. Eality abruptly deals with Ms. Harris and moves on with her day. After about 12 patients they are all become a blur. She doesn't really know anything about them, she doesn't have time. This is not what she imagined practicing medicine would be like. The HMO's question her opinions, insurance reimbursements are declining and then take months to get through, her malpractice insurance is rising, and she's already been sued twice in her career. Then there's the paperwork, say no more. Patients page her at midnight for prescription refills, and quite frankly, she's irritated and bored. She's burned-out. She and her husband haven't had a date in months, and she misses time with her kids. And did we mention, she's TIRED, really tired. On some days, everything's great and she loves her job. Bottom-line is, she'd love to quit altogether, but she can't with the $120,000 in loans she has to repay. She feels trapped and conned. Why didn't anyone tell her it was going to be like this?

There are many women physicians whose life may echo the women above. Some days you could have a day like Dr. I. Dealist and other days will be more like Dr. R. Eality. The question for many is "would you go into medicine again if you had the choice?" Surveys vary in their results, some suggest that 10% or as high as 30% would leave the professional altogether if they could.

This topic was recently discussed in our forums, and things got very heated. Burned-out physicians told stories of negativity and reality. Premeds and medical students read in dismay and they faced their 'reality check' from women further along their medical career.

Dissatisfied physicians offered this advice to optimistic premeds:

• Don't go into medicine for the money - you may be disappointed.
• If you question whether medicine is or isn't for you then don't do it!
• If you can think of doing any other career - do it!
• It's impossible to predict how you will feel about practicing medicine until you're actually doing it. Somewhat like trying to imagine how much your life will change when you have a baby.
• Listen and learn from others who have gone before you.

But what causes this dissatisfaction? Some members said that it is because women still imagine themselves being the "superwoman", juggling kids, career, spouses and family all at the same time. "I appreciate everyone's honesty. We need more of that in order to trash the myth that we women are supposed to be mothers, homemakers, wives, and career builders while making it look fun and easy", said one member. At least one ball will get dropped at one time or another. The question is, which ball are you going to bend down and pick up, and then how do you get them all juggling again!

"I planned on trying to have it all. I wanted to have a career- never needing to depend on anyone for my livelihood. I spent all my free time studying for one thing after another- physics quiz; biochemistry test; MCAT; anatomy; pharmacology; FLEX; in-house exams; Board exams. I mean ENOUGH already! But I made it. I am now a board certified Family physician! But wait, I don't really practice medicine. I fill out forms for HMOs to provide medications for my patients. I refill prescriptions for medications that really don't make patients better, just prolongs life a little, so they may get another more horrible disease like Alzheimer's", says one physician.

She continues, "Well between spending hours at paperwork & trying to have a meaningful relationship & keep the bathrooms clean, and going to the grocery store, and finally getting to bed, I realize that I REALLY CAN NOT DO IT ALL!!! It is not possible!"

Women entering medicine at a later age may find that this can help their experiences later on, especially those who had come from other challenging professional backgrounds.

Physicians who had found fulfillment and satisfaction from their careers all seemed to have been open to specialties that they might otherwise have overlooked as a medical student. They might have happened to find a specialty by chance. Some even changed midway through residency. Having a medical degree also makes you eligible for other interesting and well paid jobs, such as pharmaceuticals, research and even software development. So, there may be something there for everyone, even if it does mean leaving medicine altogether. As one member says "...be happy or find your happiness."

What are your thoughts? Are you an idealist or realist? What can you add to this discussion? Join us in the forums!