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Andrea Murina, MD, weighs whether she would recommend medicine to her own children amid AI, physician burnout, and evolving residency training standards.
In this new episode of The Medical Sisterhood podcast, host Mona Shahriari, MD, associate clinical professor of dermatology at Yale University and a practicing dermatologist in Connecticut, is joined by Andrea Murina, MD, an associate professor of dermatology and the program director at Tulane University School of Medicine in New Orleans, Louisiana.
Together they explore a question many physicians quietly ask: knowing what they know now, would they still recommend medicine to someone they love? For Murina, a general dermatologist and mother of 3, the question is far from theoretical. Her oldest son has expressed interest in pursuing medicine, and more recently so have his 2 younger brothers.
Murina also oversees more than 400 residents and fellows across the university's graduate medical education programs. She describes an initial sinking feeling at her son's news, rooted in memories of the effort, uncertainty, and stress required to reach medical school and residency. She came from a nonmedical background and entered training with little guidance. Viewing the system through a parent's eyes, she notes, has made her more critical of how medical education is structured and more reflective about how she approaches learners.
Ultimately, she concludes that the struggle is often where the meaning of the profession is found. She would choose medicine again despite years of imposter syndrome and the challenge of overcoming a tendency to faint during procedures. She also highlights the unexpected variety of her career, from teaching and hospital committees to journal reviewing and creative presentations.
Murina argues there is a limit to how far duty hours can be restricted without leaving trainees underprepared. She compares residency to training for a marathon or an Olympic event and emphasizes that competence and confidence come only through practice.
In her view, the goal of training is to produce physicians who may not know every answer but know how to find one without fear or panic. Shahriari echoes this point, recalling a residency interview in which she was asked to estimate a figure she could not possibly know, a test of problem-solving rather than recall.
At the same time, Murina rejects the long-standing expectation that physicians work while ill. She supports Accreditation Council for Graduate Medical Education requirements allowing residents and fellows to attend health care appointments, including mental health visits, as needed. She notes that physicians who fail to build these habits during training rarely adopt them later, which contributes to poor health outcomes across the profession. She encourages full use of vacation time but cautions against using sick days simply because they are available.
Murina describes herself as cautiously optimistic about artificial intelligence (AI). She sees particular potential in offloading documentation, billing, and prior authorizations, which she views as tasks below physicians' level of expertise and key contributors to burnout. Even with AI scribes, she notes that managing callbacks and messages across 3 clinic locations remains a significant burden. She hopes future tools will free more time for patient care, shared decision-making, and teaching. She also anticipates that dermatology subspecialties may evolve over the next decade, potentially creating new technology-driven roles.
Addressing generational differences, Murina rejects the notion that younger physicians lack work ethic and frames the issue as one of expectation management. Both clinicians acknowledge a tendency toward people-pleasing and difficulty disconnecting on vacation. They agree that setting boundaries with patients supports long-term practice. For prospective physicians, Murina stresses normalizing failure, remaining open to alternate pathways, and trusting guidance from mentors.
She also acknowledges that admissions and dermatology residency applications have grown dramatically more competitive. Shahriari closes by suggesting the key question for the next generation is not whether to become a physician, but what kind of physician to become and what kind of life medicine should fit into.
Editor’s note: Neither speaker had any relevant disclosures of note. This episode was summarized with the help of AI tools.
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