For more than 30 years—in fact ever since he completed his residency—Michael Collins has been an orthopedic surgeon in a practice just outside of Chicago. He’s also the author of two acclaimed memoirs: Hot Lights, Cold Steel traces the arc of his four-year surgical residency at the Mayo Clinic from eager but clueless first-year resident to accomplished chief resident. His second memoir, Blue Collar, Blue Scrubs, goes back further in time to his pre-medical school life working construction jobs.

Both books are great reads, as is a recent interview in which he reflected on his life and the changes he has seen in medicine. Some of the most interesting takeaways from the interview:

  • Back when Collins went to medical school at Loyola University (today the Loyola University Chicago Stritch School of Medicine), the curriculum was completed in three years. He says today’s four-year curriculum is better.
  • Collins matched in pediatrics before his first experience with orthopedics. He finished out the year in pediatrics and then switched to a four-year orthopedics residency.
  • In going for his residency, he didn’t do any visiting rotations. He got into the orthopedics residency because he played hockey with a guy who was high up in the department. He is staggered by what medical students today have to do to get a residency.
  • After practicing for over thirty years, how does he keep from burning out? “Burnout occurs when there is a disconnect between expectations and reality. It’s important to go into things with an understanding of what it’s going to be like. There are negatives: you probably won’t make as much money as a generation ago, plus the other things like paperwork, and the business of medicine. These are all true, and they are a problem. But I think if you focus as a clinical practitioner, basic things haven’t changed in thousands of years. You go into a room, talk to the patient, figure out the patient’s problem, and do whatever you can to help them. Helping people with their problems is the greatest thing about medicine. If you focus on that instead of the paperwork you have to do, you’re less likely to burn out.”

Collins has many more interesting observations. Ready them in the interview or take some time to read one of his memoirs.