How can someone tell if he's cut out for medical school?

September 29, 2007 6:02 PM

How can someone tell if he's cut out for medical school?

I'm asking this for a friend of mine.

Exactly *how* hard is medical school?

Let's say said individual has a love of all things that have to do with medicine; he has experience working with sick people in a medical setting and has always done well in school (although not outstandingly well). This person has a liberal arts background and was not very strong in math or science; nor does he learn particularly quickly. What he lacks in sheer intelligence or quick wit he can make up for with persistence and effort and interest. He is driven by things that are intense and fascinating and complicated but loathes politics, bad attitudes and repetitive work.

How to determine if it's doable?

posted by mintchip to education (11 comments total)

The MCAT test is both necessary and reasonably predictive. Various self-assements and practice MCAT tests can taken as well.
posted by paulsc at 6:07 PM on September 29, 2007

No offense, but probably not. While I know some base morons who made it through med school and are marginal physicians, even the really intelligent, quick and motivated students struggled while exhibiting a tremendous amount of persistence and effort.

But I don't think that would be your problem (you're asking the right questions, after all.) The problem is about the politics, bad attitudes and (in many specialties) repetitive work. Medicine would be great if it was about medicine, but it no longer is. Physicians have to love people, not medicine, for the rites of passage to be worth it. They have to dedicate their lives to people, for the carreer to make sense.
posted by jmgorman at 6:45 PM on September 29, 2007

Sounds like he'd be better cut out for medical research (something requiring a master's or non-M.D. doctorate) than being an actual doctor. Or perhaps nursing, if he really wants to work with the sick?
posted by schroedinger at 6:52 PM on September 29, 2007

Wow, loaded question. It's funny I saw this one early but I'm about to ask another question. And, it's not just medical school you have to worry about but residency and practice too so I'll hit on it.

I'm almost like the person you mention although I tend to do well in school and upon standardized tests. I was liberal artsy and well, after some post bac classes, the MCAT, and lots of applying to grad school again am I am now a doctor and, barring the winning of the lottery, won't be able to retire till I am 75.

I HAVE TO KEEP THIS SHORT FOR MY OWN SANITY.

Only go to medical school if:

1. YOU WANT TO HELP SICK PEOPLE GET BETTER. That's the only thing that will help you get through the long, painful hours learning material that you will soon forget and is very dry and rote, sadly. (And, that's the first two years of medical school).

(As for the next two, you have different challenges). If you actually feel good about sticking your finger up a 80 year old's behind to see if she's bleeding at a 3:30 AM admission in the ER when instead you could have been sleeping, you'll like being a doctor.

In short, it's not going to be about the money. At least not for your 20's and 30's anyway. Plus, if medicine has taught me anything, tomorrow is not guaranteed. You give up other things as well. On a side note, I luckily wined, dined and married the woman I love before medical school and, when I had more normal hours as lawyer. I could never fathom having developing the relationship I did with my wife while in medical school. I got to know her ambitions, got to know her family, and we really did a lot of stuff together. In medical school, that life is not so feasible. It's simply because unlike any most other work, you have to keep reading when you come home (after a couple hours of lecturing or in dissecting the cadaver).
(I probably need to take MeFi off my favorites).

Most of your day is spent filling out stupid paperwork stupid lawyers demand of us, navigating the bureuracy of the hospital, reading labs, and just making sure your patients are getting better. Honestly, it's tasks that nurses and PAs with some experience do just as well as doctors. The place we separate ourselves from them is our "fund of knowledge" and that requires a lot, a lot, a lot, a lot of dedication if you want to do it well.

The sad secret about medicine is that the imaging and treatments are so good, that you can be a lazy doctor but also a fine doctor. Read this excellent piece by a doctor who has a brain power far above mine and you'll understand what it takes:

Sorry to ramble but to sum up: At least for 7+ years medicine is going to require your all (that's when the last of many, many tests you will take end). And, it's hard to maintaing deep relationships, be well rounded, and sort of follow the other pursuits your liberal artsy mind is going to care about also. It's not just crap like knowing the Classics either. If you wanted to guarantee a loss in a current events trivia tournament, field a team of doctors.

And the latter is not a knock on the profession at all. Honestly, under the knife or when I am truly sick, the last thing I want to be going through my doctor's brain is a Hamlet soliloquy. I want her to know the best evidence based medicine possible and have the best technical and manual skills possible. Some of my classmates fit this bill and I would humbly and readily trust their opinion over mine anyday.

How can I live with myself then? Well, I'm a lot slower and I hope superior reasoning skills will help me in the end. In short, I can't name 4-5 leading causes of a left to right heart shunt off the top of my brain, but I'll probably recongize it on a physical exam or an EKG and it will be diagnosed more accurately on an echocardiogram. (The ability of 21st century imaging to make mediocre doctors like me excellent is a topic for another debate. But, again, read Gawande's piece and you'll see where, well some doctoring is actually needed.).

2. Ok, enough of my baggage. Back to your question. Is medical school "doable" Yes. Yes. Yes. Yes. and Yes.
It honestly does not take much intelligence in memorizing a lot of stuff and spit the right answer back on a multiple choice test. I would say you need about a 115 IQ to be a doctor. If you're slow at accumulating lots of information, then, well, you're butt is going to be on the desk chair longer than most people. If you bad at science, well, then, your butt is going to be on the desk chair longer than most people, but you'll get it. You'll pull through. And, it seems like you have the intelligence and drive to do it. And, really, that's all it takes. A friend of mine in medical school got a horribly low MCAT score (I'm talking really, really bad I'm shocked she was in an American medical school bad.) And, she had a liberal arts background from a prestigious school also. But, she wanted to be a Plastic Surgeon (a very tough specialty to get into) and she essentially worked real hard at it for a four years and got into a plastic surgery residency.

I'm not worried about you as you seem to have a true passion for helping people and want to be a doctor.

I'd be more worried about your discipline. Science is not harder than the liberal arts. It just requires a lot more discipline. You have to understand things from the ground up but, strangely, you can't just reason how we got there. I hope you the reason you are not a good science student is that it's not because you hate science either. That's no good in medicine. You have to be both a scientist and a humanist and I feel you have to like both too.

As far as getting into medical school. If your science grades are bad, it will be tough. You might have to retake them again or hope you rock your MCAT. Even then, you can go to a foreign medical school and just work your way into medicine here as you are an American citizen. (Some of the foreign schools are not even requiring a Bachelor's degree! But, if you can pass the liscensing tests they make you eligible for, you can be a doctor here! (Not a competitive specialty of course, but a doctor nonetheless -- perhaps even in Psychiatry which might be good for someone who is not too too excited about the so-called "hard" sciences.

Ok, I hope I helped you out a bit. Medicine sucks a lot, but I'm not going to be a doctor that convinces you out of it. I still have a ridiculous amount of pride when people ask what I do and I say I'm a doctor. And, in those rare times that I feel I influenced patient care past what the mechanized delivery of algorithmic medicine gives a person these days (surgeons might not have this feeling as much, but that field has its own drawbacks), it feels REALLY GOOD to be a doctor.

And, well, medicine has its share of nasty politics (something I find incomprhensible because you see how fragile life can be everyday), it definitely has a decent amount of bad attitudes (although I'd bet perecentage wise less than other professions) and, sadly, the work is basically repetitive. I can't remember more than 4-5 patient's names from over 75 I saw last month. You do do a lot of the same stuff until something new comes along, but that something new is probably not something you invented or pushed along anyways and it builds off the previous stuff in the first place. Talking to patients is not repetitive but you rarely have time for really getting to do that. (I guess you would in Psychiatry and you know the conversations are going to be different.....:))

I really feel anyone can be a doctor if they work at it. How good of a doctor and how much time they will have for other pursuits is questionable and you'll need intelligence to help you out there. (I can guarantee you my friend who became a Plastic Surgeon has never read a blog of any kind, but someone like Gawande, well, people blog about him).

Still, medicine is a lot more social than other professions. And, really, no patient is the same. And the desire to be well rounded can be carved out later in life or at level that you can be individually at peace with and things.

So, in short, if your friend can simply stay disciplined for a decent amount of time and get organized and work hard, he'll be a great doctor and he'll like it. Plus, being a doctor only opens more doors than it will ever close for you. He won't have to practice medicine at all -- he can work for a drug corp, teach, research, etc. So, it's a big world and most people find their way in it.
posted by skepticallypleased at 6:58 PM on September 29, 2007 [16 favorites]

I went to a totally old-school, top down, beat on the low person on the totem pole, stand up and be humiliated in front of a bunch of grey haired old men in white coats kind of medical school. My enthusiasm to study all the time and be number one in my class (which was never terribly strong) left me after the first month. Yet I survived. I guess my point is that med school is a slog. It is *all about* persistence, effort, and interest. Intelligence has nothing to do with it, at least not through your four years of med school.

Generally, med school is intense and interesting and *never* repetitive. In fact, I think that's what drives some doctors into hyperspecialization after school, the desire to be a total expert at one thing. When you're in school and residency, you are constantly being challenged, faced with things that you've never seen before and you have to piece together what's going on from the ground up. It's not so much about the list of facts that you have memorized, it's how you approach the problem of a sick person in front of you. Nowadays, any factoid, any piece of scientific evidence you need is as close as the nearest internet connection. Someone who memorizes facts quickly and scores well on tests doesn't necessarily excel in med school.

Finally, med school is frankly not as difficult as it used to be. There are work hour restrictions, there are caps on the number of patients you can admit which means you sleep more when you're on call. It's still a hard road, but possibly not as difficult as the mythology of medical school builds it up as.

Total editorial derail: as skepticallypleased alludes to, the practice of medicine after training is pretty tough. I always thought I would make it through this really difficult 7 year period of training and then be a total bad ass for having survived it and then everything else would be down hill. Sadly, the practice of medicine in the U.S. is about as difficult as the training, and possibly more so. Long hours of paperwork, increasing patient volumes, more legal hassles, declining salaries. Through all of this, you have to be smart, professional, and compassionate when inside you are emotionally and physically exhausted and every cell in your body wants to scream "Why is everything so fucking unfair??!! All I ever wanted to do was help people!!!" Med school is hard because if you weren't toughened up, there's no way you'd survive practicing in the current system. Hopefully, with more humane training programs, this may change, but I wouldn't advise anyone to go through med school unless they were prepared for the life beyond.
posted by Slarty Bartfast at 7:53 PM on September 29, 2007

I have a friend who's a bit like your situation - she wasn't the brightest in school, didn't necessarily do all that well, but with persistence and effort she made it to med school and just recently graduated as a doctor. She quite enjoys what she's doing. I also know of other people that went from liberal arts/humanities to medicine (and other hard sciences) and did well.

As I mentioned earlier, it's persistence and effort that got them where they are, so the fact that "you"'ve already got that is a total plus (unlike, say, me, who has no patience whatsoever, therefore I am not a doctor and have no patients.).

It is hard work though, and I'm glad people like skepticallypleased and others have spoken up about the realities of medical school. Where I come from, society expects you to be a DOCTOR OR NOTHING because apparently that carries bigger social stature and it means you're super smart. There is a bigger outcry over scholarship applications to medical school than anything else in Malaysia. Yet not everyone who applies is actually aware of what this entails. For one thing, the people aspect is totally undervalued here. I still hear people going on about how they'd rather trust a uncaring cold doctor who scored straight As in high school than a personable, patient, friendly caring doctor who can do just as good a job but didn't get straight As in school! Crazy!

Good luck, whatever you do, but do consider which direction you ultimately want to go.

(skepticallypleased, I found your words so important that I'm quoting you with credit on my alternative education blog. I hope that's ok.)
posted by divabat at 8:07 PM on September 29, 2007

I tell people that the two most difficult things about medical school are getting in and getting out. Medical school by itself is pretty easy (if you are the right type of person for it). In the pre-clinical years, you don't have much to do other than study - and you have a lot of time to do it in. It's basically just memorizing the syllabus.

As alluded to before, medicine gets exponentially more difficult when you finish medical school. Med school really only teaches you the language of medicine, how to think and process clinical information. You don't really learn how to be a doctor until you get to residency. Probably it's most important aspect is exposing medical students to the vast array of specialities and types of practice you can choose (forced) to pick from.

If you can't find your niche, you will most likely be miserable.
posted by i_am_a_Jedi at 8:19 PM on September 29, 2007

previous
questions along the same lines
posted by LobsterMitten at 8:48 PM on September 29, 2007

Can you pass P-chem?
posted by Eekacat at 1:02 AM on September 30, 2007

A secondary thing to consider when evaluating what people say about "the practice of medicine" today: it's all different. There are many specialties and settings with many styles and lives. If you look hard you can find one that's ok for you. MDs' favorite hobby for the past 30 years is to complain about how bad it is nowadays.
posted by a robot made out of meat at 7:31 AM on September 30, 2007

The key thing is that your friend still has a fascination and love for the art after spending some time working with sick people. In my opinion, if a person can get into medical school and he has this quality, he will be a good doctor, period.

The liberal arts background and the lack of affinity for math and science are not handicaps. One of the best doctors I know was a French major.

Sheer intelligence, quick wit, and being able to learn quickly make the job more pleasant and interesting, but they are certainly not required. If you cannot learn quickly you need to be persistent and dedicated, because there is a lot of stuff to learn. A doc's intelligence, persistence, dedication, and quick wit all help patients. On the other hand I've witnessed docs who were continually struggling at the limits of their own competence in their daily work. They appeared miserable to me and they certainly did their patients no favors. Stupidity or a lack of common sense really isn't OK in medicine, and worse, there's almost no bar to taking these qualities with you into medical school.

Very few people like politics or repetitive work; your friend will find a lot of them in medicine, just as he would in any other worthwhile field of endeavor. I wouldn't waste any more time thinking about that, unless one of your friend's options is to live off his trust fund for the rest of his life. Practicing medicine will not be so easy as that, and so if that is a viable option it probably deserves further thought.

The medical school admissions office will determine whether it is 'doable' for your friend or not. His GPA and MCAT scores will play a large role in this determination, for better or worse.
posted by ikkyu2 at 9:49 AM on September 30, 2007