Do I really want to go into medicine, or do I simply want to want it?
April 6, 2013 12:47 PM   Subscribe

I've been setting my goal on medicine (looks like it's not immediately, but in the next few years). However, I've been having doubts and second thoughts ever since I went into my undergraduate years. I'm graduating undergrad now, and have an entry-level job at a hospital. How and when will I know if that's what I want?

Undergrad degree is in biology. I have all the pre-med classes, though I may retake some as a continuing-ed student.

My family has been wanting me to go into medicine. I can't say it's life-or-death pressure, but it's definitely pressure. To be honest, I actually think engineering would have been more for me, though I'm not great at math.

Medicine definitely has some appeal to me - the flexibility for one, and I love reading about scientific research and developments. On the other hand, there are lots of things I feel I would have difficulty with in medicine - for one, having to make an eight-year commitment and the long hours / being on call (I have difficulty dealing what that type of stress). How will I know whether the pros outweigh the cons?

Have I just been hoodwinked and want to want this rigorous field? If so, how do I "short-circuit" the rumination and bias, so to speak, and pick out, intuitively, what I like and don't? (That is also a challenge for me.)

Thanks! I know AskMeFi can help guide me.
posted by Seeking Direction to Education (23 answers total) 5 users marked this as a favorite
Did I write this and forget? I'm much the same, except I'm thinking about a PhD as well.

Have you taken the MCAT yet?
posted by Strass at 12:51 PM on April 6, 2013

No, no MCAT yet. Probably within the next year or so.
posted by Seeking Direction at 12:52 PM on April 6, 2013

I'd been thinking it'd be fun to go to med school (after decades in engineering and then law) but a college buddy who got his MD back in the day warned me off -- apparently, med school is a slog, and being a doctor is no longer particularly enjoyable or lucrative (thanks to insurance companies and the corporations that own and operate many places a doctor might want to or be able to work).

It helps to know what sorts of things you do and don't like in a job, but even if you don't have a clear idea, it's probably worth it to go talk to some doctors who have the sorts of jobs you think you might be interested in. See if they like it, or if they're secretly studying to be web developers on the side.
posted by spacewrench at 12:59 PM on April 6, 2013

Possibly stupid questions: do you know doctors? Have you talked to them about what it's actually like working as a doctor? Do you have any idea what you would want to specialize in? Can you talk to someone in that particular field? Some are a lot more flexible and competitive than others. What would be your second choice? Third? Where would you want to go to school and why?

Have you sat down and just written out what the pros and cons are for both pursuing a career in medicine and doing something else? What do your closest friends think? They might have a good perspective on what you actually want compared to what you think your family wants

For what it's worth, I'm inclined to say you should not pursue it at this time, though obviously I'm just some stranger on the internet who doesn't know you as a person. Based on your question, this doesn't sound like something you want and I don't think you can spend eight years of your life working like a dog unless you absolutely want it and even if you could, that sounds like a lousy thing to do.

My sister always wanted to be a doctor. When she applied to med school from undergrad, she got shut out so she took two years and earned her MPH, then went to med school. Even she complains because it's hard - you have minimal control over your life for nearly a decade. She's sentimental and pretty type A but she has spent several holidays crying because she was late for holiday dinner, didn't get to see us open presents on Christmas, spent Thanksgiving in the hospital, etc. Plus she's 32 and still arguably in training for her career - she looks at me and see that I have a decent salary and can go to Lollapalooza and she's sometimes jealous (though I look at her and think, you'll be making six figures in three years, you can buy my ticket for Lollapalooza then, but I digress).

However, on the plus side, she has some great friends from her class. There are a lot of weird social things that go on with being a doctor. She has to field frantic calls when I think my husband has pink eye and weird calls when my dad asks if he should go to work the next day because he was bitten by a dog. My grandfather used to come up to her and just hand her all of the pills he was on. But he was also super proud of her. I'm super proud of her. Seeing her in a hospital in her scrubs and jacket was totally trippy the first time but damn, my sister is a doctor and that's badass. It's a hard gig but it's totally right for some people. I'm an outsider so it's hard for me to say this for sure but it's also very linear. Sometimes I wish my career was more linear but at the same time, she has a hard time trying to figure out when she is going to have kids, her vacations are random, etc.

FYI if you do end up applying, the admissions process is crazy. My other sister is a lawyer and when she applied to law school, it made sense. The schools publish the average LSAT scores and undergrad GPAs of the incoming class. When my sister applied to law school, she got in exactly where she predicted she would get in and got rejected from the schools she thought would reject her. When my other sister applied to med school, she got into MD/PhD programs at schools that were more highly ranked than schools that rejected her for MD programs, got waitlisted at schools that were lower-ranked than schools that accepted her outright, etc.
posted by kat518 at 1:17 PM on April 6, 2013

Does taking care of sick people appeal to you? You don't mention anything about that. That's the most common thing people with MDs do. Do you want to do that?

And what do you mean by "flexibility"? Because you sure won't have much during med school or residency. You might have some afterwards, depending on your specialty. Might.
posted by rtha at 1:29 PM on April 6, 2013 [2 favorites]

Go work, ask relevant questions of the professionals there and of yourself, and figure it out.

Don't be afraid of hard work, especially if you're young. You don't want to be one of those people who were afraid of the work it takes and then have to go around telling people that you didn't think the effort was worth the work, and then pretend you love your non-doctor job.

Commit to real consideration of the profession by understanding not only the big picture of what practicing medicine is like in the hospital setting, but the smaller mundane tasks involved, the atmosphere, the camaraderie, the politics, at the variety of levels those who have chosen the profession deal with, etc.
posted by discopolo at 1:31 PM on April 6, 2013

Also, I have family and friends who went to med school and they got through it because of the support networks they built. You can get through it. But you can't be lazy, and it's definitely been worth it for them, despite the long haul.

I've also known people who have gone back and done postbacs after working and gotten into med school. They sacrificed a lot, and just did it, without getting paralyzed by the fear and worry. Why? Because they decided they wanted it.

All you have to do is decide if you really want it, and decide that after talking to a huge number of people (and I mean a lot of different people at a lot of different levels---not just strung out residents, but people who have been doctors for 2-20 years). You can decide to talk to 6 people a week about this. Make it your project.
posted by discopolo at 1:37 PM on April 6, 2013 [2 favorites]

- for one, having to make an eight-year commitment and the long hours / being on call (I have difficulty dealing what that type of stress).

My answer to this is always, "what else are you going to do with your time that's so important?"

Doctors are notorious whiners, so take their claims that it is not "as" lucrative with a grain of salt. If you really, really want to make money-- like a lot of money-- you will be dissatisfied because the people who went into investment banking and became partners at management consulting and venture capital firms will make more money than you.

You family wants you to be independent and financially comfortable, as well as having professional respect in a world where (I am guessing) you and your family do not otherwise have a large amount of social capital.

Do you like science? Of your vision of a job where you put a lot of effort in and get a direct reward for that effort? Do you want to be a healer? Do you want a fair amount of professional autonomy (at least more than you have in most other jobs where you have to work for someone else)? Do you want to hang out with other medical professionals? Are they your kind of people? Do you want a job where you can pretty much use your skills to work as long as you want? Then being a doctor may be for you. If you want to do research, go for an MD/PhD so you don't have to worry about the loan burden.

It's hard to give you an answer because this depends on what your goals are and what kind of life you envision for yourself.
posted by deanc at 1:40 PM on April 6, 2013 [2 favorites]

A very good life long friend of mine is a doctor. She's wanted it her entire life -- since she was in early elementary school. And as a casual observer and occasional shoulder to cry on -- damn, you gotta want it. Really, really want it. Because it's rough. The competition, the crazy hours, the expectations, the bullshit, everything. Now that she's in her mid-30s, she's finally just beginning her "own" career... 14 years of post-secondary education has gotta be worth it. Granted, not every one needs *14* years (she's highly specialized), but that is one hell of a commitment to make to something if you're not sure.
posted by cgg at 1:51 PM on April 6, 2013 [1 favorite]

Sort of like boot camp, everyone starts off medical school thinking "I can't", but many people discover that they can, simply through sheer cussed willpower. It's very hard, not going to lie to you, which is why I would really say to only go for it if you genuinely love it. I genuinely love my job. It gave me literal ulcers to get to this point, but now I'm happy to go to work. But only YOU know - or can discover - what YOU want out of life.

Some additional pieces of information: there are the clinicians and the researchers, to put it simply. The researchers often (but not always) have a MD/PhD instead of a straight-up MD or DO, and either do bench or clinical research. Research-oriented docs are not generally paid "doctor money," whatever that means to you - they may do the 6-7 years of an MD/PhD program, then the 3-9 years of residency and fellowship and what have you, maybe a few years as a research fellow, and then they may make $80k a year if they are really mostly doing research and not seeing patients. Also they have to work on grant funding. Unless your department is exceptionally rich and/or indulgent, money's an issue, and seeing patients makes money, and research costs money.

That's different than the clinicians, who may make anywhere between $110k and (the sky's the limit if you're a proceduralist with your own practice). But, again, since you work up a healthy debt and spend anywhere between 7-10 years working very long hours to get there, it's up to you to do that math. Before that point, you'll be making $50-$60k/year in residency.

You don't necessarily have to love kissing babies or helping old ladies across the street to be a doctor - there are several less-or-non-patient-facing physician specialties such as pathology or radiology. But to get there, again, you'll go through the same med school training as everyone else, and their residencies have long hours too.

Of course, some people strike a balance between clinical work and (collaborative) research work. It's up to you, as everyone has said, to talk to a number of DIFFERENT doctors to see what their life is like. My schedule is not like my sister's schedule, or my cousins', or my friends'.

Another thing that can be said about medicine is the overall job security - how easy it is for me to find another job in any part of the county if I wanted to. Of course, there are limits to this, based on specialty and how dickish your hospital administration is, but most types of doctor are in need everywhere.

To summarize: so very worth it, but only if you REALLY LOVE IT.
posted by vetala at 2:04 PM on April 6, 2013 [1 favorite]

When I went back to undergrad and started working on a biology degree, there was definitely this attitude in all the students of "the best of us will get into medical school and the rest are failures and will do pharmacy school or failing that, research or failing everything else, industry." But once I got out of that environment and spent a couple of semesters at a community college getting trained in specific lab techniques (cell culture, immunoassays, PCR, etc), and started volunteering in a community lab, I realized that the research and especially industry career paths are way more exciting to me than the prospect of med school ever was.

You mention that you think engineering would be a good fit for you. Is it because you like making things? That's how I am. There are a lot of really cool things you can get into with a biology degree that will overlap with engineering--take a look at synthetic biology and genetic engineering.
posted by sunnichka at 2:55 PM on April 6, 2013

When I was 17, I did an informational interview with a physical therapist and decided "No, that isn't what I was envisioning." "What color is your parachute?" has some good info on how to do an informational interview.

Keep this in mind: Michael Krichton, author of "Jurassic Park" and lots of other good stuff, trained to be a doctor. His first book came out around the time he graduated so he never worked as a doctor. All he ever wanted was to be a writer. His family thought that was nuts, you can't make it that way, and encouraged him to go into medicine.

So there is no reason you cannot go do something else. I also know of a former doctor currently making a living by running a website (and the site has nothing to do with medicine). Plus the insurance industry likes to hire people with medical backgrounds. It helps because reading medical records is a big part of what goes on in health insurance.
posted by Michele in California at 3:16 PM on April 6, 2013

I was in your situation in my mid-twenties and asked a medical resident essentially the same questions you're asking. He told me, "There are two types of people who apply to med school. People who want to become doctors, and people who will become doctors." It made so much sense and I realized right away which one I was - I wanted to be a doctor, but didn't have the passion that would drive me hard enough to do anything it took to become one. I changed directions the next day and have never regretted the decision. I don't know if this helps or is as applicable to your situation. One other thing I would say is that the good doctors I've known view their careers more as a way of life than just a career. Not a decision to be made lightly. Whatever you decide to do, best of luck to you!
posted by pescadero at 4:29 PM on April 6, 2013 [2 favorites]

I wanted to be a doctor, but didn't have the passion that would drive me hard enough to do anything it took to become one.

I actually disagree with this. In my life, I've known a lot of med students. I've only met one person -- ever -- who went to med school and didn't go on to become a doctor. Med school may take a lot of persistence to get into, but that doesn't select for people who "will become a doctor." It selects for people who are very good at taking standardized tests and filling out applications: basically, the sort of people who are very academically oriented.

Now, I've seen people for whom being a doctor wasn't really what they wanted to do, but they became one anyway, in part because of family pressure: basically, they do very well financially but are only doing "just enough" to fulfill their professional obligations. Sometimes their finances run into trouble because they overextend themselves trying to make themselves feel better by purchasing expensive houses and wasting money on "toys" like overpriced cars or deciding to own a boat. Or they distract themselves with hobbies which takes time away from their work. Or they're sitting on a pile of money and trying to figure out how to use it to make themselves into something other than "just" a doctor (these guys end up fronting the money for stakes in fancy restaurants so they can be "gentlemen restaurateurs", and their ventures inevitably fail).

There are a lot of doctors in America. I highly doubt there exist enough people in America with the academic ability to get into med school who are "passionate" about being doctors to fill every single spot in med school. There are lots of people who become doctors and are good at it because it appeals people who want a job where they do hard work to attract and treat patients and accept challenges to perform procedures. They like being an autonomous professional "in charge" (which is why some people who didn't get into med school became biology professors as an alternative, not Physicians Assistants or Nurse Practitioners). They're the sort of people who like the satisfaction of being presented with a task, working on the task for as long as it takes to solve it, being compensated for that task, and moving on to the next task.

The reason I think that a lot of middle aged adults advise their children to become doctors is because they themselves are sort of burned out of their careers and think to themselves, "gosh. what else could I have done that would be satisfying while financially rewarding, and that I could keep doing as long as I needed to do?" They figure that in life you have to spend your day doing something, and all things considered, spending that day being a doctor is a pretty good way to spend it, given the alternatives.

I'm not a doctor. I quite like my job, which is something I spent many years meticulously planning to get. I have it now, and I love it and the opportunities it gives me. I consciously chose not to be a doctor, but I don't think my life would have been that much worse if I did so, and I would be making more money. On the other hand, I would have looked back on my life and regretted not pursuing the intellectual path I did end up taking. But I do understand the appeal, and I understand why many parents advise their children to go that route. However, it appeals to a certain type of personality and work ethic.
posted by deanc at 5:02 PM on April 6, 2013 [2 favorites]

Not a doctor but I work with them. Folks have already made some good suggestions, but I would just add the following.

* Consider shadowing some physicians. You can ask family friends, or try your university's alumni network to start. Once you begin your hospital job, ask your supervisor whether she could introduce you to some physicians for observation opportunities, if you do not have occasion to meet some directly.
* Research Nurse Practitioner or Physician Assistant as jobs. These roles will only be growing given the enormous cost pressures in healthcare today. I suggest you try to shadow some of these as well.
* One specialty that does have some flexibility (again, after medical school and residency) is Emergency Medicine. It's shift work.
posted by teragram at 5:37 PM on April 6, 2013

Thanks for the replies so far.

Question: some of you have mentioned personality; what personality traits do you think come in handy and/or work against you in medicine? I can't seem to get an honest answer elsewhere.
posted by Seeking Direction at 5:44 PM on April 6, 2013

See, I've shadowed a few doctors here and there (granted, only a few, and not for very long), but I still can't seem to draw any firm conclusions from it.
posted by Seeking Direction at 5:49 PM on April 6, 2013

Can anyone read the "tea leaves" in the following:

I don't care about prestige, just being HAPPY or at least CONTENT. (I would hate to say: "I hate my job, but it pays well!")

That said, oddly, NP and PA might feel too...compromised...for me. (No offense.) I have no other way to describe it.
posted by Seeking Direction at 5:52 PM on April 6, 2013

Question: some of you have mentioned personality; what personality traits do you think come in handy and/or work against you in medicine? I can't seem to get an honest answer elsewhere.

Read Chapter 5, Parts 8-11 of Outliers. Specifically:
When Borgenicht [who owned a clothes-making business] came home to night to his children, he may have been tired and poor and overwhelmed, but he was alive. He was his own boss. He was responsible for his own decisions and direction. His work was complex: it engaged his mind and imagination. And in his work, there was a relationship between effort and reward: the longer he and Regina [his wife] stayed up at night sewing aprons, the more money they made the next day on the streets.

Those three things -- autonomy, complexity, and a connection between effort and reward -- are, most people agree, the three qualities that work has to have if it is to be satisfying.
Imagine what it must have been like to watch the meteoric rise of Regina and Louis Borgenicht through the eyes of one of their offspring. They learned ... a lesson crucial to those who wanted to tackle the upper reaches of a profession like law or medicine: if you work hard enough and assert yourself, and use your mind and imagination, you can shape the world to your desires.
(now, take this all with a grain of salt because Malcolm Gladwell tells a lot of "just so" stories, but some of the people I know who became doctors would have otherwise opened small service or retail businesses or restaurants because they wanted jobs where they had autonomy and were able to make their living by doing something where that thing generated an associated reward)

That's a different personality type than the person who ends up in sales or PR, and even a different personality type than ends up in executive management and a different one that ends up in scientific research.

This is why I disagree with the assertion that the people who become doctors are the ones who "will be" doctors. The people who become doctors are the ones who are the sort of people who are motivated to study and work harder and longer and more persistently to get what they want. They don't work that hard because they're necessarily passionate about being doctors. They're passionate about working really hard and getting rewarded for it, and medicine is a field (among others) that feeds into that personality type, and people with that personality type who channel it into the path of going into medicine succeed at going into medicine.
posted by deanc at 6:33 PM on April 6, 2013 [2 favorites]

Medicine is the epitome of golden handcuffs.

You need to really have a shamanic trait of wanting to help people at great cost to your own health, happiness, and well-being.

Being able to kill your own ego to get stuff done is one of the biggest day to day problems for most of my colleagues, who are omg doctors how dare you ask me to do that.

As the spots for residency training become more and more constrained as applicants from the newer for-profit DO schools, those from the Caribbean as well as the legitimate foreign medical schools rapidly add up to more than the amount of spots available, the situation is going to go from unbearable to excruciating. This year a thousand graduates from LCME medical schools ended up with no residency. Next year will be worse.

A lot of people go into medical school for money and prestige. Those aren't really there anymore, so if those are your reasons you will intensely regret going into medicine. You will spend eight years in various positions where your time is not valued, your input is worthless, and most of the people you deal with on a daily basis will be overworked, underpaid, and on the edge of a mental breakdown.

However, it's hard to beat as a profession if you are a caring, insomniac workaholic introvert with no hobbies, no family obligations, no commitments, no major health conditions (including anxiety/depression) and a total lack of any sense of self-worth who's willing to live in crushing debt for at least a decade.

And that's for general medicine. For some of the more intense specialties like surgery, you basically need a raging personality disorder as a minimum qualification to enter the field.

Granted, tons of people go through the process who don't meet the conditions I outlined above, but trust me, it isn't pretty.

The look on people's faces at 2AM when a trauma code is called, the resident just got dumped by their cheating spouse and is screaming abuse at them for not knowing something they couldn't have possibly known about, they haven't seen their wife or kids or even showered for the last three days, they're only halfway through the third year and it hits them that they have made a terrible awful mistake, and couldn't possibly make it through a residency. . .but they're 200k in debt and there's no plan B.

It can be an abusive, unforgiving profession. You have to really have a burning desire to make it through to the other side and wade through all the blood, pus, vomit, needlesticks and tears. And that's just the clinical years, without going into the reams of charts, tables, diagrams you need to memorize that will inevitably be contradicted by the final training process of whatever specialty you end up going into. Massive, massive pointless timesucks at every step. Days and days of exams. Total inability to take time off when you want to. Weddings, birthdays, funerals will pass like ships in the night. Weeks will go by without seeing real daylight, only an deathless fluorescent halo fogging your memory until you can't remember what it was like to sleep in on a Saturday and wake up to the soft glow of true actinic radiation.
posted by hobo gitano de queretaro at 6:36 PM on April 6, 2013 [1 favorite]

Ok, thanks for the honesty and advice! Maybe I am the type who can put up with the BS, or maybe not. Either way, I will definitely keep on shadowing.
posted by Seeking Direction at 7:39 PM on April 6, 2013

My best advice is to do that entry level job you mention and see if you like it. I was a nursing assistant for three summers when I was in college and that removed any nagging doubts that I had that medicine was right for me. If you find yourself wanting to be a doctor after that, it's probably a good fit.
posted by karlos at 7:40 AM on April 7, 2013

To me a big part of the trouble with medicine (in the US at least) is that you amass so much debt in pursuit of your MD that nearly the only way you can pay off that debt is to be a doctor. Even if you hate it. So I, personally, wouldn't want to go to medical school unless I was pretty darn sure I wanted to be a doctor. There are a LOT of other professions out there, many of which can be done with a B.S. (or a Masters/other professional degree, if you want). Also, you can go to medical school later. I know people who enrolled in med school many years after they finished their undergrad degrees.
posted by mskyle at 10:31 AM on April 7, 2013

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