Why you should not go to medical school — a gleefully biased rant

In the few years since I’ve graduated from medical school, there has been enough time to go back to medical practice in some form, but I haven’t and don’t intend to, so quit yer askin’ already.  But of course, people keep on asking.  Their comments range from the curious — “Why don’t you practice?” — to the idealistic — “But medicine is such a wonderful profession!” — to the almost hostile — “Don’t you like helping people, you heartless ogre you?”

Since it’s certain that folks will continue to pose me this question for the rest of my natural existence, I figured that instead of launching into my 15-minute polemic on the State of Medicine each time and interrupting the flow of my Hefeweizen on a fine Friday eve, I could just write it up and give them the URL.  So that’s what I did.

Now, unfettered by my prior obligations as an unbiased pre-med advisor, here are the myriad reasons why you should not enter the medical profession and the one (count ’em — one) reason you should.  I have assiduously gone through these arguments and expunged any hint of evenhandedness, saving time for all of you who are hunting for balance.  And here are the reasons:

1) You will lose all the friends you had before medicine.
You think I’m kidding here.  No, I’m not: I mean it in the most literal sense possible. I had a friend in UCLA Med School who lived 12min away, and I saw her once — in three years (UPDATE: twice in 4 years). I saw her more often when she lived in Boston and I was in LA, no foolin’.

Here’s the deal: you’ll be so caught up with taking classes, studying for exams, doing ward rotations, taking care of too many patients as a resident, trying to squeeze in a meal or an extra hour of sleep, that your entire life pre-medicine will be relegated to some nether, dust-gathering corner of your mind.  Docs and med students don’t make it to their college reunions because who can take a whole weekend off?  Unthinkable.

And so those old friends will simply drift away because of said temporal and physical restrictions, to be replaced by your medical compadres, whom you have no choice but to see every day.  Which brings us to…

2) You will have difficulty sustaining a relationship and will probably break up with or divorce your current significant other during training.

For the same reasons enumerated above, you just won’t have time for quality time, kid.  Any time you do have will be spent catching up on that microbiology lecture, cramming for the Boards, getting some sleep after overnight call and just doing the basic housekeeping of keeping a Homo medicus upright and functioning.  When it’s a choice between having a meal or getting some sleep after being up for 36 hrs vs. spending quality time with your sig-o, which one wins, buddy?  I know he/she’s great and all, but a relationship is a luxury that your pared-down, elemental, bottom-of-the-Maslow-pyramid existence won’t be able to afford.  Unless you’ve found some total saint who’s willing to care for your burned-out carapace every day for 6-8 years without complaint or expectation of immediate reward (and yes, these people do exist, and yes, they will feel massively entitled after the 8 years because of the enormous sacrifice they’ve put in, etc etc).

3) You will spend the best years of your life as a sleep-deprived, underpaid slave.
I will state here without proof that the years between 22 and 35, being a time of good health, taut skin, generally idealistic worldview, firm buttocks, trim physique, ability to legally acquire intoxicating substances, having the income to acquire such substances, high liver capacity for processing said substances, and optimal sexual function, are the Best Years of Your Life.  And if you enter the medical profession during this golden interval, you will run around like a headless chicken trying to appease various superiors in the guise of professor, intern, resident, chief resident, attending, and department head, depending on your phase of devolution — all the while skipping sleep every fourth day or so and getting paid about minimum wage ($35k-$45k/yr for 80-100 hrs/wk of work) or paying through the nose (med school costing about $40-80k/yr).  Granted, any job these days involves hierarchy and superiors, but none of them keep you in such penury for so long. Speaking of penury…

4) You will get yourself a job of dubious remuneration.
For the amount of training you put in and the amount of blood, sweat and tears medicine extracts from you (I’m not being metaphorical here), you should be getting paid an absurd amount of money as soon as you finish residency.  And by “absurd”, I mean “at least a third of what a soulless investment banker makes, who saves no lives, produces nothing of social worth, and is basically a federally-subsidized gambler” (but that’s a whole different rant, ahem).

I mean, you’re in your mid-thirties. You put in 4 years of med school, and at least 4 years of residency (up to 8 if you’re a surgeon). You even did a fellowship and got paid a pittance while doing that.  And for all the good you’re doing humanity — you are healing people, for godssakes — you should get paid more than some spreadsheet jockey shifting around numbers, some lawyer defending tobacco companies or some consultant maximizing a client’s shareholder value, whatever the hell that means.

Right?  Wrong. For the same time spent out of college, your I-banking, lawyering and consulting buddies are making 2-5 times as much as you are.  At my tenth college reunion, friends who had gone into finance were near retirement and talking about their 10-acre parcel in Aspen, while 80% of my doctor classmates were still in residency, with an average debt of $100,000 and a salary of $40,000.

5) You will have a job of exceptionally high liability exposure.

But wait, it gets better.  Who amongst these professionals has to insure himself against the potential wrath of his own clients?  The investment banker’s not playing with his own money.  And even if he screws up to the tune of, oh, hundreds of billions of dollars, Uncle Sam’s there to bail him out (see: World History, 2008-2009).

The lawyers?  They’re doing the suing, not being sued.  But the doctors?  Ah.  Average annual liability premiums these days are around $30,000.  That goes up to $80,000 for an obstetrician-gynecologist (who remains liable for any baby s/he delivers until said infant turns 18) and into the six-digit realm for neurosurgeons.   Atul Gawande wrote a dynamite article about docs’ compensation in the 4 May 2005 issue of The New Yorker entitled Piecework — check it out.

6) You will endanger your health and long-term well-being.
The medical profession is bad for you.  Just ask any current doctor or med student.  You will eat irregularly, eat poorly when you do get the irregular meal (and sayonara to the now-outlawed drug-company sponsored meals — god bless their generous hearts and bottomless pockets), have way too much cortisol circulating in your system from all the stress you experience, have a compromised immune system because of all the cortisol in your blood, get sick more often because of the compromised immune system (and the perpetual exposure to disease — it’s a hospital where everybody’s sick, duh), and be perennially sleep-deprived.  If your residency is four years long, on average you will spend one of those years without any sleep.  A whole year of no sleep. Do you get that?  This is as bad for you as it is for patients — you’ve heard of Libby’s Law, right? Groggy doctors can kill patients when they don’t mean to.

Groggy docs can also hurt themselves.  One friend stuck herself with a needle as she was drawing blood from an HIV patient.  She’s fine now, but that was a good 9 months of panic (PS: she has since quit clinical medicine).  My good friend and college classmate James — a serious contender for the title of Nicest Guy on Earth — had a severe car accident one morning on the way to the hospital because he fell asleep behind the wheel.  Luckily, his airbag deployed and he didn’t suffer long-term injuries.  Everyone seems to know already that medical care can kill patients (haven’t read The House of God by Samuel Shem yet?  Go get it now — brilliant and the second funniest book I’ve ever read, after Catch-22), but it’s usually news that it can kill the docs, too.

7) You will not have time to care for patients as well as you want to.
This is how the math works: Many patients, few of you — usually one, unless your name is United States of Tara (and no, multiple-personality disorder ain’t the same as schizophrenia — I learned something from med school).  So you have to take care of many patients.  And if they’re in the hospital, that means they’re really sick, otherwise they’d still be at home.

So you are scurrying around trying to take care of all of them at once, which means that each individual patient can only get a little bit of your time.  Which means that you won’t have a chance to sit at the bedside of that sweet old vet and hear his stories of Iwo Jima.  Or get to the bottom of why that LOL (little old lady — medical slang’s been around way longer than internet slang, buddy) can’t get her daughter to come visit.  Or to do any of that idealistic stuff that you cooked up in your adolescent brain about really connecting with patients.

Get a grip!  This is about action, about taking care of business, about getting shit done, about making that note look sharp because the attending is coming to round in an hour and he’s a hardass, and that’s the difference between getting recommended for honors and just passing, which is the difference between scoring the residency at MGH and the one at East Bumblefuck City Hospital, so get on it already and quit yakking with the gomer (which is an older patient with so many problems you should have never let him/her get admitted in the first place — stands for get out of my ER, and I didn’t make it up the acronym, so kindly direct your righteously indignant wrath elsewhere). It’s about CYA — cover your ass.  For better or for worse, you just start to treat patients as problems and illness-bearing entities for the sake of mental efficiency (“55yo WM s/p rad prostatectomy c hx CHF & COPD”), which does not do much for your empathetic abilities.  Which brings us to…

8) You will start to dislike patients — and by extension, people in general.
Okay, so now you’re overworked, underpaid, underfed, under-laid and underslept.  Whose fault is that?  Well, it’s not really the hospital’s fault — it’s just drawn that way.  And it’s not your boss’s fault, because somebody has to take care of patients, and he can’t do it because he’s the boss, duh.

So whom to blame?  Ah yes — patients.  It’s the patients’ fault!  They’re the ones creating all the work! The ones who get in the way of your nap, your catching your favorite TV show, having an uninterrupted meal, getting together with your sig-o for some therapeutic nookie.  How dare the gomer in 345E have an MI while you’re watching CSI?  Does she have any consideration, letting her blood pressure tank to 40 over palp at 3.30am, while you’re making out with Elle MacPherson on the shores of Bora Bora (assuming you’re lucky enough to actually sleep)?  The logic may be twisted — patients, on the whole, don’t get sick voluntarily just to spite you — but it is deeply ingrained in medical culture.  Heck, there’s even a slang term for it: a hit.  As in, “We got four hits on our admitting shift at the ER today.”  Hit — the same way you would be struck by a mortar, bullet, shell, or bomb.  Getting hit is a Bad Thing.

Patients aren’t people, you see — they are potentially lethal disasters that can explode all over the place and ruin your whole day. “We got hit again” — one more patient to take care of, says the resident.

But really, is that resident blameless?  Or how about Dr Hardass the attending and his intransigent ways?  Hell, they’re at fault, too!

Soon the circle of blame expands to the outer reaches of the cosmos, and every potentially accountable organism from amoeba to blue whale will be personally responsible for your misery.  But lest you think we’ve forgotten you, patients, remember — it’s all still your fault.

9) People who do not even know you will start to dislike you.
Once upon a day, in a time somewhere between the Cretaceous and Triassic eras, physicians were held in awe and respect by the general public.  Their seeming omniscience was revered, and TV shows like Marcus Welby MD glorified their competent sangfroid and high-minded grace.  Heck, they were even considered sexy or something.

I only noticed in recent years that this ain’t the case no more, and doctors rank on the contempt scale somewhere above meter maids and at or below divorce lawyers (but still much higher than I-bankers and other invertebrates).  The average Joe and Janet are tired of the ever-rising cost of medical care, tired of all the stories of malpractice, tired of the perceived greed of the pharmaceutical firms, tired of the heartless profit-focussed practices of insurance companies.

But where do they pin their frustration?  To whom can they direct their ire?  Insurance and drug companies are nameless, faceless entities, as are hospitals.  We need a person to blame, like a nurse or a doc.  Nurses are overworked and massively underpaid, so it doesn’t really make sense to get mad at them.  But doctors — those darn Mercedes-driving, Armani-wearing, private-school using, golf-playing arriviste docs!  By being the most visible symbol of the medical profession, the doctor will have the dubious distinction of being the scapegoat for all its maladies.  Fair?  Hell no — we already told you docs are overworked, underpaid, and often railing at the same injustices Joe and Janet are.  Most of them don’t even play golf!  (They don’t have time.  Except for dermatologists and radiologists).  But such it is.  Hey, I’m just letting you know which direction the rotten tomatoes are flying so you can consciously choose to stand at the ‘toss’ or ‘splat’ end of the trajectory.

10) You’re not helping people nearly as much as you think.

So by now I may have managed to inspire your righteous indignation with some of the things I’ve said about the medical profession.  But maybe in the back of your head, you were still thinking, “Well, even though it sounds like a bunch of bitter black bile, he does kinda sorta have a point.”  In which case, I’ve almost certainly lost you on this one: “Whaddya mean you’re not helping people?  Isn’t that what medicine is all about?”

Well, actually, yes and no.  Sure, there is the immediate gratification of delivering a baby, fixing someone’s eyesight with LASIK, catching a melanoma before it causes trouble, or prescribing some thermonuclear antibiotics to kick a pesky bronchitis before it becomes lethal pneumonia.

But, depending on the field you choose, most of the time you’re not doing that.  You’re treating chronic conditions that are self-inflicted: emphysema, obesity, cardiovascular disease, diabetes.  Moreover, patients tend to be non-compliant — they basically don’t do what you tell ’em to do. In fact, you too are probably one of those non-compliant patients who doesn’t exercise more, eat healthier, and take pills as they’re prescribed.  Anecdotally, 50%+ of prescribed medications are taken incorrectly or never.

So there you are, like Cuchulain the legendary Celtic warrior, wading into the ocean and, in your rage, trying to fight the invulnerable tide and improve the health of your patients.  You pour all your earnestness, good intentions and expertise into it, and — not a whole lot happens.  Your efforts bear no fruit.  So you suck it down and move on, sustained by the occasional kid who does get better, that eyesight that does improve, that bronchitis that doesn’t turn into pneumonia.  Win some, lose many more.

AND THE ONE AND ONLY REASON WHY YOU SHOULD GO INTO MEDICINE:

You have only ever envisioned yourself as a doctor and can only derive professional fulfillment in life by taking care of sick people.*

There’s really no other reason, and lord knows the world needs docs.  Prestige, money, job security, making mom happy, proving something, can’t think of anything else to do, better than being a lawyer, etc are all incredibly bad reasons for becoming a doc.

You should become a doc because you always wanted to work for Médecins Sans Frontières and your life will be half-lived without that.  You should become a doc because you want to be the psychiatrist who makes a breakthrough in schizophrenia treatment.  You should become a doc because you love making sick kids feel better and being the one to reassure the parents that it’ll all be OK, and nothing else in the world measures up to that.  Or as my general surgery resident put it, you should become a doc because “my dad was an ass surgeon, my big brother’s an ass surgeon, and by god I’m going to become an ass surgeon.”

But woe betide you if there’s anything else, anything at all, that would also give you that fulfillment.  Because pursuit of medicine would preclude chasing down that other dream and a whole lot more — a dream that could be much bigger, much more spectacular, much more enriching for yourself and humanity than being a physician.  Just ask John Keats, Walker Percy, Sir Arthur Conan Doyle, Giorgio Armani, or Michael Crichton (some of these guys being more alive than others these days).  Or you can just ask me a few years down the road, by which time I should have a blog entry for that question, too.

*Also acceptable: You want to get into academic medicine. Pretty much need an MD or MD/PhD as prerequisite.

Update 1: To those who are wondering what I’ve been up to since the writing of this article — that’s a long story. Most recently, I’ve been writing books, including the #1 rated dating book on Amazon, The Tao of Dating: The Smart Woman’s Guide to Being Absolutely Irresistible. Check out also the very popular dating ebook for men and my other blog for more articles, as well as my HuffPost archive.

Update 2: As of 9/24/2011, there’s a Hacker News thread on this piece, with hundreds of intelligent comments from people with firsthand experience about the medical lifestyle. Check it out.

Update 3: In September 2012, a survey by The Physicians Foundation found that 6 out of 10 physicians would quit today if they could. Click on link to find what’s driving the trend.

Update 4:  In Oct 2012, Jake Seliger of the excellent blog The Story’s Story wrote a magisterial article on why becoming a doctor is a bad idea, with many angles that I hadn’t even considered. The whole antitrust suit against the Match and how it’s basically an illegal trust and how the AMA bought off Congress to head off lawsuits was particularly sobering.

Update 5: I recently had the opportunity to speak to the daughter of the lady who was the dean of of my med school. She told me that her mom specifically forbid her from going into medicine. Did you get that? THE DEAN OF MY MED SCHOOL FORBID HER DAUGHTER FROM GOING TO MED SCHOOL. I don’t think there’s anything else that could validate my decision more. This means I win.

Update 6: Great article from the Wall Street Journal on 8/29/2014: “Why Doctors Are Sick of Their Profession” by Dr Sandeep Jauhar. May also want to check out his books Intern: A Doctor’s Initiation and his latest, Doctored: The Disillusionment of an American Physician, released Aug 2014.

Comment rules: There have been a lot of comments on this article over the years, so if you wish to comment, here are the rules: if you have an intelligent contribution to make, I’ll approve it. I’m not anonymous, so you shouldn’t be either. There’s no room for hate, spite or derision on this blog, so comments containing them won’t see the light of day.

447 thoughts on “Why you should not go to medical school — a gleefully biased rant

  1. Avneet D

    Thank you very much for this article. Out of all my pre-med friends I feel that I am the only one who sees the negative sides of medicine. I’m about to graduate university and am realizing that just because I was on this path to become a doctor and followed the path to a tee and got interviews etc., doesnt mean I should go to medical school. I think I really need to try other things as well first before I dive into something that is such a huge life commitment. Thank you again!

  2. Julien B. Ouellet

    “You should become a doc because you always wanted to work for Médecins Sans Frontières and your life will be half-lived without that.”

    Actually… Even that is not a good reason! MSF is hiring a whole bunch of other professionals such as technicians, engineers and nurses.

  3. jj

    I going to do paramedicine straight after high school, then i am going to apply for medicine. Also the reason Doctors start having a negative view on patients is due to the lack of effective communication. As doctors progress they take communication with patients less seriously.

  4. Anonymous

    What job do you recommend if I just want to make money? I graduated top of my class, double-majoring in Computer Science + Biochemistry, but even if I landed at somewhere say Google as a Software Engineer, I’d still make less money than a Radiologist. I also dislike programming’s never ending learning curve, constantly having to put out fires and solve complex problems, and unreasonable deadlines for so little respect and pay. I would be willing to suffer through anything if it meant a higher salary in the end, so even though it seems like doctors have it rough, they get paid double, which is why I am still considering medicine. I’m sure I could make it into a residency if it came down to it. What are your thoughts?

  5. For the last 10 years that I have been practicing medicine, I have been one of the few physicians that remained optimistically determined to rise above the challenges of the modern day healthcare delivery system. However, in the last couple of years, it has become increasingly evident to me that if I want to continue to truly make a difference in the lives of patients and raise the level of quality of patient care, I must step out of the traditional role of physician and enter the business world. Unfortunately, physicians have been relegated to the status of paid “employees” and licensed “providers,” bound by the rules set forth by corporations and government. Corporations, although often well intentioned, do not take an oath of “do no harm” and become clouded in judgement when profit is on the line. Government agencies, although usually well intentioned, do not take an oath of “do no harm” and their judgement becomes clouded and inefficient by the nature of politics. The billboards will compassionately campaign for the corporate and agency “love of the patient,” but this is purely deception in the interest of money and politics. No one cares for patients more than their doctor. Unfortunately, the rules being set forth in today’s healthcare system are in favor of neither patients nor physicians. This is driving physicians away in droves and crippling the physicians ability to help and heal as they are trained to do. Although I am not leaving healthcare and I will always be a physician, I have come to the conclusion that being a physician alone anymore is unfortunately not enough.

    • Thanks for your contribution, Ryan. There are indeed many stakeholders in healthcare, and many of them have perverse incentives that do not necessarily align with the welfare of the patient. More power to you and all the other well-intentioned docs out there — the world needs you.

  6. Drwhoafficionado

    To the writer or reader. I recently got accepted to med school I am having strong doubts about going. I’ve been agonizing about this decision since I found out last week and I would love to hear advice that anyone has. I can’t quite envision myself as a doctor however I feel if I turn down this opportunity it is something I might regret. I haven’t found my passion in life yet however I think I’m interested in the mental health field and providing service work to those who need it. I originally was thinking psychiatry but I’m unsure whether the payoff is worth it

  7. miranda

    Hi, I am struggling with the choice of medicine or dentistry. I immensely enjoy the interacting with patients each day and it is definitely my top realistic career choice. I am currently studying an undergrad science degree and I really enjoy learning about how the body works. However, needles, vomit really stress me out and I have passed out watching an animal dissection as well as one time when I was getting my blood drawn. What I am worried about is whether I will be able to PHYSICALLY handle the training years of becoming a doctor. I feel very exhausted if I don’t get enough sleep, and dizzy when I haven’t eaten enough (probably due to the fact that I am on the lower end of normal blood pressure as well as blood sugar). Medicine is my dream career, but I worry that I can’t make it through intern and residency, and quitting then will more heartbreaking than it is now.

    Any advice?

  8. seth

    don’t worry about what your parents will think Michaela
    You won’t really see them again
    I graduated from medical school in 1987; still in full time surgical practice
    I know what I’m talking about
    father died in 2000 – I almost missed the funeral – couldn’t cancel clinic
    made it home just in time to see his cancer ridden body in the casket, hug mom a day or two, then back to work
    I’ve come to the conclusion that you can only rely on yourself in the dark of the night alone
    a few laughs with my work friends get me from day to day, but many lonely nights trying to finish my electronic medical record notes in front of the tv – too depressing to do them in bed and I can never catch up on them – 1.5 to 2 hours every night with the EHR

  9. AA

    I was planning on applying to med school in the final year of my undergraduate studies – but I’m having serious doubts. I would like to hear any opinion about whether it’s worth it for me to go through medical school. Here are some points about me:
    – I will have an insignificant amount of debt from going through med school because the school I will attend has low tuition rates (say around USD$20,000 for all 4 years).
    – I have a finance/business background, but it’s not hard for me to get in to the med school, I have the application ready.
    – I am considering medicine because of its job security, and good pay. But I value lifestyle, meaning that I want a good pay that awards me for the amount of hours I work. I can accept long hours (think investment banking) only if the money follows. Therefore at this stage I am not excited about residency (5 years for most specialties besides family medicine in my country), for all of the reasons mentioned in this article and the comments.
    – So considering my intentions, it would seem like I should not go on with residency after medical school: it would be the wrong reason and I would be miserable
    – If I go and get the MD, I will be looking at alternative careers, in either management consulting, or investments. In these fields I may be able to use the degree and the medical expertise.

    Given that my intentions are NOT to help people or “I love science/medicine”, but I will not sacrifice a lot financially (tuition is really cheap for me), and assuming that I got in – should I go through with med school to get the degree and think about alternative careers? Am I wasting 4 of my best years? Would even these 4 years of med school be too miserable?

  10. Michaela

    Currently a second year med student in South Africa & to be completely honest, I only applied for medicine because it seemed like the right thing to get into; the safest option. I knew medicine is grueling but I assumed I could just power through it & I’ll be okay. Not that I’m actually in the system, I’ve never felt this hopeless & confused. I don’t find the lectures I attend interesting, I despise my classmates because they have that arrogant “I got into med school” air about them, especially since I want to change to something else now & I just generally hate having to study something I do not want to do for the rest of my life AND now have to waste these golden years of my life on. I was so stupid during the application process in not having done any research into other careers so all I saw was the medicine route. I’m Indian btw, so in my ‘race/culture’ you basically have 3 options being: medicine, engineering and law. If you do anything else you’re below average and a disappointment to your parents & family. It’s extremely frustrating trying to explain how you feel in your unhappy situation to parents who have this narrow mindset. I feel stuck because I’ll be disappointing my parents SO much if I drop out of med school. I have spoken to my parents about how I feel but they think it’s just a phase and things will get better once I “actually start doing medicine” but I know it won’t, I’m not even looking forward to experiencing that. Also what society will think of me should I leave (I will never understand why MY life decisions are controlled by people’s opinions of me but whatever).

    I get that this profession has absolute job security and pays extremely well but I fear this desolate feeling, should I continue, will make practicing extremely difficult & I’ll just have a high paying unsatisfactory life.

    I don’t know what to do.

  11. Thaddeus Buttmunch MD

    I’ll speak First cuz I am the boldest. This Old Profession more and More like the Oldest. Gettin’ Pimped on CALL gettin’ HAMMERED kissing AZZ…it took all I had to be the head of THIS Class! We worked at St. Barnabas that’s Our Loss-Dr Richard S. P……he’s our Boss. Dick Pan be the Man…WE turned the Tricks. We ran that place from eight to six. They made the money, We ran this place…they Chuck Traynor-WE Linda Lovelace (That “Ordeal” thing-it GOT to me-now, Where the Feck was I…Oh YES.

    Live like a Nerd, work like a Geek, worked 120 Hours this week. Don’t you wish we were M1cks sp1cs, Poe Locks or W0ps, then WE could fight fires, and we could be Cops, but if you’re a Highme you Must have it All, and be a Shyster, a Sawbones or U NO One at ALL. The policeman don’t have to Bloody His Brain. Whore around every night snort Cocaine and the Fireman don’t even have to Know how to Read sit in the firehouse All DAY and smoke the Devil’s Weed!

  12. CJ

    Unfortunately, you are typically NOT your own boss. You are being told what to do by non medical administrators who have never treated a patient in their life. That is the frustration

  13. Amira

    I’m about to start med school next month, I have been reading this for about An hour now, the thing that caught my eye is you guys saying ‘you can’t live the life you could/ spending your years Unlived. What other life you would enjoy other Than working whole heartedly. I believe Tiring is way better than being bored and doing the same routine everyday…medicine is not a profession you will do the same thing everyday I mean at least you won’t meet the same people everyday and yeah you’re your own boss.

  14. Achmad

    I went to med school because I wanted to be immortal. Brainwashed with all the cartoons and superhero movies as a child, I was obsessed with making the human body stronger, immune to all disease and weakness, and eventually immortal. I have always been the straight A student and as I was graduating high school, I was confident that I could make major scientific contributions to any field I went into.

    Looking back, I probably needed psychological help. After the 6 years that I spent in medical school, I came to realize how dumb I was. To think that you can advance humanity more than all the people who ever lived combined, is, least to be said, ignorant. And also arrogant. And delusional. Also, I was so ignorant that I didn’t even realize that medical school was not a place for science. It was the place where people became doctors to treat patients. I had no interest in patients from the beginning. I wanted to cure illnesses and make miracles etc. Maybe I was just a kid. Or maybe it was my fathers fault, who is also a doctor and encouraged me to become a “research doctor” since I was little. Anyway, the only one who is to blame is myself. No one pulled a gun on me and forced me to go in medicine.

    Regardless, med school shoved me so hard in shit that I lost all my delusions and dreams. I never could quit because of my parents who kept saying “just wait until you see the clinics, just wait until you see real medicine blah blah”. I didn’t want to be patient and see it until the end. I knew I fucked up by the time I was in the second year. Now it has been 6 years and I am about to graduate with only one thing in my mind: How do I switch to a computer science career without being a burden to the people around me? Even though I never failed a class and have a respectable GPA of 3, I just can’t bring myself to like medicine. Also, to hell with money. As if I give a shit about that. But I am ashamed to tell my father that I wasted all his money for studying medicine. Although I am sure he will continue supporting me, I just want to earn my own money. Also, during these 6 years, I realized that I wasn’t interested in research after all. So I am back where I started, only older and broker. But at least I know what I don’t want to do.

    My advise is this: Don’t choose med school just because you want to do medical research. Especially if you think like “I don’t want to treat every single patient. I want to find a cure so that I can treat millions of people at once.”, then medicine will be hell for you. Don’t go there.

  15. lost

    my story is different than all of you,because i live in Ethiopia and the process of getting in to med school and the social perception of being a doctor is different.I have always wanted to be a doctor…but i feel like i never got the chance to even think about other professionsand and know what getting in to medical school meant(i was to focused on getting in).i know i am disciplined enough to be a doctor…but i don’t think i am academically capable.I don’t have any connection with the courses we currently are taking and regardless of how hard i study i don’t seem to memorize what i have studied over and over again.(how am i supposed to treat patients if i can not even memorize simple medical terms). although i got in to med school(second year)…my instinct tells me i should be on a different path e but i don’t know how.I thought once i got in to my pre clincal years my heart will be set on.i have always wanted to be the best in what i do and i do not think am gonna be that here(i want to do great things not just survive).I have not figure out who i am and what i want.i know i wanna help people so much(i see my self doing that). The idea of telling my parents how i feel scares me.the more i keep this feeling inside the more i want to fail(we take oral exams every year…it sick but that’s how i feel).am i over reacting?is it just a phase?am i good enough?…too many questions sorry…can you please give me advice?

  16. lost

    so what to do

  17. Renu

    I have been a physician for 20 years and still love what I do. I still remember the first day I got a paycheck and thought “Am I actually going to get paid for doing this?” I have been through the days where I studied for 16hrs and slept for 6. Dark dark circles under my eyes during residency….
    Of course there are days when I want to quit everything but those are far and few in between. Any job that you do will become routine after 20 years but I still find cases that stimulate me mentally. I love that I continue to learn everyday.
    I have plenty of time off, plenty of time with my family, plenty of money and am in great physical shape.
    You will always find people who are unhappy no matter what they do and have plenty of colleagues who cannot manage their time or money and constantly complain.
    Don’t let this article deter you from studying medicine

  18. Karin

    My advice is find something else to do. Your panic disorder, major depression and severe anxiety will only escalate.

  19. Dave

    Interesting blog that I just found, and true. I might add one other reason not to become a doctor: your emotional and social development is put on hold until you finish, and then it’s too late. Your age cohorts will have raised families, moved up in careers, probably traveled, built relationships, gained wisdom, and more…while you have your nose to the grindstone doing what you’re told by the attendings and nurses for all those years. And another thing–except for the rare ‘favored’ resident, no one wants to hear your ideas and you are expected to toe the line. Creativity is frowned upon and could actually get your in trouble.

    I was one of those applicants to med school who didn’t even think about applying until I was a junior in college. Never did I think about becoming a doctor and never did I dream of becoming one in my life prior to then. And it showed after I was accepted, finished med school, and went out to practice. I didn’t like medicine from the start, but stayed enrolled because I was in the loan trap right away. In retrospect–not practicing anymore after 20 years of general practice–I should have taken the $20,000 hit, picked up my things and driven home…and gone into something I was interested in.

    If anyone who reads the post thinks to themselves ‘this is me…,’ I recommend don’t do it. Don’t fall into the cauldron and get cooked and spit out like yesterday’s laundry. You will do all of these things–train, work hard, lose all that’s posted here, lose relationships, divorce, lose everything, and eventually die early, and guess what? No one will care…especially your patients. You work hard to care for them and guess what? When you’re gone, they’ll find someone else. And guess what else? You’ll spend your life taking care of people who don’t take care of themselves and don’t take your advice.

    I want those 25 or so years back, but it’s too late. Think twice. It’s a miserable profession, full of immature, childlike people or physician wanna-bes. And everyone wants to be chief. There are no braves.

  20. Constance

    So I am a 17 year old who has ALWAYS wanted to pursue her life in the medical field. Pretty much dating back to my first memory, I’ve wanted to be a pediatrician, but I’ve gotten really passionate about pediatric surgery. And I’m not passionate about it for money like everyone says. I’ve always wanted to do this and I think it’s something I could really be beneficial at. However, my biggest issue is that already at 17 I have a panic disorder, major depression and severe anxiety. So now after 17 years of pure certainty of what wanted to do with my life, I’m becoming unsure on whether or not my body and I could handle what comes with the extensive schooling, interning, residency, lack of sleep, lack of social life, etc. So now I’m seeking help from current or post medical students on whether or not I really should go through with this, before I do. I’ve done my extensive research and serious soul searching, but after reading this and the comments I’m a little frightened, so if you got advice or anything for me please let me know.

  21. Nicole Denolo

    Hello! I’m a medical student in the Philippines.

    If you’re lacking in the finance department, and it’s the sole reason you can’t take Medicine, why not consider studying abroad. In my country the most expensive top of the line medical schools has tuition fee range from 6,000-8,000 dollars as of 2016.
    I have many foreigner classmates who cleverly decided to take Doctor of Medicine abroad.
    :)

  22. yunus

    It is 05.21am I don’t know for how long I’ve reading comments and your article. My father who is paediatric professor at university and I am just graduated doctor waiting for my first job to start next week. I am sure some of us feel social pressure to specialise in major fields like surgery, radiology. I can’t make up my mind really in order to achieve what? to become like my father or other doctors. I haven’t seen my father when I was raising up. I am from Turkey which obviously doesn’t make much more differences regarding being doctor and doctor’s child. One of the reasons I don’t wanna do residency is I have been enough sleep deprived, fed unhealthily, lost my years. But I keep my admiration for people who go all the way studying, learning, becoming professors who missed the best years of their lives un-lived. Doctors make double or triple of what teachers make here. But when I was an intern doing emergency department shifts I end up thinking who possibly can understand doctors? People who doesn’t work more than 8hours a day. No way! Living humble, easy, healthy life is maybe ”the better”
    My point is some people doesn’t seem to be bothered by studying hours, missing all those good years, fun, health, social experiences, sex, culture. Which struck me really hard and after saying allright that is it, I skipped the school for a year and back-packed around Turkey and Europe.
    But as a general physician I really don’t know what to do after work. It becomes sort of life style to study, read, work. I am sure you remember after major exams weekends you end up thinking what I am going to do. Yeah it is over probably I passed it, nailed it but now what? Yeah monday something big starts again. I really one enjoy life as much as possible in an easy way like teachers, bankers, secretaries who suffer from their stress which honestly think ‘nothing’ compared to docs. When I hear them complaining I hold myself really hard not to burst with anger.
    At least in respectable, honorful way we are making considerably enough money to live on.
    Being decent human being is enough I think. Yeah lots of tears, sweat and coffee we poured to become abnormal humanbeings. I diagnosed couple of girls when I was laying down on one of girls’ chest with Atrio-ventriculer murmur, other one with hemorroid. we never will be normal if exists.
    Thank you for all comments and sharing this amazing article…

  23. esteban

    I used to be a theoretical physicist, but couldn’t find a professor job in universities close to home. So I decided to switch careers and go into medicine because I thought this would be a field where my skills could actually profit society as opposed to my former purely theoretical work. Worst mistake I ever made. I’m a resident now and it has sucked all the enjoyment I used to have in life. My life is not about helping people. It’s about kissing enough ass so that I get good enough evaluations to be able to keep going in my program. I have no time for hobbies because when I don’t work, I study or toil on my research activities.

    I used to love my job and I should have kept doing it. I don’t really see my family more now than when I was living thousands of miles away. And now I’m completely miserable. Medicine is such a toxic field in which to work. If you’re young, bright and idealistic, please PLEASE stay away from medicine and do something else. Trust me, med school will utterly ruin your life. It’s a horrible gauntlet, and it is not worth wasting the best years of your life on it. I regret it immensely. If I can convince at least one person not to commit the horrible blunder I made, then my post will have been worth it.

  24. seth

    you listed leaving your friends behind, but you left out the fact that you will leave your own family behind – brothers, sisters, mother and father.

    at the beginning of 10 years of medical school/residency/fellowship I knew that I would essentially have an exiled existence – too stupid to appreciate the loss. my 5 siblings have distant separate lives and one parent is gone – the very little time I was able to spend with them is much more precious than I realized. Even now my time out of the hospital is spent trying to catch up on patient notes, research to figure out complex problems. My vacation time is spent catching up on sleep at home, doing taxes and all the little things one needs to do just to maintain an existence – car repairs, bill paying, etc…Vacation time is not for vacation – it’s catch up time

    I have 2 children who resent and blame me for being an absent father – both in their 20’s; many opportunities lost having to go in on call during holidays; no time to go hiking, work on homework, plan birthdays, etc…I always thought they would understand that I was working hard for them…boy was that stupid

    I have not accumulated a pile of money that will allow me to retire. I see endless 60 hour weeks until I’m gone. Luckily, I do feel that I am contributing to my patients and I enjoy that. However, not everyone does well and one bad outcome can really mess with your head and bring you down. If you do this long enough you will have bad outcomes in spite of the best care. you’re skin has to be very thick to survive.

    A medical school friend who was a lawyer first didn’t match and decided to abandon medicine for his brother’s MD JD law practice. At first he did credentials law for MDs, then he switched to suing people. He makes millions, literally, in KC and Phoenix. He said one of the reasons he quit doing credentials law is that doctors couldn’t afford his upfront retainer fee.

  25. Wilhelm

    Here are some fallacious ideas concerning the medical profession/studies.

    1) Intelligence vs Memorization: Many people that are admitted into medical schools believe that they are intelligent or more intelligent than those that are not admitted. In fact, this is wrong: The obtainment of medical knowledge requires more memorization than intelligence or creativity. That is, medical students memorize what have been discovered or studied – they do not invent or create new knowledge. This is the reason why mathematics, physics, chemistry, biology, and other mathematical sciences can be studied as a category – they require memorization. How many students or even doctors are able to truly understand the medical concepts or the technical terms clearly?

    2) High Pay: Are the salaries of doctors truly high in comparison to the investment(s) of time (how many years of studies, residency, intership, practice, etc.), tuition fees, energy, life, relationships, leisures, and so forth? Make the comparison and calculate the ratio, medical students! The number looks big (how many zeros), but the investments are bigger (how many things and how much time and energy).

    3) Prestige: Are doctors truly admired? Do they truly have ‘prestige’? I do not think so. I, myself, have no admiration for doctors. Indeed, the medical profession is equal to other professions; they are not unique or more honourable than the other professions. That the medical profession is more honourable than the other professions is a social misconception. How many people can tell me some names of some famous doctors? I know of no one. How many names do you know?

    4) Risk: How many doctors are truly qualified? By ‘qualified’, I mean not qualfied by the professional organizations, but truly qualified (with respect to morality, knowledge, experience, etc.). Many students want to become a doctor because they do not see the true qualification requirements – they see only the salary, prestige, etc.

    5)

  26. Jenny

    Med school is not that hard. First 2 yrs just extension of college. 3rd year a few hard rotations. I loved the science, classes, variety of disease, trauma, drama, life stories, humanity, procedures, novelty etc. It was reality tv before there was such a thing. 4th year easy, electives. I even worked at a pharm co during evenings the last 2 yrs.
    Residency in radiology was not that bad aside from call. Trauma call was intense. Saw a lot of amazing stuff, very interesting, scary, sad, fascinating, cool, incredible, everything. The sound of helicopter landing on the roof preceded pager going off. Lots of amazing stuff in the OR too that I had no idea radiology was going to be asked for. I did witness and was victim of some of the stuff AB writes about. No fun to get yelled at and be publically shamed for mistakes. But stakes are high with human life. even so, I liked residency, had great friends. Enjoyed seeing and learning about the vast spectrum of diseases and weird stuff, stories and freakish abnormalities of all kinds.
    Went to state school. Paid off my loans first year of real job. Never had one cent paid for to attend college or med school.
    25 yrs practicing with good pay and lots of time off. No peer support tho, Radiologists are very self serving, lots of dumping, constant fear of missing serious findings and malpractice. Sit in dark room all day in front of 14 giant monitors scrolling thru several thousand images a day till your eyes bleed. Repetitive motion wrecks your neck and back and wrists. Volume increases with PACS. mammo Drs and IR drs do see lots of pts and the pt. interactions can be intense and stressful. Procedures can go south quickly and you are like a surgeon but with no direct access to the bleeders.
    But,
    Real reason it sucks is tht any job becomes highly repetitive. Same stuff every day, just do it faster, while paid less, while work increases due to technology…. Thousands more slices on every cross sectional study. No control over volume or staff as admin crushes you. Think high pay hi stress factory worker. Thankless job. Living in the dark destroys your circadian rhythm and you never sleep well. This can wreck your health over timee. if u aren’t driven to succeed, and can’t handle a lot of stress, don’t waste your time.

  27. A doctor doing first year medicine

    Wonderfully honest – thanks.

    I’m a PhD (neuroscience) who recently fulfilled her 20 year old dream of getting into medical school in the UK. Wanting to be a doctor for that long gave me plenty of time to research the career, do the experience, read the autobiographies, grill the people who know what it’s about, and even pre-read the medical textbooks (keen to be the fresher who knows how to read a 12 lead ECG). Getting in – even as a scientist with publications – was ridiculously hard so I was over the moon when I go the offer from one of the top universities for medicine, and was certain that life would finally be blissful.

    Except, it hasn’t worked out this way. I did waft into lectures on a cloud of glee and smugness for the first month or so. I did have to pinch myself on occasion and incessantly enthuse about every single learned fact to anyone who’d listen at home. I was also thrilled by how most of the material was revision for me, since I’d already learned it in my previous degrees. HOWEVER, with each passing day, I was also more and more pissed off at my fresh-out-of-school classmates. I admit, I was once 17 and also thought getting wasted was the definition of sophistication. But then I wasn’t told to conduct myself as a health professional and an example to society on day 1. I didn’t get anyone into trouble, didn’t display and encourage the most SEXIST, RACIST, and HOMO/TRANSPHOBIC behaviour and then blatantly post it onto social media (not to mention, selfies with a cadaver – yes, someone actually did that we were told) and didn’t generally discriminate against anyone. I also didn’t think I was a deity because I finally had the right to dangle a piece of stainless steel and rubber off my neck. These kids shocked me. The worst part was how much I had to rely on them in group activities and interact with them in clinical sessions. They were uncooperative, unenthusiastic and thought I was an old fart (I’m only 26 ffs!). The social anxiety that started creeping in as a result of my incompatibility with and intolerance to them made it difficult to face coming into uni each day.

    What’s even worse, is that I’d started noticing how politically incorrect and ignorant the course material and the staff that taught it were. Alcohol consumption was encouraged with amusement (this is in a country where liver disease is the number 1 killer). Drug users were condescendingly referred to as ‘junkies’ and women were not even expected to manage the Heimlich maneuver on account of their fragility or join the emergency medicine or surgical societies (those jobs are done by penis you see). I had tried raising these issues in the form of complaints (when it got really bad), but it was clear that the ever-patriarchal and somewhat elitist tone of the profession was not about to change soon.

    I was also becoming exhausted. No matter how interesting or understandable the material was, there was A LOT OF IT. The medical school didn’t seem to consider that getting home, eating and sleeping were necessities for survival. Therefore, these necessities got into the way of school work. And, damn, how POINTLESS was some of the work! Endless ‘reflection’ essays and ‘research’ projects. Having given birth to a 70K word thesis just days before starting medicine, I wasn’t particularly bothered about a 3K word ‘project’ for school UNTIL it was time to do it. Then it became clear I had no time even for that as I was grossly behind on my lecture revision.

    This went on until I cracked. My social anxiety turned into a panic disorder. I ran out of lectures. I couldn’t bring myself to attend group sessions. Just being in the hospital and medical school environment made me physically ill. I hated everyone, and everything about medicine. I once got dressed to go to school and burst into tears. Instead of attending class, I went to the medical offices and told them I wanted out immediately. It took a lot of pacifying, and reassuring me how scarily often med students and doctors develop mental health illnesses such as depression and took time out. Well, that’s comforting…

    I decided to take a year off. Well, more like it was the only option as I literally could not set foot in school. I’m not sure whether I’ll return. It’s both liberating and heartbreaking. I either tell myself that 1) I had to see what medicine is like from the inside, and I can now peacefully continue living my life having done that and realized it wasn’t for me, or 2) what the hell was I thinking starting a notoriously hellish undergraduate degree a after already having overworked through 7 straight years in higher education, 3 of which were another kind of hell I won’t describe (if you want to know – do a PhD). I don’t really want to quit medicine, I just need a break from it.

    Well, I’m still unsure which thought to go with. If 1) is true, then giving my medical school the finger after only 2 months says a lot about how I’d handle the rest of it and the job…and if 2) is true, then the only thing I can do is wait until I can try again. In a saner place.

    This comment was way longer than I intended. I just wanted to share my predicament in the hope that someone out there could relate and advise. For what it’s worth, I think walking away from medicine after having invested so much more time in it, as the author of this post did, must have been much harder. It’s awe-inspiring. I hope you’re infinitely more happy now!

  28. Stephen

    Excellent piece. That bit about getting “hit” actually had me laughing aloud. I’m currently a pre-med with some serious doubts about the current state of medicine, and I’m torn between rolling up my sleeves and trying to do whatever good I can and throwing my hands up and walking away. You have given me a lot to think about. Thank you for being so frank.

  29. E

    Hi Ali, I enjoyed reading your post and want to share my story. About the time you wrote this article in 2005 I graduated from a great institution with a BS in Cell Bio and a Chem minor. I got a 3.7GPA and a 33 MCAT the month before graduation. I did a senior thesis in neuroscience (electrophysiology) and landed a biochem research job in the year I applied to med school. I was a solid candidate, but not necessarily a standout as a white male, even with these credentials.

    the year of applying to med school, it was like a veil had been lifted from my consciousness. No longer obsessively preoccupied with getting straight As in ridiculously hard classes (don’t get me wrong, I LOVED cell bio, physics, ochem, the whole lot), I realized I really valued having a life (which I definitely did not have as a pre med: no money, no time, mega stress), and decided med school was not for me. I went into premed education and made all my own hours as a tutor. Within 2 years of graduating school and a year after withdrawing mid-flight from the admissions process, I learned to surf and spent 100 days on the ocean. I realized I wanted to be a dedicated surf athlete more than a doc. I also have mild aspergers syndrome, which means I may need a bit more self care than the neurotypcial person (or so I suspect, or maybe its just an excuse to surf more ;) ), so med school is not a great option for someone in my position.

    Do I regret the decision to forego medicine? Definitely sometimes. By now, 10 years after my decision I could be making a handsome six figure income and have my and my family’s material needs met and then some. Ultimately, I know I made the right choice, but sometimes the regret of not going to med school is real.

    To all the premeds out there, Ali has a point. No career is perfect and it is important to look at the downside of any profession and know if it is tolerable. For me, I could cope with the strain of medical training, but the prospect of trying to cope with all that stress with no personal time to compensate would not have worked. If you absolutely must be a doctor and that’s that, medicine is a great choice. However, there are other careers out there with good pay and great lifestyle.

    Now I am in nursing school, my wife is in law school. I work in an ICU as a tele tech and love my path, I work with great people and help a lot of patients. Being a nurse allows me to still help people but I will have a lot more personal time than a doc, which means I will have a lot more time for family and interests. Plus, some areas of nursing are very science oriented so I can still use my first degree.

    Its up to each individual to clearly identify who they are and what they want. However, it is interesting to note what a large percentage of physicians would not do it again. A lot of studies say about 50% of physicians would not do medicine if could go back in time. Contrast this with nurses, of whom 90% say they made the right choice, according to some surveys.

  30. PIA

    omg. hello! i’m a 16 yr old girl (i know you’d say i’m too young for all of these shit) but i really appreciate this! thank you for sharing. i am still undecided if i wanna pursue medicine on college. first, i don’t have the brains. ok i have a brain but i don’t think i am at least 51 percent sure if i’m gonna survive. i mean yes i love taking care of people even though i hate them but for pete’s sake i think i’m too lazy and in love with food and i am really lazy. idk if i’m really exagg and harsh on myself or what. what should i practice while i’m not yet in college? do i need to kick my friends and start being serious with my life? or start hating foods or stop partying? helppppp thank you so much!

  31. Glorious_Ignoramus

    I’ve come back to this post a number of times. Here is my story:

    I was a military combat medic and inspired by a physician to pursue med school. I was told “rah rah, you’re good and you can do it, I believe in you.” I bought it.

    I left decent overseas orders and a job I enjoyed to enroll in college. I used my GI bill to pay for a gen bio degree because that’s what pre-meds do. I ignored the warning signs when I struggled in physics and orgo and pushed on anyways. I kept pushing off the MCAT until it came time to graduate and look for a job…so I found mediocre pay at the VA as a clerk and it sucks. Day in day out, listen to ungrateful veterans (remember, I am a veteran myself) complain about everything they possibly can, pressuring congress into mandating absolutely ridiculous scheduling and access guidelines which no civilian hospital could even dream of touching. “I’ve been waiting over an hour to be seen in this f*cking ER” gets really, really old for a paycheck that is around $20,000 less than the median salary of a person of my educational level.

    So I realized, I’m not going to take the MCAT. Forget this. What a rat race. After fits of unrest and anxiety realizing that my degree was for naught, I toyed with the idea of a non-MCAT carib school…then realized that’s even dumber. So along comes the PA school idea. Great, I can still sort of be a doctor and I can apply right now! Let’s do this! Not. For a profession that began recruiting those with prior medical experience, it is now nothing but a pissing contest to see who gets into schools which routinely admit 3-5% of applicants. For a profession which pays about $100,000 less than what a physician of the same specialty makes, and which requires longer hours. After sitting through two interviews of a bunch of kids pretending to act like they’re better than everyone else, I have ultimately decided to forget this garbage.

    Medicine is overrated. I work with physicians who stress way too much, have ever increasing patient panels full of ungrateful public aid recipients who don’t follow any medical advice and act upset that they’re asked how much alcohol they drink during routine visits. Manipulative drug seekers, verbally abusive jerks, and patients so incompetent that they cannot function without using the ER as urgent care abound, and abound plenty. “Why get a job and pay for insurance when the VA/Medicare/Medicaid will pick up the bill for me to socialize at the hospital with consultations? If I don’t get my way, I’ll just call the director’s office and they’ll yell at the right people. I know they can’t turn me away.”

    And why work amongst a bunch of nurses who do nothing but complain, shirk responsibility and backstab each other and abuse techs and medics while they check their status updates on Facebook? What a bunch of conniving, scheming, lazy rats.

    When will the doctor see you? I don’t know because 1, I don’t triage and 2, he’s too busy on eTrade right now. Can a nurse look at you real quick? No, but if you’re lucky they might boss a tech to do it for them.

    I’m tired of chasing this “dream.” I’m tired of pumping money into pre-reqs, applications, interviews and wasting my paid time of at work. I’m tired of working with nurses and docs who could give a crap about the people they’re treating. I’m tired of getting barked at from lazy patients who are pissed off at waiting for an appointment they need because they can’t take care of themselves. I’m tired of fighting with academics that I have no interest in just to maybe have the shot at trying to impress some adcom desk monkey that I’m worthy enough for a seat in a school which charges absurd tuition rates that would take me 30 years to pay off.

    I would love to start a lineage of doctoring my family. I would love to take care of patients who need help. I would love to fulfill the hard work that others have put into me. I would love to earn the money, the respect, the satisfaction and the pride. But medicine will not accomplish that. Thank god I am finally coming to my senses about this, before I end up so deeply invested that I cannot afford to turn back.

    Time to find something I would actually enjoy doing.

  32. Dei

    Just one month into med school and I want to quit so badly. I wanted to travel but med school tied me to my hometown. It seems like a downward spiral to me. Youth wasted, I have no interest in any specific fields, and yes, a serious health compromise.
    I want to quit but I don’t know what I’d do otherwise. Everything else I want to do is shut down by my parents, especially my father who wants the prestige. Funny thing is he would not do med school himself. He also denies forcing me, but any interest in another field is quickly squashed! No support is shown. Maybe I don’t know what I want. Not forcefully anyways. I am interested in the fields of neuroscience, biophysics, electrical engineering, computer science and physics.
    I wish I could get help. I am very unhappy.

  33. Tim

    I come from a long line of Doctors. I was pre-med, but changed my senior year to business. Did business for 20 years, and by any standard, I was successful. However, I was increasingly bored with ultimately meaningless work. I was fortunate to work for companies that actually had innovative products that were interesting, cutting edge, and helpful to both developed and third-world nations. However, after ~15 years it all boiled down to two things: 1. Making money 2. What have I done for you (stockholders) lately?

    Ultimately, my wife encouraged me to return to my love of medicine. After a lot of soul-searching, I opted for PA school, and have loved it. The work is endlessly challenging, I love the continuing need to learn, and there is nothing as satisfying as actually helping people and families.

    However, you are correct in writing that we actually don’t help a large percentage of our patients; I won’t repeat your rationale, because I agree completely.

    For me, despite the reasons you list, medicine has been wonderful.

  34. Tim S

    I think the biggest failure in healthcare is the lack of tools to leverage the knowledge available for the physician’s benefit. Lawrence Weed pointed this out over 40 years ago and Clayton Christianson recently. We have the technology today to develop a digital model of a patient, an avatar so to speak, against which strategies for treatment could be played out. Most of the problems you speak of come from requiring a doctor to know all of the aspects of patient care outright. Tools should be used to make them more efficient. Training should be how to use these tools, not memorizing esoteric conditions and their treatment.

  35. Arlen Meyers,MD, MBA

    There is another side of the coin. There has never been a better time to create the future of medicine if you have an entrepreneurial mindset, creativity and imagination

  36. Dan T

    Hi Ali, do you have any more updates? I have been following this post intermittently now for many years and really appreciate the updates you’ve made.

    • thanks for the kind words, dan! there may be an update in the form of a book coming up :)

  37. LM

    I am considering a career in healthcare (rising senior in undergrad currently), and have always been concerned of the aforementioned burdens that physicians face. Ali, what is your position on a PA career? Are some of these burdens mitigated by choosing the PA route over medical school?

    • If your goal is to help heal humans and you’re not too hung up on making megabucks or the prestige of being called “doctor”, then NP is the way to go. Don’t have that much data on PA careers — see if your own doctor has one and talk to ’em about it!

  38. Ariana

    Thank you so much for this, you’re brilliant
    I am a first year pharmacy student in Lebanon, and medical school has always been my dream
    My parents told me not to do medicine, but they never convinced me
    Today, I have the choice between pharmacy and med school and I could not decide until I read this…
    Thank you sooo much

  39. Matt

    In many cases, when I read the “don’t study medicine” posts, I think back on my own path.
    I was pre-med, shadowed, volunteered for 15 hours a week at a hospital with first-hand patient exposure, knew what was available given that I saw so much of it first hand.
    Medicine looked really rough – hard to get in, hard to get thru, and challenging in practice, but had an element of helping and serving, actually doing things, and having patient contact that was hugely appealing.
    I got cold feet, and as I had an aptitude for business, and some curiosity about how companies are run, I went the MBA path.
    It was just so much easier.
    Take the GMAT, apply, get in, go, get through, get a job.
    So I wanted to speak though to those folks who look at medicine and say “Just go get an MBA and make much more money as an investment banker…”
    I’ve been an i-banker, and an investor, and worked also in real estate.
    Business can be quite soul crushing as well.
    It’s easier to get in… but that’s a detriment in many ways.
    There’s so many others who can do your job, and there’s not as much of a body of knowledge and an accreditation to give you job security.
    I went to a top tier school but I’ve had 8 jobs in the 10 years since.
    And none of them made a speck of difference in the world, nor help anyone, nor involve much interpersonal contact.
    And while physicians may not be thanked every hour like they used to be, I am sure someone does say thank you occasionally.
    I don’t think anyone has thanked me, in business, ever, not in the 10 years I’ve been in.
    With the lack of stability, the money’s not been so good, and it’s had a real toll on my family.
    And I now work for 1/2 of what I used to, and I work 80 hours per week.
    When I was working my way up, I worked 100 hours per week.
    I had my first child a month ago.
    I’ve seen him only a half a dozen times, mostly while he was sleeping, because I come home at 1am and work 6 to 7 days per week just to keep the job going… that’s finance.
    So when I hear about the struggles of medicine, as in this post, I believe them wholeheartedly.
    Medicine sounds really rough as a practice (and I saw this in the hospital) and really awful in terms of getting in and getting through it all.

    But I also know that the alternatives of any sought-after profession that people want to get in to are also just as brutal.
    I’ve got finance friends who are dying to change jobs, lawyer friends who curse their choice of profession and want to switch, and so on.
    No one seems happy.

    Except maybe some folks, on occasion.
    Some entrepreneurs, a few doctors, nurses that I met, pediatricians who get to see and help cute kids, and so on.
    Most people are just looking for an out – any out.

    So why are all these professions so brutal?
    Because the provider of the role (hospital, medical school, bank, corporation) can always keep pushing, raising the bar, etc.
    Some doctors are harsh, but many are good people at heart.
    I can count on one hand the ‘good’ people I meet in business and finance.
    Most I’d rather not deal with.

    Like many physicians in the field, if I could, I’d like to stop and not work any more.
    But I can’t. Mostly because I have a kid to support now.
    But I think back to my days in Berkeley and think “maybe I could have gotten through pre-med, retake some classes… maybe do well enough at least to be a PA, even if MD was unattainable.”
    Many PAs I met along the way seem happy.
    They went in knowing they weren’t going to be MDs, knowing they weren’t going to be making the big bucks or have the autonomy, and then found that they got to practice medicine with a reasonable personal time commitment and got to spend more time with patients and help them.
    So that’s enough, and they go home happy.
    I guess my conclusion, from these years on my own trail, as someone who took an alternate path, is that all these paths are hard, and painful, and it’s really hard to predict what will make you happy. The pain is consistent across all of them though. These are jobs… hard jobs…

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