Why medicine?

First, there are some easy, boring, true answers – I like science.  I like helping people.  I want to work in a fast-paced environment.  But all of these answers only actually address “Why a career in the health sciences?”

Things get much more interesting, and more uncomfortable, when you start considering “Why medicine, specifically?”  The best interview question I’ve ever heard was this: “You say you want to help people.  Why not nursing? There’s a nation-wide nursing shortage, but a surplus of people who want to be doctors – wouldn’t you be helping more people if you became a nurse?”

To his credit, the person who told me this story was only panicked for a minute.  He answered honestly:  “Because, sir, I respect nurses, but I’d rather be trained to call the shots.”

This guy knew why he wanted to go into medicine.  He also had the guts to answer honestly, even when his reason for going into medicine is something that, taken alone, would be a bad reason.

That said, I believe that every possible answer – when taken alone – is a bad reason.  Because you want to help people?  There’s a million careers where you can do that better, and in some cases with a much better lifestyle.  Because you want to make loads of money?  Well, good luck with that.  Because you want to impress your friends?  You can’t really impress them when you’re so busy that you lose touch with them completely.

But I believe that a couple of “bad reasons” can be okay.  The key is to make sure they’re outnumbered by the “good” ones, and to know exactly what it is you’ll be sacrificing.

1.  Write down a brutally honest answer to “Why medicine?”  Brutal is the key word here.  A lot of the time we know something’s a bad reason to go into medicine, so we don’t even acknowledge it ourselves.  For example:  if I’m being completely honest, I like how hard it is to become a doctor.  I’m stupid ambitious, I know.  I also like that it guarantees a modicum of financial security if you play your cards right.  These reasons aren’t anything I’d write in a personal statement, but I’m glad I acknowledged that they existed before I decided on medicine.

2.  Bombard yourself with reasons to NOT go into medicine. Read The House of God.  Read the Anonymous Doctor blog (try this entry, or this one, or this other one).  Read SDN (start here, then here).  Invite your surgical resident friend out to dinner, liquor them up, and ask them if they’d still choose medicine if they had to do life over again. Know the worst of what you may be getting yourself into.

3.  Then go back to your brutally honest reasons for going into medicine.  Is there another career that could satisfy those reasons?

I think often it’s the dumbest reasons that narrow the choice down to medicine.  It doesn’t stop these reasons from being dumb – it’s stupid for me to want to do something just because it’s hard – but at the same time, 1) when you think about it, with all the sacrifices you have to make?  You kind of need at least one dumb reason, and 2) I can’t change that aspect of my personality.

The real question is:  if you take all of your reasons together – good, dumb, and altruistic – do they outweigh the sacrifices?

32 thoughts on “Why medicine?

  1. So Nikki asked about the process of deciding on medicine as a career. This was tough to write – after all, I can’t guarantee I wasn’t wrong when I decided medicine was right for me. (I can’t imagine being wrong, but I also know that nobody who makes this commitment actually envisions themselves regretting it – yet people do.)

    Still, it’s such an interesting topic, I figured I’d write about it anyway.

  2. SDN is making me both dissapointed and maybe….a bit relieved (?) I want to write an enormously long comment right now, but I have a long night ahead of game show-style nightmares in which someone will cut off my head with an ax if I can’t explain the process of excitation-contraction coupling. It will have to wait for now…

    • Looking forward to hearing it. And those SDN threads can be a bit of a disappointment overload… the good news is that it probably isn’t representative of the general physician population – but the first thread I linked to is still a good “worst case scenario” check.

      It’s tough because I’m really happy to be where I am right now – so I have this natural thing where I want to encourage you to go to med school! But of course, until then, I don’t actually have the insight into medicine itself that others do – the long hours, the pay, or the culture of hard-knocks, so the encouragement thing is probably not a helpful reflex. Still, if you or anyone else decides on it, I will be a total cheerleader about it.

      • I visited SDN religiously as a premed, a couple dozen times as a med student, maybe twice as a resident, and have never been back since graduating residency and getting out into practice a year ago.

        There’s some good basic information, but it’s all mixed up with rumors, competitiveness, generalized anxiety, and trolling.

        Practicing physicians who hang out there are the equivalent of those sad twentysomethings who buy middle school students beer. Something has gone very wrong with their lives if they’re still having their social life on SDN. I would not trust them.

        I owe a third of a million dollars (PLUS the mortgage . . . oh, God). The state takes half my earnings. Every day I care for junkies, criminals, the crazy and the crazy impatient, who evaluate my work my the standards of the instant gratification, one-click culture.

        And I love my job. I LOVE my job. My retirement plan is to drop dead at work. Being a physician is awesome. Don’t let anyone tell you different.

  3. After reading this post, my wife and I are going to sit down and rehash our plans for getting into medicine. I have been a professional long enough to know that the time to question is before you pull the pin, not while the fuse it burning. Thank you for taking the time to put this together in a cohesive manner.

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  5. It’s scary to see how miserable some people become… but i don’t think that’s something unique to medicine. There are a lot of really unhappy, disillusioned people in other professions. SDN can be frustrating at times though – while there are a lot of intelligent, thoughtful comments, there are also a lot of petty, catty, disrespectful commentators who seem to be lashing out at anyone who differs in opinion from them.

    generally, my experience with physicians and medical students hasn’t been the same as SDN — most of them are happy or find fulfillment and demonstrate more maturity.

    But good post. I know I’ve got some great reasons, and some not-so-great reasons for wanting to go into medicine, but there’s sort of an attitude that the bad reasons can’t exist at all or else you have no business going into the field.

    • I agree, good point about some of this not being unique. One interesting thing about medicine is that so many pre-meds go into it without ever having been in the real world – so some of the frustrations and inner-crises are about things that you’d experience no matter what your job is.

  6. So every now and the a personality poll pops up on SDN, and you’ll notice that there’s very distinct trends on the board (or at least, some of the boards there) toward very introverted, analytical types. If you look around at most medical students and doctors, not so much the dominant personality. SDN is a very specific subset of the population and I don’t think anyone should let them influence much more other than maybe what books you buy or more factual type matters. I still hand out there occasionally, but now that I’m actually in medical school, my peers and the doctors here are much better resources.

    Anyway, I think that was a really good and well though out post. 🙂 I like that you’re helping out the pre-meds. I meant to do more posts like that but never got around to it.

  7. AP, your post helped me so much. Thank you.

    I don’t think med school is a wise decision for me. Im a 25 year old newlywed which puts me in an awkward position in terms of how much I would be sacrificing and who it would effect. When would I have kids? In 8 years when I should be starting to pay off the debt? My parents are getting to the age where I’m starting to think about their future care and how I will be the only one around to help them. If I was 20 this would be a different story. It’s amazing what a difference 5 years make.
    As an avid user of pro’s and con’s lists for tough decisions, this is one I can’t swing the way I want. If someone asked me why I wanted to go into medicine, I would not have an answer that sounds impressive or altruistic. I’m not interested in money (obviously), or the “power”. I wouldn’t even say that I want to do it to “help people” as that doesn’t mean much anymore. “Helping people” seems like a pretty subjective goal in medicine these days. All I can say is that medicine is the only thing that has failed miserably to bore me. I fall asleep every night reading med blogs and with the completion of the semester today, all I can think of is how I can’t wait to go to the library and read med books that I don’t have to read. I don’t even care that that makes me, quite possibly, the most boring, antisocial person on earth, because I LOVE it.
    Right now I’m on track for nursing school and I hope that it will satisfy my craving for all things medicine related. I’m a bit worried that I will have trouble being someone who is assumed to not technically have a decent knowledge base that I can use to think for myself. I would be interested to hear other nurses perspective on this.
    SDN made me both sad and angry with how the medical system now seems to devalue the very thing it should value the most, students and doctors themselves. The personal sacrifices are enormous, and it doesn’t seem like there is any payoff anymore, monetary or psychologically. It’s dishearting at best.
    I have to note that I realize that I a lot of what I’m saying is nothing more than observations and assumptions made from the peripheral view. I will take any contrary insights anyone is willing to offer up. After all, I’m just a hopeful future nursing student.

    • My mom’s an RN, and she has been the medical guru of our family for years. She even got a PhD and is a professor at a nursing school – so if it helps, there’s definitely tons of room for advancement and ambition in nursing as well.

      I hear you on the med books. I would think that nursing would definitely satisfy the desire for medical knowledge and only be lacking on the molecular side of things – but I hope you get to hear from a nursing student or nurse on that subject! (I’d be interested to know what The RNinja has to say, since she’s seen both sides!) I think it’s incredibly important to keep that sense of wonder and happiness with medical knowledge by having it be a part of whatever you go into.

      You know, one interesting thing about what you said – the instinct to avoid “being someone who is assumed to not technically have a decent knowledge base” – is that it was definitely one of the reasons I chose medicine – and yet! Not only will it be 7 years before anyone will believe that I have a decent knowledge base – but even then, the level of respect I’ll get from my colleagues depends on the specialty I choose. (At least at my hospital, the phrase “future family med doc” has actually been used as an insult. It’s nuts.)

      I should mention the other commentators are dead-on when they mention that SDN is a bit of a biased community. The happy doctors don’t have the drive to get on the internet and tell the world how they feel.

      I’m glad it helped! Best of luck with the decision!

  8. SDN, and it’s Canadian counterpart, PreMed101, are exactly the wrong places to get your information about medicine. As noted above, it’s a very self-selected community, and there is quite a bit of attitude there that doesn’t translate to the real world (or, at least the lack of anonymity outside of the internet keeps in under wraps in the classroom). If you really want to know about medicine, speak to people who you know and more importantly, who’s opinions you trust. They’re going to be infinately more helpful than some stranger on the internet who’s personal experience or hangups may be influencing their decision (medical student bloggers are, of course, the exception to this rule :P)

    As for why medicine, for me it was more a process of elimination. I knew I wanted to do something in the sciences; that was definitely where my strengths lay. After going through undergrad, I realized a few things:
    1) I lacked the dedication to be a good teacher; I couldn’t sit at home every night, generating lesson plans and reviewing every student’s work.
    2) I lacked the creativity and forward thinking ability to do research.
    3) Medicine was pretty cool.

    Now, I wish I’d followed my own advice and talked to a few more people before setting down this road, but I don’t regret it. Sure the work is thankless, and the hours long, but at the end of the day, you have the opportunity to do some of the most interesting stuff in the world for the most vulnerable people in the world (at least, in my opinion). As a doctor, you hold a lot of power in your hands, and, if properly exceuted, you CAN make a huge difference in a number of lives, even if you never see the results yourself. That may be a bitter pill to swallow for some – after all, how satisfying is it to know the cantankerous old man who comes through your door every week is actually living longer and better because you’re diligent about tinkering with his 20 medications – but ultimately, those are the kinds of victories you’re going to get in medicine. If you’re not happy with that, then you might want to reconsider.

    As for reaching the decision of ‘why medicine’, I think what you’ve got there is a great method. So many people seem to think they will just ‘default’ into medicine, when its really a difficult choice that should not be taken lightly.

    [I also love the nursing comment; I ask it at least once to all my friends who are pre-meds, and most are dumbfounded]

  9. the reward is greater than the effort. every day. working with talented, motivated people. meeting wonderful patients. some are not, but most are. and are amazed to be treated well in a time of fear and vulnerability. and you- you -can make a difference for them.

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  11. Why medicine? Because the human body fascinates me. Everything about it, every chemical doing it’s job to keep us in equilibrium, it’s absolute poetry to me. I could have gone into biology or biochemistry, but I also know I’m not an academic.

    Why not nursing then? Because nursing doesn’t go into as much detail about every disease.

    When I sit in the park, I don’t just people watch. I disease-watch. That is why I picked medicine, and I loved every minute of med school.

    And when the hours make me want to scream, I just remind myself that at 3AM the bus driver who takes me to work starts her shift, and she get’s off at 6PM. You will never achieve anything without hard work, at least in medicine it’s rewarding.

  12. I’d just like to say THANK YOU. I’ve been looking through the internet trying for someone to give it to me straight. I’ve sort of always known I wanted to go into medicine and only told them in the last few months, they were all very shocked as no one close to me has even been to university but I know it’s the right thing and that all my hard work will pay off and I’ll go to university…Hopefully! Its so nice some one putting it in this way. Thank you!

  13. Hi AP. I’m a post bac pre-med currently working on my second degree and am planing to apply to med school next summer. I just stumbled upon your blog today and was hoping you might shed some light on when to let go. I’ve sensed and explored around wanting to go to med school for years (mainly trying to find the confidence within myself to commit and to combat the sense that I should become a bikini model like my sister- but that is here nor there). Overall I have had a calling to medicine since high school and I want to be a leader in a profession that challenges me and makes a difference. It pulls at me and when I am not doing something related to medicine or to science my brain and my heart are yearning for the grind. I also totally resonate with your quote about calling the shots. After my undergrad I went for it and jumped straight into straight science as a post-bac and am on my last year (year 3). Overall 7 years of college has left me pretty burnt out. The stress of getting the highest grades and the daunting statistics of GPAs and MCATs and how many people apply… and so forth are becoming exhausting, my anxiety has reached an all time high. I’m beginning to wonder if I can handle 4+ more years of school and all the sacrifice that comes with the 2nd half of my 20s. For the last year I have really had a hard time distinguishing if I’m just burnt out or if I am ready to move on. I do fear that medical school will trap me and I will feel even less free than I do now. Maybe this is because I have made getting into medical school my life that it is hard to walk away and even to know what else to do. I also read your 3rd year burnout post and thought you might be able to help.


    • You know, undergrad is stressful as hell once you decide you want to go into medicine. But once you make it to medical school – as long as it’s a Pass/Fail school in the US and you’re not shooting for EM, derm, derm, plastics, or ortho – you’re set. Getting through med school will not necessarily be as hard as it was to maintain 90%+ in 5 hardcore science classes at once.

      I mean, crap, that’s ridiculous. Looking back, I have no idea how I did it. That’s way more academic pressure than I’m under now.

      US medical schools are generally very good about only admitting students who are capable of making it through the 4 years and coming out the other side as a doctor, so I wouldn’t worry about not being able to cut it academically. And if you love medicine and reading about diseases, the material should cure any post-grad burnout. 🙂

      And as for the 2nd half of your 20s… depends on what kind of person you are, I think. There are a lot of people out there bemoaning the loss of the “best years of their life”, but the thing is, I don’t really know what they mean. You party in college, sure. In med school, you party on the weekends if you’re into that sort of thing.

      But if you *don’t* go to med school, are you planning on going out on week nights? Or having the freedom to suddenly decide to take a week-long roadtrip? Or moving to another city on the fly just because?

      I guess I suspect that the “best years of your life” are hypothetical years nobody really gets. Everybody except for the super-rich will lose “the best years of their life” to the job they hold in their 20s. Careers are freedom-suckers. That’s what’s funded the recent glut of Deep Quarter-Life Crisis movies about brooding 20somethings faced with the Real World and losing their childhood and facing up to Important Life Facts.

      So I guess I’m trying to say that medical school WILL trap you. But you know, so does everything.

      Don’t reject your application before you even submit it to the medical schools. That’s their job, and deciding that will be their problem. 🙂

      By submitting your application, all you’re risking is a couple thousand bucks for the interviews – and while that sounds like a lot in the short-term, I think visiting med schools and hearing about their curriculums and touring campuses will really make it clear to you whether you WANT to do this or not. And that will either save your career choice, or save you $150,000 and 4 years. Should be the best couple thousand bucks you ever spend. So I’d say go for it! 🙂

  14. I am a pharmacy graduate and wanting to apply to medicine…infact i have an interview in 10 days time…the thing is I wanted to do med ages ago when I finished school but due to certing circumstances i didnt so now i have an interview and i feel like am throwing it away coz really i havent prepared for it at all. I dont even have an answer for the ‘simplest’ question: why medicine? welll I have one but i dont know how to put it together…doing pharmacy enlightened me, i saw what docs do on a daily bais while working as a pharmacist in hospital…i like the job (ward-rounds, interesting meetings about oncology, clinics, teaching, diagnosis also seeing how docs break bad news to relatives) it gave me a better understanding of what medicie involves. SO in all honesty i like the job aspect = i have seen…thus this is what i want to be, this is what i want to spend the rest of my life doing (talking to patients, finding out thier problems, diagnosing them, choosing best treatment plan, discussing with other members of team, opinion so valued, you get so much resposibility and trust that you feel yo have to preform well…i like the fact you get responsibility) Other factor is am just geniunely interested in how the body works…in my spare time i like reading anything med related from sport injuries to physological problems…Its intriging …………..problem is i dont know how to word this for an interview. And by the way the blog is really intersting to read 🙂

    from uk

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  16. Reblogged this on Pre Med Musings and commented:
    Always important to consider questions like this. Reading this post helped realize I’m just as stubborn as this blogger. Mainly, one of the reasons I have such an intense passion for becoming a doctor is because it’s ridiculously hard, and I truly enjoy having that sort of challenge in my life.

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