I can’t tell you how much it frustrates me to hear doctors discouraging pre-meds from entering the medical profession. If you want to be a physician — go do it!
The problem that I see is that most pre-meds — and even many physicians — don’t have work experience in other fields. So, they don’t have the experience needed to realize that many of the hard parts of medicine are just as hard in other jobs. And on the upside, there are (amazingly!) real benefits to becoming a doctor. (Aside from saving lives, and all that jazz).
I’m starting this blog to try my best to counter this discouragement, and hopefully provide some inspiration to future pre-medical students. Despite the challenges in medicine today, you should *still* become a doctor if you want to become a doctor. Please don’t let all the negative energy associated with medicine discourage you.
Why Most Serious Pre-Meds Drop Out
I usually find that it’s not low grades or a low MCAT score that keep pre-meds out of medical school. Surprisingly, many medical schools have forgiving policies when it comes to grades or test scores — for example, Texas medical schools will take your best MCAT score (so if you have a bad day, you can give it another go); California schools will take your most recent. And if you get a C in Orgo, it’s not the end of the world, as these same schools will take your most recent grades over your earlier ones.
In speaking to “ex pre-meds” in my post-bac program, the #1 reason why students drop out is because people tell them not to become doctors.
If you don’t believe me, do a Google search on “Don’t Become a Doctor”, and you’ll find:
NY Times: “You hear it all the time from doctors — they would never choose medicine if they had it to do all over again. It’s practically a mantra, with the subtle implication that the current generation of doctors consists of mere technicians.”
Med School Hell: “Even if you’re completely happy in medicine right now, stick with me for a few posts and you may just learn something new”
Yikes man! It’s no wonder that so many students get spooked! Why would you put all the effort into your pre-medical coursework if you’re just going to turn into another old, jaded physician, regretting his career choice?
Why Most Doctors Tell You Not to Do It
1. Money: With Medicare cuts and reimbursement rates struggling to keep up with inflation, physician future earnings are in question. Not only that, but any doctor will tell you that if you were to channel the amount of time and money that you spend on medical school into a business venture, you’d have a good chance of success and could earn higher earnings in a shorter amount of time.
2. Time: The 8+ years you spend in medical school and residency are years you could spend in the workforce, earning a salary and making your way into an industry.
3. Autonomy: As insurance companies control how medicine is dictated and performed, physicians have extremely limited autonomy in how they practice. Understandably, someone who has gone through extensive academic training feels that he knows how to serve the patient’s best interest and doesn’t want to let the financial interests of a large insurer conflict with what he knows is best for the patient.
The problem with these three objections is that you will find them in any career, and they ignore some of the main benefits that make practicing medicine so awesome.
Read this again! These problems are present in *many* careers, and they completely, completely ignore the really good stuff about practicing medicine.
Why You Should Still Do It
1. Money: I want to address this point extensively because I strongly believe it’s one of the largest reasons students don’t become doctors, and I want to explain how a career in medicine can have higher, if not similar, earnings potential to other careers. Here’s what people usually say:
“Medical School is Too Expensive”: Correction — some medical schools are too expensive. But there are others that are really affordable. If you attend an in-state undergraduate education and an in-state medical school, you can make the math work so that your education is a wise investment. (Practical ways to keep your educational costs down is a whole other article)
The average medical school student will graduate with $160K in debt, and I will show below how this investment can pay itself off with the right specialty.
“Start Your Own Business with The Money You Spend on Medical School”: Remember that the odds of you starting a successful business are even lower than the odds of you getting into medical school. I am sure that pre-medical students, for as smart and hardworking as they are, may have an even better chance of success in business than the average entrepreneur. And with $160K in cash on hand, they have some time and some resources to make their business a success.
However — remember that it will take you just as much effort to create a successful small business as it will take you to get through medical school and residency training. And not only will it be hard for you to reach a scale where you are netting $300K to $500K/yr, but you’ll also be subject to the ebbs and flows of the economy. Unless you have a very, very strong competitive advantage, you’ll always run the risk that a competitor comes along to gobble you up.
This is anecdotal, but speak to any small business owner and they will tell you the same thing. Running a small business is a daily hustle — and if you don’t believe me, you should try it yourself!
“Your Friends in Finance, Consulting and Corporate Will Make More”: Many doctors will point to friends from college (who they were just as smart as) in other careers making $1M/yr. Remember that the majority of investment banking analysts will leave within 1-2 years, and that less than 5% of them will ever make managing director or partner. So while there are going to be some notorious exceptions, a lot of those same friends will leave consulting/finance/corporate, and if they never get to a high paying gig again, they won’t earn as much as you.
“You’d Earn More by Working Earlier”: This is not always true! Unless you are an extremely sought after college graduate, your salary during the years of 22-30 won’t be extremely high.
Before I decided to leave the corporate world to go into med school, I did a pretty heavy analysis of whether it was a sound financial decision. What you find is that — if your cost of living is reasonable — the two most important factors in determining your final net worth are (1) how high your salary is and (2) what rate of return you can earn on your investments. You’ll see that you won’t start to hit a high savings rate until you start making above $300K, and a salary level that high won’t come quickly in the corporate world.
Here’s a cash flow statement for you to look at if you are a geek like me and want to see the numbers:
I’ll stress again that you should NOT go into medicine only for the money — that’s, again, a topic for a whole other article — but if it helps you sleep better at night, you should know that the money in some specialties is still not all that bad.
Finally, the “money” argument above also ignores one of the best parts of medicine — security. Physicians are always in demand, and based on the future population boom, demand for physicians will increase. You *never* need to worry about not finding a job. Do you realize how absurd that is?
Speak with anyone working in the corporate world or running their own business, and if you are lucky enough to have a real conversation with them, they’ll tell you how stressful it is to have to constantly worry about making a sale or hitting a revenue target. I understand that practicing medicine has its own stress, but the job security that physicians have is outrageously, outrageously good.
Ok, onto the next objection:
2. Time: If you are the *right* type of pre-medical student, and you are meant to become a doctor, you will enjoy your pre-medical courses, volunteer experiences, research, and medical school. This is critically important! You will *want* to spend four years of your life in medical school learning the ins and outs of all diseases — in fact, you probably geek out at WebMD.com every once in a while just to find a new one (not that I do that or anything…)
The time that you spend in pre-medical courses, medical school and residency is not time wasted because you will enjoy it.
3. Autonomy: I completely understand how ridiculous the bureaucracy of medicine is — there are billions of dollars lost every year because of how hard it is to get anything changed. And, medicine that’s provided by for-profit insurance companies creates some sickening incentives, and removes any bargaining power that physicians have in controlling how they treat their patients.
With all of that said, I want you to keep a few things in perspective:
1. Your friends in law, finance, tech, consulting and corporate also have limited decision making power: At large organizations — whether a large law practice, large corporate, etc — you will constantly be fighting to get support and buy-in for your projects. You have some control over how you get projects done, but if someone in the organization “outranks” you, you’ll have to change course. And speaking from experience, it can be just as frustrating to be forced to make a decision that you don’t agree with as it can be to be told how to treat a patient.
2. Your friends in law, finance, tech, consulting and corporate have limited bargaining power: Large companies have massive bargaining power. Even if you have a highly sought after skill, such as software development, you will have limited negotiating power over your salary and work hours. Just like there aren’t strong physician unions, there aren’t strong labor unions in the corporate world, and large employers have a lot of control over working hours and salary.
3. Your friends as small business owners are always serving the end customer: Successful business owners don’t get up each day deciding what they want to do all the time — they are *always* fighting to serve the end customer (at least, the good ones). When your salary depends on how many people purchase pay for your products and services, the end customer you serve will always hold the power in the relationship, and will dictate what you can and cannot do.
So yes — I understand that physicians can’t make independent decisions. But many other people can’t either.
4. Passion: For those of you who have seen someone lose their life, or else have their life turned upside down rapidly, you will appreciate how important it is to follow your passions in your life. If you spend your life doing work that you sort of like because it paid well, I guarantee that you will regret not at least giving your passion a try.
*Everyone* wants to feel like their life has meaning. If you are one of those people who feels compelled to practice medicine, are you really ever going to be satisfied until you give it a try.
To summarize: if you still want to practice medicine, there are both strong practical and emotional reasons to pursue your passion.
Why We Need You to Do It
I could point to the economics here that show how demand for physicians services will outstrip supply, but the more important point is this: the world needs good doctors. Smart, passionate, moral, and generally good people should absolutely become physicians.
For the points I’ve outlined above, I still think that medicine makes sense on a very pragmatic, career focused, even financial basis. But at a high-level, you need to understand that choosing to become a doctor is by far one of the best things you can do with your life.
So go do it!