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OP,

I appreciate your maturity. It takes a lot to look into the concerns you have about a field that you spent your life dreaming about.

I had many of the same worries that you did during the application cycle and ultimately, I still continued on this path. What kept me awake when I was balancing classes and extracurriculars while jetlagged from interviews was the idea that I wanted to do nothing else with my life. They tell us all to have plan Bs, and while I did have a plan B, I knew my plan B would never satisfy me.

Would you feel fulfilled doing anything other than medicine? Would all the night shifts without your children in your arms be worth it to save a life?

This application cycle will pull you in every direction and I promise by the end of it you'll know.
 
Med Ed said:
The rise of midlevels? Advent of a single-payer healthcare system? Even liking science?
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Idk a single physician that enjoys the rise of mid levels with less education and autonomy on par with physicians. We've discussed this topic ad nauseam on SDN and nobody likes it.

Liking science might be an issue. But I like to think that application based science is different from abstract science.
 
Sunbodi said:
Idk a single physician that enjoys the rise of mid levels with less education and autonomy on par with physicians. We've discussed this topic ad nauseam on SDN and nobody likes it.
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Normal: "I want to be a doctor."

Not normal: "I want to be a doctor but I'm so concerned about encroachment by midlevel providers that I'm going to pursue a different career entirely."
 
Hey OP, you could just become
a midlevel. It’s a pretty good life. In many ways, it’s a sweet tradeoff to get some of the best parts of being a doctor while avoiding some of the worst parts, all while helping patients and making a good living. As long as you can make due not necessarily being the captain of the ship or having a chip on your shoulder, might be a good compromise.
 
Med Ed said:
Normal: "I want to be a doctor."

Not normal: "I want to be a doctor but I'm so concerned about encroachment by midlevel providers that I'm going to pursue a different career entirely."
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wait I’m confused how a physician thinks it’s not normal to consider the pros and cons of a career?
 
premed1875 said:
wait I’m confused how a physician thinks it’s not normal to consider the pros and cons of a career?
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It is perfectly normal to consider the pros and cons of a career, but no premed should be worried about a horde of NPs taking over all the MinuteClinics in rural Arkansas.

More rational considerations would include the nature of the work itself and the opportunity cost to become a physician.
 
Medicine is a very big sacrifice. But the way you scored you could go anywhere you want, and probably do a lot of good in your career. I think you should do it. Seems like you're a very smart guy who should have a place at the table if you want it. You're not going to get rejected btw. So thats really not even a con to consider....
 
Med Ed said:
Normal: "I want to be a doctor."

Not normal: "I want to be a doctor but I'm so concerned about encroachment by midlevel providers that I'm going to pursue a different career entirely."
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Except that’s not what I said 🙁... I’ve repeated many times in this thread that there are numerous aspects of a future in medicine that seem concerning to me (most drawn from posts here and from r/medicine from actual, practicing physicians/residents), but the greatest thing (i.e. the one thing that truly mattered to me) that had been giving me cold feet is the fear that committing to medicine will mean that I will never be able to leave this path if I (for whatever reason) wanted to in the future. I get the sense now that that’s not the case. Currently, I dream of eventually becoming a physician in clinical practice, but how can I predict how I’ll feel about that 20-30 years from now with certainty? Maybe as a physician you have more perspective on how one’s relationship with the profession might evolve over time, but you can’t really expect someone who’s still premed to have that same perspective.

Also, I never said I didn’t love science— I DO love it. The worry was that I could have ended up loving other things too if I had grown up in a different environment or if I chose to invest my time learning more about other fields. In retrospect, contemplating this was maybe not a productive use of brain power because I’m sure this could be true for a lot of people across a variety of different fields.

SunBakedTrash said:
Hey OP, you could just become
a midlevel. It’s a pretty good life. In many ways, it’s a sweet tradeoff to get some of the best parts of being a doctor while avoiding some of the worst parts, all while helping patients and making a good living. As long as you can make due not necessarily being the captain of the ship or having a chip on your shoulder, might be a good compromise.
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All in all, I would still rather be a physician. I do want to be able to have the training and expertise to take the lead on helping patients and solve more difficult/complex problems. I think I have the capabilities to become an MD, and I do believe I would regret not using my abilities to go through a more rigorous educational and training program. Physicians also have an intellectual engagement with the scientific side of things that I would want that mid levels aren’t necessarily so involved in (i.e. greater involvement in research). And all things considered from this thread, it seems like having an MD will open more doors to branch out should I desire it in the future. I have one life, and I don’t really want to take it “half-way” just because it might be easier... (I mean no offense to midlevels when I say this ).
 
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justwaking said:
Except that’s not what I said... I’ve repeated many times in this thread that there are numerous aspects of a future in medicine that seem concerning to me (most drawn from posts here and from r/medicine from actual, practicing physicians/residents), but the greatest thing (i.e. the one thing that truly mattered to me) that had been giving me cold feet is the fear that committing to medicine will mean that I will never be able to leave this path if I (for whatever reason) wanted to in the future. I get the sense now that that’s not the case. Currently, I dream of eventually becoming a physician in clinical practice, but how can I predict how I’ll feel about that 20-30 years from now with certainty? Maybe as a physician you have more perspective on how one’s relationship with the profession might evolve over time, but you can’t really expect someone who’s still premed to have that same perspective.

Also, I never said I didn’t love science— I DO love it. The worry was that I could have ended up loving other things too if I had grown up in a different environment or if I chose to invest my time learning more about other fields. In retrospect, contemplating this was maybe not a productive use of brain power because I’m sure this could be true for a lot of people across a variety of different fields.


All in all, I would still rather be a physician. I do want to be able to have the training and expertise to take the lead on helping patients and solve more difficult/complex problems. I think I have the capabilities to become an MD, and I do believe I would regret not using my abilities to go through a more rigorous educational and training program. Physicians also have an intellectual engagement with the scientific side of things that I would want that mid levels aren’t necessarily so involved in (i.e. greater involvement in research). And all things considered from this thread, it seems like having an MD will open more doors to branch out should I desire it in the future. I have one life, and I don’t really want to take it “half-way” just because it might be easier... (I mean no offense to midlevels when I say this ).
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I'll be the one to say: go into medicine.

It looks like you're just getting cold feet because you applied.

If medicine is your passion you won't be able to see yourself doing anything else.
 
justwaking said:
Except that’s not what I said 🙁... I’ve repeated many times in this thread that there are numerous aspects of a future in medicine that seem concerning to me (most drawn from posts here and from r/medicine from actual, practicing physicians/residents), but the greatest thing (i.e. the one thing that truly mattered to me) that had been giving me cold feet is the fear that committing to medicine will mean that I will never be able to leave this path if I (for whatever reason) wanted to in the future. I get the sense now that that’s not the case.
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"I fear that by the time that I actually become a doctor, there will be no inkling of respect for doctors anymore."

The fact remains that of the five concerns you enumerated in the original post, three of them are rather atypical for a premed to even bring up. They sound more like the musings of a disgruntled individual posting in the medical student forum. Given that I deal with disgruntled medical students on a regular basis, that original post had an ominous tone, which is why I even chose to engage with this thread in the first place. Going to medical school is a big event in one's life, and it can certainly be difficult to differentiate normal cold feet from more insidious warning signs.

justwaking said:
Currently, I dream of eventually becoming a physician in clinical practice, but how can I predict how I’ll feel about that 20-30 years from now with certainty?
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Death and taxes.
 
Med Ed said:
"I fear that by the time that I actually become a doctor, there will be no inkling of respect for doctors anymore."

The fact remains that of the five concerns you enumerated in the original post, three of them are rather atypical for a premed to even bring up. They sound more like the musings of a disgruntled individual posting in the medical student forum. Given that I deal with disgruntled medical students on a regular basis, that original post had an ominous tone, which is why I even chose to engage with this thread in the first place. Going to medical school is a big event in one's life, and it can certainly be difficult to differentiate normal cold feet from more insidious warning signs.

Death and taxes.
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I really appreciate your responses and your engagement in this thread. I should say again that my biggest concern (the first item in the list, and the one I've tried to highlight throughout my replies) was really the only concern that was giving me trouble.

As for the 3 things that you label as abnormal for a pre-med to consider (I'm assuming these are: single-payer, physician autonomy/respect, liking science), I've already addressed the third item in that list. As for the other two items, these are things that I have frequently read about either on r/medicine or r/medicalschool (not sure if you use Reddit at all) and on SDN. As pre-meds we are told to gain clinical experience, shadow physicians, and engage with people medical professions sufficiently before committing to medical school because, as you and many other's have said, it is a big event (and a big commitment). Everything in my own life experience has told me that I would enjoy being a physician, but is it wrong to second-guess myself when others *actually* more deep in the field (med students, residents, attendings) are actively voicing their concerns about these things on public forums? As someone who wants to eventually arrive at clinical practice, should I not be worried about these things that current practitioners in the field are labeling as major concerns? Given the big commitment that this path requires, I am partially guided by taking others' experiences into account.

I guess, with you being an actual attending, I would find it helpful if you offered your views on those concerns instead of simply labeling them as weird/abnormal for a premed to have (again, these are thoughts echoed from things I have read on here and Reddit from med students/residents/physicians-- they didn't just pop up out of no where).
 
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justwaking said:
I really appreciate your responses and your engagement in this thread. I should say again that my biggest concern (the first item in the list, and the one I've tried to highlight throughout my replies) was really the only concern that was giving me trouble.

As for the 3 things that you label as abnormal for a pre-med to consider (I'm assuming these are: single-payer, physician autonomy/respect, liking science), I've already addressed the third item in that list. As for the other two items, these are things that I have frequently read about either on r/medicine or r/medicalschool (not sure if you use Reddit at all) and on SDN. As pre-meds we are told to gain clinical experience, shadow physicians, and engage with people medical professions sufficiently before committing to medical school because, as you and many other's have said, it is a big event (and a big commitment). Everything in my own life experience has told me that I would enjoy being a physician, but is it wrong to second-guess myself when others *actually* more deep in the field (med students, residents, attendings) are actively voicing their concerns about these things on public forums? As someone who wants to eventually arrive at clinical practice, should I not be worried about these things that current practitioners in the field are labeling as major concerns? Given the big commitment that this path requires, I am partially guided by taking others' experiences into account.

I guess, with you being an actual attending, I would find it helpful if you offered your views on those concerns instead of simply labeling them as weird/abnormal for a premed to have (again, these are thoughts echoed from things I have read on here and Reddit from med students/residents/physicians-- they didn't just pop up out of no where).

Also, I don't really understand your response, "Death and taxes" (sorry).
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He's saying "death and taxes" because those are the only two certainties in life, and you are concerned about how you'll feel in 30 years "with certainty."

I think all of your concerns are legit, and you are clearly very bright and can very likely be very successful doing a lot of different things. The bottom line is, given the sacrifices involved and the political and structural uncertainty of what the profession is going to look like over the course of your career, it just sounds like you might be happier doing something else, with less personal sacrifice and less opportunity cost.

You are concerned about being stuck in medicine, and you really shouldn't be, because a talented person like you can always leave and do something else. The issue with that would be potentially leaving a huge potential sunk cost on the table if you walk away. It's not as easy as anyone might be leading you to believe to transition from being a clinician to running a hospital network, or a pharma or biotech or insurance company if you get bored and think you might want to do that in the future.

If you wouldn't rather be a doctor than do anything else, even if mid levels start running the world or single payer becomes a reality in your lifetime, then you might want to rethink the sacrifice and huge opportunity costs now rather than regret your decision later. I really think that's all anyone who is steering you away is trying to say.
 
justwaking said:
Hi all, this is partly to vent and throw my thoughts out into the open, but also to receive some advice from the community.

As background: I'm a pre-med applying this cycle with an app I've worked very hard on (3.95GPA, 525 MCAT, >1000 hrs of clinical/research exp, 100s of volunteer hours, the works etcetc.)

Lately, I've been thinking very hard about this path and whether it's right for me or not (I'm not sure there's a way to really know 100%).

It's not that I don't think I would like being a doctor. Based off of my clinical experiences and my values, I think I would LOVE being a doctor (the greatest pulls for me is the direct personal interaction the job involves, the privelege of being intimately involved in others' lives to make a difference, and being able to have a positive impact on people's lives/my community/the world). And now just as I'm applying I'm getting cold feet again.

Why? Well a few disruptive and intrusive realizations/thoughts have been wracking my brain constantly for the last few days (haven't slept well in a week...)
  • Sacrificing freedom/independence in my 20s/30s: The majority of my friends are in SWE (software engineers), consulting, IB. I have 2 premed friends I'm very close with, and a few current med student friends I'm less close with. While the path to medicine has always seemed glorious to me, I am (quite frankly) jealous of my friends when I hear them talk about their plans. My current view is that if I'm going to continue down this path, I would love to eventually arrive at clinical practice, but I fear that I am restricting myself to never doing anything outside of medicine up until the point I die. I hear my friends saying they plan to move jobs every 2 years (something I see as terrible honestly; as I hate applying for stuff) or plan to switch careers (e.g. going from tech->product management or consulting->starting a business; this seems cool to me). In the path to being a physician, that freedom to move around and liberally carve one's professional path as you go just does not seem to exist. Correct me if I'm wrong.
  • Rise of the mid-levels and decreasing respect/autonomy for physicians: I understand that this should NOT be a sole motivator for going into medicine, but I will admit that the prestige/respect involved with being a doctor is one thing that made medicine alluring to me. I browse r/medicine and this website a lot, and it seems like doctors just get **** on from all angles. The public is grossly misinformed about the hierarchy in medicine (midlevels vs doctors, med interns vs residents vs fellows vs attendings). I fear that by the time that I actually become a doctor, there will be no inkling of respect for doctors anymore. Disrespect from admin/the government during the COVID-19 pandemic has only made my sensitivity towards these issues worse.
  • Advent of single-payer system: I am 100% for expanded access to healthcare. I welcome universal access to healthcare, but I fear the possibly catastrophic disruption that exploding our current system and putting single-payer in its place will have on the field of medicine. I fully expect single-payer to come in my life time, and I'm worried that salaries will tank and doctors will lose even more autonomy (and mid-level autonomy will receive even greater support due to lower costs). While autonomy and money are NOT sole motivators for me, they are definitely things that are important to me when considering my future given the immense monetary and temporal sacrifice required by this path.
  • Alarming physician dissatisfaction: As much as I have evaluated my decision to march along this path, convincing and proving myself that being a physician is the profession for me, the reality is that I am not a physician. I think that recent figures from MedScape report that ~25% of doctors regret their career choice (or something like that). I can convince myself that this is the right path for me, but I am also a realistic person. 25% is A LOT-- how can I say that I won't end up in that group? It scares me.
  • Do I even like science?: I've always been convinced that I like science/biology. However, I grew up in a household where both my parents went to medical school and my sister is an MD/PhD. It was the thing I was most exposed to, and by working hard, I became "good" at it. I am a fairly competitive person, and I do derive a lot of joy/self-esteem from success. This has made me wonder: do I only like science because I've invested the most time into it and therefore it's the thing I'm best at studying (i.e. do I only like science because I've managed to find success in science by working hard)? Would I like something else just as much if I spend my efforts there instead?
I honestly think I have a terrible terrible case of "grass is greener" syndrome... To re-iterate, I am still convinced that I would love being a physician and clinical practice, but I worried that, in this one life that I have, there could be something else for me as well and committing to medicine will mean I will never have a chance to explore.
All things considered, my logical self says I should not throw away years of investment into this path over a few intrusive thoughts that have clouded my mind these past weeks, but my emotions have been more vocal about this than ever (the last time something like this bothered me was sophomore year of college) and this is the closest I've ever felt towards abandoning this path.

Current MDs/Med students (or even pre-meds with similar doubts): How did you address doubts about medicine? Did you have similar concerns?

To calm myself down a bit, I did some searching and I was wondering if the following plans seem feasible:
  • If I get rejected this cycle: I'll quit pre-med or at least take a year off to explore something else like learning coding for a career in SWE (am I crazy? My MCAT score expires in 9/2022 I believe)
  • If I get accepted this cycle: I plan on getting an MD, but I've also been curious about how MD/MBA programs work. I would plan to complete residency and practice clinically, but I would hope that if I wanted to, I'd be able to look into consulting or something outside of clinical practice. (Is it possible to do consulting and clinical practice part-time concurrently?)
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Hey - I'm an incoming M1 with similar stats - got into schools like Harvard, WashU, etc. for reference (your stats indicate that you *could* be in a similar boat). I had your angst throughout the entire admissions process, ESPECIALLY during the interview season. Oddly enough, I had your same concerns (sacrifice, actual love for science, healthcare can be a **** show). First thing that helped me - I listed out all other career avenues and watched "Day in the Life" videos to see what they're really like. If you want to be a physician or leader in healthcare, you might pretty quickly come to the realization that the path you're on is the right one for you...at least it did for me. Hope that's a start. I don't want to ramble - please PM me if you want to know how I personally tackled each of your bolded concerns.
 
Here’s a no-so-secret secret: people in healthcare, particularly doctors (and nurses), and even med students and residents, love to complain and worry. I’m guilty of it too. We’re in such a privileged position but we worry so much about single patients healthcare, midlevels, etc. I feel we’re in this ivory tower worrying about distant more esoteric things while everyone else around me is worrying about just making it to their next paycheck, affording new clothes for their kids, etc.

The truth is our jobs are still here. Our salary will still be great. Worst case scenario it goes down a bit. Maybe we lose a little respect and autonomy. Single patient healthcare would honestly likely make as many things better as it makes worse-it would likely overall be a wash. Regardless, why worry about it? Either it comes or it doesn’t. Regardless of what healthcare system we have to work with or insurance the patient has we should still take the best care of them that we can.

Cold feet are normal. People get them before their wedding. Jobs aren’t that different than spouses-we can all worry about whether we’ll still like them in 30 years, and if they’ll be as fun and exciting, and delve our minds into anxious oblivion— or we can search the best we can with the time we have, follow where our heart takes us, and make a commitment. At a certain point you just have to have faith you’re on the right track and go with it it.
 
@justwaking: I also had same concerns. Seems normal to me. And healthy to come to terms with considerations of commitment. Pragmatic to weigh the pros and cons, and consider rewards versus sacrifices. What is astonishing to me, however, is the glib dismissal by those who profess to educate and guide medical students. It would be one thing if the advice was truly proffered for your benefit, though some here seem to occasionally enjoy making pre-meds feel small as if to elevate their own station.
 
justwaking said:
As for the other two items, these are things that I have frequently read about either on r/medicine or r/medicalschool (not sure if you use Reddit at all) and on SDN.
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I do use Reddit for certain specific purposes, but it's even worse than SDN for providing a completely distorted view of reality. People have been fretting over midlevels for many years, and absolutely nothing substantial has ever come of it. If anything the majority of midlevels get incorporated into physician-run practices and, if used properly, can increase efficiency and patient satisfaction. Physician autonomy has eroded over time, but that is more a consequence of payment systems and state regulations. Regardless, we're the only ones who can do what we do, and among all the e-moaning it's easy to lose sight of the power and influence that physicians wield. Single payer (aka Medicare for all) was an idea floated by two former presidential candidates. Heck, it sunk one of their campaigns. The guy they ended up nominating was part of the administration that built the ACA, which most of the country now views favorably (52-41). Even if they do manage to set up a public option it will take many years before public health insurance threatens the existence of private insurers, if at all.

@RangerBob is correct, everyone in medicine loves to complain, it has been a professional pastime for the last century. You have to take it all with a pound of salt (including what I'm telling you).
 
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I’m only an MS2, so take my advice with a grain of salt. But what I’m going to say is more about timeline in going to med school than anything else.

I think what you’re worried about are valid things to consider. I think some of them aren’t things that should particularly concern you (eg, midlevels), but it’s smart to at least ask about it.

That said, one of the things you mentioned was spending your 20s in school and training. I didn’t go to med school until I was 35. I spent my 20s and early 30s working as an OR tech, playing music professionally, writing for a living, seeing crazy **** in the Navy, and meeting my wife and having a couple kids with her.

And now I’m in med school. I’m a bit older than most of my class, but I’m doing great and really loving it. If I had gone right away, yes I’d be an attending now, but I wouldn’t have had any of those experiences that I had, and I’d regret that.

My point is that med school will always be there. If you are afraid of missing out on your 20s, go live your life and do some cool **** (just don’t do anything stupid that would affect your ability to get into school or get licensed). You can always go to med school.

I’m not saying it’s the best path for everyone, but it is the best path for some people. I’m just saying that you don’t have to decide between medicine now or not at all. You can also pick medicine in a little while.
 
Matthew9Thirtyfive said:
I’m only an MS2, so take my advice with a grain of salt. But what I’m going to say is more about timeline in going to med school than anything else.

I think what you’re worried about are valid things to consider. I think some of them aren’t things that should particularly concern you (eg, midlevels), but it’s smart to at least ask about it.

That said, one of the things you mentioned was spending your 20s in school and training. I didn’t go to med school until I was 35. I spent my 20s and early 30s working as an OR tech, playing music professionally, writing for a living, seeing crazy **** in the Navy, and meeting my wife and having a couple kids with her.

And now I’m in med school. I’m a bit older than most of my class, but I’m doing great and really loving it. If I had gone right away, yes I’d be an attending now, but I wouldn’t have had any of those experiences that I had, and I’d regret that.

My point is that med school will always be there. If you are afraid of missing out on your 20s, go live your life and do some cool **** (just don’t do anything stupid that would affect your ability to get into school or get licensed). You can always go to med school.

I’m not saying it’s the best path for everyone, but it is the best path for some people. I’m just saying that you don’t have to decide between medicine now or not at all. You can also pick medicine in a little while.
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yeah this is a perfect example of someone capitalizing on their time before med school.

but make sure you’re the type of person to do this. I thought I was, but I ended up just watching a lot of Netflix
 
First, I would like to congratulate you on the job well done with stats/volunteer hours! As a nontrad premed who has/had years of self-reflection, I recommend taking a gap year, because like others said, medicine will always be here when you’re ready.
You say you love science, you love medicine...Why? Like you’re saying if you’ve never really had anything to compare it to and your entire family are physicians so that’s all you mostly know aside from your engineer, nonpremed, etc. friends.
When challenges come, how will you manage it?
I can also say that earning trust doesn’t come from title. It comes from your character and competence. I’ve worked with physicians that you can tell hate their lives vs ones who absolutely love their job, or at least for the most part.
You exploring other options then coming back to this is actually going to benefit you more.

I just hope that ADCOMS can select applicants who will make great colleagues and physicians, because we spend our days with these people and you need those reasons “why” that will allow you to push through when times are hard, without treating others like crap because they are miserable....But that doesn’t also just happen in medicine.
Goodluck on your journey and I hope you truly find something you are passionate about! 🙂
 
I think you should take at least one gap year and remember that you always can try to defer. I felt that I grew a lot during that time and I think it’d be good for you too. I think your concerns are legitimate but when you read everything negative thing you can on the internet things often seem like the sky is falling.

Would you be unhappy when you’re 35, been working at a desk job for the last 10 years, and your med school friends are now physicians who do amazing, meaningful things every day with great job security and a great salary? changing the trajectory of my whole life because of the mere possibility of things changing (for the better? Worse) would drive me crazy when I realized everything basically stayed the same and I had to deal with the actual day-to-day of these sexy jobs like CS or IB (lol)

Also, I would try and reframe your thinking. It’s not healthy to think that you’re giving up your 20s and always living for the future (when I get into med school then... when I match then... when I’m a doc then.... when I get that new car then...) If you’re interested in being a physician you should hopefully like school/learning to maybe enjoy the fact that you have no real responsibilities other than getting good grades (which you’re obviously very good at) while your friends have to worry about every deadline,getting fired, recessions, etc.

I think you should apply so you’d get in with one gap year and see how you feel when you can just relax a little and think and work in the real world.
 
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