deferred student seeking answers: how do you know if medicine is right?

[mercury029]

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Hello all; I'm new to this website and was hoping that I picked the right forum to ask my questions. I graduated from college last May and was granted a one-year deferral from a med school. I wanted to take time off to explore research, generally take a break from school, and try to figure out if becoming a physician really is the right choice. (By the way---who knew finding a short-term research position would be so hard!)

Sooooooo here's my dilemma. I'm very interested in science, and I love working with people. I think healing would be an amazing profession. But for so long now I've questioned if I can really handle the sacrifices that go along with becoming a physician. The biggest is wondering if I will have time to start a family. I know that it is something that I definitely want to do and if my career stood in the way of my family, I'd choose to care for my family. Such decisions for women. I've brought this before many a health-care worker and they always say things like "Be a dermatologist! They have great pay and nice work hours." But I think I'd be interested more in something like pediatrics or mental health.

My second qualm is just the determination itself. I shadowed various docs (cardiologist, pulmonologist, internist, pediatrician, ophthamologist, and a general practicioner) and I wasn't sure if I felt that...spark. You know, that "wow this is what I could do for the rest of my life!!!!" thing. Another big reason why I didn't want to take away a slot in this year's M1 class from another student who knew for sure that he or she wanted to go to med school. If I'm not sure about my WANT for the job, will I have the stamina to even get through med school?

Another question I get asked is "Well, what would you do otherwise?" To that I don't really have an answer yet. But I don't want this lack of a "better" plan to be the reason why I go to med school.

So any advice is wholeheartedly welcomed. Fears you have/had, if they were resolved, personal stories of how you came to your career decision; anything to give a little perspective to a person who is almost at the end of the line with worry.

Thank you.

 

[huktonfonix]

Do some more shadowing until you're either sick of medicine or decide you want to do it for a career. Either way its better to find out now than later. Depending where you go 1st 2 years aren't too bad. You'll still have time to do outside activities (quite a few people in my class either have families, got married, or had kids) in the 1st 2 years. Not saying its easy, but it can be done. The hard part is 3rd year when you are on call all the time and working 60-100+ hours a week. 4th year can be this way also, although you can arrange an easy schedule. If you want to go into a lifestyle specialty its not as easy as just choosing it. You'd have to bust your butt to get good grades, and ace your boards otherwise you probably won't be able to do it. These are very competitive fields (Derm is probably the worst). You will also be working 50-80 hours a week during residency depending on what you do and this will be another 4-7 years. So basically, it will be another 8 years minimum of a lousy schedule before you can practice and get a decent schedule (which again may be more time). But if you really do love it, go for it.

 

[ForceField]

I'd have to disagree with you about the first two years not being that bad. Perhaps I may just work slower than others, or I'm just a perfectionist about everything so I leave no stones unturned, but I'm an M1 in the Chicagoland area and my academics have be busy beyond belief. Outside of school, I work out and haven't had much time to do much else. However, I've never hesitated about studying, etc., and the main reason why is because this is what I really want to do. If I ever had second thoughts, I probably would quit and definitely wouldn't be able to do the work. The only second thoughts I have are in my choice of medical school... I'm left wondering if I would've been happier at Vanderbilt, Northwestern, etc., but that's the only time I think twice about things, and it's too late to change that.

I think you really need to be sure with what you want to do before you enter medical school, not necessarily concerning a specialty, but with becoming a physician. Hope this helps. 🙂

 

[huktonfonix]

Yeah thats kind of the "depends where you go" thing regarding the first 2 years (wait for 3rd year, though). But I agree with forcefield in that make sure it is absolutely what you want. There WILL be times you will want to quit and think you made the wrong choice. I have no doubt about that. Almost every med student has hated life at one point. The clinical years have a way of doing this especially when you're q3 working 120 hours a week and not seeing anybody outside of the hospital. But hopefully, the positive moments will outweigh these. Keep your eye on the big picture whether it is being a doctor or being with your family and friends.

 

[driedcaribou]

Wow, that's very noble of you to not 'take' a spot from another student.

It's also very honest of you to admit that medicine might not be the career for you.

Realistically, it's going to be very very hard for you to find your calling within a year's time.

I think it would be risky for you to take a few years off before applying for medicine again due to the fact that it's so competitive. Also, your MCAT scores may expire.


I don't know how old you are but if you're 21, then I would say not to worry about starting a family. If you're 35, then I'd tell you to forget about medicine or freeze some of your eggs... 😉

You don't have to work full time once you're a fully licensed doctor you know. Perhaps initially just to pay off that debt but after that, you should be able to have a career most people would kill to have.

I don't know anything about your life or your life experiences but a lot of jobs are demanding with your time. Medicine is just a different commitment. Financial bankers in their first year can pull off 60-80 hours a week of work. If you're a construction worker, you could be doing back breaking labour from 5 am to 6 pm 6 days a week.



You like people and you like science and you're obviously compassionate as demonstrated by your actions.
I think you'd make a fine physician.

I say go for it. Just make sure you find time to smell the roses.

And besides, you can always change your mind later and open a coffee shop... you can tell the kiddies.. 'yea.. I was a doctor once...'


🙂

 

[ollie2003]

i think getting an md is a good idea if you are interested in a career in the sciences, but don't know specifically what you want to do.

i think an md affords more possibilities than a phd (assuming you are considering graduate school as an alternative) in the end. you can always later choose to do research full time. if you take a look at some of the top research institutions in the country, many PIs are MD's only. A phd is not a requirement to do good science.

i also think you should consider the fact that graduate school is just as time consuming. i work with a number of grad students in a lab and they are working as many hours as any med student i've talked to.

i struggled with the same decision---i want to do science but don't know what is the best way to go about that. in my opinion an md will give you many, many opportunities in the future. you don't just have to be a practicing physician.

 

[jbish]

I agree w/ Ollie's statement about not needing a PhD to do research and being perfectly qualified with an MD. My dad is not a people-person...in fact, he thinks that if he had to apply now he would go straight for the PhD as it's too "personality" oriented now...but he sure makes a damn great Pathologist! And..they also have pretty good hours compared to others. He chooses to put in 10/11 hr days but I know his colleagues get away with/choose less. However, it's an expensive endeavour (ha, British spelling) and of course really time-consuming so in the end, it'll be up to you and your bank account.

 

[Neuronix]

I want to give a quick blurb about MD/PhD, because I think it's a frequently ignored or unfairly discouraged option.

So everyone knows you don't NEED a MD/PhD to do medical research or some mix of clinical and research, but why not get one? There are still clear benefits to the track. The first benefit is an integrated cirriculum of medicine and research that will hopefully get you exposed to thinking about translating both. The second is that it will probably be fully-funded (e.g. no debt--full tuition break and stipend). The third advantage is that MD/PhDs match extremely well. But regardless, you're probably going to have to spend more time in research later if you do decide to do some sort of basic science research in your career. Many go ahead and spend alot of extra time getting a PhD in their post-doc or doing two post-docs to really get going. Would the time spent by a MD researcher in training be the same as the MD/PhD researcher because the MD has to make up the research training somehow? It's hard to say. I've talked to many MD researchers who have said that today they would go for the MD/PhD. The reasons given are that it wasn't really an option in their time and med school didn't cost nearly as much.

But, if the idea doesn't excite you, I guess it's not for you. I love the idea of bringing new cures to medicine. PhDs really do not get a good medical handle on things. Everything in grad school is molecular these days. Even courses on basic anatomy (like neuroanatomy for example) at both my undergrad and my grad school are optional and rarely offered. Maybe you don't know what you want to do. Hey, that's fine. I don't either. MD/PhD can be a good way to put off the decision between medicine and research, and not have to pay alot of money while doing it. One can argue that as MD/PhDs increase in number, there will be more and more spots that give preference to MD/PhDs, not that there aren't already.

Another thing we hear from people (women especially) is that the program is too long and they want to start a family. I always wonder, when is a better time? You're gonna be in it for the long-haul, and academic medicine doesn't exactly get easier than your training. Many people in our program have children and they're flexible about that. Also, you can still leave the MD/PhD program if necessary, go with your MD class, and owe nothing from the time you were a MD/PhD student. On the other side, it's uncommon and very difficult to switch from a PhD to MD/PhD or MD (at least without graduating). Our first year class is 9 women and 7 men, so it's certainly not a program that favors again anyone.

Since you're already in and deferring, I wonder if the school has a good MD/PhD program. If so, you could transfer in after one year of med school.

Leaving all the MD/PhD stuff aside, I think you should at least get a MD over a PhD. There's a reason why attrition from PhD programs is at least 1 in 3. Medical students have basically a guaranteed job coming out and you have a ton of options when you graduate. They also work hard to make sure that you are moving through the program, and almost nobody fails out. Grad students get screwed in so many ways. If you're lucky and you pick a good lab and do some good work and graduate in a reasonable amount of time, you still have to contend with the boatloads of other PhDs fighting for positions. If you go this way, you should plan on *fighting* for tenure for a long time. It's not really any better in industry either (unless you're MD/PhD). Remember, you're going to have to pick a career, unless you just become a stay at home mom, and any of them are potentially compatible with children. I just don't want to see you as one of those often rejected applicants who started in some other career or PhD program, realized that there were no jobs or that the program sucked, and then tried to get back into medicine.

As you can see, I batted around this decision for awhile and came to be where I'm at now. Would I have gone to a MD program if it was free? Probably. But, I'm happy with my choice, and without any parental support I'm glad to be living comfortably while getting my training.

Feel free to PM me and good luck!

 

[awdc]

Originally posted by driedcaribou
If you're 35, then I'd tell you to forget about medicine or freeze some of your eggs... 😉

Freezing eggs isn't a very viable alternative since the eggs are stuck in metaphase-II until just before fertilization. Apparently, the delicate mitotic spindles don't handle the freezing/thawing process well. And you need the eggs that have completed meiosis-I because those are the only ones that can be fertilized. Heh, sorry, I couldn't resist since we just learned that in class today.😉

 

[DocRuth]

mercury029,

I just finished reading an absolutely fabulous book which I highly recommend to any other women considering medicine as a career. It is called This Side of Doctoring: Reflections from Women in Medicine and it has stories from about 100 different women. It explores some of the historical challenges of being a woman in medicine and the question of balance, especially the balance between having a family and having a demanding career. After reading the book I realized that although it's not particularly easy (but then nothing meaningful is), it is really doable to live a full life. It's a really inspiring book without being fluffy or trivializing anything.

Oh, and one of things that has been pointed out to me recently by my own doctor is just how flexible a career medicine is - and it's getting more flexible as training programs are adjusting to a world in which people want to care for their families.

Hope that helps, and let us know what you decide to do! Best of luck with everything.

 

[DocRuth]

oops! Forgot to mention the book is edited by Eliza Lo Chin MD, and it is published by Oxford University Press (www.oup.com)

 

[deleted29780]

i have really learnt a lot in here, thanks guys.😀

 

[idq1i]

Originally posted by awdc
Freezing eggs isn't a very viable alternative since the eggs are stuck in metaphase-II until just before ovulation. Apparently, the delicate mitotic spindles don't handle the freezing/thawing process well. And you need the eggs that have completed meiosis-I because those are the only ones that can be fertilized. Heh, sorry, I couldn't resist since we just learned that in class today.😉

Metaphase I just before ovulation
II just before fertilization

😉

 

[awdc]

Originally posted by idq1i
Metaphase I just before ovulation
II just before fertilization

😉

Oops... good catch. I'm editing my original post.

Now getting back on track (sort of). I've been following this post with some interest since I am also interested in getting involved in some research. I just don't know quite how to get involved. Not so much to do it full-time but if I ever want to investigate something, I wouldn't feel like a fish out of water. To me, it seems the only way to learn how to do research is to actually do it under a mentor. With that said, how does a M.D. degree qualify someone to do research? And someone mentioned that a MD could do research with additional training but where would one get additional training? Is the only option looking for a suitable mentor or are there formalized training programs? And like the OP, I had trouble finding a short-term research position in my free year. Is research really that tough to break into? Thanks.

 

[jbish]

With that said, how does a M.D. degree qualify someone to do research? And someone mentioned that a MD could do research with additional training but where would one get additional training?


The MD's that I know that do research mostly do clinical research and they didn't have any special training. They just decided what they wanted to do, wrote a grant proposal, got the money, got approval, and did research. My dad did some basic sciences research (something with E. coli and plasmids) and he did the same..just decided he wanted to do the research, wrote the grant, did it. So, if you want to do it I don't think you necessarily "need" additional training. I mean, sure, my dad had to learn at some point how to work w/ those little buggers, but that he probably learned in college w/ his biochem/biophysics degree.

 

[Neuronix]

Originally posted by awdc
With that said, how does a M.D. degree qualify someone to do research? And someone mentioned that a MD could do research with additional training but where would one get additional training?

If you want to do basic science research, there's two ways that I know of for you to do it after you get your MD degree.

The first path is going straight after your MD and doing a post-doc. This way you skip residency and you blow any opportunity you have to do clinical, but it's an option that a small number of people take who decide they really don't want to do clinical medicine. I'm not sure exactly how you go about getting that post-doc, as you're going to be a huge investiment from a PI because that PI is going to spend alot of money and time training you from scratch. Connections in that regard would probably help.

The second path is doing a basic-science fellowship after your residency. They exist at many programs and I don't think it's very competitive to get into one after your residency. This will tack on at least another 3 years to your training to get you ready to be a basic science researcher. In both of these paths there are usually opportunities to obtain a PhD, but typically that will tack on several more years above your post-doc/fellowship. There are combined fellowship/PhD programs, but they tend not to be well regarded because they're squeezing in both a fellowship and a PhD in like 3 - 4 years. Either of those things alone often take that long.

There's two reasons you can't just go from a MD and expect to be a basic science researcher without ALOT of previous research and an inordinate amount of help. Research funding is competitive. You have to write grants to bring in the money to run your experiments, pay your assistants, etc. Writing grants requires a good amount of training and experience that is difficult (impossible?) to pick up on your own in this competitive environment. The other reason is that some institution needs to give you lab space and start-up money, and they're not going to do that unless you've shown promise in research and in writing grants in your post-doc/fellowship.

There's always weird ways around things. For example, there are some who have transitioned from clinical research to basic science research over time without any formal basic science training. Regardless, you have to compete hard for research dollars and space with all those PhDs I mentioned before that need jobs and money. It's been getting more competitive for a long time, and it probably will get worse. The MD degree may give you extra perspective that will help your research, but alone it's not going give you an edge over PhDs unless you learn how to do research just as well.

 

[neuropain]

I am in med school and everyday I wonder why I am here...

Be sure this is what you want before you enter... Once you get here you are almost sucked in....

 

[mercury029]

If any of you ever look at this post again, thank you so much for your input. I'm on my way to medical school this fall; it is an opportunity that I cannot pass up.

😀

 

[Blake]

If any of you ever look at this post again, thank you so much for your input. I'm on my way to medical school this fall; it is an opportunity that I cannot pass up.

😀

Congrats 😀

 

[Justin4563]

hey mercury,

Let me tell you something.. When i started med school I was fairly motivated, I loved the ****. I liked the patients.... Now Im finishing my residency. and let me tell you.. There is no ****ing way i would do it again.. The system is awful..... its not worth all the time away from "normal life activities" I mean there has to be a reward at the end.. whether its financial, the emotional high, or something. THere is neither... You dont even get paid nearly what you are worth..... SO my advice.. do something else..

IF I worked 1/10th of what i have worked in the past 7 years just studying the stock market trends day in and day out.. I would be a f ucking millionaire by now.. see where im getting at with this