I need advice!

[Evee87]

Hello everyone! To start off, three general notes: First, I've never written a legitimate blog before or posted on a message board, so I am very new at this. Second, I accidentally posted this message on the "Welcome New Members" message board so this a repeat. Sorry if you're reading this for a second time. And third, this is a rather long message because I am in the midst of making some pretty grave decisions. Please bear with me.

My reason for posting this message is fairly simple (and yet complex at the same time): I am not sure if I want to go to medical school or not. I am an undergraduate student (junior) so it's getting to be that time when I need to start looking for medical schools, taking MCATS, applying to schools, etc.

Ever since I first started thinking that I would like to go to medical school after graduation, I have had doubts and endless questions as to whether I would make a good doctor or not, whether that is what I want to do, and whether medical school would be the quickest way for me to achieve my lifetime goals. A brief summary of my interests/what I want to do with my life:

I am interested in the behavioral aspects of human health--namely, why humans behave in ways that compromise our health. To be more specific, I would like to look at the factors involved in the adoption and modification of health-related behaviors, including cultural, socio-economic, and family influences, psychology, etc. I am not as interested in the biological aspects of health and disease (although I acknowledge that the study of physiology and pharmacotherapy has played a key role in improving the health of our nation). Another broad interest of mine is international disparities in quality and access to health care and other services implicated in good health and why, historically and anthropologically speaking, some populations enjoy good overall health while other populations suffer. I am thinking that my particular interests will lead me to a career in public health and/or epidemiology and/or anthropology, but I am not sure (and need help deciding) if being a physician should be my first priority before entering any of these fields. The alternative would be to go to graduate school and get my Ph.D. in Public Health. Whatever field I go into, I would like to work on behalf of the poor and make it my duty to challenge societal structures that have resulted in disparities in health and human rights.

Earlier this evening, I constructed a list of Pro's and Con's (the Pro's being reasons I want to go to medical school and the Con's being reasons why I feel hesitant to do so.) Below is a rough summary of this list. Keep in mind that some of these assertions may not be factual; they are simply thoughts that have been bouncing around in my brain. If there are any points that you disagree with, please let me know!! That is why I am posting this message.


Reasons Why I Want to be a Doctor
-The goal of the occupation is concrete: “Treat patients.” There is not a lot of room for questioning or confusion regarding what I’ll be doing on an everyday basis (whereas in research there is constant questioning of purpose, goals, etc.)
-I will see the tangible results of my practice every day in the patients I make better. There will be no disconnect between me and patients.
-Medical school will be rigorous and a way to prove that I am intelligent, capable, and passionate about what I’m doing.
-People will listen to me because of my expansive medical knowledge (i.e. I will gain credibility). I will be better suited to join a public health organization than I would with a Ph.D. or Masters Degree. Once I start working on publications, I will be a more credible source if I have my M.D.
-I could travel internationally and provide basic services for the poor (or work in a clinic for underserved communities in the U.S.)
-The distinction of “M.D.” impresses people. It’s fun to say “I’m going to be a doctor” and I’m fairly certain it will be even more gratifying to say “I’m a doctor.”
-I like studying and working hard, so these are not barriers to me going to (and possibly even enjoying?) medical school.
-I have a unique admiration for doctors that is not present when I view most other professionals.



Reasons I am Hesitant to Go Down the “Doctor” Path
-I don’t agree with several aspects of modern (Western) medicine including: The way physicians tend to view patients as a collection of biological processes rather than as whole persons (in other words, I would rather take a more holistic approach); The reliance on drugs to treat virtually everything (going along with this, there is not enough emphasis on prevention); How important money is (including doctor’s salaries, profits made by HMO’s and big drug companies, health insurance and the patient’s ability to pay for services, etc.).
-There is not a lot of room for creativity within a medical education, as it is mostly technical training. I might get so lost in the technical aspects of medicine that I would lose sight of the big picture.
-Even though I like studying, medical school is going to be extremely difficult and I am not certain I will be able to cope with the daily stressors.
-I get squeamish at the sight of blood.
-Medicine doesn’t really match my personality or interests all that well. I feel strange telling people that I’m going to be a doctor. A lot of my friends and acquaintances have remarked about how it is shocking and rather puzzling when I tell them I want to go to medical school.
-I don’t really want to be a practicing physician. I would prefer to get my M.D. then go directly into working within an NGO in research and/or policy.
-I don’t believe Western medicine is always superior to other forms of healing. In fact, I am interested in looking into alternative pathways to health.
-I don’t know if medicine is necessarily what I’m interested in—I could be equally well-suited for social work, international relations/politics, anthropology, or sociology. I am mostly interested in learning about different cultures, how they interact with one another, and how we as a human race have come to be the way we are.
-I would like to eventually be a public health policy-maker and I’m not sure if becoming a doctor would be the quickest or most effective route to achieving that goal.
-I question whether making people feel better through the use of drugs would really be gratifying for me (especially since I think a lot of drugs are wildly over-prescribed and that humans should generally take more preventive measures—i.e. proper nutrition and fitness, good sanitation, stress-relieving techniques—to improve their overall health).
-I may not be content with the relatively “micro” approach of a physician; I think I would prefer working on a community or population level.


That is the end of my list. If you have felt any of these apprehensions as a Pre-Medical student (or even if you haven’t) please let me know of what made you decide to either go or not to go to medical school. Also, I am interested in any general pieces of wisdom or advice. And I love bluntness!


Thank you VERY MUCH for reading this entry. Sorry for the excessive length!

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[Law2Doc]

... I am not sure if I want to go to medical school or not.

Let's put it this way -- if you are this hesitant and can make a longer list of reasons why you might not like medicine, you don't want to go into medicine. I also note that some of your pro-medicine reasons are pretty shallow (people will listen to me, an MD impresses people), or not medicine specific (liking studying and working hard). Only do medicine if you really want to practice medicine, the way it is practiced in this country. If you don't agree with the Western principals, or have no interest in practicing, don't try to swim against the stream-- there are plenty of non-practicing, non-medical school "alternative" med jobs you can find.

 

[MarySue99]

Yeah, I think that you should get a masters or PhD in Public Health or psychology, as that is really what you want to do. I don't think that you would have a problem getting involved in the projects you mentioned with a PhD. Also, if you get a PhD, you can still be Dr.- I think you have to really want to do medicine to go through the horrible process of applying and the rigors of Med school. Don't be miserable in something you don't want to do.

 

[HumidBeing]

Sounds like an Masters in Public Health would be very appropriate for you.

You pretty much said that being a physician would not suit either your goals or your personality. You desire to do public service in a different way. You need to follow your intuition, your heart, your common sense - whatever you want to call it, because it's telling you that becoming an MD is not what you want.

 

[ChubbyChaser]

I agree with Sue, go with Public health or Psychology.

 

[lei217]

You definitely do not want to go down the "doctor path." Given that most of your reasons to do so consist of things that could be found in other professions or educational programs and most of your cons are the actual concrete basis of being a physician here in the western world, you really should not try to put yourself through all of the applying and education so that you could achieve goals which could likely be obtained with a PhD in Public Health or Sociology/Epidemiology. I struggled for a long time with my decision as well but now that I know it is for me I am able to go through this crazy process and I really don't think you should waste your time, money and sanity on something that you deep down know you don't want to do.

 

[gbennett]

this is my first post as well, but as an mph student, i feel compelled to reply.

when it comes down to it, this is your career. do what makes you the most happy, and from your post, it does not sound like medicine is it. as a person currently involved in public health, the options for a person with a PhD in public health or a DrPH are exciting. The field is exhilarating, and there is no need to be a physician in order to get respect in the field or make things happen. consider how you will get the most gratification, and run with that.

my suggestion would be to hold off on the mcat. write the gre, and pursue a masters in public health. push hard to attend an incredible school of public health, like harvard or johns hopkins. this is entirely possible, regardless of gpa (and believe me, i know) if you show the proper amount of dedication, compassion, and since interest. at one of these institutions, you will be exposed to amazing people who are working in public health but are not physicians. i believe you will be inspired and discover what your goals actually are and what your true passion is. with a masters in public health, you will be able to either pursue an MD, go right into a PhD or DrPH, or get a few years of experience and then go for the advanced degrees. public health is an incredible field, and if you love it, nothing will make you happier.

 

[HumidBeing]

gbennett, very nice post.

 

[doinmybest5840]

Two things:
1: If you're not sure if you should go to medical school, you should not go.
2: From what you wrote about your interests, public health or anthropology sound like the best routes for you, in my opinion.

Medicine is a huge undertaking, and not a decision to be taken lightly. If you've been contemplating this since you graduated from high school three years ago and you're still not sure, then this is not the career for you. Obviously you have reservations, and you seem to have found other occupations that would better fulfill your life goals (as I mentioned above). Good luck!

 

[mpatricksweeney]

I'm also in MPH program with international focus...

Two things which may be helpful as you decide for med or ph:

1) really digging into volunteer clinical experiences to see whether you'd enjoy it day by day...(consider reading david hilfiker's book, not all of us are saints, which narrates his experiences as a doc in underserved dc, or ten fingers for god by paul brand, his indian memoirs from working with leprosy patients...and others)

2) if possible, identify the specific ways you want to be of service...you mention your 'duty to challenge societal structures.' that's good, but thematic and broad. to make meaningful impact on disparities will require excellent training in a suitable skill set. as you mention, the skill set taught in ph school is VERY different than the skills in med school. to bring integrity to your education, i'd encourage you to really develop the ph skills if it's what you're most drawn to.

there's also the concurrent md/mph, but again, the time you're able to devote to ph skills may be small, and leave you feeling unprepared for ph practice. on the other hand, the mph can bring valuable perspective for your work as a doc.

as others have mentioned, there are mds researching/teaching in ph schools. some i've spoken with practiced medicine for decades, but later felt they'd have greater impact researching at population level.

have you sought out any mentors??

both are worthwhile...blessings on your path.

 

[smq123]

I am not as interested in the biological aspects of health and disease (although I acknowledge that the study of physiology and pharmacotherapy has played a key role in improving the health of our nation).

Don't go to med school. You will spend the VAST majority of your time on the biological aspects of health and disease, even as a third year. You don't have to love it, but you have to have some interest in it. Otherwise you'll be a great social worker/therapist, but a pretty crappy doctor. Aside from helping you decide patient care, your patients will ask about it - I had patients ask me to decipher fetal heart strips for them at 5 AM.

-Medical school will be rigorous and a way to prove that I am intelligent, capable, and passionate about what I'm doing.
-People will listen to me because of my expansive medical knowledge (i.e. I will gain credibility). I will be better suited to join a public health organization than I would with a Ph.D. or Masters Degree. Once I start working on publications, I will be a more credible source if I have my M.D.
-The distinction of "M.D." impresses people. It's fun to say "I'm going to be a doctor" and I'm fairly certain it will be even more gratifying to say "I'm a doctor."
-I have a unique admiration for doctors that is not present when I view most other professionals.

* These really aren't very good reasons to go to med school. It seems more like you want to become a doctor to show other people what you can do, which isn't enough to make up for the huge loss of sleep, huge stress load, and heavy financial burden.

* Having "expansive medical knowledge" is great. But you have to gain that knowledge first - and you've already said that you have little interest in pathophysio/biological disease processes. Since those things make up > 80% of what you will learn in med school, I don't know how much medical knowledge you'll truly gain.

-I could travel internationally and provide basic services for the poor (or work in a clinic for underserved communities in the U.S.)

You could - but only after a VERY long time. So many pre-meds come in to this process saying that they "can't wait" to work with Doctors without Borders (= MSF). Unfortunately they'll have to. MSF does not accept residents - they will only take people who have completed training (i.e. attendings). Same thing for underserved clinics. That means: 4 years of med school + 3 years of residency = 7 years, at a minimum, of waiting and training. 7 years is kind of a long time....are you willing to wait that long?

-I like studying and working hard, so these are not barriers to me going to (and possibly even enjoying?) medical school.

Please understand - medical training brings a whole new meaning to the phrase "working hard." When I said earlier that I've had patients ask me questions at 5 AM - that was at the 11th hour of my shift. I had 3 and a half more hours to go. Surgical rotations, even for 3rd year med students, routinely go from 5 AM to 8 PM. OB/gyn rotations have similar hours - and then you have to go home and study for the end-of-rotation exam. It's not always fun, and there's a lot of stress that goes with it.

-I don't agree with several aspects of modern (Western) medicine including: The way physicians tend to view patients as a collection of biological processes rather than as whole persons (in other words, I would rather take a more holistic approach); The reliance on drugs to treat virtually everything (going along with this, there is not enough emphasis on prevention); How important money is (including doctor's salaries, profits made by HMO's and big drug companies, health insurance and the patient's ability to pay for services, etc.).

I still don't think that you should go to med school. But these are commonly held misconceptions, and it ticks me off when people propagate them:

• Good doctors realize that biological processes do not occur in a vacuum. A disease in the lungs might be causing the fever which is leading to the delirium. Medicine, when done correctly, is NECESSARILY a "holistic" approach. This does not mean that all doctors should be social workers, though.
• Many doctors do NOT rely on drugs. Most doctors are smart enough to understand that many patients can't afford to pay for drugs, and would rather not prescribe them.
• You're also over-estimating the average patient in the US. Do you know how many patients would RATHER take a drug? Curing certain illnesses is hard work - and some patients would rather just take a drug and take the easy way out. You could try to stop smoking by going to meetings and avoiding tobacco - or you could ask your doctor for Chantix. I would say that > 75% of the patients that I've seen would rather take Chantix. You could cure obesity by watching what you eat and by exercising - or you could take a pill or get surgery. MANY patients would rather take a pill, than go to Weight Watchers. Some of it is the doctor's fault, but some of it is the patient's fault too.

-I get squeamish at the sight of blood.

I totally don't get this. There are so many pre-meds who say "I get tunnel vision whenever I see a drop of blood," but then go on to insist that they'll be "fine" because they'll "just become a psychiatrist or radiologist or something." Because psych patients don't bleed/vomit/have diarrhea? Because radiologists don't have to get IV access? Because you can just skip the "bloody" rotations during third year by saying "Nope - I'm going to do psych!"? Come on.

-I don't really want to be a practicing physician. I would prefer to get my M.D. then go directly into working within an NGO in research and/or policy.

Then don't become a physician. I don't understand why you're conflicted about this...

Fundamentally, med schools are looking for future practicing physicians. Why subject yourself to the torture of med school if you don't plan on practicing it?

-Medicine doesn't really match my personality or interests all that well. I feel strange telling people that I'm going to be a doctor. A lot of my friends and acquaintances have remarked about how it is shocking and rather puzzling when I tell them I want to go to medical school.

-I don't know if medicine is necessarily what I'm interested in—I could be equally well-suited for social work, international relations/politics, anthropology, or sociology. I am mostly interested in learning about different cultures, how they interact with one another, and how we as a human race have come to be the way we are.

I think you answered your own question....

-I would like to eventually be a public health policy-maker and I'm not sure if becoming a doctor would be the quickest or most effective route to achieving that goal.

It isn't.

-I question whether making people feel better through the use of drugs would really be gratifying for me (especially since I think a lot of drugs are wildly over-prescribed and that humans should generally take more preventive measures—i.e. proper nutrition and fitness, good sanitation, stress-relieving techniques—to improve their overall health).

I would love to spend more time on preventive medicine - if there were funds for it. And if patients were receptive to it. One of my favorite residents on ENT always "busts" on scrub nurses who smoke. He's actually quite gentle about it, and during slow moments in the operation, he'll talk to them about how bad smoking is for them. (This is particularly true when he's operating on someone who has tongue or tonsillar cancer from years of smoking.) He'll offer to prescribe them Chantix, even, if it will help. The nurses just look at him like he's crazy, shrug their shoulders, and ignore him.

 

[Evee87]

This is a great post! Thank you! I think I may seriously take your advice into consideration for my post-graduation plans.

 

[Evee87]

Clarification: I would like to thank you all so much for reading my post and for all your awesome responses! Thanks especially to smq123 for such a thorough analysis (and for your bluntness!) Also gbennett and mpatricksweeney who are both in public health, your advice and testimony is much appreciated. I am seriously taking gbennett's advice (go get my MPH first, then decide if I want my PhD or MD). I'm so glad I made the decision to post on this site. You all are great!