While some of what you write makes sense, I'd suggest that if you have no passion in life and just want to make it day to day, then medicine is an extraordinarily bad choice. It is not a good day to day job. It's a job that is hugely consuming -- will such up much of your twenties during school and residency, and then require you to put in long hours, always keep reading, always need to keep abreast of the changes in your field. You will never get to the point in your career when you can safely say, I'm done with the learning phase, now I can just put in a normal week and enjoy myself on the weekends. You will in all probability be working 60+ hours a week in almost any specialty, and expected to be informed on the various field specific articles/studies. It is simply not a good job to be putting in your time until you can go home. There are plenty of jobs where that's the mindset -- where you don't need to keep learning, don't need to put in crazy hours during training, aren't held to such liability, aren't expected to pass relicensing exams and keep up to date on current changes and developments. They aren't in the professions, but they exist in abundance. If your goal is to make it day to day, then that is a much smarter direction.
As for telling folks -- you can always do a ROAD specialty -- that's just not going to be true for most of the class at most schools. I'm pretty sure I wouldn't advise someone looking at med schools to go if their sole goal was derm or rads. Because most likely they won't get it. About half of all folks going to med school are going to realistically have to decide between primary care, and other noncompetitive things. And a lot of the hours in those things aren't as good, nor is the pay as impressive. But if you are going into medicine because you like the idea of being a clinician, find it interesting, like working with people etc, then sure, it might be a good fit, because even on the down side you probably will be able to satisfy these sentiments.
I don't think you need a "passion" for helping people, or have known since childhood that you wanted to be a surgeon, etc. But I do think that when you are picking a path that requires 4 weeks of schooling, plus 3-7 years of residency (during which you may be working 80 hour weeks), plus possibly a fellowship, before heading into a practice that still probably requires 60+ hour work weeks, you have to like it. You cannot look at it as a "live for the weekends" or get through day by day kind of job. This is going to be the majority of hours of your awake life for the rest of your life. You have to really like it.
Folks who have no choices in life take the 9-5 jobs where they do something they don't care about and live for the weekends. They are basically "doing time" until they die. Folks who get into med school do have choices in their life, choices many americans don't. They are among the top educated folks in the country, with good grades and lots of doors open to them. When you are in that situation you HAVE to find something you enjoy and go with it. You are foolish if you figure -- well, this is safe and stable so I will "do my time" here. You are squandering the opportunity to find and do something you find enjoyable and fulfilling. Saying "I have no passion for anything" is really just saying you didn't take the time to figure out what you have passion for. Everyone has likes/dislikes -- you just have to spend enough time figuring out what they are. Lots of premeds don't, because the science courses, research and ECs eat up a lot of time in college. But it's a big mistake. Sorry, but I read the first post in this thread as a bit of a cop out by someone who didn't spend the time necessary to figure out where their passions lay.
I don't think the question is really should you go into medicine as just a way to twiddle the time away till you die. Rather, I think the question is how easy medicine is as a career to enjoy and how do you know if you'll enjoy it.
It is very difficult to get a good sense of what clinical medicine will be like before you enter the field. Even my friends who had parents in the health care fields said they were surprised by what it was like. Given that many medical sub-fields require effectively 80+ hour a week until you die, going to medical school if you think you have to go into one of those is a huge gamble. On top of this, there as so many negative aspects to practice modern clinical medicine or surgery (mostly stemming from fatigue, but also including bureaucracy, ungrateful/uncompliant patients, lawsuits) that, in my personal opinion, it actually becomes the minority of people who can actually look past all this stuff and truly love what they do. If I were a pre-med today and I knew from advice that 1) it's very difficult to get a good sense of what medicine is like before you do it and 2) odds are you'll wind up hating day to day life, I would make the rational decision and not enter the field if I didn't have some romantic drive that compelled me to do it.
Similarly, primary care fields is filled with so many daily hassles that despite the better lifestyle, most practitioners are pretty miserable, even with the good hours and decent salary (as compared to the vast majority of the population). What I've seen when working with the primary care folks is hours upon hours of arguing with insurance companies, massive amounts of paperwork and billing forms to fill out that need to be frantically written which can actually take up the majority of their day, and scores of patients who are just looking to get you to fill out their disability forms/perscribe pain meds/won't take their insulin/etc. It thus becomes difficult to enjoy your job.
It's actually a bit of shame to me. My personal driving motivation in life is research, but after an academic career is over, I think I would quite like to go to a small down and be the local "doc," caring for the community. However, there seems so much hassle in primary career that I don't think I could deal with it all unless the system changes substantially.
There are, on the other hand, fields of medicine that are easy for most of the population (at least the population applying to med school) to enjoy on a work-a-day basis. These fields are the ones mentioned above where you either get to focus on more on patient care like you would as a surgeon or internist without the fatigue and overwhelming lifestyle of a general surgeon, cardiologist, etc. These are fields like otolaryngology, ophthalmology, endocrine surgery, anesthesiology, etc. There are also fields like radiology and pathology that allow you to focus on learning and problem solving, which very much appeal to folks like me.
Now, while many of these fields are difficult to get into (holy crap, have you looked at the derm match stats!), I think it does a disservice to paint them as impossibly difficult to get into. Hell, 70% of those with a board score between 180-190 got into gas and passing is 185, and most average US med students could probably match into ER or rads if they wanted to. The difficulty, of course, is how do you know if you'll be average? Well, you don't. Med school is really, really damn hard and your competing against really, really smart people. However, if you have average grades and MCAT scores along with a good work ethic, I don't think it's unreasonable to think you'll be average in med school. Outliers will of couse exist, but that's a risk I think is reasonable to take, especially compared to the uncertainty in other fields of human endevour these days.
On a more philosophical note, I think the notion of passion is pushed a bit too hard on us. Back in the day, everyone seemed to advise me that I needed to spend two years on a desert ranch meditating to learn about myself and what I wanted to do. Well I did something along those lines, tried a lot of different jobs and fields, and what I learned was, well, I'm a pretty mellow guy who enjoys learning and could probably be happy doing most things. I now seem to have found my niche in the world and am pretty darn happy in it. Do I have the drive to do it every waking moment of the day? No, not really to be honest. Is it fun enough to spend 60 hours a week on without regret? Hell, yeah. I think there are a lot of opportunities in medicine like that.
I do think you need that drive in certain areas of this field or you will be miserable, but there are certainly areas in medicine where if you just want a cool job, you can get that as well.
