Why You Shouldn't Go To Medical School

Now I realise the people who frequent this site are either interested in studying medicine or dentistry, but I thought it would be worthwhile to post something that would give us med hopefuls a little less anticipation of Mc Dreamy and a little more stern reality. I found a blog about the experiences of a graduated medical student who decided not to practice and have quoted it here... obviously the author’s from America and so her “fee concerns” are only a reality if you’re going somewhere private like Bond.

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Why you should not go to medical school — a gleefully biased rant

Ali B - May 23, 2005 @ 5:59 pm ·

In the few years since I’ve graduated from medical school, there has been enough time to go back to medical practice in some form, but I haven’t and don’t intend to, so quit yer askin’, dammit. But of course, people keep on asking. Their comments range from the curious — “Why don’t you practice?” — to the idealistic — “But medicine is such a wonderful profession!” — to the almost hostile — “Don’t you like helping people, you heartless ogre you?”
Since it’s certain that folks will continue to pose me this question for the rest of my natural existence, I figured that instead of launching into my 15-minute polemic on the State of Medicine each time, interrupting the flow of Hefeweizen on a fine Friday eve, I could just write it up and give them the URL. So that’s what I did.
Now, unfettered by my prior obligations as an unbiased pre-med advisor, here are the myriad reasons why you should not enter the medical profession and the one (count ‘em — one) reason you should. I have assiduously gone through these arguments and expunged any hint of evenhandedness, saving time for all of you who are hunting for balance. And here are the reasons:
1) You will lose all the friends you had before medicine.
You think I’m kidding here. No, I’m not: I mean it in the most literal sense possible. I have a friend in UCLA Med School who lives 12min away, and I’ve seen her once — in three years. I saw her more often when she lived in Boston and I was in LA, no foolin’.
Here’s the deal: you’ll be so caught up with taking classes, studying for exams, doing ward rotations, taking care of too many patients as a resident, trying to squeeze in a meal or an extra hour of sleep, that your entire life pre-medicine will be relegated to some nether, dust-gathering corner of your mind. Docs and med students don’t make it to their college reunions because who can take a whole weekend off? Unthinkable.
And so those old friends will simply drift away because of said temporal and physical restrictions and be replaced by your medical compadres, whom you have no choice but to see every day. Which brings us to…
2) You will have difficulty sustaining a relationship and will probably break up with or divorce your current significant other during training.
For the same reasons enumerated above, you just won’t have time for quality time, kid. Any time you do have will be spent catching up on that microbiology lecture, cramming for the Boards, getting some sleep after overnight call and just doing the basic housekeeping of keeping a Homo medicus upright and functioning. When it’s a choice between having a meal or getting some sleep after being up for 36 hrs vs. spending quality time with your sig-o, which one wins, buddy? I know he/she’s great and all, but a relationship is a luxury that your pared-down, elemental, bottom-of-the-Maslow-pyramid existence won’t be able to afford. Unless you’ve found some total saint who’s willing to care for your burned-out carapace every day for 6-8 years without complaint or expectation of immediate reward (and yes, these people do exist, and yes, they will feel massively entitled after the 8 years because of the enormous sacrifice they’ve put in, etc etc).

3) You will spend the best years of your life as a sleep-deprived, underpaid slave.
I will state here without proof that the years between 22 and 35, being a time of good health, taut skin, generally idealistic worldview, firm buttocks, trim physique, ability to legally acquire intoxicating substances, having the income to acquire such substances, high liver capacity for processing said substances, and optimal sexual function, are the Best Years of Your Life. And if you enter the medical profession during this golden interval, you will run around like a headless chicken trying to appease various superiors in the guise of professor, intern, resident, chief resident, attending and department head, depending on your phase of devolution; all the while skipping sleep every fourth day or so and getting paid about minimum wage ($35k-$45k/yr for 80-100 hrs/wk of work) or paying through the nose (med school costing about $40-80k/yr). Granted, any job these days involves hierarchy and superiors, but none of them keep you in such penury for so long. Speaking of penury…
4) You will get yourself a job of dubious remuneration.
For the amount of training you put in and the amount of blood, sweat and tears medicine extracts from you (I’m not being metaphorical here), you should be getting paid an absurd amount of money as soon as you finish residency. And by ‘absurd’, I mean ‘at least a third of what a soulless investment banker makes, who saves no lives, produces nothing of social worth, and is basically a federally-subsidized gambler’ (but that’s a whole different rant, ahem).
I mean, you’re in your mid-thirties. You put in 4 years of med school, and at least 4 years of residency (up to 8 if you’re a surgeon). You even did a fellowship and got paid a pittance while doing that. And for all the good you’re doing humanity — you are healing people, for godssakes — you should get paid more than some spreadsheet jockey shifting around numbers, some lawyer defending tobacco companies or some consultant maximizing a client’s shareholder value, whatever the hell that means.
Right? Wrong. For the same time spent out of college, your I-banking, lawyering and consulting buddies are making 2-5 times as much as you are. At my tenth college reunion, friends who had gone into finance were near retirement and talking about their 10-acre parcel in Aspen, while 80% of my doctor classmates were still in residency, with an average debt of $100,000 and a salary of $40,000.
5) You will have a job of exceptionally high liability exposure.
But wait, it gets better. Who amongst these professionals has to insure himself against the potential wrath of his own clients? The investment banker’s not playing with his own money. And even if he screws up to the tune of, oh, hundreds of billions of dollars, Uncle Sam’s there to bail him out (see: World History, 2008-2009).
The lawyers? They’re doing the suing, not being sued. But the doctors? Ah. Average annual liability premiums these days are around $30,000. That goes up to $80,000 for an obstetrician-gynecologist (who remains liable for any baby s/he delivers until said infant turns 18) and into the six-digit realm for neurosurgeons. Atul Gawande wrote a dynamite article about docs’ compensation in the 4 May 2005 issue of The New Yorker entitled Piecework — check it out.

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Ali Binazir » Blog Archive » Why you should not go to medical school — a gleefully biased rant

I obviously can't comment from personal experience, but I'll just quietly point out that the differences in the health systems of the USA vs. Au/NZ are, erm, vast. Sure, a lot of the concerns raised in that blog are valid (if dramatised at times), but it sounds like working conditions are a little better down under than they are in the states...

I remember reading this blog, a few months ago when someone put it up on whirlpool. Obviously the $$$ related points are not valid here. But still, (despite the bias) a good read and something I did take into consideration when accepting an offer (points 1, 2, 5, 6, 7 and 8).

The US system involves far fewer years training, and ultimately, doctors can make a heck of a lot more once they've earned their stripes (when compared to staff specialist wages in the public sector here). The oft-made suggestion that things are harder WRT money and training in the US is misleading.

By stating that consequence 'x' "WILL happen to you" she is implying that 100% of medical students/doctors will experience or have experienced 'x' at some point in their career. I firmly disagree.

Her propositions all seem like personal statements about experiences that she had to endure throughout her career. This doesn't mean that every person undergoing the same path will irrevocably suffer similar consequences. Lets look at a couple of examples:
1) You will lose all the friends you had before medicine.
What if you met those people through a leisurely event (like a book club, sports club, knitting club (?) or some other non-med related event). Being a doctor would still permit you the option of attending social gatherings after work. In fact, its necessary to keep you level-headed and sane!
But let's be generous here and grant the proposition true. So what?! Life is all about change. You win friends, you lose friends. Life goes on. At the end of the day, if you feel fulfilled doing what you do, then losing a few friends really is not the end of the world. And just to put things into perspective, let's say that you had 20 close friends that you lost after deciding to pursue a career in Medicine. There are 7 billion people in this world. 20/7,000,000,000 = a very, very, very small fraction of the worlds population. There will be other people.

2) You will have difficulty sustaining a relationship and will probably break up with or divorce your current significant other during training.
3) You will spend the best years of your life as a sleep-deprived, underpaid slaveRead self-help books on time management, balance and maintaining healthy relationships in demanding times. Your significant other could also be very patient and understanding. To flat out claim that "you WILL have difficulty" is rather presumptuous.

Some of the subsequent issues are more grounded in monetary factors which I don't really consider worth any appraisal.

Judging by the style of writing and over-dramatization, I'm inclined to think that the author is (or perhaps was at the time of writing the article) rather emotionally unstable. A successful career in Medicine (imo) requires an optimistic outlook on life, resilience and the ability to regulate emotions which seems rather lacking in this authors experience.

Just my $0.02

I posted this answer on BoS to the same topic so I'll copy/paste it here:

1. This one depends on how well you manage your life, some do it better than others. Make an effort to keep in contact and you should be fine.
2. See 1.
3. Actually, this is mostly untrue in Australia. Sleep deprived...Maybe. Underpaid, arguable. The base income I think is 55k AUD a year in NSW at the moment and is slated to rise in coming years - from what I heard, most interns (first year grad) will pick up around 70k ish a year on average in Aus including bonuses which isn't too bad for a fresh graduate. The average pay for a consultant is around 270k AUD per year depending on your source. Medical school with HECS costs 40k AUD TOTAL, not per year.
4. This is a deeply personal question that you'll have to ask yourself. Are you satisfied with what you're getting from what you do?
5. Reality of the profession these days.
6. Learn to look after yourself.
7. Welcome to reality.
8, 9, 10 - Seems like someone is getting over dramatic. A lot of this isn't true.

Take what you will but remember that article is written from an American context and perspective which will be different from what we experience here. The hospital and health systems are completely different and ultimately med isn't for everyone.

Hmmm... all of those doctors who have broken marriages and relationships (higher than the national average).... all of those who struggle to hold together a good work-life balance - it's largely because they lack sufficient strategies, or that they're "emotionally unstable"? What a lovely thought: just invoke a few simple coping mechanisms, and all will likely be well.

Originally Posted by chinaski

Hmmm... all of those doctors who have broken marriages and relationships (higher than the national average).... all of those who struggle to hold together a good work-life balance - it's largely because they lack sufficient strategies, or that they're "emotionally unstable"? What a lovely thought: just invoke a few simple coping mechanisms, and all will likely be well.

I wouldn't exactly label it a simple strategic approach, but I believe it can done with some patience, effort and marriage/relationship counselling.

I would respectfully suggest that such approaches are incredibly simplistic. In a nutshell, it's a bit rich for people who aren't even doctors to be speculating about the comparative ease of juggling life and a demanding career they are yet to experience. This is not a criticism (I certainly don't expect people to fully comprehend the situation until they are in it); just an observation, and perhaps a warning for others not to think they are above the stressors that negatively affect countless souls ahead of them. If it were so simple, everyone would be coping magnificently. It is perhaps far more constructive to think about why they are not. Puzzle me this: why is the work-life balance issue so frequently alluded to in the context of a medical career? Why is it such a huge problem?

Originally Posted by chinaski

I would respectfully suggest that such approaches are incredibly simplistic. In a nutshell, it's a bit rich for people who aren't even doctors to be speculating about the comparative ease of juggling life and a demanding career they are yet to experience. This is not a criticism (I certainly don't expect people to fully comprehend the situation until they are in it); just an observation, and perhaps a warning for others not to think they are above the stressors that negatively affect countless souls ahead of you. If it were so simple, everyone would be coping magnificently. It is perhaps far more constructive to think about why they are not.

With all due respect, I would like to emphasise that I never claimed that the work-life balance would be easy to achieve. On the contrary; I imagine it would be a very difficult task indeed. However, the tone of the article suggests that this work-life balance is almost an impossibility, which I must disagree with.

Your point about my lack of experience is well taken.