Last year, I was asked to speak about medicine alongside two doctors at my old high school’s careers evening. Collectively, we touched on the topic of medicine being an incredibly fulfilling career; we expanded on the many amazing aspects of the role. We all said the cliche of “it’s a vocation, not a job”. But there were a few things I really wish I had had the chance to say, because they were things - important things - that I didn’t learn until after getting that acceptance letter into medical school.
A lot of people go into medicine because they care about people. But sometimes you’ll care too much. Some days, you’ll lose your grasp of that fine balance between clinical detachment and empathy, the distinction between your professional and personal time. You might find yourself waking up, stressed, at 6am to call the nurse to ask if they remembered to do an important blood test on patient X, because you have a feeling that it wasn’t clear enough in the plan. Or find yourself ruminating at night about the minor fluctuations of your patients’ infection markers. When your patient coughs on the ward round, it’s not a harmless tickle in their throat. What you’ll hear is pneumonia, sepsis, potential postoperative complication.
A lot of people go into medicine because you get to help people. But sometimes you can’t. Often, there’s no solution to their problem. Or you’ll try to help them and inadvertently cause them harm in the process (iatrogenic harm occurs more often than you’d expect). Or the team will pull off that big risky operation to cure the cancer, but the cancer will recur in several months’ time and the patient doesn’t survive anyway. Medicine is humbling; you’ll learn very quickly that there are limits to human intervention.
A lot of people go into medicine because it’s a good, secure job. Things most parents and high school advisors don’t tell you about working as a doctor: there is a staggering amount of paperwork; you often don’t get paid for working overtime or for doing extra work when your colleague(s) are sick; you may have very little control over what cities you can live in for more than a decade of your life while studying/training; and physician suicide/poor mental health rates are alarmingly high.
A lot of people go into medicine... and then leave the profession. Because there are easier, fulfilling careers that are more appealing even with the sunk cost of 6 years + of study and a student loan exceeding $100,000. And there is no shame in walking away from a job that asks so much of you on a daily basis. No matter what crisis is going on in your personal life, no matter how racist or unreasonable a patient is being towards you, no matter how little sleep you’ve had or how many days you’ve worked in a row, there’s pressure to put on a perfect, professional front. It’s an enormous pressure that can definitely and understandably make people’s compassion wear thin.
The people who go into medicine and stay in the profession do so having faced, and continuing to face, many of these less attractive, inherent parts of the job. They’ll befriend futility, become close companions to moral complexity, embrace humility and keep going. They’ll find in the deepest parts of themselves enough reasons to get them out of bed every day. One exhausted surgeon told me that there was nowhere else they’d rather be than in the operating theatre. Another doctor said that they stay for their patients.
You have to be a wildly hopeful and hardworking person to be a doctor. But that doesn’t mean that all wildly hopeful and hardworking people should become one. If you do pursue medicine, do it understanding why it’s a vocation and not a job. And know more than anything you will need resilience. Much more resilience than it takes to get that acceptance letter into medical school.Support Villainesse