Reconsidering a Career in Medicine

  • /Reviewed by: Amy Rontal, MD
  • It takes some courage to reconsider a major life decision made long ago but for some of us it is a necessity. Many chose a career in medicine from a very young age — sometimes childhood. As passionate as this may seem, it also begs the questions: “How thoughtful was this decision?” and “Have I changed as a person since this decision was made?”

    For every person, the reasons for choosing medicine are different but there are some commonalities: a desire to help others, a secure and rewarding job, respect from the community, and, let’s be honest, it makes our parents happy.

    Here’s the twist though: a life and a lifestyle in a medical career has changed over the past 20 years and sometimes the idealized vision of this life is no longer accurate. The truth is often less glamorous: residencies are harder to come by, competition is greater, billing amounts are decreasing, office days are longer, malpractice cases are soaring, and burnout and physician suicide are very real problems.

    I have seen many talented and motivated students reach an impasse in the pursuit of a medical career; typically this involves going unmatched repeatedly or being stuck on an exam for years.

    Here’s where a brutal reevaluation is necessary. Expenses accumulate, money is not being earned, student loans garner interest, and there is a real personal cost to keeping life in a suspended state for a long time. Major depression is common, a state of apathy takes over, and persisting in this situation can have serious psychological effects.

    Here are the counterarguments (and their counterarguments!) for reconsidering a career in medicine:

    1. “I’ll never pay off my student loans unless I become a doctor.” —A very compelling argument. Most licensed physicians are paying off loans for 20 years after becoming board certified.
    2. “I’ll never forgive myself if I give up. I’m not a quitter.” —Another profound statement. Sometimes quitting is reevaluating and repositioning life goals in the light of experience and wisdom.
    3. “I’m so embarrassed I didn’t stay on track like my classmates.”—It is tough. We are not all on the same journey and most journeys are not a straight line.
    4. “I don’t know what else I would do.”—Yes. If you spent 18 years planning a career in medicine there are no handy alternatives until you spend some time thinking. What else are you good at? What do you love? It will take some time to come up with options; this is normal.
    5. “My parents will be so disappointed”—I agree. You have all invested a lot in this process. But if the process becomes harmful and unhealthy then it cannot continue.

    In closing, please take care of yourself and your psychological health. Be sure this is still what you want even though the money, prestige, and security are not what they are idealized to be. And please remember, you are a unique individual with more than one talent; what else might you want to bring to the world and your life? Who else could you be? What would life look like? Change can be beautiful.

    Further reading:

    The Psychology of Physician Burnout

    Managing Anxiety in Medical School

    Discussing Burnout – Dr. Neha in the Hot Seat