Everyone thinks I love my job. They are right. I do…most of the time.
There are fleeting moments when I regret every decision I made after high school. On those occasions, I try my best to remember why I made those decisions. I try to remember why I chose medicine.
Half of the time, I end up okay. I relax and my joy for the work returns. The other half of the time, I continue thinking, entering a spiral of negativity that does eventually go away.
My pondering over the years has led me to settle on reasons why people should pursue medicine as a career and why they shouldn’t.
I want to share these with you.
REASON TO PURSUE MEDICINE #1: YOU GET TO TOUCH LIVES
I could fill a book with the stories of people whose lives I know I have touched. There are people alive now who would likely be six feet under if not for an intervention I made.
I remember an elderly man with Chronic Obstructive Pulmonary Disease, a sort of irreversible asthma. He was brought into the hospital early one morning by frantic relatives. He was not breathing.
I coordinated his resuscitation and got him to the Intensive Care Unit where I continued managing him. A few days later, he walked out of the hospital breathing normally.
I remember the gratitude in his son’s eyes as he shook my hand. I will never forget that.
Then there’s the story of the young child who had intestinal abnormalities which led to multiple abdominal surgeries. I recall carefully monitoring her care and making sure everything was done perfectly. A year after her recovery and discharge, her mother sent my colleagues and me a touching video of the young child saying hi and thank you to us.
Then there was the young woman with inoperable liver cancer. His condition was likely due to chronic hepatitis B which he contracted in childhood. I had no medications that could cure his disease, but I had words.
I helped him come to terms with his diagnosis, and reconcile with estranged family members.
I managed his pain and the complications of his condition. I helped him connect with palliative care resources. He passed away, but I helped him pass away in a better way.
The stories are many, and they all point to one thing. Medicine is a career path that will help you touch many lives in positive ways.
REASON TO NOT PURSUE MEDICINE #1: YOU WILL NOT CHANGE THE WORLD
I think many people fall into this trap. Clinical medicine practiced as it typically is worldwide will never change the world. If you want to change the world through medical science you need to be doing cutting-edge research, or public health and advocacy. The doctors in the consulting rooms help individual patients but their practice alone does not cause seismic world-shaking effects.
If you have grandiose ideas, or if you want to “heal the world”, clinical medicine might be the wrong move.
Nowadays many schools offer public health as an undergraduate course. Look into that if you love medical sciences AND want to create massive change. You should also consider governance. Of course, some doctors end up on that path after going through many years of medical training. However, I have learned that most of those people never enjoyed the clinical practice and would have chosen an alternative path earlier if they had one available.
REASON TO PURSUE MEDICINE #2: YOU WILL LEARN SOMETHING NEW EVERY DAY
I am a nerd. My favorite thing about medicine, by far, is studying. I enjoy learning new details. I have fun connecting new facts together in a perfectly fitting puzzle.
The human body fascinates me. I am intrigued by how the parts of the body are designed to work in harmony. I find it incredible how even a small change can lead to a cascade of logical abnormalities.
Medicine is all about learning. You will study hard to enter medical school. You will study harder in medical school, and when you are done, you will work and study longer and much harder in residency.
This is the field for you if you enjoy studying.
If the prospect of learning something new every day excites you, you should consider a future in medicine.
Bonus point: If everything I have said resonates with you, Internal Medicine is probably your specialty.
REASON TO NOT PURSUE MEDICINE #2: YOU ARE ALWAYS GOING TO BE LEARNING
It does not stop. Medicine is ever-evolving and we, as practitioners, must evolve with it or risk being stuck in the mud.
When I was in medical school, hypertension had a certain definition. The definition changed when I graduated. There was a certain way we approached treating Hepatitis B. That approach was changed this year (2024). We have new protocols now.
Definitions change. Medicines change. Protocols change. You will have to change. You must keep learning for the benefit of your patients.
By far the most frustrating thing (sometimes) is when you feel like you have finally mastered an aspect of healthcare and then someone comes along and points out depths you hadn’t considered before.
What do you mean we actually recognize 5 types of hypersensitivity reactions? Wait, type 5 is essentially a type of type 2…? Then…why?
That’s going to be your story. If you enjoy constantly being surprised, go for it.
For some though, constant stability might be more important. In this case, medicine might not be for you.
REASON TO PURSUE MEDICINE 3: YOU’RE GOING TO MAKE STEADY MONEY
It is hard to imagine a society without healthcare. It is harder to imagine modern society without organized orthodox medicine.
We live in an imperfect world. People fall sick. Accidents happen.
Doctors are always going to be in demand and that demand is likely to always outstrip supply. Pretty much every nation in the world is experiencing a shortage of doctors. Pretty much every nation in the world is expecting that shortage to worsen in the future.
Not counting exceptional cases, a doctor is always going to have a job. You will have a steady income for most of your life. As you age, that income is likely to grow.
If you live in a well-developed nation then you will do very well. If you live in a less fortunate nation, you should be comfortable.
Medicine is a great career to choose if comfort and stability are very important to you. You will always be okay.
REASON TO NOT PURSUE MEDICINE 3: YOU WILL NOT BE FILTHY RICH
If your goal in life is to make boatloads of money then stop right now. Say bye-bye to medicine. It is not going to work unless you live in a nation like Canada or the USA, and even then, you will never be a billionaire with just medicine alone.
Maybe you are okay with that. Maybe you believe (as several people do) that billionaires are inherently evil. If so, then medicine might work for you.
If you want to make loads of money, go into tech, construction, finance, or business.
Most nations finance healthcare through the government. Governments do not have money. They will pay you as well as they can. You are free to negotiate higher wages (and you should), but you will never be paid millions (by the government).
There you have it. 3 reasons to pursue medicine, and 3 reasons not to. I hope you have found this beneficial.
I have several more ideas bouncing around in my head. It is therefore likely that I will release a second part to this. Till then, enjoy your life, take care of yourself, see you later.
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