It’s better to not go into medicine than try to get out of it

“Passion isn’t a path in the woods. It is the woods.”
-Tom Robbins, “Half Asleep in Frog Pajamas”

I’ve met plenty of accidental physicians. These have been photographers, travel writers, artists, outdoor guides and chefs who awoke one day to find themselves doctoring. Their passions didn’t die — they were just delayed by lifestyle choices. By the time they recognized a need to follow their passion, they were at least partially through residency and carried the twin burdens of medical school debt and the expectations of medical culture.

Through knowing these people, themes surrounding why they chose medicine have surfaced:

  • They misinterpreted their understanding of the path to becoming a physician to mean that they should become a physician — that because they understand the path, it must be the right one.
  • The lifestyle or career they really want has a less clear or a riskier path. They play it safe, do the responsible thing, make their families happy and pursue medicine while postponing their genuine interests.
  • They make the mistake of perceiving their lives as fragmented pieces they can “balance” rather than the whole that it is. This ultimately drives them to the conclusion that they can be a doctor by day and a [blank] on the side.

What I wish I could say to myself as a pre-med

There is comfort in understanding the path to becoming a physician. There is security in having an endpoint that is understood by the people whose opinions you value. The problem will arise when you discover that comfort isn’t always a good thing and these choices primarily affect your personal happiness, not your family’s. Identify who you’re trying to please. Have this conversation early and move on. The conversation about why you aren’t going into medicine is much easier to have than the conversation about why you’re leaving it.

The path to medicine can end with the worst form of comfort. It leads not only to no growth but no motivation for growth. As a physician, you will have job security, financial stability, and status — it becomes easy to set auto-pilot and marginalize your personal development, or worse, neglect it. When you are a physician, your work it isn’t neatly compartmentalized in such a way that you can do eight hours of work and eight hours of play and finally achieve balance. There is no “balance.” The whole thing is your life and should be accepted completely. Planning to balance your life by postponing what you want doesn’t represent a more mature, responsible decision — it represents settling. It will lead to great dissatisfaction.

Pursuing a career you understand but do not feel passionate about is a safe and seductive compromise. A career where the path is challenging but clear. Forging a path toward something you like and failing is better than succeeding on a clear path toward something you don’t.

Medicine isn’t dating. It’s a marriage with seven kids with and intrusive in-laws. If one is getting married but thinking about when they can see their ex, they probably shouldn’t be getting married. They can divorce and pursue their ex, but it won’t be easy or cheap. When you sign up for medicine, you’re signing up for a lifestyle.

If you are looking at medicine as a means to do the thing you really enjoy — stop. Go do the thing you really enjoy. Do not plan on being half-present as you make your way through medicine. Don’t endure the training so you’ll have the time to pursue what you really love. Pursue it now. You’re not talking about a menial job — you’re agreeing to a way of being where people’s lives are dependent upon your competency, decisions and commitment. This is a service-oriented, patient-centered lifestyle.

If you don’t really want to be here, don’t be — go make your own path and do the thing you want to be present for.

David Beran is an emergency physician.

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