A prospective medical student asks for advice

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A prospective medical student wrote me this, and below is my response:

I am currently an engineer working for _________ . I graduated with a degree in Chemical Engineering in 2014, and I am now in my first job out of college.

I have been working toward a career as a physician since high school, and took some time to get out into the world and work prior to jumping straight into medical school, to ensure that medicine is the proper path for me.

I have been accepted to medical school, and if I decide to go that route, I will begin school this August.

My intention for writing is to quell some of my fears of entering a broken system. Like you, I am also a proponent of the Austrian School of thought, and I am training myself to become as well versed in economics and sound thinking as I am able, so that I am armed when entering the healthcare field.

I am facing the decision as to whether or not I should go to medical school, or continue my career as an engineer. I know that I am the only one that can answer that, but my hesitance comes from the fact that I am leaving behind what could be a career with far fewer headaches and less bureaucracy, and voluntarily entering a field that is full of both. I seem to hear nothing but doomsday-type scenarios and complaining for healthcare professionals. Is there any hope for me, or should I turn the other way while I still can?

I personally know doctors who are bogged down by government standards and bureaucratic nonsense, and I am curious as to how you deal with this? I understand you run a private practice which gives you far more control over the outcomes of your profession.

In addition, what do you think the future will look like for my generation of physicians (I am 24 years old), and the healthcare environment in general?

Lastly, are there any healthcare specialties that are less directly impacted by many of the issues that plague the current system?

Don’t get me wrong, there are countless meaningful reasons why I do want to be a doctor one day (so don’t take my uncertainty the wrong way!), but I am having trouble getting my head around these issues, and I feel the need to tackle them head on by sharing my thoughts with you.

Any advice would be great – and I will continue to do as you advised in an earlier post to incoming medical students – READ, READ, READ!

This is the biggest decision of my life (so far), and I am fortunate to have found a like-minded thinker in a profession in which I have much vested interest.

Thanks for taking a bold stance – I will continue to stay Alert & Oriented!

Regards,

My response

Hi ____

Thank you for your kind comments.  My thoughts:

Your sense of unease is very healthy.  I would be concerned if you did not have any unease or qualms.

You are correct that the field is extremely bureaucratized and the autonomy of physicians increasingly limited.  In that sense, medicine is very unattractive, especially since there isn’t much hope–as far as the system is concerned–for significant improvements in that regard.  In addition, the economics are unfavorable, particularly if you end up with a lot of school debt (which you should try to avoid as much as possible).

That said, medicine can also be a very strong calling, and may still be the right choice despite the terrible system.  As you said, only you can decide, so my advice is for a lot of deep introspection, and for you to reflect on whether “you see yourself” or identify as a doctor.

If you do, and if you think not being a doctor could frustrate a longing, then you should probably go for it.  And since you are “alert and oriented,” I think you stand a much better than average chance of having a very good profession.

As the system gets more bogged down, I believe that emerging free market opportunities will increase, and it is possible that, in a few years, it will be easier for med school graduates to follow a trail that minimizes the encumbrances of the system.

For example, I came across of a family residency program that trains resident in the direct primary care model.  That will make setting up a reasonably enjoyable practice much easier.  On that note, the surest bet for an enjoyable career in the foreseeable future is family practice and other primary care specialties.  These specialties are most adaptable to private practice.

That said, I think it will also change for other specialties, but to succeed as a specialist on the free market demands a certain reliance of specialization that can only come with years of work experience.  Hard to imagine a specialist starting a private practice from the get-go.

You should also keep in mind that a number of MD’s can go on to have fulfilling non-clinical careers, but it’s harder to plan for those at this stage.  Careers outside the country may also be possible, if you had no objection to doing that (but those are also more difficult to plan for or bank on at this time).

Hope that’s helpful.

And I hope that’s helpful to other prospective students!

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