Do I or don’t I….go to medical school?

Because finding an image for this post was too much work after I wrote this. Credit: XKCD.com (my one true love)

I’m going to make an even further departure from my regular theme of posts as I’ve been getting a few emails from readers who are looking for career advice; and my answers have had some consistent themes, so why not exploit that and make a blog post out of it, right?

The questions I generally get have to do with choosing one, or a combination of three career paths:

1) Go to medical school
2) Go to grad school
3) Become a trainer/nutritionist plus or minus #2

Eric Cressey has written an excellent viewpoint on deciding between an undergraduate education in Exercise Science vs not: (Here and here)

His perspective, I find, is mostly financial; but that’s not say that it’s a bad or incorrect place to view the issue. However, that’s not really the crux of my advice on deciding where you should go.

Most people who are writing to me have questions about #1: medical school. They want to decide whether they should go into medical school, or pursue a career in either training or coaching or research. They’re fueled by their passion in fitness and nutrition. They’re almost always young.

So the first piece of advice I always give people before I go into why they want to do what they want to do is this:

Can you actually get into medical school?

Picking between option A and option B depends entirely on whether A and B are actually available to you. The admissions criteria for every medical school are different from one another—sometimes by a lot. I probably applied 5 times to get into medical school (only 3 of which I really took seriously; a story for another time.) By the third time, I really dug hard into figuring out how to work within the system. I discovered that no matter what, I would never be able to get into about 4/5 of the medical schools in my home province because their admissions criteria just didn’t play into my favour. If I wasn’t a physician today, I would STILL not be eligible for admission in 4/5 of those medical schools.

So before you ask whether you should do A or B, you should first figure out whether it’s actually possible for you to do A or B, because after some homework, the answer might surprise you. It might be that your GPA is just too low. Or that you don’t have the pre-requisite courses (and you may or may not be willing to take those courses to get them); or that the way they decide the “GPA cutoff” is by only averaging pre-requisite courses that you would have to refresh to get higher grades; or that you don’t meet the MCAT or GRE cutoff (wait, you HAVE taken the MCAT, right?)

If you’re trying to decide whether to go to medical school or become a trainer, and you haven’t taken the MCAT, haven’t looked into the admissions criteria of the schools you’re interested in attending, then you’re making a illusory choice. It’s like asking, “Should I buy a bag of M&M’s or a small tropical island?” If you don’t have the resources to buy the island, you’re stuck with M&M’s (which is not necessarily a bad thing.) And if you’re trying to decide “Should I commit to buying a bag of M&M’s or a small tropical island IN THE FUTURE?” it’s still an illusory choice, because you don’t actually have the resources to do either of those things right now, which then turns your choice into a choice of preference or goal-setting.

The funny thing about preference and goal-setting is that it’s not static. When you make a goal, it’s an ephemeral thing that you construct in your head and then use to make future decisions. “Should I take organic chemistry?” gets answered “Yes,” because you’re guided by, “I want to go to medical school.” You can, at any time, choose to move your goal. So if you end up taking organic chemistry and failing organic chemistry, the question, “Should I take organic chemistry again?” isn’t necessarily, “Yes,” because you might change your mind about how badly you want to go to medical school.

So my second piece of advice when people are struggling with whether or not to go to medical school, is:

You don’t have to commit until you actually get a letter of offer from a medical school.

You can, believe it or not, toy with the idea of going to medical school. Or grad school. Or becoming a trainer.

Remember when you were a kid, and you wanted to be a fireman, or a teacher or a movie star? Remember what happened to those? Maybe you’re one of the rare ones—you knew from the youngest age you can remember that you wanted to be an X, and now you are an X (which, unless X is “doctor”, why are you reading this? And if X _is_ a doctor, you’re already a doctor. Why are you reading this?)

If you’re like the rest of us, X changed yearly, or more. For some, X changed because they lost interest. For others, they realized it wasn’t realistic to be a rock-star/architect/princess. And perhaps more realistically, X changed because we realized that we just didn’t meet the requirements for the job or the training, whether by financial, emotional, psychological, intellectual or physical constraints. Not everyone, no matter how hard they dream or how hard they work, gets to be an Olympian. Or an astronaut. Or a princess. Sometimes, you allow the dream to pass; other times, the dream is taken from you. Either way, until it’s a realized dream, it’s just a possibility. Change is possible.

This isn’t to say that you shouldn’t dream or have goals; but I think I meet far too many undergrads who have laser-like focus on medical school to the exclusion of everything else. I haven’t figured out how to tell if it’s because that’s what they really really want, or because they see it as their only ‘safe’ career option. Ultimately, the qualities that make up what people tend to think of as a good physician have more to do with someone who has breadth of life, than lasered focus (unless, you are, in fact, working with a medical laser.)

I’ve had the fortune of making so many wonderful friends from all sorts of places: doctors, dentists, lawyers, teachers…but also actors, directors, artists, entrepreneurs, trainers, athletes. My friend’s cousin makes diving documentaries. He gets paid a nice amount of money to go scuba diving with a camera! For every physician I know, there’s another job where I think to myself, “Man, my guidance counsellor really had a limited scope of knowledge…”

If you marry yourself to a career that doesn’t exist yet, two things can happen:

1) The disappointment of not achieving that goal by your self-defined target date is ego-crushing.

2) You could miss out on an opportunity that brings you more fulfillment than you realized.

In the first, getting into medical school (and even grad school) is something that is largely not under your control. There is a lot of luck and alignment of random factors that has to happen. This is even more so with getting into a residency program of your choice. The sooner you realize this and give up the idea that your ‘medical career fate’ is actually in your hands, the happier you will be in the long run. Investing (emotionally, spiritually, intellectually) in a goal over which you have little control is a great way to ruin yourself.

A common rom-com theme is the one where the protagonist chases after the unattainable object of their affection while their true love is by their side the whole time. In every story, there is a kernel of truth. And so, in the second, consuption of your life whilst missing your “true love” should not be entirely dismissed. Maybe medicine is your true love. Maybe it’s not. There’s only one way to find out; and what I’m saying here is that you _can_ date around before you marry medicine. It not only makes you a more well-rounded person as a whole (which also, actually makes you more attractive to medical schools,) but it can also confirm your decision to commit whole-heartedly to one path or another; and also if/when you become a physician, innoculate you a bit against well-entrenched medical perspectives that, at times, are really outdated, or have simply outlived their usefulness.

You can, in fact, become a trainer who then goes to medical school. Or you can go to grad school and then decide to go to medical school. You can totally do the opposite too; go to medical school and decide medicine isn’t for you and totally change career paths. I think a lot of it just depends on what presents itself to you. The idea that you have to lay in a course, go to warp 9 and commit fully to make it, I think, does more harm than good. Even Star Trek: Voyager stopped along the way before they got home (I mean how boring of a series would that have been otherwise, eh?)

Lastly, my in-general advice about deciding to apply to medical school has more to do with developing as person than it does as a trainer as an alternative. The road to becomine a physician is quite long. And once you embark on that road, while it’s not impossible to take a break from it, it generally a continuous road. As with all endeavours, there is a cost to all decisions (which seems to be the overarching theme of my entire blog.) I think the overlooked costs to entering medical school are the ones that have very little to do with career.

While lots of doors open when you get into medical school (if you think deciding to go into medicine is hard, just wait ’til you have you have decide on a specialty,) a large number of doors also close on things that you might not have considered as being ‘important’. I think sustained travelling is one of those doors. I think sports or arts above any level other than “hobby” is another. You do hear about medical students and residents who were somehow capable of starting and building businesses or high-level non-medical skills, but I think, by and large, those people are truly outliers (and not in the Malcolm Gladwell sense,) and the idea that you’re above average (though that is usually what is required for medical school admission) quickly falls to the wayside when you’re just trying to get enough sleep in time for your next night on call.