I spent three years trying to get into medicine, two years learning it, and the past one year thinking about leaving it.
ok the real life was not so drama, but I needed a good intro ;)
Learning potential and work-life
I want to prioritize learning skills, improving myself and accumulating career capital, at least in the early part of my career. However, as I went through the clinical school curriculum, I realised that a large chunk of time would have to be spent on rote memorization. To me, memorization is often the least useful way of learning, especially of random details that are not organised in a systematic way (such as the various numbers in clinical guidelines). I know I will easily forget about them in the future if I do not choose the clinical speciality, and no trace of my effort will be left. In contrast, informatics projects are built on top of each other; even if some details were forgotten, the projects could be made into products with actual benefits, and live forever in my portfolio.
Even if I decide to finish medical school, I am not sure about medicine as a full-time career. A big chunk of being a doctor is mundane paperwork that provides little room for growth. I am also worried about the opportunity for developing interpersonal relationships in medicine. There is a clear professional boundary between doctors and patients. As I value developing long-term friendships, this might be another pull away from medicine (maybe less of a problem for private practice). Should I specialise, if I am interested in digital medicine? Specialization is great in making an expert but experts can be blinded from other aspects of healthcare. It is nice to have a hammer, but not every problem is a nail.
The broader context of decision-making
I must consider the broader context that influences my thoughts. The decision to study medicine was my own, but it must have been guided partly by people around me. It is difficult for me at age 16 to know exactly what career I want. Even if some students saw the mundane side of medicine, it seemed bearable since students were also learning things mostly for the sake of getting selected into a good undergraduate course. However, the university gives me the freedom to explore subjects like engineering and to be surrounded by Olympiad gold medalists who had chosen a subject that improved their thinking and not just knowledge. That made a world’s difference in skills and career adaptability - even just after two years of training. They can analyze problems with partial differential equations, and I got acquaintance with Sir Krebs and his amazing cycle that I have also forgotten. On the other hand, leaving medicine has become a fad because of the boom of entrepreneurship and content creation, so I might have been subconsciously encouraged.
Of course, I need to care about my standard of living. As a student, I find myself stressed about money from time to time. All I want is a job that provides enough income so that I can focus on what I enjoy the most (which can be my work). As my Engineering friends graduated, reality crept in. Some of them are getting jobs at finance firms with £200k+ starting salaries and planning to retire at 30, and some get jobs at software firms with (more standard) £60-80k. I did not maximize my earning potential by shopping around for jobs, so my summer’s data science internship pay in the public sector is at the lower end, but it is already higher than a junior doctor’s pay. These pay discrepancies across different sectors frustrate me because the type of work they do is mostly the same. In fact, I would argue that firms that pay better are also more established and therefore offer better career training pathways - in other words, they learn faster (at least at particular skills). The tech firms are also much more transparent and results-driven - again, better for self-improvement. So why on earth would someone want to spend three years and £180k+ international medical student fees to start a job that’s paid less and offers less learning?
The bright side
And yes, there are reasons why one would do that. For one, learning medicine can (sometimes) be really fun. Even when I go to the hospital as a patient, whenever I introduce myself as a medical student, the doctors are all super excited about teaching me, and I really enjoy the clinical reasoning and decision-making. Medicine can also be really fulfilling (sometimes, also in the right speciality). I can never forget the time when I was still young and impressionable - when I pushed a patient back to his family and the joy flowing through my blood by knowing that the patient can probably live 10 years longer because of an afternoon’s work by the surgeon. This level of human touch and trust is rare. Besides, medicine can allow for more autonomy as compared to corporate jobs after age 30, once one becomes a senior doctor and starts their own private practice. Moreover, I cannot ignore that medicine is a really safe career option - the kind of safety which one could rely upon even during a world war. I mean, if I were to be put into a concentration camp, hopefully, I would still be given the potatoes in the soup if I were a doctor whom the guards would need. This kind of safety, thinking as a financer, should make up the majority of one’s portfolio. Then one can add entrepreneurship as a high-risk high-return kind of endeavour. Last but not least, while going into finance will probably make the most money, it is harder to visualize the actual impact as compared to building a startup. And if I still want to work on health tech, perhaps getting to know the healthcare system a bit more will be a better idea. Of course, I have to think about how much clinical medicine I need to know for what they want to do. Training till 80 will probably give me the most clinical insights, but is this really what I want?
Making a career that I want
Of course, one may cry (myself included), what exactly do I want? This is exactly the problem. I know I want to make good healthcare available to the mass on demand, but I do not know how to get there. I believe it needs someone or a team with scientific, technical, clinical, and business skills, but what is the right mix? Sadly, no company puts up advertisements to hire a business-minded graduate with both medical and engineering degrees - which would exactly match my profiles. Wait a minute, maybe that is where a problem can also be an opportunity. No pre-made job for my profile is disappointing, but it indicates an opportunity for innovation. Someone needs to marry data science into healthcare and do it at scale so that my dream jobs can be created. Maybe that person can be me :)
Market opportunities and career training come hand-in-hand. A great job market does not live independently from a great market. When we build attractive health tech ventures as healthcare providers, someone will develop a new way of training clinicians with technical skills with less emphasis on rote learning, and someone will offer the trainees my dream jobs on demand. But it will not be that exciting anymore, since the groundwork has been laid. Such a career will also NOT be that secure anymore: if someone can be trained by a system, they can also be replaced by the system.
So yes, there are a lot of factors to get my head around: learning, work-life, pay, and impact. Decision-making would have been easy if we could predict the future. But prediction is hard, especially about the future :P.
My current plan is to go to clinical school to learn enough clinical insights to be useful as a clinician in interdisciplinary collaborations, and to become familiar with the healthcare system for future entrepreneurship. I have never let schools dictate my education, so I will carefully examine what I need to learn and learn them well. While queuing in the medical career path, Meanwhile, I will work on informatics projects with real-world impact - I expect these to take off but am not exactly sure when, and perhaps another decision needs to be made when that happens.