“Why do you want to go to medical school?” This question is the logical starting point for a basic conversation between a pre-med student and his or her advisor; or a medical school admissions interview. In my own five years as a pre-med advisor, I must have posed the question a thousand times. Yet, the responses I got only rarely varied from what seemed to be a script. More often, I received the following response, verbatim: “I’ve always loved science and I want to help people.” I believe the elements of the response were generally spoken with sincerity, but the sentiment only scratched the surface of the much more interesting stories I knew were underneath.
I am the daughter of a physician who practiced internal medicine in a small town for nearly forty years. Like him, I always wanted to help people, but unlike him, I am squeamish. I became a counselor and social worker. Eventually, I found my way to pre-med advising, where I could apply my skills and experience to help young people aspiring to a kind of life I knew well. After all, I grew up observing and admiring the practice of medicine.
My father impressed upon me the importance of careful diagnosis. He taught me that the good medicine was and always would be dependent upon the taking of a good history, and conducting a methodical, thoughtful exam. The most important tools at a physician’s disposal were his or her hands, laid carefully where needed, and ears, listening attentively to the person in the room or in the bed. In my advising office, I came to see that the metaphor of the doctor-patient relationship held just about true to the relationship between advisors and their students. To the extent that I could listen, I could help.
In the spirit of diagnosing the problem before offering a treatment, I think it is important to hypothesize why so many pre-meds cite an axiom (being ‘good at science and wanting to help others’ as the reason to become a doctor) as if it is a revelation. In my opinion, the pat nature of the oft-stated rationale derives from one or more of the following: 1.) The idea took shape early in childhood, 2.) The image is usually inspired by a role model caring physician; 3.) The notion was reinforced by cultural or familial expectations; 4.) The plan was not questioned, and provided a definable path in an uncertain world; 5.) The formula coincided with an incident of illness in one’s family or community, generating a general desire to “fix it.”
Again, there is nothing inherently wrong with aspirations cultivated in childhood. There is much to be gained from having heroes who inspire us. Family and cultural traditions can be a source of pride and continuity. The desire for stability is understandable. And personal experience can be a great motivator. But when these are long-ago planted seeds; or seeds planted by someone else; or when the soil hasn’t been tilled; the blossoms that follow will be less robust than they could be. They will fall short of reflecting the depth and complexities of the college student who is his or her own person, on the brink of applying to medical school. Genuinely motivated pre-med students can and must clarify for themselves and for eventual interviewers why, according to all available current data, they are heading down the arduous path to medical school.
So, how can you develop a more fully realized claim on the path you are choosing? The Rx is relatively straightforward. With a little bit of further introspection and/or some probing by trusted advisors, most pre-med students actually can and do go deeper. I believe that by asking and being asked pointed questions, you can discover the authentic sense of purpose required for the supremely difficult journey of becoming a physician.
Here are five kinds of questions that I believe can help you identify and articulate for yourself-and for anyone else who asks-a more nuanced and authentic raison d’etre for pursuing a life in medicine:
Have you exposed yourself to other options and considered other paths?
Students who open themselves to the possibility of other directions my affirm their medical intentions, or they may discover roads less travelled. Either way, undergraduate summers and breaks can be the perfect opportunities to test the waters. Pre-med students often operate with the misconception that every waking hour should be sent in a medical setting. To the contrary, time spent comparing other options is time well spent in the interest of clarity and self-awareness. And realizing sooner than later if one has a different calling is only for the good, too. Occasionally I had a student come in to apologize to me that he had an internship in finance or a job in government that he loved, and did I think it was okay if he left the pre-med fold. There are no apologies necessary. Ask yourself what other paths you could follow.
Have you encountered obstacles that challenged your resolve but yet you persevered?
A physician’s life will inevitably be punctuated by failure and loss. While the magnitude of a doctor’s responsibilities cannot be approximated, a pre-med student can and probably should have some experience with disappointment and adversity, and some demonstrated capacity to rebound. While you may assume academic perfection is the gold standard for pre-meds, resilience is arguably the currency of greater value. I generally didn’t worry about the motivated student who stumbled on a C in Orgo but showed up in my office to strategize about a game plan in response. I worried a lot about the student who got a B for the first time in her life and thought she would have to become a lawyer instead. And in some ways I worried more about the students whose lives were untouched by pain than those who fought a range of demons to find themselves in my office. Ask yourself how you have confronted your own vulnerabilities and what you know about your capacity to rebound.
Can you distinguish between your own desires and the expectations of others?
I often wondered, “Whose dream is this anyway?”. Many brilliant and capable students are also accustomed to pleasing their families and fulfilling perceived expectations. It is critical to be choosing the path of medicine intentionally and not merely obediently. I often received phone calls from parents who clung tightly and lovingly to the goal of having their children gain acceptance at a top medical school and become a physician. Sometimes it was about following in the family footsteps, and sometimes it was about blazing a new trail. Either way, these parents had all kinds of questions for me. In some cases, I had never, and would never meet their children. Happily, college students can vote with their feet and if the pre-med dream belonged to mom or dad alone, then I consider it a victory that the child went his or her own way. It was harder when students who had not yet differentiated their parents wishes from their own. That is work that needs to be done long before an AMCAS application is in the works. Ask yourself whose dream it is.
Have you had recent exposure to the realities of clinical practice and/or research?
Many students overlook the need to gain practical experience with clinical and research environments as an undergraduate. Spending long days and nights in the trenches with sick children is a whole different enterprise than just “loving kids.” The tedium and precision of the lab may or may not be tolerable to every self-professed lover of science. A casual exposure in high school does not provide sufficient data for a decision about the rest of one’s life. Whether you volunteer stacking band-aids in a hospital or you get a formal job in a clinic, it matters what you see and how it makes you feel, not so much what you do. If you are considering a life in medicine, you just have to find a way to spend some time up close and personal, in more than one setting, before you commit. Ask yourself if you can envision yourself as the doctors you are observing.
Are you developing passions and relationships that will provide balance in your life?
Students often asked me whether or not it was a good idea to keep doing activities they loved that fell outside the formal requirements of preparing for medical school. Athletics, arts, study abroad, and humanities coursework fell into this category of, “Is it okay if I…?” My answer was almost always that not only was it okay, it was actually essential to have creative outlets that would allow expression seemingly unrelated to medicine. When alumni physicians came back to our campus to share their journeys with current students, I always asked, “What would you do differently if you could do your undergraduate years again?” What I heard was, “I would take more art classes… I would not have traded being on the football team… I would have studied abroad…” Medical school and life beyond it will place all kinds of demands on your time and energies. Ask yourself if you are cultivating the habits of mind, heart, and being that will replenish and sustain you for the long haul.
The choice to become a doctor can be a choice to dare greatly. There is nothing wrong with being good at science and wanting to help people. Of course you are, and of course you do. But if you dig deeper, you will likely find much richer story lines – and your most compelling truths. Hard questions are the best medicine. Most importantly, deep inquiry will increase your self-awareness and self-confidence as a pre-med student. Possible side effects include being much more memorable on your interview days.
About the Author:
Jess Deutsch, EdM,MSW was a pre-health advisor at Princeton University from 2008-2012. She is now an education consultant in private practice, advising students and parents on a wide range of topics in secondary and higher education, with an emphasis on authenticity and balance. Her services to pre-med students and parents are intended to augment campus resources for academic planning, interviews and AMCAS personal statements. Students and parents may contact her at Jessica.firstname.lastname@example.org.