This year has been a challenging one to be in medicine. In truth, “challenging” is quite the understatement, and words like “impossible” and “traumatic” come to mind. Our already taxing jobs with high burnout and depression rates were compounded with a pandemic where we have seen people die at rates we have never dealt with before, right now at 1 in every 1,000 Americans. We have not had (and still do not have) proper protective equipment, we continue to deal with surges and shortages of ICU beds, and we have worried, for very real reasons, that we, too, could die from COVID-19. And, the inequities and racism in our system has been exposed by the pandemic time and time again, even affecting our own physicians, as the recent death of Dr. Susan Moore highlights. If any of us still harbored that same idealized version of medicine that might have drawn us to it when we applied in college to “help people,” by now it would be nearly impossible for that image to remain the same today.
That is why as someone who likes to be honest and real, but also wants to be a mentor to women in medicine, when I was asked to give a lecture to an undergraduate Women in Science class about my career and going into medicine this year, I hesitated. I instantly remembered people telling me in college not to go into medicine because of paperwork or insurance stressors and feeling like everything people were telling me was negative. But, I also felt they never took the time to understand me, or how my feelings factored into any of it. I didn’t want to be that person for someone else, and either discourage their dreams or come off whiny about the career. I also wanted to still be authentic. Balancing the two felt much harder right now.
I decided to speak to them honestly about how I hated basic science in college and never really felt like I fit in in medicine (and still don’t). I came up with 5 tips that I wish somehow had told me, basically some advice to my younger self. It included the following:
1) Take Time to Figure Out What You Like, and Always Question It: I very much believe that the way we teach medicine and apply (and have prerequisites to apply) for medical school, we never have time to truly ask ourselves if this is what we want to be doing. Even me, when I took a year off after college to work in health policy, I was still applying to medical school at the same time. It was not like I ever got off the path to becoming a doctor and took a breather to ask myself what I was doing and why, even though so many times along the way I wondered if it was right for me. I told them, and would tell you, that questioning the career is necessary. If you could see yourself doing something else and being happy doing something else, you should consider it. You should make sure you are doing this very long and involved career for you and because you want to, not because someone told you to, or that is what smart people do, or science people do, but because you want to truly be a doctor. There is also no time too late to question it, and you can ask yourself at any point along the path. Of course, you will feel more stressed the later you ask, but that does not mean you are stuck. You can always, always question it.
2) Study and be Interested in WHAT YOU WANT: Throughout college, I remembered people saying to all of us in advising that we had to major in a science (or at least minor in one) to get into medical school. When I was in college, I hated premedical classes and could barely stand being in them. I found the people in them too competitive and stressful, I dropped biochemistry twice, and honestly found solace in the small, discussion and writing based classes of anthropology and public health. I became an anthropology major (and got a Masters in it) because of that balance and even with people telling me to take more science, I didn’t do it, because it was not interesting to me and it wasn’t required to get into medical school. I simply stopped listening.
When I said all of this in front of the students, from their questions it was clear that this is still the same message they are getting today: science majors have more success in medicine and getting into medical schools. We claim we want diversity in medicine and that needs to include background, field of study, and thought. College should be a time of exploration academically, and if that leads you to loving something else, that is more than ok. You do not need to choose between subjects (you can be a writer AND a doctor, or like history AND medicine). You will not be a worse doctor because you like English, in fact, you probably will be a better one.
3) Be Yourself Every Step of the Way, Even If People Think You Aren’t Science/Medicine “Enough”: There are a lot of times throughout my college and medical school career that I can remember feeling like I didn’t fit in because I didn’t like basic science or enjoy anatomy. Or, because I wanted to go home and write instead of go to a surgery shadowing opportunity. This feeling was only reinforced by advisors suggesting I do more “science” related things or pushing me to fit more into the mold. Sometimes I even still feel like that- as a pop culture loving, freelance writing, psychiatrist. But, I think it is important for everyone to realize that medicine needs people to be themselves and bring those parts into medicine. Along the way, it might feel a bit harder to stay the course and not configure yourself into their mold, but in the end, I at least feel a lot happier as myself (and think you probably will, too).
4) Advocacy is Essential to Medicine and Can Be Part of Your Job: Advocacy is not a prerequisite to apply to medical school like research is or shadowing is (though it should be). It is not even something most medical schools encourage or teach. But, if this pandemic has taught us anything, it is that advocacy in every single way that we can use our voices publicly, including writing, social media, op-eds, and other forms of media, is critical to our jobs. If we cannot advocate for our patients and ourselves in the public arena, misinformation continues to be rampant with no counterarguments and is very dangerous. Plus, celebrities and politicians are taught to better spread it. We should value the part of us that wants to use our voice and give back and not silence it, which often starts in college if not before.
5) Taking Care of Yourself, Including Understanding Yourself, Is Key to Survival and Success: Finally, I encouraged them to be more aware of themselves and their own emotions earlier in their studies and careers. I noted that if I had learned better coping skills in college, I might have been able to apply them more readily in medical school for test taking or rotations when I noticed I had more anxiety or felt more strained on self-care or sleep. Learning your triggers and coping mechanisms earlier helps you be resilient and helps you adapt as you face more and more stressors along the way. Yet, I also strongly encouraged them to go to therapy as I believe it helps you better take care of patients to understand your own past and reactions, but also, simply, is a place to go to have support when you need it. Learning the value of therapy early in your career is critical in my opinion, especially given the stressors on our mental health as physicians over the pandemic.
After I finished the lecture, I received a few e-mails in my inbox. They were truly the most beautiful e-mails I had ever received. The theme of all of them was that I was the only person who had ever told them they could stick to a non-science major, or writing/journalism and still do medicine. They even said that they would stay in their non-science majors, because I showed them, they didn’t need to choose. That is exactly what I would hope for, that they, and anyone reading this, stay themselves, and keep their interests, and if that still leads them to medicine, that they infuse it with their diversity of thought and our field becomes all the better for it. We need it, especially now as we fix the broken pieces of a broken system and our broken selves and try to put it back together, hopefully better and more equitable and mental health conscious than it was before.
Jessi Gold, MD MS
Assistant Professor of Psychiatry, Washington University in St. Louis
Dr. Jessi Gold is a guest writer for InCrowd. You can read more about her on her website: drjessigold.com.