Blog | Thursday, February 7, 2019

Why are there still so many students flooding into medical school?

It's no secret that physician job dissatisfaction is soaring to unprecedented levels, with over 50% of practicing physicians reporting burnout. While many factors have contributed to this epidemic in America over the last 20 years—not least of all electronic medical records that are taking a heavy (and unacceptable) toll on physicians' time—this is not a phenomenon unique to the United States.

I went to medical school in the United Kingdom, and have many friends still working in the country's National Health Service. My own opinion from listening to them and watching the news, is that morale is far worse over there than in America, primarily due to everyone having a uniform single sole employer (the government), and that employer harshly renegotiating contracts over the last several years. I'm sure every other country has their own problems as well.

Which leads me to my next point: Medical school is as tough as it ever has been to get into. Applications in both the US and UK remain at historically high levels, and the profession remains one of the most competitive to get into. This despite all these students knowing full well that there's great job dissatisfaction among practicing doctors. Not to mention also being fully aware of the financial burden they are going to take on. In this world of online media saturation, it's impossible not to know this. So why the dichotomy? Is it because medical students are still at an idealistic stage of their life, with TV drama expectations of what life is like as a doctor (something I've talked about before in this video)? Is it because they think things may change by the time their turn comes around? Or do they simply not care, and believe that the unprecedented job security is worth it?

I actually remember back when I was a student right before medical school, watching a British TV show (think it was on the BBC, and may have even been called “Doctors”—such an original name!). The show tracked a group of students applying to medical school, and followed them over 15 years to the top of their careers. Some had become hospital specialists, others general practitioners. It was a fascinating show that I wish I could dig out and watch again. I remember them starting really enthusiastic when they got into medical school. Sadly, after 15 years, most appeared jaded and overworked. I recall a fellow student at the time, who also wanted to become a physician, remarking to me how depressing it was. But it didn't deter us—we wanted to become doctors and save lives! This was also at a time when the government in the UK gave physicians more freedom, and well before the age of social media. It was therefore easier to pass off as an isolated phenomenon, which wouldn't apply to us.

Truth be told, despite the challenges of frontline clinical practice today, I have absolutely no regrets whatsoever choosing medicine. It has allowed me to travel the world, grow as a person, gain perspective, and meet some amazing people along the way. When it's about true patient care, and serving them to the best of our abilities, few jobs could be more personally rewarding. But at the same time, it's a career that's certainly not for the faint hearted. It's physically, mentally and emotionally demanding. I recently read an article which was discussing this very topic: burnout and why medical schools are still so full. There was an interesting comment at the bottom that went something like this: Clinical medicine and patient care in the trenches is tough, no matter where you are. Even without any external forces. It's just a fact of life.

As long as everyone knows that, there shouldn't be any surprises.Suneel Dhand is an internal medicine physician, author and speaker. He is the founder of DocSpeak Communications and co-founder at DocsDox. He blogs at his self-titled site, where this post first appeared.