What I Wish I Knew Before Applying to Study Medicine

I’ll never forget the morning I received my conditional offer letter to study medicine at The University of Nottingham.

Getting into medical school was this huge campaign that had become my life for the previous 18 months.

I ticked all the boxes in this well crafted plan to do everything I could to get ahead of the competition.

And one random winter weekday morning whilst I was alone in the house that fateful letter arrived… “Congratulations…Pleased…Conditional Offer”

Each individual word lifted my hopes until my brain finally confirmed the full message.

Then I celebrated by running around the house singing Lionel Richie “All night long!”— for reasons still unbeknownst to me.

The relative scarcity of med school places to the amount of applications made me feel like one of the special few. I’d made it into the ultimate career.

The idea that we were ‘elite’ was built into us from day one of med school

Being a Doctor was a status symbol and that meant doing everything you could to get it and keep it.

Medicine vs your Health

The problem is that if you’re not conscious, this prestige can cloud your judgement.

You'll progress through a career that demands more and more of you until you have nothing left to give.

It can easily become a matter of surviving the insane conditions in this career rather than thriving.

And survival is also about out performing competitors.

If everyone else is coping then you better be able to cope too.

No one wants to be the only one who couldn’t hack it so you end up pushing yourself too far damaging to your health in the process.

The moment I started working as a junior doctor the reality of the nightmare hours and shift patterns hit me like a tonne of bricks.

Having sickle cell meant the stress I was under made my crises flare more frequently.

But I kept pushing myself in spite of this because I didn’t want to appear weak, I wanted to maintain my identity as an unbreakable Doctor.

It was mainly my physical health that suffered but for many its their mental health.

The negative emotions and stress we endure control our lives and eat away at our most vulnerable areas over time.

Last week the NHS decided to cut funding for the Practitioner Health Program which provides counselling and mental health services for doctors.

It just blows my mind how insensitive and out of touch society is with our emotional well being as Doctors and Health Care Professionals.

Its like sending soldiers to fight in wars and then when they return with PTSD just being like;

“Oh you saw you best friend get decapitated?”

“That must have been pretty hectic”

“But its all good right, because at least you have the Prestige of being a Soldier!”

You can’t put people in traumatic situations under immense stress and pressure and then just ignore any negative consequences of that.

People literally kill themselves trying to maintain the prestige of being a Doctor.

There’s a reason why Doctors have one of the highest suicide rates of any profession.

Repressing Emotions

Healthy competition makes EVERYONE perform better.

Unhealthy competition makes a minority perform better—

Everyone else just gets various degrees of Anxiety and Depression but keeps plodding along anyway.

To add to the pain most of us are also nice people.

We want to help people less fortunate than us, relieve peoples suffering and use our skills for good causes.

We are taught to repress our own emotions and ignore the effects of stress on ourselves.

We’re not allowed to have feelings because the patients, the people who are really suffering need us.

There’s no teaching on how to cope with the inevitable stress and emotional carnage of being a Doctor in med school.

No one wants to admit that they aren’t coping until its already too late.

Our basic needs take a back seat to patient care and upholding the public perception of the profession.

It’s a culture of wearing the stress and strain as a badge of honour.

If you can’t cope then you get spit roasted ideologically:

• (Competition) you are not good enough and go down in the rankings for jobs.

• (Self worth) you fail in your mission of helping people

Self Actualization > Prestige

More people are searching for purpose and meaning in their jobs today than in the past.

Self worth comes from within yourself rather than being attached to a job title.

You can read my previous letter about self actualization. Read here

As you can see from the pyramid Self-Actualization is above both esteem needs

A self actualizing person does not care about Prestige.

When you progress to the goal of self actualization you become free from the need for Prestige.

You start to see your medical career for what it really is.

You can make a real judgement as to whether the good outweighs the bad.

Then you can be at peace with whatever decision you make rather than complaining and living in doubt and bitterness.

In recent years the idea of Doctors in the UK being well respected has started to deteriorate.

It was only a couple of years ago I covered locum shifts for a GP who had been hospitalized by a patient that didn’t get what they wanted.

Junior Doctor, Consultant and GP contracts are all evidence of a profession that is significantly undervalued.

Does the historical prestige justify the current working conditions?

Should doctors really need to strike to justify their worth?

We need to get with the program its not 1948 anymore, Nye Bevan is long gone and evil forces are now working to see the NHS fail.

How to see the truth of your Career Choice

The short answer- Reflect, Reflect, Reflect

Many people avoid reflecting because they are scared of change.

They are scared they may find something that puts them in the uncomfortable position of fighting between:

• The crystal clear awareness of needing to change.

• The fear, risk and effort of actually taking action.

They are too focused on their life as it is right now and how its been for however long.

This is the mental barrier that prevents them believing they have the capacity to take action.

I delayed doing any serious reflection for years because I knew deep down my medical career was killing me.

But I didn't want it to be true because of the fear of change.

Don’t delay the inevitable.

3 Modes of Reflection

• Journaling

• Meditation

• Coaching/Counselling

Journaling

• Journaling is a great way of expressing your thoughts.

• Writing thoughts down is more powerful than simply thinking them inside your head.

• Writing is a clearer way of thinking

• Once you get into the flow of writing you capture those fleeting but important thoughts.

• These are the elusive thoughts that cause the light bulb moments and expose the truth.

Meditation

• Meditation is a way of increasing your awareness of thoughts

• Whilst we may normally only be aware of the tip of the iceberg. Meditation helps us see the body which produces it.

• Meditation can help you think more critically and non-judgementally about why you feel a certain way rather than just beating yourself up or beating other people up on Twitter.

Coaching vs Counselling

Its important to differentiate these 2 important interventions.

They are similar in that they both involve answering questions asked by another person.

But differ in their goals.

Train Track metaphor

Your life is a train journey passing from one station to the next as you progress towards your full potential.

Most people get to a certain station in life and then just stop there for various reasons:

• They don’t know which station to go to next

• They don’t think they have enough fuel to get to the next station

Coaching helps people decide where to go next and empowers them with enough fuel to get there.

Some people stop because they have broken down or fallen off the track, they can’t move even if they wanted to.

Counselling helps them get back on the track.

Therapy repairs their broken engines.

Alongside journalling and meditation I believe Coaching and Counselling/Therapy are essential for people trying to live healthy and fulfilled lives.

Whether you pursue a medical career or not should be based on a clear understanding of your values and your health.

Not because of a job title and Prestige.

Summary

I’ve discussed the factors which inappropriately influence people to embark on and persist in medical careers, these include:

• Scarcity: A psychological principle that makes any opportunity appear more enticing

• Competition: The evolutionary drive to survive and outlast others.

• Prestige: As per Maslows hierchy of needs, humans need to feel esteem from others and self esteem. The title “Doctor” provides this.

I’ve discussed how medical careers are a cause of a great deal of trauma and ill health but people wait until its too late to seek help.

Martydom: The desire to help people is prayed upon by a system of increasingly harsh working conditions and cultural changes that force us to play the Martyr.

I’ve discussed how to overcome the influence prestige and see the truth of your career choice.

Self-Actualization: Cultivate purpose and meaning within yourself and you won’t need to seek esteem from job titles which are prestigious but damage your mental and physical health.  

Reflect, Reflect, Reflect

Thats all for now

Lewis

P.S

I help Introverted Doctors Escape Career Stagnation by being True to Themselves.

If you or anyone you know needs help, click here to book a free call and we can talk it over.

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