Why We Go to Medical School—and Why We Stay

Magda Sime, Fourth Year Medicine

The question I dreaded most in my medical school interview was, “Why do you want to be a doctor?” My anxiety around this question made me doubt whether I was making the right decision in applying. I believe that only a select few people have a deeply profound and specific reason for choosing a career in medicine—and I was certainly not one of them. I hadn’t grown up dreaming of taking this path. I made a last-minute, arguably uninformed decision based on an idea of what I thought I wanted my adult life to look like, and a feeling I had during my work experience when I was barely sixteen. For a long time, this didn’t feel good enough—especially when I was surrounded by would-be medics who had grown up equating their entry into medical school with destiny.

The “why” of medical school plagued me, as I struggled to answer it for myself, let alone for others. I spent the better part of two years hoping no one would notice that I wasn’t entirely sure what I was doing. Luckily, not many people did ask. For the most part, it makes sense to people why someone would decide to go to medical school; the assumptions and stereotypes of a medical student—smart, overambitious, self-sacrificing—can quickly be assigned to you as soon as you mention it.

Anyway, I wasn’t asked why I was choosing to go to medical school in my interview. Instead, I was asked to talk about a moment when I had questioned or doubted my choice to study medicine. I presumably spoke about my dreadful BMAT score and how I hadn’t let it squash my conviction—which was a lie; my conviction had been squashed. The irony now is that, after four years of medical school, I could fill a book with moments and days when I’ve questioned my decision to study medicine.

When asked, I often describe medical school as one of the most humbling experiences a person can go through. I could tell you about twelve-hour shifts, shivering on train platforms, waiting patiently—and desperately—for my presence to be acknowledged. I could tell you about the look a surgeon gives you when you answer an anatomy question wrong, being disoriented by Passmed, and the desperation that comes with waiting for an end-of-placement form to be signed. I have cried. I have experienced burnout. I have seen patients belittled—often women in pain—and I’ve been belittled myself. Any one of these days would be enough to make many people reconsider whether medicine was the right choice. But in reality, it’s all the days in between the truly awful ones—balancing revision, getting lost in hospitals, waking up before the sun, being confused by emails—that build up to create a stressful life. Even before anything goes wrong, my day can feel longer and harder than the days of some of my non-medic friends.

In a recent conversation, when I asked a consultant why he had chosen his specialty, he answered by telling me that the first thing he’d have any medical student reflect on is whether they actually want to be a doctor in the first place. We both laughed, and he went on to tell me how much he loves his job as a gynaecologist—but I couldn’t help but hear his joke as a warning. As the bureaucratic challenges of the NHS increase—with the added uncertainty of foundation jobs through random allocation, worsened further by the invention of placeholder jobs—and as competition ratios for specialty training get dramatically worse, the question has shifted from “Why go to medical school?” to “Why stay in the medical profession?”

In many ways, medical school put me at ease; I found that I loved what I was learning. It has helped me grow more confident and less fearful. I’ve found more open doors than closed ones. I understand the medical profession better now—well enough to know I didn’t know a thing when I started. Most importantly, I’ve learned that a doctor’s abilities often lie more in how they communicate than in what they know. There is such privilege in being a witness to some of the worst and best moments of people’s lives.

Despite all the bad days, there have been plenty of good ones.
Four babies have been born under my watch—all baby girls, all younger sisters. I was one of the first people to hold them, wipe them clean, and keep them warm. The day a surgeon ordered me to hold out my hands and dropped a tumour into them was, weirdly, nearly as thrilling as the day I was first handed a newborn. I’ll remember the morning I spent on the complex chemotherapy ward round, in awe of how smart the doctors were; the day I first intubated a patient; having my hand squeezed by a woman during her contractions; and my first successful cannula. Other good days have been spent in the park with friends, celebrating small victories, running mock OSCEs in someone’s house, and pretending to study in coffee shops.

We all have reasons for why we chose to study medicine, no matter how complex or hard to express. These reasons are not static; they change as we do—growing with our understanding of ourselves and of the profession. Doubt is often a sign of overthinking rather than indecision, and it doesn’t take away from the reasons behind our choices. Some days, I think I know why I’m here; I’m simply not reminded of it every day.

Medical school, with its constant push forward, rarely gives us time to consciously reflect on our motivations. Yet motivation is exactly what I’ll need in the coming years, as I prepare for my final exams and begin work as a foundation doctor.

Some days, I’m sure I don’t know what I’m doing. And on others—I know exactly why I’m here.