Advice to Third Year Medical Students

Given all the complaining by doctors about change, it comes as no surprise that medical students are having self-doubts and questioning their career choices. I interact with all kinds of students at various stages of their undergraduate and graduate careers and they seem to fall into three categories—those that can't wait to get into the game, those who have doubts about their choices but are too paralyzed with fear and anxiety to do anything or keep it to themselves, and those who quit to do something else. Maybe they missed my advice column when they were a premed.

Here's what I tell medical students if they are silly enough to ask me:

1. The opportunities presented by a dysfunctional system makes this a great time to be an agent of change. If you think taking care of patients is hard, wait until you experience trying to treat the status quo.

2. You, like many, had an inadequate job preview when you started thinking about applying to medical school in high school. I certainly did. It's a lot like an arranged marriage. You don't know what you don't know and the more you learn, the less you know. The good news is that the success rate of arranged marriages is substantially higher compared to self-choice.

3. There are many who have felt like you at your stage of education and are now happy despite “the system.”

4. There are many ways to add patient defined value without seeing them face to face for the rest of your career. In most instances, though, you will need some clinical experience to do so.

5. You could be looking at a 40-year career or longer.

6. Don't feel guilty about self or career doubts. It comes with the territory.

7. What's past is past and is a sunk cost.

8. You may, in fact, not be cut out to do what you thought you wanted to do or someone expected you to do. As a third-year med student, I would give yourself more time to be aware of whether that is the reality or not. The answer will become apparent sooner than later. Take heart in knowing that most of your fourth year will be spent away from it all looking for a job. Consider it an informal gap year to catch your breath.

9. Find a mentor who can be supportive.

10. Having a warrior mentality will come back to haunt you. Find the people who want to help you and graciously accept it and thank them for it.

Here are some other thoughts if you decide to stick it out.

While you may feel alone and abandoned, the medical educational establishment is realizing that they are placing a generation at risk by not accommodating your emotional needs and doubts. It might be hard to find help and reconcile the mixed messages you are getting, but seek the solutions that are there.

Life as a third year, when you are just beginning to get a sample of the complexity, challenges, and opportunities in clinical care, is much different than life as a resident or a practicing doctor. Each comes with its own requirements to adapt. Generations have done it in the past, and most will continue to do it in the future and it is most likely that you will part of them. I'm glad I was.