Is Medicine the Right Path?

Part of Before You Commit. If you read one thing here, maybe read this. It's the page I most wish someone had handed me before I applied.

If you're anything like I was, first in your family, low-income, maybe an immigrant or the child of one, there's a good chance you didn't really choose medicine. You drifted toward it by gravity.

I understand that gravity completely. My father drove a taxi. My mother stayed home. Neither of them went to college, and there wasn't a single doctor, or an advanced degree, anywhere in our family tree. In a family like mine, "my child is a doctor" isn't just a career. It's proof that the sacrifice was worth it, that all those extra hours added up to something the whole world respects. It's stable and honorable. It translates in every language and every country. For people like us, choosing medicine is one of the most rational bets there is.

So I won't talk you into it. What I'll give you is the one thing nobody gave me: permission to actually ask whether this is right for you, instead of assuming it by default and finding out ten years in.

First, let me try to talk you out of it

When students ask me to mentor them, I usually start here. Medicine is a good profession. I don't want fewer people to enter it. I want to make the choice harder to romanticize.

Medicine asks for years of delayed freedom, repeated exams, physical and emotional stamina, and a willingness to do unglamorous work for people who may never know your name. It can narrow your options for a long time before it expands them. If you want the status, the family approval, or the idea of helping people more than you want the daily work itself, those motives may not carry you through the cost.

That is useful information, not a test you fail. The point of this page is to help you find it before the commitment gets expensive.

Every career is fraught. Every one carries a cost that isn't advertised in the brochure. Medicine's costs just happen to be quieter than most, and the people selling you premed advice have every reason not to mention them. So I will. Not to scare you, but to trade the fantasy for the real thing, so that if you choose this, your choice survives contact with reality.

What it will actually take from you

It will take a chunk of your life you don't get back. Your twenties, often your early thirties, go into training. While your friends are buying homes, traveling, getting married, taking their weekends, you'll be on call. I missed weddings. I missed moments in my closest friends' lives that don't come around a second time. And my body paid its own quiet tax, years with no time to take care of it, and some of that hasn't come back. Time and health are the currency here, and you spend them slowly, for years, before anyone hands you anything. Go in knowing that.

The system will try to break you, and sometimes it succeeds. I want to be careful and honest about this. Physicians and trainees carry real, elevated rates of burnout, depression, and suicide. People are not weak for struggling under that pressure. I hit my own low point as a resident. I lay awake questioning my own worth. Am I actually smart, or did I just fake my way here? Do I even know what I'm doing? If any of that is hitting close to home for you right now, please know that support is out there. You are not the only one who has felt it. (If you're in crisis in the U.S., you can call or text 988. This is a real part of the path.)¹

The hours are the hours. Residency is capped at 80 hours a week, and that's the cap, brushed up against routinely, with 24-plus-hour shifts stacked on top.² There were nights I drove home so exhausted I was fighting sleep at the wheel. That's what "training" actually feels like from the inside.

Even getting sick can feel like letting people down. I remember having COVID during residency and feeling awful about calling in sick. I knew someone else would have to come in and take care of my patients. If I did call out, I felt like I had to defend how sick I was, as if being ill needed to be proven before it counted. I felt sheepish. I felt unfair. Someone else would have to cover for me, and I knew that person was probably already tired.

That is what training can teach you if you are not careful: your own needs become an inconvenience, while everyone else's needs feel like an emergency. A normal weekend can start to sound luxurious. In residency, a golden weekend means getting both Saturday and Sunday off in a row. Two ordinary weekend days acquire a name. Four days off in an entire month can feel like a good schedule.

There is a difference between accepting that training is demanding and pretending this level of sacrifice is harmless. You should know how quickly the culture can turn rest into guilt, especially when the service is understaffed and every absence creates more work for the people beside you.

There may not be a clean off switch. This does not mean every physician works every day or that every specialty has the same life. Some doctors build genuinely predictable schedules. But medicine can make it difficult to forget your responsibilities completely. During training or in a call-heavy specialty, your pager can go off at any moment. A patient can become sick overnight. A colleague can call because there is no one else available. In an outpatient practice, the pager may become an inbox: charts to finish, messages from patients, refill requests, results to review, and people who are frustrated when their doctor does not respond immediately. Sometimes the inbox comes home with you, even when the workday is technically over.

The expectation is often wrapped in the language of a calling. Physicians are asked to be selfless, to put patients before themselves, to stand on the front lines, and to keep going when the system is already asking too much. We saw the nobility and the cost of that during COVID. Many doctors stayed because serving people in crisis really was their calling. Many also stayed because the alternative felt like abandoning patients, leaving a colleague to pay for your rest, or admitting that you could not carry one more thing. That guilt is real, and it can keep a person working long after the work has stopped being safe or sustainable.

You should ask yourself how much boundary you need in a life. Most people considering medicine are already willing to work hard. The harder question is whether you can accept a profession where responsibility may follow you home, where being unavailable can feel morally loaded, and where rest sometimes has to be defended instead of assumed. A doctor who rests is not failing a patient. If the only way a system functions is by asking exhausted people to sacrifice themselves indefinitely, the system is the problem. You should know that before you call the sacrifice a calling.

You are signing up for a lifetime of tests. This is the gut-check nobody makes you take honestly. If you're a shaky test-taker, if standardized exams fill you with dread, understand that medicine is a treadmill of high-stakes tests that never fully stops. The MCAT is the entrance. Then shelf exams, then Step 1, Step 2, Step 3, then your specialty boards, then recertification for the rest of your career. If sitting in that room again and again for decades sounds like a specific kind of suffering for you, that is worth taking seriously now, not after you've borrowed the money.

Is it going to make you rich? Be honest with yourself. I remember, as a broke medical student, sitting in a restaurant doing math on the menu, literally calculating how to get the most food out of a chicken sandwich for the least money. Around that same time, a friend of mine, 24 years old, was working at Netflix making over half a million dollars a year, and he never thought twice about what he ordered. He was genuinely surprised watching me count. That image has never left me, and you deserve to see it clearly. If early wealth is the dream, medicine is one of the slowest, most expensive roads to it. You'll earn almost nothing well into your late twenties or thirties, often while debt compounds. Doctors are comfortable and secure. But if you're doing this for the money, there are faster and cheaper ways, and I'd rather you know that before you sign up than resent it after. Money is not why we do this.

And some days it feels like social work. Heroic diagnosis is a small slice of the real job. A lot of it is insurance, and placement, and housing, and addiction, and a broken system you're trying to move a human being through. For some of us, that is the meaning. The messy, human work is the whole point. For others, it's a grind they never pictured. You should find out which one you are before you're in it.

And you should know the other doors exist

Something I didn't understand at your age cost me: I had no idea how big the world was. I didn't know what consulting was. I didn't know what a software engineer did, or what "tech" or "investing" even meant as careers. I thought I was good at school and that it would take me somewhere, and it did, but I was navigating with half a map.

You are not choosing between "doctor" and "failure." There's an entire world of ways to use a scientific mind and a desire to help people. Public health, policy, biotech, medical devices, health tech, research. And increasingly there's a whole frontier of medicine-adjacent work that didn't exist when I started: training and evaluating medical AI, building health tools, informatics. Some of the most meaningful things a medically-minded person can do now don't require the exam-and-call grind at all. The knowledge is portable. The suffering is optional. Know that these doors are open before you decide the only door is the one everyone in your family already sees.

Why I am still glad I did it

Medicine never became easy.

Near the end of my last year of residency I was running half an hour behind in my VA clinic. The patient had been sitting there that whole time. I came in apologizing, the way you do when the schedule has gotten away from you, and before I could finish he said, "Doc, thank you."

I had no idea what he was thanking me for. So I asked him.

He said, "You probably don't remember me. I look different now. You took care of me in the ICU."

Then I placed him. A year earlier I had been the senior resident overnight when he came in profoundly septic. I put in the line that gave us access. We started antibiotics and pressors, and through the night his pressure kept sliding until he was on three of them at once. Before we intubated him he told me he was scared, and I told him we were going to do everything we could. Then we sedated him and put him on the ventilator, and I did not know whether he would wake up.

I rounded on him for days while he lay there sedated. Then I rotated off service.

And then I forgot about him. That is the part I would leave out if I were trying to make myself look good. There was another rotation, another 80-hour week, another unit full of people just as sick. He became one of the patients I never followed up on, which is most of them.

He had been carrying that year around with him. I had not been carrying it at all.

Nobody goes into medicine expecting to be thanked. You learn early that most of what you do is invisible to the person you do it for, and that plenty of patients will be angry with you on days you did nothing wrong. That is the job, and I am fine with it. But I spent one night of my life on this man, he spent the year since alive because of it, and he waited past his appointment to tell me so.

I am not going to inflate that. One clinic visit does not cancel the 80-hour weeks, or the burnout, or the parts of the system that need to change. It cures nothing.

It is why I can sleep. There are not many jobs where you can go to bed knowing everything you had that day went to somebody else, and that for at least one person it was the difference between being here and not. I got to be that for him. I would do it again.

For years, deep in residency, I kept thinking I should have just become a software engineer. I love technology. I train AI models and build my own apps, and I think this is one of the most exciting moments to be alive for it. Working in that world is also what makes me value medicine. Technology keeps getting more efficient and more capable. Genuine human connection is becoming rarer. Medicine kept me in a life spent with actual people when it counted most. It gave me stability in a world where whole industries get laid off overnight. It also made me an expert in something real, and a lot of people go their whole lives without getting to be that.

So here is my honest answer, one first-gen kid to another. Medicine will take a great deal from you, and it does not owe you wealth or ease in return. If you want the work itself, the responsibility and the chance to be useful when usefulness matters, it can give you a life with real weight.

Whatever you choose, choose it on purpose. If, after all of this, you still want it, good. That's the only reason worth starting on.

This page shares one physician's honest experience; it isn't medical, financial, or admissions advice. Your path will be your own. Last reviewed: 2026-08-05.

References

988 Suicide & Crisis Lifeline — call, text, or chat, available 24/7/365 in the United States. ↩
ACGME Common Program Requirements (Residency), effective 2025, requirement 6.20: work hours "must be limited to no more than 80 hours per week, averaged over a four-week period, including all in-house clinical and educational activities, clinical work done from home, and all moonlighting." Requirement 6.22: work periods "must not exceed 24 hours of continuous scheduled clinical assignments," and 6.22.a allows up to four further hours for transitions of care and education — which is where "24-plus" comes from. A Review Committee may grant rotation-specific exceptions up to 88 hours (6.24). ↩