| Pros | Cons | Neither pros nor cons, but worth considering...

Deciding on a career in medicine is a very big decision--perhaps the biggest decision of your life. It's hard to know, especially in the early years of college, whether this field would be the right fit for you. Going down the medicine pathway is quite a significant time and financial commitment, and much of it is made before you really have any experience of what the practice of medicine is like or how it compares to other possible fields. We (UCSF medical students) wrote this list of pros, cons, and neither-pros-nor-cons to help you think more about whether it really might be the right decision and worth exploring more. Some parts are from our own personal experience and thoughts, and other parts are culled from other resources around the web.

Pros

  • Medicine is allows you to help other people, often in a very direct way. It is a profession which is founded on relationships with people, and as such, can provide tremendous personal rewards both immediately and in the long-term. The most important part of clinical medicine is seeing and working with patients; although there can be a lot of involved paperwork, clinical medicine is fundamentally NOT a desk job, NOT a cubicle job. If you enjoy working with people at a level beyond the superficial, medicine can be very satisfying.
  • Medicine can be very intellectually satisfying. Medicine is a field which allows you to learn theoretical scientific principles and then see them in action or apply them in the real-world (mixed with a heavy dose of practical experience and common sense) to directly help other people. You will learn a huge amount of knowledge that will make you a kind of "expert" to help solve other people's problems. In certain specialties, diagnosing illnesses can be a bit like detective work.
  • Breadth and diversity. There is such a wide range of what physicians do now, that in some ways you are almost guaranteed to find somewhere you will fit in. There's room for all different personality types and talents. Some people devote their time to research and see patients very infrequently; others see patients exclusively. Some physicians go on to work in industries for pharmaceutical companies; others become experts in policy issues and become involved in the political or policy process. There's a specialty for practically every body part in the human body and then some; you can be as specific as you like, or alternatively, as general as you like. There's room for people who like to teach, people who like to work with their hands, people who are extraverted or who are introverted, people who like excitement and drama or people who prefer consistency. You can get to know a few patients very well and develop long-term relationships with them, or do shift work and see new patients every day. In short, you can shape your career into practically anything you want, which is flexibility that is nearly unparalleled in other fields.
  • Reasonable job security. You will have a skill that will serve people in need, pretty much wherever you go. It does not necessarily mean physicians make a lot of money, but it would be rare to be unemployed.

Cons

  • Long training and lack of control. To become a fully fledged independent doctor, there are many years of training that will consume most of the early years of your life, during which you will have very little control over your hours and even your location. While your other friends who have graduated college are potentially working and "having a real job" and making money, you will be in medical school, still taking classes and exams for at least the first two years. After four years of medical school comes residency, the length of which varies by specialty from 3yrs to 8yrs or more. The process by which a medical school graduate is placed into a residency for further training is called "the match." Like medical school applications, it is another round of numerous applications and flying all over the country for expensive interviews. Unlike medical school applications, however, you do not "choose" to go somewhere based on where you are accepted; instead, you rank your choices in order of preference and a national computer algorithm picks out the one institution that you "match" at based on a combination of your preferences, the institutions' preferences, and other applicants. It can be very scary and frustrating to have a computer choose where you will spend many years of your life! After graduating residency, you can then practice medicine unsupervised, but many people who desire a career in academics or research will then go on to complete an additional 1-2 years of fellowship training in a sub-specialty, which is yet another "match" process rife with uncertainty and lack of control. Thus, it can be in your early to mid thirties or later before you really begin your career as an "attending," or an independently practicing doctor. That being said, after residency there is a great variety of ways you can choose to structure your life: see "breadth and diversity" above.
  • Work-life balance. Training in medicine not only requires many years, but many long hours each day as well. Although with work-hours restrictions, the length of shifts may become increasingly limited, medicine will no doubt continue to make many demands on your time. The time commitment can put significant strain on your personal relationships. Furthermore, it can be tricky to plan a life with a significant other if during those early years you have little control, as aforementioned, over where in the country you are. Planning to have a family can pose additional challenges as well. These challenges are often worst during the residency training period, but can continue on as an attending as well. Finally, once one is in the medical world, it can be hard to find time to meet people outside of the work environment.
  • Expensive. Training to be a doctor is an expensive endeavor, starting from applying to medical school to paying for it on the meager residents' salary. Salaries of attending physicians have also been on a downward trend over the last decades as well, so despite the relative job security in medicine, it rarely makes sense to go into it purely from a financial motivation. The MSAR will have more detailed numerical estimates of the average debt load of the medical school graduate for each particular medical school, but suffice it to say, debt upwards of $100,000 just for medical school is not uncommon. Combined with undergraduate educational debt, this can be an even greater burden. Furthermore, when considering financial aid and scholarship funds, medical schools will almost always consider your parental income as well. Even though for other types of graduate schools you may be considered an independent adult, for medical school an expected family contribution is still considered. State schools are often less expensive, but they are still expensive. After graduating, you will have to start repaying all your educational loans on a residents' salary that is only $45,000 a year, which probably works out to not a whole lot more than minimum wage given the hours.


Neither pros nor cons, but worth considering...

  • A lifestyle, not a job. Committing yourself to medicine is committing yourself to a lifetime of studying to further your own knowledge to help your patients. The learning does not stop after graduation; medicine is a scientific field where advances are made every day, and it is your obligation as a physician to keep up with the advances in your field so that you can deliver the best possible care to your patients. This means that you can never stop studying; if doctors today who have been in practice for 50 years still practiced medicine the same way it was taught 50 years ago, we'd all be in trouble. You must be self-motivated to devote this time and energy outside of your "workday" seeing patients.
  • The culture of medicine. Just as there is a "culture" associated with business, with law, with engineering for example, there is a "culture" associated with medicine. When you enter into it, you are agreeing not only to learn vast amounts of knowledge, you are learning a whole new vocabulary, a whole way of thinking, new standards of communication, and a whole set of specific expectations for what it means to be a doctor. To immerse yourself in this world can be fun, but it does change your whole life.
  • Common ailments are common. Most physicians see very common ailments many times a day; the practice of medicine therefore can be quite routine and emphasize compulsive thoroughness. There is relatively less demand for abstract creativity although those in academics can find opportunities to be creative in research arenas.