Why I left medicine

They say that hindsight is 20/20. In retrospect, of course I shouldn’t have applied to medical school in the time frame that I did. I am a first generation Chinese immigrant with virtually no personal and very little professional experience with western medicine. I do not have any physicians in my immediate family, and I don’t know of any in the US well enough to gain adequate insight into what it means to be an American doctor. I was drawn to the noble ideal of being in a profession where I could help people in a meaningful way. I was influenced by the high status physicians hold in the US workforce, and the good, stable income that comes with the job. I am smart, studious, but I lacked clinical experience, and that ultimately led to my downfall.

I started medical school at Rush Medical College in Chicago in the fall of 2012. Rush is a well-regarded healthcare enterprise in the Midwest and one that is difficult to secure admissions to, especially for out-of-state folks like me. I was very fortunate to have gotten in. In my first year, which was taught mostly by basic science PhDs, I consistently scored in the top 15% of my class–I “honored” my courses as the saying goes. That changed suddenly during my second year, when the curriculum shifted to more of an MD-focused instruction. My lack of clinical experience and knowledge became very apparent by the way I was scoring on my exams, and I adjusted by putting more time into studying, which for a medical student is saying a lot.

Ultimately, the stress associated with the second year got to the point where I was forced to seek medical attention to stabilize my mental health. At its worst, I remember not being able to go to sleep for five days straight because I was so afraid I couldn’t rote memorize the long lists of medical terminologies in time for the exams. None of the material of that newly reformed second year curriculum made any logical sense, it just read like gibberish to be internalized. I didn’t know how my other classmates did it, if not for having been exposed to the material previously either in their undergraduate or masters studies. Without going into too much detail, I ended up taking two research gap years to recuperate after passing my NBME Step 1 exam and, ultimately, upon my return to Rush, decided to cut the cord when it was determined that I needed to remediate my very first third year clinical rotation, which sardonically was medicine–I took it as a sign.

I’m going to skip some of the uncomfortable interactions I had with a few attendings I worked with at Rush. I think those sorts of interactions are, unfortunately, ubiquitous in a field where people are overworked and the stakes are high. In other words, I don’t hold any resentment against the MDs who wanted to portray a “tough love” persona. I think that’s ingrained in the culture and people’s personalities and difficult to change.

What I was most disappointed about with my experience at a major US medical school was the very rote-memorization focus of the preclinical curriculum, which has evolved heavily since I left. I felt that, unless you already had extensive previous training in the clinical arts, which some people did because of familial connections and/or difficult-to-attain clinical experiences, you were sort of set up to fail with the curriculum that was provided. What was also concerning was that a large portion of the medical school curriculum was outsourced to third-party exam preparation companies. Students (myself included) spent exorbitant amounts of money on standardized exam prep books and digital multiple-choice question banks to supplement their institution’s curriculum to prepare for the national boards. Overall, I didn’t feel this was very fair to those who were not aware of the best strategy to game the tests, and felt that we, as medical students, were putting our trust in private exam prep cottage industries that may not have our best interest at heart.

To conclude, I think the American healthcare system is about to face a serious reckoning. Since I’ve left in 2016, there has been a mass exodus of both young and retiring physicians exacerbated by both the COVID pandemic and the inefficiencies associated with the electronic medical health record system. The US is experiencing an ever worsening and severe physician shortage and the declining general health of this country will only worsen if this trend continues. I think more and more young doctors are beginning to see past the illusionary corporate marketing campaigns of these large healthcare enterprises that mask some of the ridiculousness associated with medical training and realize that they’re operating in a less-than-ideal situation.