Is Medicine worth it?

Hey guys,

so im starting med school in September and I really dont know if its worth pursuing anymore. I know ill enjoy the course, its just the lifestyle after that's really putting me off the whole career. The long hours, the pay, racism in the NHS, especially hearing so many medics already saying to stay away, and if they had the money, they'd leave.

I guess what im asking is, anyone who's still pursuing a career in medicine regardless of this all, what is your motivation?

Firstly congratulations on getting into medical school! Enjoy it, it can be hard work at times but you'll also have an absolute blast!

So I think you're thinking along the right lines. I never considered what life as a Doctor would actually be like until just before I started FY1.

I'll start with the negatives, that way I can finish on a positive note.

So I am an FY3 Doctor meaning I have just completed my 2 foundation years and I am taking a year out of training. I was rather lucky in that my rotations during Foundation Years meant I had a few that were not as intense in terms of work hours, but it could still be gruelling at times.

However if I am honest the work hours aren't the worst of it. Most of your friends and colleagues will be on similar work shifts and so to you it will just feel "normal". Additionally the working hours are nowhere near as bad as they were say 20 years ago (This is Going to Hurt did not lie according to older colleagues I have asked) and they are a lot better than what many Doctors abroad have to deal with. To put some figures on it the longest work week I have ever done was about 72 hours. The longest stretch I have done was 10 days, and I have seen colleagues do 14 day stretches. HOWEVER my typical work week is more like 53 hours (48 hours contracted but you rarely finish on time) AND the contract means that if you do a lot of shifts one week, you should be given days off the next week so that on average your work hours do not exceed 48 hours a week. But there is variation between trusts and specialties.

In terms of the pay, again it isn't great. Since 2008 Junior Doctors have had a real terms pay cut of 30%. Due to recent changes in the BMA expect to see strike action over this in the next few months. Whether this will be properly addressed remains to be seen. When I was a student the 2016 strikes happened and it didn't make much of a difference. A lot of Doctors would tell me to leave the profession on placement and morale has remained low since.

And it's not just pay. Myself and other colleagues regularly feel that we are infantilised at work by both senior Doctors and allied health professionals, but when it is convenient we are suddenly given the respect of being a Doctor (ie when someone wants to pin all the risk on you). This is all the more so when AHPs who have done less training but are working "similar" jobs to us are paid more. I won't go into detail here because I don't want to sound like I am bashing colleagues, but suffice to say this doesn't help morale.

In terms of NHS racism, tbh I haven't experienced much of this, either at medical school or as a Doctor. I wouldn't say the NHS is more racist than the rest of society tbh so make of that what you will. Some people will have had worse stories than others and I think it can be particularly bad for foreign doctors though. There are many ethnic minorities in the medical profession, especially amongst the juniors so that also may be why I personally have not experienced much.

Now for the positives.

Medicine itself is an absolutely great career. Genuinely. You get to make a difference to people's lives, you get to learn all sorts of cool mind boggling stuff, perform procedures and basically be a highly trained professional. Few other jobs will give you that personal satisfaction or intellectual stimulation. None of the above has changed this and the low morale that Junior Doctors are feeling is rarely due to the job itself. In fact in many ways it is due to things that are preventing us from focusing on the job itself. It's not for everyone and people do drop out simply because they don't like medicine but in my experience they are few (others dropping out for financial reasons or work-life balance reasons etc).

Yes the pay is crap, and I think despite the strikes it is only going to get worse but as a medic you'll be highly sought after internationally. UK won't pay you, fine. Someone else will. There is no reason to accept a lack of renumeration for your skills and you can always vote with your feet. This is easier said than done especially if like me you're close to family etc but the NHS is staffed full of Doctors who left their home countries to come here for economic reasons. It is perfectly valid for you to do the same. I highly recommend that all medical students starting now should think about a get out plan from year 1 onwards. I highly suggest doing the USMLE or looking at what it might take to work in Canada/Australia etc

It's also important to realise that whilst yes those who go into banking or did law at the elite universities will earn more than doctors, we're still earning more than many in society and in the NHS at Consultant level. Wages atm are pretty crap across the board for most people.

The lifestyle is what you make of it. You won't really know what you want until you start work tbh. Some people will happily work for 80+ hours a week due to the satisfaction that being a Neurosurgeon brings them. Others will become GPs and work 3 days a week. Others will mix their clinical work with teaching. There are specialties that are basically 9-5 with manageable on-call commitments (eg Dermatology, Ophthalmology, Radiology etc), although these are fairly competitive. But the point is, it isn't all 9 am - 9 pm everyday. And work-life balance means different things to different people. If work is really important to you then you'll seek a different balance from the person who would prefer to spend more time away from work for reasons of friends/family/hobbies etc.

So my advice is if you're really unsure, then perhaps see if you can defer a year to think about it. I applied first time didn't get in but tbh I wasn't really motivated. Took a gap year and on reflection decided I really did want to go down this path and I think I did better at medical school due to having a better mindset when I started.

If you actually do want to be a Doctor but are unsure because of what others are saying then I would say don't be deterred. A medical degree still means something and even though our country seems determined to undermine its Doctors, other countries would be more than happy to welcome you!

...do you think that the issues with pay etc causing doctors to relocate to different countries and the fact that their are shortages in doctors (E.g the GP shortage issue), causing the NHS to become more reliant on hiring doctors from outside the UK will become a greater issue as time passes?

Hey! Current med student here, I know I’m not the OP but this is actually a super useful and helpful response! You do just tend to hear the negatives a lot when it comes to graduating and working in the NHS.

Also random question but, do you think that the issues with pay etc causing doctors to relocate to different countries and the fact that their are shortages in doctors (E.g the GP shortage issue), causing the NHS to become more reliant on hiring doctors from outside the UK will become a greater issue as time passes?

Hey guys,

so im starting med school in September and I really dont know if its worth pursuing anymore. I know ill enjoy the course, its just the lifestyle after that's really putting me off the whole career. The long hours, the pay, racism in the NHS, especially hearing so many medics already saying to stay away, and if they had the money, they'd leave.

I guess what im asking is, anyone who's still pursuing a career in medicine regardless of this all, what is your motivation?

I've lived around doctors all my life (both my parents are, 2 of my cousins and 3 aunts/uncles, as well my own frequent hospital visits) so I think I can answer this from the point of view of the people around you.

Both my parents always say they "love their jobs more than life itself," and I believe them, its very interesting, rewarding and respected work. However your concerns are quite the same I had when choosing my degree (I've chosen chemical engineering instead). The long hours were definitely an issue for my parents, especially at the start of their careers, where my mother worked 10-12 hour long night shifts 5-6 days a week, and it wasn't much better for my father. On the other hand, the pay is great. We are very much well off, rich even maybe, but this may only be because they are both consultant level, but still, at the start we were still great financially.

I remember my dad once coming home and telling me about a racist occurrence at his work, where a white man refused surgery from him (we are black) and even called him the n-word. However he assures me that this was a one time thing, but it has never sat right with me and pushed me away from medicine.

However the main reason I chose engineering over medicine is because all the doctors that I've known, from my parents to my cardiologist, told me to do dentistry or engineering, but never medicine, and since I trust them I took their advice.

However I think medicine can still be perfect for the right person. If it is right for you, do it.

Hi, thank you for your amazing reply! I know this was sent quite a while ago but I was wondering exacty why all the doctors around you in your life told you to do anything but medicine haha? I mean if they love the job more than life itself, why advise another young individual to definitely not do it? I hope you don't mind if I ask!

This is a common trope among doctors and I think that there are several reasons why.

Chances are that the reasons that a doctor went into medicine are not necessarily the reasons keeping them in medicine (be that for better or worse). They know that what they thought they were getting into and what they ended up in are worlds apart and they probably perceive a new applicant to medicine as being hopelessly naive as they were. It's impossible to know until you know and they may just want to save you from that.

Doctors have often only done one thing in their entire working life. It's easy to look around at other people and say, oh gosh i wish I had more variety in my life. I agree with Adam Kay when he says we select our doctors far too young. Opportunities for doing other things are so limited in medicine because you wrap your entire life around it. Then it becomes difficult to leave, for various reasons, without it feeling like a massive loss of your sunk costs.

It is also just almost cultural to say this now and doctors have been saying it for decades. I think, though, this may have something to do with the types of people who found their way into medicine in the second half of the twentieth century. My parents who were both in medical careers - one a doctor - tried everything to dissuade me from doing it and succeeded, at the time. They never really explained why at the time but I came to realise later. For much of the twentieth century, medicine has often been a target career for social mobility. Looking at my father who was a doctor, who grew up below the poverty line but had the good luck to attend a decent school, medicine was presented to him as a way out. In different circumstances, he probably could have turned his hand to a number of different careers and been successful, but at the time, medicine was something that people who were above average academically and who wanted a safe pathway of upward social mobility did because it was a great leveller. Unlike law, your ability to achieve financial and professional success in medicine didn't depend so significantly on who you knew because the end goal of a consultant job was always in sight. Once people have cleared that social hurdle, they look at their own children who don't have that gap to traverse and want to offer them the options that they didn't have. I will add that in my father's case I think it was also a case of not wanting to see the child he despised do as well as he did but that's another story! However, I do agree that there are far more pathways open to people now and I often do encourage people to look elsewhere, to give themselves options and to try different things.

Obviously, people's negative experiences will shape their opinions and what they advise others to do. I think people's understanding of you and how you might do also comes into it but I would take this advice under caution. They don't know the person you're going to grow into. Interestingly, anyone who is not a member of my family and who has known me professionally or personally has always supported me doing medicine. But it can become quite difficult to imagine people becoming doctors who aren't. Doing medicine or any kind of healthcare profession puts you on the other side of a social divide that no one really acknowledges exists. There's almost a natural instinct to discourage others who just don't know and haven't experienced the things you have from crossing over, again, for better or worse. There are some things I know from working in healthcare that I really wish I didn't. When I see people preparing to come into my profession or into medicine I often find myself wanting to say, "No, no, you don't. Just stay over there. You don't want to come over here, trust me." It's part territorial, part protective, and almost no parts logical. I think it's also just a part of the game for some. People like to be able to say, "Well, don't say I didn't warn you." If you make it through the hazing ritual, most doctors would probably say, all right, lets see how we can help, then.

Plenty of other reasons I suppose. I know one doctor from school who was bullied relentlessly who makes it her mission to deter anyone bearing the slightest resemblance to the people who bullied her from entering medicine. She's occasionally been brought up on it at work for being harder on some med students and juniors and she's told me in confidence that she generally does come down harder on people who present with the slightest bullying behaviour and tries to make sure that they get a harder time getting through. So people can say "don't go into medicine" for petty reasons or territorial reasons as well.

I doubt you'll find many doctors who say things like, "oh yeah, best job in the world, come right in." It takes so much sacrifice to go into medicine and there won't be many doctors who don't regret it on some level on their worst days. You'll find the same with teachers, lawyers, bankers, vets, restauranteurs... It's almost just the way of the world.

Hey, howcome you switched from med to computer science? I'm thinking of a similar switch.

Firstly congratulations on getting into medical school! Enjoy it, it can be hard work at times but you'll also have an absolute blast!

So I think you're thinking along the right lines. I never considered what life as a Doctor would actually be like until just before I started FY1.

I'll start with the negatives, that way I can finish on a positive note.

So I am an FY3 Doctor meaning I have just completed my 2 foundation years and I am taking a year out of training. I was rather lucky in that my rotations during Foundation Years meant I had a few that were not as intense in terms of work hours, but it could still be gruelling at times.

However if I am honest the work hours aren't the worst of it. Most of your friends and colleagues will be on similar work shifts and so to you it will just feel "normal". Additionally the working hours are nowhere near as bad as they were say 20 years ago (This is Going to Hurt did not lie according to older colleagues I have asked) and they are a lot better than what many Doctors abroad have to deal with. To put some figures on it the longest work week I have ever done was about 72 hours. The longest stretch I have done was 10 days, and I have seen colleagues do 14 day stretches. HOWEVER my typical work week is more like 53 hours (48 hours contracted but you rarely finish on time) AND the contract means that if you do a lot of shifts one week, you should be given days off the next week so that on average your work hours do not exceed 48 hours a week. But there is variation between trusts and specialties.

In terms of the pay, again it isn't great. Since 2008 Junior Doctors have had a real terms pay cut of 30%. Due to recent changes in the BMA expect to see strike action over this in the next few months. Whether this will be properly addressed remains to be seen. When I was a student the 2016 strikes happened and it didn't make much of a difference. A lot of Doctors would tell me to leave the profession on placement and morale has remained low since.

And it's not just pay. Myself and other colleagues regularly feel that we are infantilised at work by both senior Doctors and allied health professionals, but when it is convenient we are suddenly given the respect of being a Doctor (ie when someone wants to pin all the risk on you). This is all the more so when AHPs who have done less training but are working "similar" jobs to us are paid more. I won't go into detail here because I don't want to sound like I am bashing colleagues, but suffice to say this doesn't help morale.

In terms of NHS racism, tbh I haven't experienced much of this, either at medical school or as a Doctor. I wouldn't say the NHS is more racist than the rest of society tbh so make of that what you will. Some people will have had worse stories than others and I think it can be particularly bad for foreign doctors though. There are many ethnic minorities in the medical profession, especially amongst the juniors so that also may be why I personally have not experienced much.

Now for the positives.

Medicine itself is an absolutely great career. Genuinely. You get to make a difference to people's lives, you get to learn all sorts of cool mind boggling stuff, perform procedures and basically be a highly trained professional. Few other jobs will give you that personal satisfaction or intellectual stimulation. None of the above has changed this and the low morale that Junior Doctors are feeling is rarely due to the job itself. In fact in many ways it is due to things that are preventing us from focusing on the job itself. It's not for everyone and people do drop out simply because they don't like medicine but in my experience they are few (others dropping out for financial reasons or work-life balance reasons etc).

Yes the pay is crap, and I think despite the strikes it is only going to get worse but as a medic you'll be highly sought after internationally. UK won't pay you, fine. Someone else will. There is no reason to accept a lack of renumeration for your skills and you can always vote with your feet. This is easier said than done especially if like me you're close to family etc but the NHS is staffed full of Doctors who left their home countries to come here for economic reasons. It is perfectly valid for you to do the same. I highly recommend that all medical students starting now should think about a get out plan from year 1 onwards. I highly suggest doing the USMLE or looking at what it might take to work in Canada/Australia etc

It's also important to realise that whilst yes those who go into banking or did law at the elite universities will earn more than doctors, we're still earning more than many in society and in the NHS at Consultant level. Wages atm are pretty crap across the board for most people.

The lifestyle is what you make of it. You won't really know what you want until you start work tbh. Some people will happily work for 80+ hours a week due to the satisfaction that being a Neurosurgeon brings them. Others will become GPs and work 3 days a week. Others will mix their clinical work with teaching. There are specialties that are basically 9-5 with manageable on-call commitments (eg Dermatology, Ophthalmology, Radiology etc), although these are fairly competitive. But the point is, it isn't all 9 am - 9 pm everyday. And work-life balance means different things to different people. If work is really important to you then you'll seek a different balance from the person who would prefer to spend more time away from work for reasons of friends/family/hobbies etc.

So my advice is if you're really unsure, then perhaps see if you can defer a year to think about it. I applied first time didn't get in but tbh I wasn't really motivated. Took a gap year and on reflection decided I really did want to go down this path and I think I did better at medical school due to having a better mindset when I started.

If you actually do want to be a Doctor but are unsure because of what others are saying then I would say don't be deterred. A medical degree still means something and even though our country seems determined to undermine its Doctors, other countries would be more than happy to welcome you!

Hi, sorry for the late reply.

I have a lot of love for medicine, I cannot deny that. I don't think there is any job out there that can compete with it in regard to the fulfilment, hands-on work, the knowledge you gain, and the impact you make.
However, I wanted to be realistic about what my future looked like. I want to have control over my life and job. I want to be compensated fairly for the work I do. I do not want to be working 6 days a week doing 60 hours, I do not want to be working night shifts, and I do not want to be so burnt out by my job that it starts to affect my personal relationships. I have always aspired towards the longer specialities too, they personally excite me, but the constant studying and exams which you also have to fund yourself seem dreadful.
I put a lot of thought and research into this, I compared different medicine pathways and long-term lifestyles; it didn't weigh up enough.
so I declined my offer to study medicine and chose computer science. I enjoy coding and programming and can see myself in that role. However, I do have my reservations about comp sci too. My work life will not be as exciting, or fast-paced, and every work day will probably feel the same. I guess what I'm trying to say is I don't know if I've made the right decision as of yet. The grass isn't always greener on the other side.

I don't know if any of this will help you. I hope you gain clarity on your future aspirations and apologies if my explanation was all over the place.