Medicine is Paradise?

Medicine is Paradise?

You did it. You scored the top grades in high school and gained admission into medical school. The future is bright and the sky is blue. Grannies drool over your success and mothers lambast their children for not following in your footsteps. You are Zeus, ascended into heaven itself, atop a moral ivory tower elevated above the peasants below. Fiscal concerns? The accumulation of wealth? Laughable, you muse, lost in your bubble of self-aggrandisation. I am a saviour, chosen by destiny to help the suffering and heal the sick.

Day One

It's your first day. You have a 9:00 am lecture – Lipid Metabolism. Easy peasy. I've been crushing lipids since I was four years old. You walk into the lecture, and witness an elderly woman with a PhD at the lecture stand. Couldn't be me, you muse. She probably didn't get into medical school and was forced to do a PhD to find a job.

The First Lecture

The first slide is on classes of lipids. What is an eicosanoid, you wonder? The lecture slide says "Many are derived from arachidonic acids. Four classes, prostaglandins, thromboxanes, leukotrienes and lipoxins." Not only does the slide not tell you what an eicosanoid is, it raises four more further questions. Interesting, you muse. I'll look into it after the lecture.

50 slides later, the lecturer has progressed to the exocytosis of chylomicrons. The only words on the slide are "Short chain FFA go directly into blood circulation!", and an indistinguishable diagram. You could not follow from slide 10. You look around you and see others staring into their computer screens intently with a blank stare. Uh oh, this is harder than I thought.

6 lectures later, it is 5:00pm and you are utterly exhausted. During the debriefing, a bald, grizzled old man with no tone or emotion in his voice says: "We expect our MBBS students to conduct no more than 28 hours self-study per week. If you achieve this, you should be in good stead to attain a passing mark.

28 hours? That's four hours a day, seven days a week, after a 9-5 schedule. You'll get home by around 7pm and study until 11pm. Wow, this is intensive!

Week One

A few of your cohorts have dropped out. Weaklings that couldn't handle medicine, you think. Couldn't be me. You wonder why they left so quickly, and just out of curiosity you check the year one syllabus.

200 lectures of 100 slides each? Holy shit. That's just the lecture content, making up about 50% of the curriculum. You browse further and see that there are hundreds of hours of practicals, and hundreds more of case-based learning, medical ethics, and other bullshit professionalism courses.

You have a small (okay, major) panic attack as your life flashes before your eyes. Dating, falling in love, pursuing your interests, starting a new hobby, going on trips/exchange, meeting a great group of bros, doing stupid shit, partying? How the fuck would you have time for that (you won't)? But one thought brings you back to reality. You sacrificed so much to get into medical school, you're not going to be the pussy that drops out during the first week.

End of Year One

After managing to meet regularly with a social worker, a clinical psychologist, and a psychiatrist, you are still on long term Prozac and Concerta. You have a chronic, moderate depression that will not go away no matter how hard you try. You passed year one by the skin of your teeth. Aside from that, you have nothing to show in terms of university life or social development.

Your friend who went to UCL Economics comes back from summer break. Your arrogance has not diminished despite your depression. "Pleb that didn't have the stomach to do medicine. When we are 35 I'll be sitting in my private practice, rich as hell, while the peasant will still be TOILING AWAY, working for THE MAN. I'll be my own boss in no time. 14 years later, I'll be happy!"

Turns out, he has done a spring intern for a company called Barclays. "Oh, so you're looking to go into finance? Working with the big banks?

"Yeah, I secured a spring internship at Barclays. I'm with the sales and trading division."

Despite having no idea what a Barclays is, you nod along, while quietly thinking to yourself: “Really, sales? He was a top scorer in high school, all that academic work and effort just to end up becoming a salesman? Good luck being a branch teller.” When you get home, you try to find out more about what exactly it is he wants to do.

Holy mackerel, starting salary 110k? With just three years of education? You looked at the average salary of UCL Economics grads (50k) which was half that of medicine before deciding to go for medicine. You look at the salary progression and begin to get green with envy. For the first time, you find out what an investment bank is. Apparently, there are careers in business where you don’t earn 30k working out of a bank branch or insurance company. Millionaire by 35? My parents said I would end up unemployed if I studied business!

Luckily, your superiority complex returns to bring you back to reality. Couldn’t be me. I’m not a greedy person. I don’t want to work for a corporation, making the rich richer! I’m not a greedy banker, I’m Father Teresa! I dedicated my life to serving the poor!

End of Year Two

At the end of year two, you fail the final examination and are asked to sit the resit, with one month to prepare. After two years of this bullshit you are ready to call it a day with a charcoal burner (helium would work too). You strike a deal with yourself – since I don’t have the energy to repeat the year, if I don’t pass the resit, time to get cozy with some carbon monoxide.

You begin fantasizing. Damn, I wonder what I would have become if I didn’t listen to my father and chose to study business instead. I probably wouldn’t have ended up depressed and suicidal. You go on LinkedIn and see where your friends are at. Damn, one is at Amazon. Another one is at Deloitte. Your best friend is doing a Barclays summer. All are dating. They all seem content and satisfied.

For the first time in your life, you discover what Investment Banking is. “Wow, these people are all dressed in suits, working out of a pristine, climate controlled office with commanding city views. What a beautiful working environment. They look so confident and happy. I bet they run the world – they are the real bosses.” A glimmer of hope appears in the back corner of your mind. “Man, I wish I could be like them. My life would be completely different.”

Your eyes pop out of your head when you see the starting salaries. 110k USD as a first year analyst? 15 years later, 1-3M as a Managing Director? Holy shit! 15 years later as a doctor I would earn at most 200k USD! You go down a rabbit hole as you learn about private equity, private credit, the buy side, and much more.

Through some miracle (and hard work), you pass the resit. You begin to look seriously into leaving medicine. If you can’t beat them, join them., right? “Man, my high school grades were the top. I passed two years of medical school. Surely some university will take me. I’m so fed up with medical school.

Year Three

You begin to have coffee chats. You meet up with another friend at Citi IBD. “Hey bro, I don’t know if I would leave medicine if I were you. I applied to Citi this year and it was a complete bloodbath, man. There were 3000 applicants, and they only took 50 for the spring week. Think about the opportunity cost. It’s a huge risk.

You hit up people on WSO and end up talking to earthwalker7, who resides in the same city as you. “Yeah, I worked in REPE for a while and it was boring. Finance is not as interesting as you think. It is a field with zero barriers to entry, and it’s unprotected. You have a real risk of getting squeezed out once you get older. As a doctor, you get unbeatable job security, a meaningful job, and zero risk. You wanna know how much I made as a VP? I didn’t make that much (proceeds to say a very high salary)."

You think back to your psychiatry rotation, where you saw a old man with dementia yelling his lungs out, a schizophrenic woman completely delusional and mumbling about getting a diploma, and a girl who repeated 10th grade 4 times. You think that Earthwalker does not understand the reality of medicine, although he definitely does not seem to love finance.

You talk to many more people. You talk to a girl at Cambridge, who didn’t get a return for her spring week, didn’t get a return for her summer, didn’t get a return for her off cycle, and now works at a small boutique. With a slightly flamed out demeanor, she asks you: “Why would you leave?”

You talk to people working in your home city. “It’s a young man’s game.” “Finance is dead in this city, FDIs are pulling out, and the markets are in free fall. Lots of bankers on the street are getting fired. You should be grateful to be a doctor.” “It (medicine) is just a super visible, and stable career path.” “They are hiring Redacted, you wouldn’t stand a chance as a local.”

You talk to someone who worked at HL RX for 5 years. “I was just on call 24/7. Sometimes I would work until 3 am. The hardest part about banking, is that they control your life. At least in medicine, after you complete a shift, you come back home and you get to forget about work.”

You begin to browse WSO and see the many threads. “Motherfk*ing toxic job.” “Why you shouldn’t go into investment banking.” “What is so sh*t about this industry.” You discover that finance (investment banking), which you once held in such high regard, is mostly about working in excel and creating pitch books to convince clients to engage in capital raising. At the senior level, it is a sales job. That being said, finance is very broad and you are happy to explore other careers.

Oxbridge extends you an offer of admission. You have the chance to restart completely with a BA. Your offer expires on September 30th. If you don’t take it, you continue with medicine.

IS MEDICINE PARADISE?

(If you read this far, thank you very much. Would love to know your thoughts, WSO community)