“Should you give up on your dream to become a doctor?”

Should you give up on your dream to become a doctor?

By: LifeofaMedStudent

“Should I give up on my dream to become a doctor?”

“How will I be able to get into medical school because my GPA or MCAT is low?”

“I’m afraid I won’t get in the first time around… should I consider Caribbean medical schools?”

These are questions I’m asked fairly frequently on Twitter, usually by DM. And while I’m happy to try and provide a little guidance, it is often based on very little information about the person in question. Usually a few lines about their struggles in some area, and that they’ve always dreamed of becoming a doctor, but are now worried. “#LifeofaMedStudent – what do I do??”

This is one of the most difficult parts of running this site. Giving what I think is realistic advice, while still trying to have a positive outlook – something I lean towards both on this site and honestly is who I am as a person. I truly want you to succeed, despite the odds! I want the best people to become doctors, and not necessarily always the absolutely smartest people.

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But admissions committees aren’t set up just to be dream crushers. They want you to succeed as well as their institution. But the statistics are there… the MCAT scores.. the GPA.. in many ways admissions are trying to protect you as an applicant as much as their institution. Failing out of medical school is a life-altering disaster, both personally and financially. Graduating from medical school and not matching into a residency is nearly as bad, if not maybe financially even worse. And as an institution, match rates matter as well.

“So #LifeofaMedStudent – what should I do?”

I’ll give my usual quick answer first… then a more detailed version.

“First, no one can tell you what to do. This is a personal decision. If your dream is to become a doctor and nothing else in your life will ever make you happy, then don’t give up. Don’t let someone talk you out of it. Make the best of your application and focus on the major aspects. If your GPA is poor, you need to kill the MCAT. If your MCAT is poor, you need a strong GPA and some decent extracurriculars. If both the MCAT and GPA aren’t great, you’ll need the rest of your application to be absolutely spectacular. Go heavy with research, shadowing, and volunteering activities. And at the end of the day if you could be happy as a nurse, physician assistant, nurse practitioner, or another healthcare provider – strongly consider that if eventually faced with few options to become a physician. But there is always hope for you, and the chances are NEVER ZERO, you just might have a tougher or longer road ahead.”

I like that basic answer because it stays positive, while acknowledges it will be harder for the applicant in question. I give out some version of it probably once a week. The better answer, of course, is much more complex.

On #LifeofaMedStudent, I love to focus on the optimistic and share the success stories.  I also highlight failures when I see them, though it is a lot more uncommon for the failures to be out in the open public. Twitter itself seems to be dominated by truly inspiring physicians who matched despite being from Caribbean schools, or those who are now easily graduating after getting in with below 3.0 GPAs and low MCAT scores. We all know that doctor who struggled and struggled, took the long or difficult road, but are now happily practicing. Those are the stories we all love to read.

But I think someone has to write the tough posts as well and highlight the “warning: results aren’t typical” aspect of it. Because often results sometimes AREN’T great – there just aren’t as many blogs dedicated to it.

The point of medical school should not be to get M.D./D.O after your name – it’s to practice medicine. So, let’s talk about The Match. Without a successful match, you generally won’t get to practice. Instead, you are left with years gone and often overwhelming debt. What do the statistics say? Sadly, in 2016 only slightly over 50% of International Medical Graduates (IMG) matched. For US-citizen IMGs – the number was 54%. For FMGs/non-US citizens, just 50.5%. Basically a coin flip – only one you’ve gambled hundreds of thousands of dollars and 4 years of your life. Compare that to US medical school seniors – who achieved a 94% match rate and impressively 80% matched with one of their top 3 choices. DO schools also had excellent levels of success, with about 49% matching into an Osteopathic program and 46% successfully matching into an NRMP program (these numbers include S.O.A.P matches).

The lesson here is simple: I would suggest doing everything possible to get into a US medical school, either the MD or DO path. If you don’t get in the first time around, I’d do a Masters program in the US – particularly one connected to a medical school you have an interest in and a reasonable chance to matriculate into. If I didn’t get in after the Master’s, I’d take wait another year and reapply, doing anything in that time possible to bolster your application.

When would I personally consider an IMG/Carribean path for medical school? Very cautiously. And maybe only as a last resort. The exceptions might be if you are certain you want to go into primary care, where the residency spots aren’t nearly as competitive. Otherwise, if you have extended financial means – such that the 4 years of tuition and living expenses was not a major consideration. The path isn’t impossible, it’s just that the odds are longer (but definitely improbable for some specialties), and the financial risk much greater.

Talking to a program director recently, he was mixed on Caribbean schools. Saying many residencies don’t give them a serious look, but he always has.  “The good ones [applicants] regardless of where they are from, find a way to get your attention, and almost always do well.” Asking around my own program, I note that the few IMGs all have USMLE Step 1 board scores in the 250+ range.  Those numbers clearly dwarf my own, and are sure to get your attention. Goes back to the same idea, that very smart and capable people go to Caribbean Schools – especially the older and more established ones – and go on to do great in medicine.

“So #LifeofaMedStudent, but what should I do?”

I can layout the numbers. I can give suggestions for improvement. But ultimately, that’s a question only YOU can answer. With the practice of medicine and as with life, there are risks and benefits. No path is a sure thing, just as even the simplest surgery isn’t guaranteed to go perfectly. If you know in your heart medicine as a physician is your only way to happiness, how could I ever tell you not to pursue it – even if I know statistically you have an uphill battle. Be the best version of yourself you can be. Do everything you can to make your application shine. I’ll be rooting for you – because I want good people as my colleagues, and good people taking care of my family – not just numbers on an application.

What advice would you give to struggling pre-medical students? What lengths would you go to be a doctor? Give your thoughts in the comments section.

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