What applicants should know about a career in medicine
Patrice Baptiste, who has mentored applicants to medical school, explains the realities of being a doctor
Having mentored applicants to medical school, it surprises me that the same misconceptions about a career in medicine crop up year after year. This article describes some of the things you should know before applying to study medicine.
You will spend more time managing patients with chronic conditions than curing them
Given our ageing population, many of the patients you care for will have long term health conditions. Examples include chronic obstructive pulmonary disease (COPD), diabetes, hypertension, asthma, depression, cancer, epilepsy, and Alzheimer’s disease.[1 ]In England, more than 15 million people have a long term condition and the number of people with three or more long term conditions is predicted to rise from 1.9 million in 2008 to 2.9 million in 2018.
Although doctors can offer drugs for symptomatic relief or to help slow down disease progression, there is often no cure for these conditions. Doctors and patients therefore have to share decisions about how to manage these conditions in the long term to make sure the patient has the best possible quality of life.
You won’t get rich quick
If you think medicine is a ticket to earning lots of money quickly, then this is not the profession for you. It can take up to six years of study before you can call yourself a doctor. Then, you will have two years of foundation programme training to qualify as a junior doctor; and then you must undertake specialty training, which can take an additional three years (GP training) or up to nine years (paediatrics).
Your first job after medical school will pay between £22 862 (€26 86224; $28 545) and £32 066 per year and specialty trainees are paid between £30 302 and £47 647 per year, depending on seniority. This pay is supplemented by additional pay for working unsocial hours.
Whatever specialty training pathway you choose, you will have to pass specialty exams that can cost thousands of pounds, and many candidates need to sit them more than once. Other costs involved with being a doctor include annual medical indemnity and membership of unions such as the British Medical Association.
Once you have completed specialty training, you will be a qualified consultant in your chosen area of medicine and you can earn between £76 001 and £102 465 per year, depending on your experience and specialty. GPs and consultants might look like they have a comfortable life, but they have sacrificed a lot to get there.
Doctors need to be good communicators
Doctors need to work with colleagues from other specialties who have different skills. You need to be a good listener and be able to cooperate. For example, if a patient has a cardiac arrest on the ward, you will need to work with the nurses who alerted you that the patient was not responsive, and who can give you details about the patient’s background. You also need to be a good communicator when explaining test results, complex treatments or delivering bad news to patients.
Sometimes doctors develop mental health problems
Studying and practising medicine can be draining—it takes a lot of emotional, mental, and physical commitment. As a medical student you may feel pressure (often from yourself) to be the best, or even just to keep up with the demands of the course. A Student BMJ survey of 1122 UK based medical students in 2015 found that 30% (343) had experienced or received treatment for a mental health condition while at medical school, and just under 15% (167) of the survey’s respondents said that they had considered committing suicide at some point during their studies.
Positive thinking can make a great difference. It’s not always easy to see past the exams and on-calls, but it is important to try to do so. Think about how you will spend your free time when your exams or on-calls are over. Ask yourself what it is that drives you, and what you are trying to achieve in the long term.
If you experience a mental health problem during your career, advice is available from your university’s student support services and from the British Medical Association’s counselling service. In recent years there has been more openness within the medical profession about mental health problems and discussions about how doctors can improve resilience when times get tough.
You will probably change your mind about the type of doctor you want to be
When you apply to medical school you might have an idea of the type of doctor you want to be when you qualify. Before I started medical school I was adamant that I did not want to be a general practitioner; but after wanting to be an ear, nose, and throat surgeon, urologist, cardiologist, and neurologist, I did settle on being a GP. As I progressed through medical school and reached my early 20s, I realised that general practice would provide me with a good work-life balance and allow me to explore interests outside clinical practice. Keep an open mind about what each specialty involves, talk to senior doctors, and do your research.Patrice Baptiste, general practice specialty trainee year 1
Romford, Essex, UK
Competing interests: None declared.
Provenance and peer review: Commissioned; not externally peer reviewed.
- Department of Health. Long term conditions compendium of information. 2012. www.gov.uk/government/uploads/system/uploads/attachment_data/file/216528/dh_134486.pdf.
- British Medical Association. Pay scales for junior doctors in England. 2014. www.bma.org.uk/advice/employment/pay/juniors-pay-england.
- British Medical Association. Pay scales for consultants in England. 2014. www.bma.org.uk/advice/employment/pay/consultants-pay-england 1.
- Baptiste P. Exploring doctor’s mental health. BMJ Opinion 2015; 29 October. http://blogs.bmj.com/bmj/2015/10/29/patrice-baptiste-exploring-doctors-mental-health/
- Lee YY, Medford ARL, Halim AS. Burnout in physicians. J R Coll Physicians Edinb 2015;45:104-7. www.rcpe.ac.uk/sites/default/files/lee_5.pdf. doi:10.4997/JRCPE.2015.203 pmid:26181523.
- Billingsley M. More than 80% of medical students with mental health issues feel under-supported, says Student BMJ survey. 2015. Student BMJ 2015;23:h4521.
- Royal College of Psychiatrists. On looking after yourself: A survival guide. 2011. www.rcpsych.ac.uk/pdf/PSS-guide-15_for%20web.pdf.