Through the work I do with Medic Footprints, I’ve met many a medical student who has quietly confessed to me their struggles with their studies, and asked whether I think they should simply quit medical school.
It might be the stress of the gruelling degree that’s getting to them, or the loss of conviction in their direction. Personal issues and a lack of support might be compounding their distress. Nowadays politics also has a part to play, as recent events have shone a harsh light on NHS working conditions, and medical students haven’t had much of a say in the debate. It’s no wonder they’re disenchanted.
But I find this question really hard to answer. I wish I could write a checklist or questionnaire that helps you decide – but the truth is, there are so many factors, variables and possibilities involved in this dilemma. It’s a deeply personal and sometimes quite horrible place to find yourself, and if you’re reading this, you might well be going through this yourself.
What I can do is tell you about own battle with this question. Over my six years in med school, I asked myself again and again whether I should leave.
I was really excited to start my studies at Bristol, but almost from the first semester of the first year, I had suspicions that this degree wasn’t right for me. It was weird – it just didn’t feel right somehow.
However, there were three things that stopped me from taking decisive action at that point:
1. Despite my misgivings, I did actually enjoy some of my classes. It turned out (to my shock) that I was fairly good at biochemistry. My natural nerdiness and curiosity made things like physiology and genetics fascinating, and while nothing about histology sparked even the remotest interest, and the smell of formaldehyde in dissection classes made me feel sick, the ratio of classes I liked to classes I disliked was fairly balanced.
2. Going to university was a huge change in my life – there was a lot going on, and I was gaining independence and evolving as a person. There were so many things I felt confused about and unsure of that medicine was just one thing on a long list.
3. It simply felt way too early to decide. I was always a dedicated student at school, and I didn’t like to give up on things. I had worked so hard to get into med school, and I wanted to give it a chance. I felt I owed it to myself and my family to get through the exams and give clinical a go, and if I’m honest, I felt too young and inexperienced to make those kinds of life decisions.
Nearly dropping out
By the middle of the second year however, things were not going well for me. I was struggling mentally and emotionally, and when I went to see the pastoral care advisor, she helpfully shrugged and suggested that I just ‘take a year or two off to sort myself out.’ I hear that pastoral care has improved since I left Bristol – I really hope that’s true!
Things got so bad that I got to a point where I couldn’t cope anymore, and fled from Bristol with no real intention of returning. I quite literally packed my bags, left my housemates a goodbye note and got a train home. This is the closest I came to dropping out. I was a total mess, and I couldn’t face the idea of continuing. I did eventually return and go back to my studies – but not without the assistance and support of family, friends, doctors and therapists.
Needless to say, it was a real low point, and it left me feeling quite confused over whether it was medical school that was making me unhappy, or whether I was just really unhappy in general. The two things seemed to merge quite a bit – stress at uni affected my mental state, and my mental state gave me a bit of a negative view of my studies.
In hindsight, I should have done more to take care of myself during this time, but my attitude to life then was very much ‘grit your teeth and get through it.’ Youth and physical fitness got me through a lot – I went on lots of long walks, and danced on the university ballroom and latin team. I also met my now husband in the latter part of that year, and he did a lot to help stabilise my mood.
Unable to put my finger on what was making me miserable, I gave my degree the benefit of the doubt and continued.
The credit crunch
The financial crash had a big impact on my view of things. My friends doing three year degree courses were worried about launching a career in such an uncertain climate, and I had heard horror stories from people who had already graduated and were now struggling to find jobs. People always told me that ‘medicine is a stable career’ (even though it actually isn’t that stable, when you take everything into account) but it felt safer to hide away from the big scary world for a few more years at university.
Still, I knew I needed a break from medicine.
Intercalation in Leeds
Now, in retrospect, it probably wasn’t the best idea to use an intercalation as a ‘break’. Doing a Bachelor’s degree in a year (even if it is intercalated) does not constitute a break! Certainly not for me anyway. And I’m not sure why I chose to study medical imaging. For a person who dislikes maths, doing a degree in what essentially was mostly physics, was a terrible idea. I hated it.
I also made the move for the year to Leeds in order to study it. My reasons for doing this included a vague desire to ‘get away’ from the Bristol scene, and because my best friend was studying there. Actually, the fact that medical imaging was one of the intercalations offered at Leeds, but not at Bristol, was probably why I chose that course. If the course had been offered at Bristol, I might not have been permitted to leave.
When I talk about it now, I see so clearly that I was a just bit lost. My series of sub-optimal decisions was just an attempt to run away from my problems, but at the time, I felt I was being pragmatic and making the best of things.
I left Leeds with an unsatisfactory 2:1 degree, having found the course totally boring and pointless, and with the uneasy feeling that I’d done myself a disservice somehow. I don’t, however, regret the friends I made and the experiences I had that year – I had a lot of fun living up north!
Running off to Paris
Although I briefly went back to Bristol to start my clinical years, I was already planning to leave again. The ERASMUS exchange was on the cards – the very reason I had chosen Bristol University in the first place. They don’t run the exchange anymore, which is a shame, because it was one of the most amazing things I have ever done.
My application to the exchange was successful, and I went away to Paris for six months to study at the Université de Pierre et Marie Curie. It was a bit stressful, because they had a different syllabus (obviously all in French) and I still had to sit the same exams as everyone else when I got back, but it was totally worth it. I had adored French at school, and the chance to actually live in France was a dream come true.
I also desperately wanted to include my love of languages and words in my new medical lifestyle. French and German had been my favourite subjects at school, and I couldn’t bear the idea of losing my fluency. The exchange gave me the chance to see if the two were compatible. You can never really know these things until you try them, I guess, and I was optimistic (perhaps naïvely so) that I could balance my outside interests with my medical career.
Finishing the clinical years
With four years out of the six done by this point, the idea of my quitting medical school seemed rather silly. I had come this far – only two more years to go – I might as well finish. Again, I was grappling with the dilemma that, although I didn’t really like being in hospitals, I wasn’t sure whether I didn’t like it because I was ‘just a medical student’. Everyone seemed to say that being a student was a bit rubbish, but it all got better after you qualified.
How could I possibly know, therefore, whether I would like being a doctor?
When I qualified, I realised that it was true – being a doctor was better than being a medical student in lots of different ways. I really enjoyed parts of my F1 year, and had my character been otherwise, I might have been one of those doctors who loves the job but hates the system.
Of course, that turned out not to be the case, but I could not possibly have predicted that as a student. I did not know myself well enough then to make that call – it was only at SHO level that I began to understand what I needed.
I really didn’t want to leave uni with an unfinished degree either. I couldn’t imagine what I would do or where I would go. The last four years had been solely dedicated to becoming medically qualified. What on earth would I do with my life if I left now?
When the last year came round, I was feeling pretty good. The marathon was nearly done. By April, I had my passed my finals, got the SJT out of the way, secured a place at my desired Deanery, and was about to jet off for an amazing elective in Sri Lanka and India. It was the end of an era – I had done it! I felt more relieved than happy, but it was a nice feeling to finally be able to put Dr in front of my name, and swearing the Bristol Oath on graduation day was an exciting and proud moment.
How do I feel about it now?
I can honestly say now that I am really glad I completed medical school. I feel incredibly privileged to have had an insight into the worst and best moments of human life, and even though I left the profession in the end, the fact that I am a doctor has benefited me enormously in my new career. Doctors seem to have no idea of their value in the non-medical world, and how many transferable skills they have. My medical education has opened doors to me that would never have even been visible otherwise.
That’s not to say I don’t have regrets about how I reached that point – I do wish I had taken better care of myself, been kinder to myself and allowed myself a little more breathing space. Medical school is a weird, highly-pressured environment, and this does hugely impact your decision-making. What I discovered is that it isn’t really possible to completely disentangle personal and professional/educational issues. They are intertwined, and as soon as I gave myself the chance to properly reflect, I was able to start tackling both.
I really admire people who make the decision to leave while they’re at medical school, or even just after finishing med school. People like Dr Hana Ali, who knew that her passion didn’t lie in medicine, and pursued a career in business as soon as she’d qualified. The truth for me is that I just wasn’t ready to make that leap at the time. I didn’t know myself well enough, or have the confidence to follow my instincts. There was a huge piece of personal development to do before I was able to make that decision for myself. Part of me also just wanted to see how it all played out – to just try out being a doctor, so that I was absolutely sure it wasn’t for me. Leaving medical school is an incredibly courageous and very personal decision, and being ready has as much to do with it as knowing it’s the right thing for you.
It’s not just you
I hope that sharing my story helps people to feel less alone. I used to think that everyone else was doing so well, and often wondered why I couldn’t cope as the others seemed to. I was constantly intimidated by the intellect of my peers, and a little jealous of those who were always going out, and aced exams even though they said they’d ‘hardly done any revision’. When I look back now, I am proud of having passed every exam, including the ones after the ERASMUS exchange, but while I was actually in Bristol, I felt woefully mediocre.
With so much pressure, and an examination structure that pitted us directly against each other, I suppose it’s no wonder that it all got a bit competitive, and some people played up to this more than others. I heard stories of med students sabotaging each other, or hiding resources from other people – I can’t say for certain if those stories were true, but I can see how stress and desperation might drive such practices.
I was never the best – I never got a distinction or really excelled in any modules. By the end, it was my aim simply to pass! But it didn’t matter a jot once med school was over, and it certainly doesn’t matter now. I know I was a damn good doctor, and I know I have got to where I am now because of medicine. I just wish I had known that it’s OK to have doubts, that it’s right to give precedence to your health and happiness, and that it’s possible to leave if it doesn’t work out.