Strewing career advice fills me with horror. I never foresaw the internet; or the mobile phone. Even now, I just can’t come to terms with the simple and widely known fact that any of my girlfriends from the remote past can reach me with the tap of a few buttons, or by speaking a few terse and upsetting sentences into an App. She can be across the Arabian sea, and I can be in Galapagos Islands. The sheer enormity of it boggles my head; and the brain within. The fact that I can do the same only makes it worse.
So, what kind of a world, will an eighteen-year-old encounter, twenty years from now, when existence reaches a crescendo and the merciless mid-lifespan Sun shoots forth its barrage of withering rays? What will India be like then? Will it still be spending a measly one percent of its healthcare on public funded health, while the US spends ten and most European countries manage fifteen? Will we care? If we do, can any one speak out without the IT, ED, and the CPC snapping at our heels?
So, you see- this isn’t easy. Yet I can’t resist the temptation. It is a known fact that when the testosterone wanes, and the target equipment starts its inevitable shrivel, we men get an irresistible urge to communicate, pontificate, preach, hold forth, and generally make an ass of ourselves. Our target is the next generation, and the subject of our discourse is, well- how to not make an ass of themselves in life. But I bask in the illusion that some young people need it; may listen to it, and even- benefit from it.
Let me tell you one inconvenient truth. Most people go for Medicine because it is prestigious, and thinks it is guaranteed to give one a certain high level of social status, security and money. This is the primary reason. Passion, interest, and an ardent desire to serve the fellow human- maybe there, I don’t deny that.
I had a certain amount of passion for it and a keen interest in science. But let me be frank. The perception did sway me too.
- Medicine still, is big. A successful Doctor is a big shot. This may change a bit in the future, but is likely to continue, in a more subtle and emaciated form.
- It is challenging, and for the right person, extremely rewarding.
- One will never be bored. Terrified; often, and Frustrated; yes- but bored- almost never, in most specialities.
- Many of your close friends and relatives may benefit, though your immediate family will suffer.
The Cons- In general:
- The Medical profession is the most regulated and audited one in the world. Every one of your actions are likely to be put under the microscope and sifted for faults. One may have to renew credentials every few years throughout one’s life. Holidays might have to be sacrificed for ever. Bad outcomes might haunt you and scar you for life. But this enormous responsibility will not be compensated by money or prestige. The rewards maybe good, but the Risk- Benefit Ratio is already low, and it will plummet further. The world will progressively resent the respect that taking responsibility gives you. The MBAs, the administrators, the civil servants, and the politicians are going to run the show. Para medical specialists will be given increasing responsibilities, and even prescribing privileges. They will corner the benefits, but might not take any responsibility.
- The training and credentialling takes years, and even decades. It is difficult to change course after basic training. If one is trained in computer science, mathematics, statistics, commerce, economics, management, English or even engineering, it is only for four years and your background is still quite general. One can look around at the rapidly changing world, see opportunities, and get trained while doing novel jobs. After years, re-training and changing careers are relatively easy. But- MBBS is about six years in India and it is all about looking after and treating patients. A young person trains for eight years to do pediatric cardiac surgery and then can take another ten to fifteen years to get an opportunity to head a team. At this point, it is nearly impossible and or unthinkable to change her course in life if circumstances so demand.
- Hence your sense of identity is intimately tied to your profession. Alternate careers are seen as failures. A change of course and parallel paths are considered weird, or even crazy.
Cons- Specific to India:
In addition, Indians can have certain specific problems.
- As a general rule, only the urban rich can complete a Medical Education properly. Any training after the basic degree is considered as university courses and are charged fees; sometimes heavily. In most of the rest of the world, these are just reasonably paid jobs, with a credentialling exam at the end of it.
- India needs a lot more doctors; yes. But where are they to work? Most of the population is poor, and government spends a very meagre amount on healthcare, and the public facilities are generally abysmal. Frequent transfers, endemic corruption, lack of facilities and a culture of heavily hierarchical politics, makes the public sector a set-up designed to send a conscientious doctor into nervous breakdown. Most doctors are aspiring for the private sector, which caters for two or three percent of the population (paying out of their pockets).
- Many states like Kerala, Tamil Nadu, Maharashtra etc are saturated with doctors. So are the big cities. The real deficits are in the smaller towns and villages of the North. There, there is an emerging middle class that can pay. The public facilities are improving very slowly. But how many of the newly minted middleclass or rich, comfortable, urban young, many of them women, are going to migrate from the saturated south and work permanently in a small town or a village in say, Bihar, Rajasthan or Uttar Pradesh? It is easy to say that they should.
- If one is looking to go broad, any other degree is much better. Medicine is heavily regulated and tied to the needs of all the developed countries. Credentialling is really tough. Most won’t accept our higher training.
So, a few final thoughts:
Are your parents very rich? Don’t you require money at all? Are you very passionate about Medicine? Are you good at dealing with suffering humans? Can you manage an angry crowd with aplomb? Are you willing to work quite hard for your entire life? Do you remain calm in situations where others get frustrated and throw things around? Do you feel that generally you are less anxious and less fearful in most situations than most people? Go ahead. Medicine is the right career for you.
Do you satisfy all of the above except the rich part?
You too can take Medicine. But only if:
- you get MBBS in a Public funded Medical School where the fee is nominal. In India, one cannot take a large educational loan and expect to pay it off after passing, with your earnings. It is nearly impossible.
- You are ready to start work after your degree. Specialization may have to wait.
- You are ready to work in areas of the country where actual need is there. This includes smaller towns and rural areas of the North, East and North East of the country.
- If you don’t expect near-ideal facilities. In a developing country like ours, one cannot expect to go to work in the morning, and expect the system to support you. You will have to make the system from scratch and make it work. People will fight you, and you have to keep your ground.
It has been a long article, but it is from the heart, yet with a lot of thought. : )