The Premed’s Best Interest
Happiness on the way to medical school
The New Physician December 2009
by Daniel E. Ehrmann Volume 58, Number 9
Physicians are often lauded as the ultimate altruists. And from the day future physicians begin their quest to become doctors, they are inundated with messages that preach the importance of tending to the wants and needs of others. It makes sense that they internalize these messages, and they serve to form the foundation of our modus operandi.
However, premeds often take this message out of context, assuming that an unwavering devotion to the needs of others includes those far beyond the patient. Premeds then expand this group to include advisers, program coordinators and medical school admissions directors. Before we know it, future physicians get caught up in the perceived wants and needs of everyone around them.
While these sources are meant to provide premeds with direction, they are often a source of unhappiness and stress. Many premeds fail to realize the degree to which they blindly follow a path that can be traversed rather happily. In being programmed to care for the desires of others, they become drones for the powers that be: those that premeds think determine whether they will have the opportunity to become physicians. Premeds major in biology because that’s what they think will make them look the best. A poor test performance leads to disappointment, not because they have fallen short of their own expectations, but rather because they have fallen short of someone else’s. Future physicians volunteer and gain clinical experience because they have to. They do research not because they find the topic inherently fascinating, but because that’s what the adviser’s checklist said. This leads to profound unhappiness and a lack of satisfaction in the amazing work that they do.
The solution depends heavily on finding happiness for each student’s own self-interest: Aspiring physicians need to understand what leads to happiness and be more selfish in its pursuit.
Recently, I read Happier, by Dr. Tal Ben-Shahar, a psychologist at Harvard University. He argues that true happiness is the lasting fulfillment achieved when one participates in activities that provide both pleasure and meaning. His equation for achieving happiness is almost insultingly simple: Rate each of the activities that you do on a daily basis on how much pleasure and meaning they provide you. If possible, take the activities that score the highest and do more of those, and do less of the activities that score the lowest.
Premeds may cynically remark that they don’t have time for any of that nonsense. That is incorrect: It’s not that you don’t have time; it’s that you choose to prioritize your time with activities that you perceive to be more important. And since these perceptions are based on the wants and needs of others (like admissions directors), you essentially end up packing your days with the things you think a premed needs to do to succeed.
How about this, then? If you can do less of something that doesn’t provide you with pleasure and substitute something that does, do it. But, if you can’t, consider your real reasons for doing the things you feel you have to do.
All of us future physicians need to identify what drives us to become physicians. What is it about becoming a physician that interests us and makes us happy? For example, I have a profound interest in autism. I can’t change the time that is reserved in my day for classes, but I chose to major in psychology to learn how autism is diagnosed in a clinical setting and how the syndrome affects self-esteem and interpersonal relationships. I minored in a subject that covers the history of medicine so I could learn about discrimination against people with autism during the eugenics period of the 18th, 19th and even 20th centuries.
But aspiring physicians need to have clinical and volunteer experiences. Sure, this makes us more well-rounded and prepared for a career in medicine, and that’s why such experiences are highly valued by the powers that be. In my case, rather than go through the motions, my options became myriad and appealing. I could get involved with a student organization that fosters pen pal relationships with children who fall on the autism spectrum, or be a mentor to a teenager with autism in the city that surrounds my school. Maybe I could tutor younger children with autism in basic communication and interpersonal skills or shadow a child psychiatrist.
Aspiring physicians also need to do research. It’s true that medical admissions directors value research experiences because they provide the hypothetical-deductive reasoning skills necessary to become a physician. But, rather than be a drone entering data for a project that I neither understand nor care about, maybe I should get involved with a lab that looks at sleep-disordered breathing and its implications for autistic disorder. I might even have the opportunity one day to oversee a project of my own, specifically based on my interests.
And it is through this selfish pursuit of the activities that give us both pleasure and meaning that you can transform your entire experience as a premed. Your days will still be very full, and you will have a lot of work to do, but you will be doing the things that you love, going to sleep at night exhausted but satisfied. And the powers that be will respect that.
Maybe your passion is global health, the urban underserved, young mothers or infectious disease. Or maybe it’s intramural football, watching movies or cooking. Take a step back from your conditioning, acting solely based on what you think others want. Instead, isolate what makes you happy, what provides you with both pleasure and meaning. Do more of that.
If we, as future physicians, make these changes, at the end of our premedical careers not only will we be more willing to tackle the everyday requirements of the med school world, but we will be more optimistic and enthusiastic to pursue a career as empathetic physicians. We will have a driving force behind our hard work and, in the process, we will become well-rounded. Ben-Shahar says that true happiness comes from minimizing the blind pursuit of goals and enjoying the journey. If we take a little more time to care for ourselves, we will function happily en route to achieving the goals that have previously dictated our every action.
Daniel Ehrmann is a first-year at the University of Michigan Medical School. He authored this story as a senior premed.