Finally have some time to reinstall the website and add in some new features. It should be all done by the end of the week.

A scary thought crossed my mind tonight. I know how to get into medical school. I understand how the system works. I played the game and succeeded.

What happens if I don’t succeed in becoming a good doctor? What if I am inadequate?

Finally done school! 3-4 months pursue other hobbies and do anything else other than medicine.

Congrats to all the readers who received an acceptance into medical school. Enjoy this last summer before your long journey begins. To everyone who was waitlisted, best of luck in your wait and hopefully someone will free up a spot for you. Finally, for those rejected, don’t give up! If this is your goal and you want to become a doctor, you will get there. It’s only a matter of time.

Feedback: I have now worked on this blog for almost a year now. I’ve gotten lots of wonderful comments from readers but I want to know a few things.

Has this blog helped you in anyway? It’s always nice to hear success stories, and if I was able to provide you with something useful on this site, what was it?

What type of articles would you like to read? More stories from medical school? Admissions information? More about me?

When I check the stats for this site, I see that every week hundreds of people come to read what I have written. However, few leave comments or provide feedback. As a writer, I find it frustrating sometimes not knowing who my audience is. Are you mainly high school students looking for university advice? Current medical students or residents? Interested public?

Let me know.

Why do people succeed? How do they do it? Don’t we all want to know the secret to success? Countless numbers of self-help books have tried to discover it. The media always speak of the latest success story. And no matter how old it gets, we still love hearing about rag-to-riches stories. What is the key to success?

One way I have tried to tackle this question is through biographies. I have always been curious to see how the rich, famous and powerful found their success. What special activities did they do? Who did they know? What was their motivation and their inspiration? Because of this natural fascination, I must have read at least fifty different biographies and autobiographies in my lifetime. It didn’t matter who the person was – businessman, scientist, doctor, writer, politician, holocaust survivor – I was always looking to see how other people did things differently.

And my conclusion is…

There is no Secret

There is no single piece of advice – a secret limited to only a select few – that will make you successful. In fact, you already knew that.

You see, when I say there is no secret to success, what I mean is that everyone already knows the secret(s). A formula for success most certainly exists. In fact, you have heard it hundreds and thousands of times. They are:

Work diligently, be passionate – love what you do, be kind to others, have patience, know thyself, think positive thoughts, step outside your boundaries, think outside the box, have a commitment to service, dream big, have persistence, be courageous, respect others, speak up, be yourself, be grateful, have a good attitude, follow your dreams. And so on…

All these cliches advices, adages and old sayings are the keys to success. These lessons have been learned, followed and shared for thousands of years, from the earliest Greek Philosopher’s to modern day blog posts.

There is nothing new under the sun…

Yet, each time I read these words of wisdom, I find something new. No matter how many times I have heard them, they mean something different to me each reading. There is a reason I believe these “secrets” are called secrets. Because we are able to draw fresh inspiration from these proverbs over and over again, their renewable nature is the mystery itself.

Much like the classic vase and faces optical illusion, the common wisdom we all know and take for granted is in fact not so common at all. Each person will interpret the “secrets to success” differently. Some people will see the vase, some will see the faces. As with the secrets to success, each saying can be viewed in infinite ways.

For example, the advice of “hard works pays off” meant different things to me at different stages in my life. When I was preparing to take the MCAT, I could see the correlation between time and effort studying to a good test score. The more I studied, the better I did on practice tests, and the better my eventual score. Similarly, there were other times when I saw what would happen when I did not put in any effort. After each experience, I would view and reaffirm the concept “hard work pays off” in a different light.

One habit I frequently do is to take a old saying, motivational quote, proverb, verse, prose or any advice and dwell on it for a week. For instance, I would choose a quote that particularly speaks to me such as “Success is the ability to go from one failure to another with no loss of enthusiasm.” And for that entire whole week, I would start my days thinking about this quote and throughout the day see what it means to me. And sure enough, throughout that week, what turns out to be a simple sentence becomes a profound life lesson. I start noticing areas where I fail at because of lack of enthusiasm. I become more aware of the powerful effects a contagious enthusiasm can have on others. And at the end of that week, I have gained a very valuable and powerful lesson of success.

So really, there is no secret to success. At least not in the hidden sort of way. Instead, we all already instinctively know the secrets to success. The real mystery is decoding what they mean to your life at this point in space and time. If you can unravel the secret from these timeless words of wisdom, you will have found your secret, and your success.

A trait I’ve noticed in medical students is that they’re strongly opinionated. Compared to undergrad students, medical students have something to say about everything. Not convinced, ask your average college student about health care, politics, economics, social issues or poverty. A good majority will not know about the topics, be undecided or have mild answers.

Ask a medical student and expect to listen to an earful.

Part of this phenomenon is due to a self-selection bias. The type of students who are admitted into medical school tend to be curious, vocal, and passionate. They get involved with student politics, world issues and have given most of these things much though. I’m not saying that you can’t be an outspoken student as an undergraduate, the incidence just happens to be much higher in med school.

Sometimes the intensity does get to me. It can create a divisive environment where neither party is willing to back down. Students will impose their views on others and make their voices heard.

On the flip side, being passionate and strongly opinionated, holding to one’s opinions unreasonably or stubbornly  can be admirable. It’s what makes physicians such good advocates. It’s what drives student to strive to do what’s best for the patient. It’s strong-minded people that push for improvements in the status quo, and ultimately those who persist, through criticism and self-doubt, are those who get the job done.

Those three things – autonomy, complexity, and a connection between effort and reward – are, most people agree, the three qualities that work has to have if it is to be satisfying.

-Malcolm Gladwell “Outliers”

The following phrase caught my eye while I was reading Outliers written by one of my favorite authors, Malcolm Gladwell – author of The Tipping Point and Blink. It neatly sums up what I believe is a common frustration amongst doctors.

The work in medicine is complex. Most people will agree that diagnosing and treating disease in itself is fascinating. Communicating effectively with people and helping patients live better healthier lives is difficult but rewarding.

However, modern medical practice is facing ever increasing pressures from government, health insurers and patients themselves to change how health care is delivered. There is less and less autonomy for doctors, who now have to follow countless guidelines and documentation. A lot of the new regulations are good, but many are set in place for legal reasons in case of lawsuits.

Medicine is also becoming more complex. Complexity is a good thing in one’s work according to Gladwell, however medicine is speeding towards an information overload. With health care information, genetics, new synthetic drugs, treatments and legal issues arising, doctors are faced with ever increasing workloads. Sure, doctors today work less than the medical generation before, but the current system is severely understaffed and overburdened.

Finally, the connection between effort and reward is becoming strained. Doctor compensation especially in primary care roles aren’t being addressed. Taking extra time to see a patient, which requires more effort and hopefully leading to a better outcome, isn’t rewarded accordingly. Preventative care which requires enormous efforts on the parts of both health care providers and patients isn’t reimbursed.

Many of these factors are out of the doctor’s and health care provider’s control. There needs to be a repairing of these broken connections in order to improve future medical costs and care.

It’s been an eventful year 2008. New city, new school and a journey into medicine. Next year looks promising and I”ll be sure to update often.

Have a happy holiday season, a Merry Christmas and a Happy New Year. I hope all your new year’s dreams and goals go well.

Usually medical students are busy deciding what residency or specialty they will end up in after their medical school years, for me I have a different question on my mind. What kind of medical career do I want to have? Medicine is flexible discipline, broad enough to have interests for everyone. For me, I just seem to be interested in too many fields. After much consideration, I’ve come to see three distinct paths ahead that I can see myself doing, each with their pro, cons and other considerations.

1) Academic / Research / Education / Industry

Pros:

• Intellectually stimulating / rewarding
• Opportunity to positively impact large population
• Able to pursue self academic interests / curiosity
• Furthering of human scientific knowledge
• Flexible, Job Security (after tenure)
• Less on-call frequency
• Teaching, Giving back
• Chance for $$$ – large research grants / business opportunities

Cons

• Low patient contact
• Dealing with administration / bureaucracy / politics
• Tied down to an academic institution / company
• $$$  – dependent on finding grants / funding / profits
• Need patience – years before fruits of labor realized
• Uncertainty in research / discovery

Other Considerations

• Several more years of scientific training, most likely needing a PhD
• Need to find good mentors / research experiences
• Emphasis on publications / teaching

2) Social Equality / Public Health / Relief Work / Third-world countries

Pros:

• Serving people who need it the most – poor, needy, vulnerable, sick
• High intrinsic satisfaction from helping others
• Sense of justice and doing the right thing
• Meaningful patient contact – Saving lives
• Seeing and knowing that your efforts are making a difference
• Wider exposure to the world

Cons

• Emotionally draining – facing insurmountable challenges
• Not as comfortable a lifestyle
• Possibly live in different country – away from home
• May strain family life – traveling, may be gone for months, raising kids
• $$$ – considerably less
• Fixing the underlying causes / system is hard and lengthy in time

Other Considerations

• Additional training, MPH (epidemiology, statistics, environmental)
• May need to pick up additional language(s)
• Understand health related economics,  policies, government, organizations

3) Private Practice / Clinical Work / Health Care Team

Pros:

• Valuable patient contact
• Training and development of clinical skills
• Medical practice autonomy – how you run your clinic, manage patients
• Ability to influence your community positively
• $$$ – higher, have control over income
• Family friendly – settled down location, routine in your lifestyle
• Outside interests – control of time, pursue hobbies (specialty dependant)
• Comfortable lifestyle – will be able to buy a house / nice car / raise kids
• Job stability and certainty – high demand for primary care

Cons

• Regular routine – may become boring / tedious
• On-call frequency higher if in hospital / shared practice setting
• High volume of patients / long work hours – may be stressful
• Not as far impacting as breakthrough research
• Treating patients and disease only – Less likely to change health care system
• Overhead costs, malpractice fees?
• Aging population – puts a strain on healthcare workers

Other Considerations

• Can sub-specialize, focus on specific groups or niche fields
• Able to work anywhere, anytime (dependent on your preferences)
• Short training period

These are factors that I have given much thought too. Ideally, I would like to do all three; realistically I would most likely pick just one.  The reason is that it’s very difficult to excel in more than one area. I am a finite person with a finite amount of time, and each of these paths can be a separate career on their own. The large amounts of training and energy needed to get good at any one leaves you with little to contribute to other ones. Obviously, the pros and cons are specific to me. Some might see low patient contact as a pro and other people might hate research.

So this will be the question I will be thinking of for a while. I have at least four years of medical school and 3-5 more years of residency to think this over with. If anyone has faced this question before and has experiences they can share or advice they can give, please leave a comment below. It will be much appreciated.