it's all worth it. The sleepless  nights, countless hours studying,  

and missing special occasions to spend  time with your one true bae, your organic  

chemistry textbook, are enough to make anyone  second guess their choice to pursue medicine.

Dr. Jubbal, MedSchoolInsiders.com.

If you’ve struggled to determine if  becoming a doctor is right for you,  

or if you’ve second guessed your choice along  the way, you’re not alone. This video is for you.

The vast majority of premeds and medical  students struggle with their decision,  

suffer from imposter syndrome, and feel  confused about the process of becoming a  

doctor thanks to a lack of clear guidance.  So many medical students I've worked with  

over the years through Med School Insiders, as  well as the colleagues I went to school with,  

feel lost navigating life as  a premed and medical student.

Dr. Amit Pandey, a young hospital medicine  physician practicing in San Diego, California,  

was a premed not too long ago who struggled  through those same challenges. His new book,  

The Premed Paradox: What You Need to  Know about the Life of a Physician,  

is his effort to empower premeds and help them  through those struggles. It dives deep into  

the life of a doctor, covering everything from  the logistical steps of medical education and  

training to the emotional experiences of medical  practice. At its core, this book empowers premeds  

with the knowledge they need to understand  the complex life and career of a physician.

Dr. Pandey recounts a story in the book’s opening  chapter that taught him an important lesson about  

becoming a doctor. One day, in the beginning  of his first year of residency, he needed to  

perform a procedure called a paracentesis, which  removes fluid from the abdomen of a patient to  

relieve pain or diagnose infection. As he was  arranging his procedure kit and getting ready to  

inject a numbing medication called lidocaine, he  encountered some unexpected turbulence. He recalls

“To my absolute shock, I immediately felt  the glass tip of the vial penetrate both  

gauze padding and sterile glove,  cleanly slicing through my thumb,  

which had applied the pressure. I placed the  lidocaine bottle back on the kit and looked down,  

horrified, as round drops of bright red  blood began to emerge from the slit in  

my pearly white glove. I looked over to  the supervising doctor who was standing  

behind me and barely managed to croak out  these five words: ‘I think I cut myself.’”

This was a powerfully humbling experience  for Dr. Pandey. He was able to bounce back  

and complete the procedure smoothly after  stabilizing his injury. But the experience  

taught him a valuable lesson: No matter how  prepared you think you are, there will always  

be bumps and hurdles along the way. Medicine  is a challenging but exciting career. Having  

the humility to know that you can never know it  all, while also pursuing as much knowledge as  

possible to prepare yourself, will make premeds  stronger when they join the medical profession.

Let’s now take a deep dive into what  the decision to become a doctor entails,  

and what every premed and medical student needs  to know about the process. Plus, we’ll take an  

inside look at the most important lessons Dr.  Pandey learned from a decade of medical training.

First, let’s unpack the premed paradox,  which Dr. Pandey describes as the following:

“How could so many intelligent and  hardworking individuals dedicate their  

lives to becoming a physician, perhaps the  longest and most arduous professional path,  

with such little information about  what that commitment actually entails?”

More than 50,000 students apply to MD medical  schools annually, and many more start out  

as a premed at the beginning of college. But  most have no idea what it’s actually like to  

be in medical school, choose a specialty, work  as a resident for 3 to 8 years, or choose your  

type of medical practice. And it’s not their  fault; these questions are near-impossible to  

answer early on as a premed, and this real-life  exposure is extraordinarily difficult to come by.

The level of commitment on relatively  low information is a huge leap of faith.

Dr. Pandey notes that “there is a  certain gravitational pull when it  

comes to the medical profession that can keep  one pushing forth for a decade or more despite  

difficult odds…But for all premeds, this pull  [should] not come at the cost of deliberate  

self-reflection. Commitment to a career  as a physician is a wonderful undertaking,  

but one to be chosen carefully  and for the right reasons.”

So, why do students want to choose a career in  medicine when they have so little information?

Medical students typically  have a desire to help people,  

an intellectual interest in medicine,  and some financial motivations.

But expectations of prestige and financial  gain are not good reasons to pursue a career  

in medicine, as the job is neither as  lucrative nor as respected as it once  

was. On the other hand, a genuine  intellectual interest in medicine,  

a desire to interact with diverse people on a  daily basis, and a desire for lifelong learning  

and innovation are reasons that will lead  to long-term job satisfaction in medicine.

There are also alternative career paths  in healthcare, such as becoming a dentist,  

pharmacist, optometrist, nurse  practitioner, physician’s assistant,  

nurse, physical therapist, or clinical  psychologist. These each have distinct  

advantages and disadvantages  compared to becoming a physician.

For example, dentistry requires 4 years of  undergrad and 4 years of dental school but  

can have a shorter training. Dental  residency is optional. If chosen,  

it ranges from 1 year for general dentistry to 3  years for specialties like orthodontics. This is  

considerably shorter than the minimum  of 3 years for medical residencies,  

up to possibly 8 years in certain  surgical or medical subspecialties.

The cost of dental school is typically  slightly higher than medical school on  

average. Dentists also generally go into private  practice more frequently than physicians. To  

learn more about what it takes to become  a dentist and whether or not it’s for you,  

check out our So You Want to Be a Dentist  episode linked in the description.

Meanwhile, nurse practitioners and physician’s  assistants work alongside physicians,  

typically under their supervision. Their training  is shorter and less expensive, and consequently,  

their earning potential is lower. That  said, they have more flexibility and can  

change between specialties easily throughout  their career, whereas physicians cannot.

Premeds should consider these comparisons, as  becoming a physician isn’t the only possible  

path within the healthcare profession.  Many students want to become a doctor  

because they love science and want to  help people, which are things that can  

be achieved through other career paths as  well. Being aware of the alternatives will  

help you make an informed decision when  choosing the path that’s best for you.

The next challenge anyone who  wants to become a physician  

faces is navigating the journey  of actually becoming a doctor.

Getting into medical school is no small feat.  The med school application process is long  

and challenging, and only approximately 40% of  applicants are accepted annually. Fortunately,  

this is the aspect of becoming a doctor that  has the most resources available for students.

The Med School Insiders blog has many guides  outlining each aspect of the application process,  

including a month-by-month timeline that  outlines everything you should be working  

on each month during the application cycle. If  you’re a premed, this resource is invaluable.  

Find it in the description. Medical School 

Getting into medical school can feel like the end  of the race when it’s actually only the beginning.

Dr. Pandey describes the early  years of medical school, stating:

“Years one and two are primarily classroom  learning, a bit like undergrad ‘on steroids.’  

This time is spent learning the bread-and-butter  medical knowledge needed for clinical practice.”

You might “dissect the chambers of  the heart in anatomy lab, learn the  

pathophysiology that drives neurologic  disorders like Parkinson’s disease,  

or grasp the microbiologic causes of  historical diseases like the Plague.”

Moments like this can be exhilarating,  as you finally gain the knowledge that  

you set out to learn. But these early  years are often described as drinking  

through a firehose. Students have to learn  so much information at such a rapid volume  

and pace that traditional study methods do  not suffice. It’s at this time that students  

must adopt active study techniques,  healthy habits, and defined routines.

The latter half of medical school is when students  finally get the chance to practically apply what  

they've learned during clinical rotations. But  this time is a whirlwind as you jump from one  

rotation to the next in rapid succession. While  it involves difficult work hours coupled with  

intense studying, it is exciting as this is your  chance to test out the various specialty choices  

you could potentially pursue. Specialty Choices 

The next hurdle medical students face  is choosing a specialty and career path.  

Although clinical rotations help students better  understand their likes, dislikes, and interests,  

the required clerkships only cover the core  medical paths, which include family medicine,  

internal medicine, OB/GYN, pediatrics,  neurology, surgery, and psychiatry.

There are many other paths and  subspecialties a medical student can pursue.

For example, a graduating medical student might  match into internal medicine residency. From  

there, the internal medicine resident  can become a primary care physician who  

sees patients in a clinic, or a hospitalist  who sees patients admitted to the hospital.

They can also choose to  pursue additional training,  

called a fellowship, in many fields such as  cardiology, gastroenterology, or pulmonology,  

to name a few. If they choose a fellowship  in cardiology, they can go even further to  

do subspecialty training in something like  electrophysiology or advanced heart failure.  

This whole pathway can take more than  10 years after undergrad to complete.

Residency After choosing their  

specialty, medical students move on to residency,  

the real core of medical training and the time  when the student really grows into a doctor.

Some residencies are more inpatient heavy, while  others are more outpatient focused. Inpatient  

refers to taking care of patients admitted  to the hospital for acute medical issues,  

while outpatient is caring for  patients in a clinic setting,  

such as a primary care doctor or  specialist doing a scheduled visit.

Getting a comprehensive picture of what  it’s actually like to be in residency is  

critical for anyone deciding whether or not  they want to become a doctor. Reaching out  

to those who are going through or have been  through residency, watching videos like The  

Day in the Life series on the Kevin Jubbal  M.D. channel, and reading personal accounts  

from practicing physicians like Dr. Pandey  can help students understand what they are  

committing to. This knowledge is crucial as  a premed making career decisions early on. 

Career Practice Eventually,  

after finishing their training, physicians must  choose their preferred career practice setting.

Academic practice involves supervising and  teaching medical students and residents,  

as well as performing academic research.

In community practice, most of your  time will be spent on clinical work,  

as there’s less teaching and research involved.

Private practice is essentially a  physician running their own business,  

providing medical care to  a private set of patients.

Learn more about each of these career paths in our  

video Academic vs Community vs Private  Practice, linked in the description.

Data published in 2020 reports  that “49% of physicians worked  

in practices completely owned by  physicians, down from 54% in 2018.”  

Currently about half of physicians are  in private practice, but this number  

decreases in metropolitan areas where larger  medical groups dominate more of the market.

In The Premed Paradox, Dr. Pandey  explains that understanding the  

different career paths you can take  in medicine early on can help aspiring  

physicians prepare for what awaits  them during their career in healthcare.

Lastly, there are some aspects of a doctor’s  journey that are rarely taught and sometimes  

considered taboo to speak about. Finances 

It is no secret that medical school  is very expensive. The average medical  

student graduates with over $250k of  total student debt. But that notion  

may be somewhat abstract when you are  early on in your education or career.

Dr. Pandey describes an example of two  college friends graduating together,  

one off to medical school and the other taking  a job as an engineer in the tech industry. The  

engineer starts to earn immediately upon landing  a job after graduation. The med student is slowed  

by two important factors: Debt due to expensive  medical education and Opportunity cost—the cost of  

time spent not earning money in medical school and  then earning a relatively low salary in residency.

Medical students, residents, and new attending  physicians must exercise considerable patience  

and delay gratification. They must wait for  financial success, which will come years down  

the line after debt is paid off and the lower  resident salary rises to the attending physician  

level. They must be okay with reaching financial  milestones later than their peers in other fields.

On the other hand, being a physician provides a  “high financial floor,” as Dr. Pandey calls it,  

or in other words, a very solid  guaranteed salary once training  

is complete. It also provides a high  degree of job security. In general,  

healthcare workers remain in demand  and are less likely to be laid off than  

workers in other industries. These are strong  financial benefits of a career as a doctor.

Understanding these factors, how to manage debt,  and prioritizing financial education is critical  

for anyone interested in a career in medicine.  We break down why so many physicians struggle  

with managing money in a previous video, Why Are  Doctors So Broke?, linked in the description. 

Burnout Burnout is another  

important topic critical to understanding the  healthcare profession. It leads to mental and  

physical exhaustion, detachment from  work, and decreased effectiveness.

Medicine is undoubtedly an awesome career, with  great psychological benefits, such as saving  

lives, caring for others in times of need,  continuous learning, and opportunities for  

innovation. But the career also carries inherent  challenges which make it high-risk for burnout,  

including long work hours, many bureaucratic  tasks, and facing life and death on a daily basis.

A survey by the American Medical Association  showed that 42% of all physicians self-reported  

some form of burnout. Critical care  reported the highest rate of burnout at 48%,  

while plastic surgery had the lowest at  23%. While burnout is common in medicine,