PMY 215 : Why Do You Want to be a Doctor? You Need to Know This!

Session 215

In this episode, Ryan breaks down some answers to questions that he has heard from students from the mock interview sessions to help you start thinking about what your motivations are before going down this journey.

Ryan initially had a discussion with a student he was doing mock interview with a career changer, someone who started off her career in finance and then decided to take the healthcare route, becoming a nurse and working as a nurse for several years now. She is currently applying to medical school because she wants to be a physician. When asked why she wanted to change course and become a physician, she wasn't able to come up with an answer. So Ryan dug into her story and discovered there was more to it.

Throwing some questions at you, why are you embarking on this journey to take 4 years of your life for medical school plus 3 years of residency and be hundreds of thousands of dollars in debt?

What motivates you? What was that spark?

If you don't know these things, then you better take some time to figure these out. See if you have any of the answers listed below and learn how to approach them.

Having health issues as a kid

Having health issues as a kid is not a good reason to become a doctor because plenty of people who have also had health issues did not go on to become physicians.

What was so special about your interaction that made you take that next step and go volunteer in a hospital and find somebody to shadow? What emotions did you have? Why did you take those next steps? It's important to tie that together. You already have this initial seed planted in your head but you need to take that next step.

You love science and you love helping people.

You don't need to tell people that you love science and you love helping people since obviously you like science enough to go through undergrad as a premed and clinical classes. As well, you're entering a career where you're really going to help people and they will  be demanding of your time, empathy, and everything because they need help.

You want in-depth knowledge of clinical medicine which you couldn't get through an NP.

You can get in-depth clinical knowledge as an NP but what is it about being a physician that makes you think having in-depth knowledge is going to make you satisfied?

You want to be the clinical knowledge expert and be able to make the final decision.

This answer focuses on you and your knowledge and your power of yielding the final decision. In many states, a PA and an NP can practice independently these days so you can make the final decision as a PA or NP and study as much as you want and do as much homework after you graduate from your programs and get the level of knowledge that you want.

When you talk about your explanation behind why you want to be a doctor, talk about the impact you want to have on the patients. If you want to have in-depth knowledge, what does it mean for the patient?

You don't want to feel limited in what you can do and in using information at your fingertips.

This can come across in a negative way if you come from a perspective that you don't want to be limited by the credentials telling you what you can and can't practice. Again, be sure the patient is in the conversation so it doesn't come off as negative and instead of talking about how you can be limited to a scope of practice, talk about affecting change in the patients or doing something to help the patients.

Reframe this into how you don't want to be limited because you want to be able to act on information and make a difference immediately for that patient. This changes the whole sentiment of what you're saying because it's now focusing on the patient and helping the patient. Focus on the patients.

You love the intellectual stimulation.

These are very cliche things and aren't really relevant to why you want to be a physician. Tie it together with having the satisfaction to make a difference in the patient's life and it makes a huge difference.

You were exposed to medicine at a young age because your parents are physicians or coming from a healthcare background.

Again, what is that next step? Draw upon the experiences of a patient. Talk about the connection you can have with a patient as a physician. How do you want to impact patients? How did you go from your parent being a nurse to you wanting to be a physician? Why not a nurse or a PA?

You want an increased level of knowledge vs. nurses or PA's.

True, but that answer alone does not suffice. Why do you want more knowledge? If your reason is autonomy, that is not a reason to want to be a physician. Start thinking deeper. Why do you want to have increased knowledge? Why is autonomy so important to you?

You want to make treatment plan decisions.

NPs and PAs also make treatment decisions. They have this power and a lot of them are practicing in an environment where they work on their own. You need to dig deeper and have more to your answer.

You want to help people and give back.

Noticing how the physician makes the patients feel comfortable and seeing that action solidifies why you wanted to be a physician can be a powerful answer because there is this unique interaction between patients and doctors.

You have a PhD and you need to become a physician to have that opportunity to treat patients.

Saying it this way is powerful because you're focusing on the patient. It's not about you or your level of knowledge or your power. It's all about the patient.

Why do you want to be a doctor? It is very important to know this. So think about these things when you're figuring out why you want to become a doctor.

Links and Other Resources:

www.mededmedia.com

If you want to work with Ryan, go to www.medicalschoolhq.net.

Dr. Ryan Gray's The Premed Playbook Guide to the Medical School Interview is going to be published in June. You can pre-order it now on Amazon or Kindle. Sign up for Kindle Unlimited and read the book for free.

Transcript

Introduction

Dr. Ryan Gray: The Premed Years is part of the Med Ed Media network at www.MedEdMedia.com.

This is The Premed Years, session number 215.

Hello and welcome to the two-time Academy Award nominated podcast, The Premed Years, where we believe that collaboration, not competition, is key to your premed success. I am your host Dr. Ryan Gray, and in this podcast we share with you stories, encouragement, and information that you need to know to help guide you on your path to becoming a physician.

I want to wish everybody a happy and healthy New Year. This is the first episode of 2017, I hope everyone's holidays were fantastic. Maybe you're listening to this podcast on a new shiny device, or shiny new device, and are listening maybe on fancy new headphones listening. Hopefully you don't hear all the imperfections in my voice through those fancy new headphones, but I just wanted to say welcome to The Premed Years if this is the first time joining us, or me. If this is not your first time joining, welcome back. I got a few emails over the holidays from people taking long car rides saying that they found this podcast and just started listening, so welcome to all of the new listeners. Go check out everything we're doing over at www.MedEdMedia.com.

What’s Your ‘Why’

This podcast came out of a discussion that I had today with a student that I was doing a mock interview with, and she is a career changer, she started her career in finance, went to school for business, was in finance and quickly decided that she wanted to go into healthcare, and was able to transfer jobs through a connection into a healthcare field, and through that job became interested- more interested in healthcare, and started a nursing program, and decided quickly that she would probably want to go on and get her NP to be a clinical nurse and to actually practice as an NP. And that kind of fell through the cracks and now she's applying to medical school, and has graduated as a nurse, and has been working now for several years and now wants to go back and be a physician. And when I pushed her on this topic of why are you changing course? Why are you now wanting to be a physician? What was it that when you were in finance, what sparked your mind and said, ‘I need to be in healthcare.' And she couldn't tell me. And I wanted to talk today about why. Why do you want to be a doctor? Why is it that you're embarking on this journey to take four years of your life for medical school, and three plus years for residency, and get hundreds of thousands of dollars in debt? Why are you doing that? What were your motivations? What was your spark? If you don't know those things, if you don't know those things you need to take some time and figure that out. And so we actually dug, and dug, and dug, and dug, and I learned that there was more to her story than she was letting on. And she had a family member- or herself, she had a lot of healthcare as a teenager, and that was her initial interest, being involved, and seeing all these physicians, and everything else. And that's a common initial story, but the next question is what did you do next? You can't just say, ‘I want to be a doctor because I had a lot of health issues as a kid.' Because that's not a good reason to be a doctor. There are plenty of people that have health issues that never go on to be physicians. What did you do, what was so special about your interaction that made you take that next step and go volunteer in a hospital or go find somebody to shadow? Go and obviously be premed and start down that path. What was it about that experience? What emotions did you have? What impact did that have on you? Why did you take those next steps?

It's important to tie that together. You have this initial motivation, this initial seed that's planted in your head. You need to take that next step whether your parent is a physician, whether you're a first generation immigrant and you want to do better than your parents of working all the hours that they're working, you want to make an impact. It doesn't make any sense for you to just want to be a physician because of that. So I want to actually break down some questions- or not questions, some answers that students have been giving me through mock interview sessions, and I want to talk about them, and talk about what's good and what's bad, and help you as you're listening to this start formulating your mind, and start thinking about what your motivations are behind going down this journey. Because they need to focus around a couple things.

The obvious things there, you love science, you love helping people. Great. Those are kind of unsaid necessaries. You don't need to tell people that you love science and you love helping people. I hope you like science enough to suffer through your undergrad career as a premed with it, and then take four years or two years for clinical classes in medical school for it as well. And then obviously the helping people part. You're entering a career where you're going to help people, and people are going to be demanding of your time, and demanding of your empathy, and demanding of everything because they need help. So I hope you want to help people, I hope you love science, those aren't good reasons to want to be a physician. You need more than that, so let's go ahead and talk about some of these reasons.

Wanting In-Depth Knowledge

So I want to continue talking about the student that I talked to today; the one that talked about starting off in finance, and then transferring over into a healthcare related field but not clinical, and then going on and getting her nursing degree, and then thinking about becoming an NP. And she talked about- as I was asking this question, she talked about talking to NPs, and learning their story, and after talking to them she learned that she wanted to pursue becoming a physician instead. She talked about wanting in depth knowledge of clinical medicine, and she knew she wasn't going to get that through a nursing program or an NP. And so she felt strongly that she needed to pursue medicine. I asked a follow-up question, I said, ‘Okay so you want in depth knowledge. You can do that through being an NP. You can study as much as you want and gain as much knowledge as you want, what is it about being a nurse? Or being a physician? Or being whatever? What is it about being a physician in this specific case that makes you think that having that in depth knowledge is going to make you satisfied?'

And her answer was that she wanted to be the clinical expert, have the- be the knowledge expert, and make the final decision. So I thought about that and I still wasn't satisfied with that answer because that answer focused on her, and her knowledge, and her power of yielding the final decision. I would argue that in many states, a PA and an NP, a lot of states you can practice independently these days. And so you can make the final decision as a PA or an NP, and you can study as much as you want, and do as much homework after you graduate from your programs as an NP or PA, and get the level of knowledge that you want. There has to be something more.

Not once in her explanation did she talk about the patient. What impact would she have on the patient? And that was a big thing that hit home, and stood out to me significantly. So think about that when you're talking about your answer, and your explanation behind why you want to be a doctor. If you want the most in depth knowledge in the world about the human body, great. What does that mean for the patient though? Think about it in those terms and it comes across a lot differently.

Having Full Scope of Care

Another student that I did a mock interview with today talked about transporting a patient, and the patient having a CT scan, and the tech noticing something on the CT scan and kind of mentioning it to this student about, ‘Hey maybe you should be a little gentler with this patient. There might be something in here that I see, and so just be careful.' And so the student was careful, and transported the patient back up to the room, and told the nurse like, ‘Hey the tech saw this finding, maybe we should be gentle.' And the student talked about how the nurse and the tech were both reprimanded in that situation because they were going above and beyond their scope of knowledge and their scope of practice. And while I agree that they're going above and beyond their scope of practice, they are doing it for the benefit of the patient. And this student, when I was probing him about why he wanted to be a physician, he gave this as an example of why he wants to be the physician to have that scope of care so that he can have that level of knowledge. He doesn't want to feel limited in what he can do, he doesn't want to feel limited in using the information at his fingertips. And it came across in a negative way because he was coming at it from the point of view that he doesn't want to be limited by ‘the man,' by the credentials that are telling him what he can and can't practice. And so it was very similar to the previous student who talked about having this depth and this understanding, this second student was talking more about actually the practice of it and not being limited.

Again, nowhere in the conversation was the patient. And so we re-worked it so that it wasn't negative about being mad that the nurse and the tech were reprimanded, and how dare they whatever. We re-worked it so that he could talk about how the nurse and the tech are limited in their scope of practice to affect change in the patient, and do well by the patient, and do something to help the patient. The nurse and the tech were very limited even though according to the tech there was something obviously wrong with this patient that needed to be handled. And so we talked- I talked with this student, I said, ‘Look if you reframe this and talk about how you don't want to be limited because you want to be able to act on information and actually make a difference immediately for that patient, that changes the whole sentiment of what you're saying. It now focuses on the patient and helping the patient with that increased level of ability and scope of practice. So you're not limited in what you can do. You can use that information immediately to help that patient. Focus on the patient.'

Relating it to the Patient

Another student a while ago talked about kind of the stereotypical, the cliché things about the interest in medicine, science and clinical experiences, and enjoying sciences in class during school, and being a science nerd and a Science Olympiad, and loving the intellectual stimulation of being given a list of symptoms and trying to find the diagnosis. Those are all very cliché things, easy to talk about, aren't really relevant to why you want to be a physician. And this student then talked about having the satisfaction to make a difference, and specifically obviously a difference in the patient's life. And when she was able to tie it together with that, it made a huge difference in how I took her discussion about why she wanted to be a physician, because she was able to relate it to a patient. You're entering a field to be a clinical physician, most people. Some people that are listening maybe want to be researchers, bench researchers and not see a lot of patients, but most of you listening are wanting to enter clinical medicine. Clinical medicine means interacting with patients and helping patients. And so tie your ‘why medicine' together with your patients.

Another student that I worked with talked about her initial interest being her father who was a physician, and being exposed to medicine, and having that interest and hearing cases at dinnertime, and visiting his work, and seeing all that happening. A lot of kids who have parents who are physicians don't themselves go on to become physicians, so what is that next step? For her, she started off premed, took a little hiatus, and then as a patient she had a connection with her physician, and she realized she was missing that, and remembered that, and drew upon those experiences and those discussions, and hearing her dad talk about the clinical side of medicine even though he's a radiologist. I don't know how much clinical there is there. But anyway, when she was experiencing this as a patient, it drew her back into the premed world because the connection that you can have with a patient as a physician. And that immediately hit home to me because she's talking about connecting with a patient. She's not saying her dad's a physician, therefore she wants to be one. She's saying, ‘I want to have a connection with a patient, and I want to do that through being a physician.' There are many ways that you can connect with a patient; you can be a social worker, you can be a psychologist, you can do lots of things, but she wanted to do it from the physician standpoint partly because of those initial exposures with her father who was a physician. So take that into consideration. How do you want to impact patients? What interactions do you want to have with them? What impact do you want to have on them?

Another example here of a student who talked about nursing versus medicine, and I kept wanting more. This student talked about her dad being a nurse, and so she was interested from a young age in healthcare, and listening to her parents talk about healthcare disparities, and so she was interested in sciences, and she started shadowing a physician in college. And so I questioned that leap, ‘How did you go from your dad being a nurse to you wanting to be a physician? Where did that leap come in?' Especially if you have a parent who is in healthcare as a nurse, as a PA, you're going to have to answer why not a nurse? Why not a PA? Think about those answers. So this student talked about how in medicine you have more knowledge. You've heard this one before. A lot of students talk about the increased level of knowledge that physicians have versus nurses, versus NPs, versus PAs. Yes it's true, we go to school a lot longer than NPs and PAs. They have a good deal of knowledge but our knowledge is more in depth, more broad. And so that answer alone isn't sufficient enough. She talked about having more knowledge and increased clinical knowledge, and as I listen to these students during mock interviews I type notes and in bold letters at the end of this line I said, ‘Why is that important? Why do you want this increased knowledge?' She followed that up with saying physicians have more autonomy, and that's another kind of dagger in my heart when students say that. That's not a reason to want to be a physician. You need to- because again I could make that argument that in some states as a nurse, as a PA, you can have autonomy, and practice, and do your thing. So you need to start thinking a little bit deeper than just, ‘I want to be the boss.' Think about that. Why do you want this increased clinical knowledge? Why? What is it about the autonomy? You could mention, ‘I know in some states that PAs and NPs have some autonomy, but I want to be able to practice in any state where I choose to live in the future, and not have to worry about what state I'm in and if I can practice on my own.' And I may ask, ‘Well why is that so important to you? Why do you want to practice in an autonomous fashion,' if that's the right way to say that. What is so important about practicing and having that autonomy? So think about those things.

Having the Power of Decision Making

Another student who sent a dagger through my heart was a student- we were talking about a physician having the ‘power' to make decisions; making medication decisions, treatment plan decisions. And it was that dagger because again, NPs, PAs, they make treatment decisions, they make medication decisions, they have this power. A lot of NPs and PAs are practicing in an environment where maybe technically they have oversight, but they're working pretty much on their own and maybe the physician reviews a couple charts every now and then depending on what the rules say need to be done. So dig deeper, dig deeper, dig deeper. Need to dig deeper. It's not just having the power of making decisions because that's not strictly anymore specific to being a physician. There has to be more to your answer.

One student here that got it mostly right was a student who talked about having this desire to always kind of want to help people and give back. And she was on the kind of premed track in high school which is kind of cool if you're in high school and it has a premed track, and going to the morgue in tenth grade, and looking at a human liver, and handling a human liver in AP bio. But once she hit college she became a scribe and followed a physician, and what she said with that experience was how she noted that the physician- how the physician makes the patients feel comfortable. And seeing that, seeing that interaction, having that solidify why she wanted to be a physician. There is an interaction between a physician and a patient that only a physician and a patient have. Some NPs and PAs have that connection with patients, but there is this unique perspective and psychology with patients that the doctor is there treating you. And so that is powerful, and this student realized that, and said a physician makes these patients comfortable, that's what I want.

‘Needing’ to be a Physician

This last one here I want to mention is somebody who is technically already a doctor, they have a PhD and they now want to go back and be a physician. And their PhD is in psychology, and they are very well integrated into a great healthcare system in the northeast area, and interact with neurologists, and she realized at some point that being a physician was what she really needed to do. And she used those words and it was powerful when she said that, by talking about needing to be a physician. She saw what she was doing as a psychologist, and she witnessed what her mentor was doing. The mentor was a neurologist, and seeing what he was able to do, and how he was able to affect the patient. She as a psychologist couldn't do that and she wanted that opportunity to treat patients. She needed it. She needed that opportunity to treat patients, and she said it in that way, and that powerful, and it just hit home to me. She focused on the patient and that was so powerful to hear. It wasn't about her, or her level of knowledge, her power, her autonomy. It was about the patient. Think about that as you're formulating your response to why you want to be a doctor.

If you're listening to this and you work with me in the future, I'm going to ask you this question, ‘Why do you want to be a doctor?' It's an important thing to know. You need to know this, you need to practice it, and if you listen to this podcast and you don't get it right, I think I'm going to have some punishment for people. Maybe do some pushups or something. I don't know what I'm going to do. But anyway I hope this will help all of you listening as you listen to this, listen to it again, start thinking about your answers, listen to this one more time, think about how your answers are fitting into what we just talked about, and if you're on the right track.

Final Thoughts

If you're interested in working with me for mock interviews, don't hesitate. I've had to turn down a lot of people that are emailing me at the last minute saying, ‘I want to work with you,' and I just don't have time for them. I've been lucky that a lot of people want to work with me, and I've been very busy. And people are emailing- people are still getting interviews late into January, beginning of February, and so they're getting an interview going, ‘Oh my gosh I got an interview, I want to work with you,' and I'm like, ‘Sorry, I don't have time.' So if you're interested, go check out our services, go to www.MedicalSchoolHQ.net and at the top there click on Our Services and the mock interview prep. I hope to hear from you, if not this podcast and all the other podcasts that we do all on the interview process should help you out tremendously.

And also obviously my book, ‘The Premed Playbook: Guide to the Medical School Interview' is being published in June of this year, June of 2017, you can preorder it on Amazon right now for the paperback version. You can get the Kindle version right now which was my self-published version, the published publisher version of the Kindle is coming out soon. You can sign up for Kindle Unlimited and read my book for free which is pretty awesome. And yeah so go check out all those things.

Alright I hope, as I said at the beginning, you have a happy, healthy New Year. As always I hope you continue to check us out every week at the Medical School Headquarters, Med Ed Media, and here at The Premed Years.

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