1. Be prepared to give up your life, because the time commitment is even more than you think. Say good-bye to your weekends and evenings. You don’t get to pick when you’re working what kinds of hours, like nights, or even when you take your vacations. Even if you decide to be an in-office physician after residency, just because the office hours are 9 to 5 doesn’t mean yours are — you’ll probably be there until 8 (though you will, at least, get weekends — if you don’t get called in for a patient emergency).
2. You might not know exactly what kind of doctor you want to be until the end of med school. A lot of people go into medicine because they like science or the idea of helping people or saving people’s lives, but with no idea of what they actually want to do. Some people don’t even know their chosen field exists until halfway through! It’s totally normal and totally OK.
3. When you choose a specialty, you’re pretty much choosing it for life.Medicine isn’t like most careers, where you can move around different roles within a field, or even change fields completely without a ton of time and schooling. You can’t go from being a general pediatrician to a surgeon (at least, not without devoting many years and dollars to more education), so think really carefully when you do make that decision.
4. A 24-hour shift means you’re going to be up a lot more than 24 hours. You have your commute to the hospital, the fact that you need to eat to survive, and between emergencies and paperwork, a 24-hour shift can easily turn into a 30-hour one. You have your life to account for too — some days you’ll be awake something like 36 hours if you ever want to get any errands done (especially since when you finally do sleep, you’ll probably sleep for almost 24).
5. You should probably be type-A. You’ll need to be really organized and stringent with yourself in med school, but you need to be even more so once you actually become a doctor. Good doctors are incredibly dedicated and perfectionists in everything they do. You should want to give up all your time so you can be the best at what you’re doing. No one wants a doctor who doesn’t try her absolute hardest.
6. You’re not going to be the smartest person in the room anymore. You probably spent your entire academic career being the most intelligent person you knew, but when you become a doctor, you’re surrounded by brilliant people. There will always be someone who knows more than you do, and you’ll feel bad about it. Especially in the beginning, you’ll really struggle with this. But the sooner you swallow your pride, the sooner you can get over yourself and start really learning from those brilliant people.
7. You’re never going to know everything. You’ll pick up more and more knowledge as you gain time and experience in your field, but there are always new discoveries and new treatments being made. It can be really daunting, when you have so little free time, to spend it reading up on the latest studies, but it’s your responsibility to be on top of it. Even 20 or 30 years into your career, you need to be constantly learning — no one wants a doctor working with outdated information.
8. You’re going to mess things up. It’s everyone’s biggest fear and it’s omnipresent, since you’re doing about a thousand tasks a day that could go wrong. You can’t really afford to screw up, since it’s often someone’s life on the line, and between doctors, nurses, and pharmacists, there are lots of checks and balances in place — but inevitably, you will do something wrong at some point. Often it’s something pretty minor that doesn’t affect a patient’s livelihood, like giving a medication at the wrong time. But sometimes it is, like giving the wrong medication or overdosing a patient to the point that they have to go to the ICU. The important thing is to be honest when it happens and report it objectively, so corrective measures can be taken. You will learn from your mistake, and the incident will become so ingrained in your brain that you’ll likely never, ever make it again.
9. You need to be really good at working with other people. Being a doctor is not a one-woman show. You have to work as a team with other doctors, nurses, and support staff, particularly if you’re working in a hospital. You can disagree with someone’s treatment plan, and you can hate who they are as a person outside of work, but when you’re at work, you need to be professional. Learning how to get along with different personalities is a huge, and challenging, part of residency.
10. You’re going to learn just as much from your peers as you will senior physicians. No doctor is good at everything. Some doctors are really good at finding diagnoses for strange sets of symptoms but suck at bedside manner. Other doctors are really personable with their patients but struggle with problem-solving. See which of your fellow doctors have the skills you lack, and pay attention. You’ll pick up lots of things along the way from doctors who inspire you.
11. Being a doctor is a ton of paperwork. So much paperwork. A lot of medicine is simply documentation: if you don’t write down that something happened, it’s like it never happened. From giving someone a medication to completing a procedure, you have to honestly and objectively document every. Thing. That you did, both for the safety of the patient and for liability reasons.
12. It’s always going to be difficult when a patient dies. No matter how often it happens in your line of work, having a patient die will always be sad. When the patient was really, really sick, it feels like any other person — you find comfort in the fact that they’re in a better place for not suffering so much anymore. For patients with terminal cancer, their families have often accepted it toward the end, which makes it a little easier. It’s harder when it’s a kid who died in a freak accident or something suddenly went very wrong; you feel like it’s a huge loss of potential, someone who could have changed the world. The whole department mourns the person.
13. Doctors and nurses don’t always get along. It’s a problem more often with older nurses, who have been doing their jobs for many years, and young, new residents. The nurses feel like they know better, and the residents don’t feel like they’re getting any support. But really great relationships can and do form, particularly between the younger nurses and doctors.
14. You’re going to be in charge of other residents after just a year. A year is a long time to learn things when you’re putting in 85-hour workweeks, so you’re better prepared than you think you are, but it is hard to find a balance between working together and delegating without being bossy. It’s like any job when go from being the lowest on the totem poll to getting one notch ahead; you have to learn how to take up that responsibility in a way that benefits you both. You need to be authoritative, but you also have to be humble enough to recognize when you don’t know something and consult other doctors for help.
15. Be prepared to move. It’s hard to stay in one place for med school, residency, fellowship, and the jobs that come after. It’s easier if you’re based in a big city like New York or Los Angeles, but understand that the best program for you and your specialty might take you to a completely different part of the country than your family and friends.
16. You’re not going to get rich. Plastic surgeons and doctors in affluent communities who don’t take insurance are a very small segment of the medical population. You’ll be comfortable, but you won’t be rich by any means (especially if you calculate what you make per hour — your friends making the same salary are literally working half the hours you are). You’ll also likely graduate medical school with quite a lot of debt. If getting rich is what you want, you should look to a different job, because you’ll probably be happier doing something else.