time to be honest

May 14, 2010 is a momentous day. Not for most people, but it is for all the UBC med school hopefuls. As I have had the privilege of knowing so many bright, motivated, and (most importantly) kind-hearted people at UBC who are striving to be all they can be via a medical education, today is the day when many of my friends get the good news (unfortunately, some getting the bad) - and as I finish my fourth year here, most of the people in my entry year have applied for Sep 2011. So, apart from me first offering my congratulations to everyone who was successful and my encouragement to those who were not ("successful" meaning only in terms of the news. I am sure all med school applicants are capable, talented and motivated people and that sometimes it is luck of the draw among other equally talented people), and apart from having my life affected by having people really close to me enter such a rigorous program for the next 4 years and such a prestigious profession (and apart from me and my run-on sentences): why I am writing is about my own visceral reaction in regards to my chosen career, which is (right now) Pharmacy.

You may have wondered why I am not applying for med school. It's not a question I'm not familiar with. I have given many different responses to different people, and the variety is partly due to the sensitive nature of this topic (if the other person is also planning to apply), due to my preference for humility, due to others' usually inflated opinions of myself, and also due to the fact that I didn't really know myself. But right now, I think it's important that I come clean, at least in this regard. I'm going to try and rationalize why med school is not in my immediate future. I'm also going to try and explain why deep down, I feel some jealousy that is easily limited by confidence in my own abilities and by realism (read this sentence again when you finish the whole entry). And because I've obviously been crippled so far in my ability to explain this, I'm going to have to be explicit and honest, without my usual satire or self-depreciating approach.

Why Med School is an Option:
-Med school would give me the tools that I would need to help people easier. As many of you know, pharmacists are limited (by data availability, by interprofessional barriers, by their business model, by legislation, and by training) in our ability to help patients. On the flip side, the ability of doctors to help their patients seems unlimited by comparison. If you wanted to do anything as a doctor (except perhaps sell drugs), you probably could. Oh, and this is only relevant because indeed, in my career, I do want to be helpful and make a positive impact in people's lives. But it would be nice to be a doctor, and if I had to pick a degree to have, it would be the MD.
-In many ways, I am the perfect applicant. I have good marks, a resume that makes me sound better than I am because it is well-rounded (awards, volunteerism, work, interests). I would probably do well on the MCAT, I would probably do OK on the MMI, and I could probably get into a med school if I dedicated myself to this and applied. (Recall that I've promised not to be self-depreciating here; not trying to be egotistical, just honest.)
-People think I would be a good doctor. It's the easiest question to answer. Versus, justifying why I'm in pharmacy is harder, because the medicine question is always looming and people tend to wonder why you don't shoot for the stars, especially if they are within reach. I think that in several ways I would be a good doctor. I care. What I mean by that is that I would actually want to be a doctor, not for the status, not for the money. I'm perfectly happy with being part of a practice that is only somewhat profitable. I already have a good background in health care and would be able to identify DRPs or other health-related problems reasonably well.
-Med school would teach me things I would want to learn about. The best thing people usually cite about Pharmacy school is the people you meet, and that is no different for me. People I've met are generally very nice, and I consider myself also generally nice, but in a different way than most people (this is a tangent). However, parts of the curriculum have been a disappointment and med school is better funded, allowing for better lecturers / lectures and a more holistic approach (hopefully?) to learning.

Things holding me back:
-A reason I tell a lot of people is that I'm tired of school and want to get into the workforce. This isn't true. I'm not tired of school, but I'm worried I won't do well in med school. I'm sure that whoever's reading this is thinking that that shouldn't be a reason, but I know how I study better than anyone else does. And the way that I study (over my entire schooling) is a mechanism to achieve marks rather than that of lifelong learning. I am one of the best students / learners you will meet, given time. Given time, I can learn and become adept at most things that are either memorization or process-related - a good example is running chromatography columns. I got really good at it over 3 months in the lab. However, I'll admit that this is a minor reason, so we won't consider this one.
-As I've mentioned before, one of the reasons that I've been coy about this topic is that others around me are applying. What I may not have mentioned is that that is a reason too for me not applying. One of the things I don't like to do is to show others up. So if my friends / Joey apply and don't get in, and I do apply and get in, what does that do to our relationship? And it's not just the relationship I'm worried about, it's about the other person's ego, or confidence, or what they're going to do with their lives after they get rejected. They are going to feel less than me, and it would be difficult for me to share any learning or excitement I had in med school. It's easier if I say I'm not interested, and we can encourage each other in our own paths. (this is somewhat of a moot point after today, though.)
-Another reason is that I've told so many people that I'm in pharmacy and not going to med school. That is a reason, even though it shouldn't be. I don't like the idea of going back on what I've been telling people; it's difficult to explain and I will guess that some will think poorly of me for flip-flopping (and perhaps, also lying on the Pharmacy entry interview, etc.).
-Another reason is that I don't think I'll be a good doctor. I started talking about this above. Generally, I'm not really a people-person - not that I don't care, because I probably care too much - but I'm not engaging and I find it hard to communicate sometimes. Language isn't my strong suit. In the pharmacy for example, I find it hard to do little things like remember patients' names, remember their faces, and I'm horrendous on the phone. I have a hard time making out what the other person is saying, if the voice is soft or accented. And I speak oddly - I slur words together, trip over my own tongue. It is frustrating particularly when I have my own stereotype to overcome as well. I know that my strong suit is more of an analytical style of thinking; assessment if you will, and so this is suited for pharmacy-style checking and optimization. It's not a holistic, synthesis style of thinking, which would be needed for diagnosis and care planning. I don't have much life experience either, which makes it difficult on occasion for me to connect with people.
-This train of thought above is what led to my previous post about med school interviews, and basically leads to the idea that I don't deserve to be a doctor. My resume is, to be blunt, inflated. It does reflect the amount of effort I put into my volunteering. I sometimes comment on how some people I know can "waste" so much time, but that's just the way things are for them. For me, I like my life to be efficient, to be productive, and so for me, it's important that I am spending my time at university giving back and volunteering. This leads to others commenting on how smart I must be to do all that I do. I say that people have this wrong, which isn't entirely true; this is just a small piece of it. I care a lot, I am efficient, and in some areas of my studies I have the ability to deduce things that others can't, which explains the smart part. In general, I do all that I do because I want to. The problem that I have is that I'm not actually doing or accomplishing anything. I spend so much time on my volunteering, but the outcomes that I expect are not there. That's frustrating for me, that's disappointing for me, and it doesn't reflect well on how well my marks / resume / potential med school application will correlate with my ability to serve the population as a doctor.
-Another reason is that pharmacy isn't bad. In fact pharmacy is very promising for me. It fits my skill set in many ways. The direction of the profession is changing. My pharmacy education and perhaps residency is interesting to me and I think that if I start keeping the big picture in mind and not so much the marks, I can really learn a lot and help some patients, which is what I've wanted to do all along. It's (usually) a 9-5 job, pays well (which is a consideration when we think about my priorities in life, which is a good family and the career after that, and I still need to figure out my religion and spiritual life), and I see flashes of neat things within this profession that I want to get involved in.


If I have more reasons to add, I'll do so. I'm not going to try to conclude this because I don't think the chapter's finished; the door's open, and obviously not to the exclusion of professions other than med and pharm. If you're planning to comment, please do, but I would encourage you to tell me face to face and not electronically.

NB If this ends up biting me in the butt when I apply for interviews and stuff, so be it; I'm just being honest. So if you are a human resources person stalking me on the Internet before considering hiring me, I hope you consider that I am a caring and analytical person that isn't afraid to criticize myself and to try to improve, and please consider whether my faults I've listed above are any worse than those that other applicants would have hidden or (?worse) not taken the time to understand themselves or be honest with themselves or others.