I’m Halfway Through an Eight-Year Medical Program and I Don’t Want to Be a Doctor Anymore

At one in the morning, the phone lit up.

A medical student sent a message: halfway through an eight-year program, he didn’t want to study anymore. He said that later, in thoracic surgery, cardiology, nephrology, pulmonology, proctology, he would spend his whole life guarding one organ. Pointless. A five-year program you grit your teeth and get through. Eight years is too long. If he changed careers after graduation, the cost would be too high. How many eight-year stretches does a person get?

I replied: Sleep first. Tomorrow morning, go to the academic affairs system and read the withdrawal terms once. Cry after.

I

Fold an A4 sheet in half.

On the left, write: things in medicine that disgust you. On the right, write: if medicine disappeared tomorrow, what do you want to do?

The left side might say: memorization, exams, anatomy, pathology, night shifts, writing medical records, research, promotions, doctor-patient relationships, always dealing with just one organ.

The right side might say: writing songs, programming, building products, opening a café, filming, investing, teaching, science communication.

After you finish, look at the left side. Find the item that disgusts you most. Is it the knowledge itself, or the doctor’s lifestyle? Is it the discipline of medicine, or the hospital system? Is it that you don’t like medicine, or that you’re tired?

If for three straight months you can’t sleep, wake up with a tight chest, and have no interest in things you used to like, go to the hospital’s psychiatric department first. Don’t use dropping out to solve depression.

II

Dr. Ke also did an eight-year program. Also wanted to run halfway through. Ran three times.

In his first and second years, he skipped class and went to the drama club. He met some people who made music. They wrote songs; he wrote lyrics. Tianjin bands, buyout. The expensive ones went for four or five hundred yuan; most went for about one hundred. In half a year he wrote a dozen or so and sold them for less than two thousand. He shoved the guitar scores back into the drawer, went to the cafeteria, and bought two steamed buns. In his third year, he returned to medicine.

In his first year of graduate study, he started a business. He pulled in roommates and two senior fellow students. They cooperated with pharmacies, gave free physicals in residential neighborhoods, and issued membership cards. Take the card to a designated pharmacy for discounts; the team took a commission. At first they made some money. Later they joined with a boss to do medical data. The boss bought machines; they supplied the team. The content was too far ahead of its time, or the details went wrong. The boss lost money, and the team disbanded. He cut up the remaining membership cards, threw them in the trash, and went to the lab at night to wash bottles.

In his first year after graduation, in Hangzhou. He independently managed patients, difficult family members, complex diseases. The rental apartment was very small. He wrote a novel. A few hundred thousand words, posted online. The backend data didn’t move. He closed the webpage, flattened the instant noodle cup, and the next day at seven did handover. Returned to medicine.

Three escapes, three returns. Whether changing careers is bitter is a separate question. Start doing it first. Once you do, you know whether it works or not. If you don’t, there’s always a “what if” left in your heart.

III

The American 4+4 makes sense. First study four years of something else, become an adult, become interested in being a doctor, then go to medical school. Choose later, more maturely.

China’s eight-year program is different. At eighteen you fill in your application, and once you enter, it’s eight years. Early choice, long path, expensive exit.

4+4 can be a mirror, not a verdict. It tells you that mature choice matters. It does not tell you that you must drop out now. What you need to solve is the next year. Put the Chinese and American education systems aside for now.

IV

Give yourself three to six months. Go try. Don’t drop out right away.

Pharma, devices, internet healthcare, medical AI, medical editing, consulting, insurance, public health, medical investment. Find internships. Do medical science communication, medical translation, medical illustration, research projects. Learn statistics, programming, health economics, law. Invite people who changed careers for coffee. Ask about income, thresholds, what they do every day, what they regret.

Start doing. Writing lyrics and not making money is information. A startup losing money is information. A novel no one reads is information. Not liking it is also information.

V

Go to academic affairs. Ask clearly:

If you quit halfway through the eight-year program, what degree do you get?

Can you transfer to the five-year program?

Can you take a leave of absence and keep your student status?

How do standardized residency training, a PhD, and medical licensing count?

If you change careers after graduation, what industries can a medical doctor enter?

Don’t calculate costs from imagination. Sunk cost counts as tuition. Institutional cost must be calculated clearly.

VI

Set a stop-loss point. For example, one year.

After one year, if you can get an entry opportunity in some field, the income is acceptable, and your life is better, continue.

After one year, if you are more anxious, poorer, more lost, go back to medicine. Change direction within medicine.

Without a stop-loss point, you will forever be stuck in “what if.”

VII

Within medicine it is not only thoracic surgery, cardiology, nephrology, pulmonology, proctology. There is also general practice, psychiatry, rehabilitation, anesthesiology, radiology, pathology, dermatology, ultrasound, geriatrics, palliative care, public health, hospital management, research, and teaching. Some look at people, some at systems, some at technology. Not all organs.

VIII

Changing careers after graduation is costly. A medical doctor is not equal to only being a clinician. Pharma medical affairs, clinical development, pharmacovigilance, devices, consulting, insurance, AI, publishing, public health, medical law, medical investment. Medicine is the base. You can build a second path.

The high cost is: not liking it, not acting, dragging it to thirty and blaming yourself.

A life does not have many eight-year stretches. An eight-year can be split into sixteen half-years, thirty-two quarters. Verify a little each quarter.

IX

If you end up back in medicine, it is not shameful. Dr. Ke returned three times. When he went back, he chose it himself. He knew what other roads looked like, knew what he could do. Medicine was no longer the only cage, but an acceptable choice.

If you try and it doesn’t work, coming back isn’t shameful. If you try and it works, go. Standing in place, using “I don’t like it” as a reason not to move, is the most troublesome.

X

That medical student asked me what to do.

I said: Don’t drop out yet, and don’t just endure. Attribute. Trial and error. Calculate. Stop loss. Go try, go ask, go intern, go write, go learn, go collide with the real world.

You don’t need to decide your whole life today. You only need to decide what to do in the next three months.

The 1 a.m. message. The next morning at seven, he went to academic affairs. The staff member didn’t even look up: “Dropping out requires a parent’s signature.” He took a form and went back to the dorm. On the desk lay yesterday’s unmemorized pharmacology. He sat down, put the form under the book, and turned to page 347.

There was still class in the afternoon.