The author should take care to avoid generalizing his own experiences to that of all potential applicants. While not all students may know exactly what they wish to do at age 20, many do. Should deciding to be an engineering major during freshman year entail such criticism?

As for choosing medicine as a way to avoid making major life decisions, nothing could be further from the truth. A decision to prepare for and apply to medical school is no small decision and requires forethought and persistence. The pre-medical curriculum and "standard" EC's are specifically designed to weed out students who are either unprepared or uncertain. Mandating that students spend two years of their lives sitting under a tree would just cause the most driven students to lose sight of their goals and join the rat race.

In short, the author would be well-advised to take notice of the 97% graduation rate of US allopathic medical schools. Perhaps our medical students are more prepared, dedicated, and passionate than he gives them credit for.

Yes, it is difficult to avoid making generalizations when addressing a topic of this magnitude. However, I think logic and common sense go a long way in demonstrating the basic kernels of truth in my arguments. Even if some students do know what job field they wish to enter at age 20, there is a strong chance that these sentiments will change as the individual continues to grow, learn, and mature. The difference between an engineer at 20 and a pre-med at 20 is that the engineer will not be middle-aged by the time he or she decides that maybe this profession is a stepping-stone to something else, or not right for them at all. The real "rat race" here is medicine, because medical students are caught in a ten-year long cycle that treats humans like machines instead of people who have the capacity for development, creativity, and self-examination. Many physicians, I believe, compensate for this deprivation in mid-life by developing interests in history, literate, writing, politics, and social change. Finally, a 97% allopathic graduation rate is a poor indicator of passion. It denotes only intelligence and dedication (dedication to what cause, exactly, I'm not sure), and I'm confident you can point to several people you know who have throughout their lives achieved excellent marks out of habit and not out of interest in the topic. The fact that you refer to a 2-year pause in one's education as "sitting under a tree" suggests that you support this kind of robotic approach towards life.

It is obvious that the author is a disillusioned pre-med, a student that is realizing medicine is not his calling. There is nothing wrong with changing your mind after the collegial experience but to generalize all premeds in this fashion is not only ignorant but arrogant. Most pre-meds have a strong drive to become doctors; they're motivation is relentless and inspires them to enter this profession without haste. The long hours of planning and studying are there to ensure that only the strongest and most passionate "survive." They are by no means sheltered or blinded by the realities of this committment. To study and practice medicine is my life's work, and it is one I do gladly each and every day. I didn't have to sit and contemplate my existence to know I was destined to be a doctor. Many medical students feel the same way. If Plato had to take many years off to ask himself if medicine was for him, then it probably wasn't.

I disagree with the author as well. It is difficult for an undergraduate student to access the level of dedication & certainty others harvest within. He should've conducted research into this question before making these faulty assumptions. Medicine is a profession that is not only highly competitive, but academically challenging. It is not meant for everyone. It is the equivalent of being a professional athlete, in the sense that a person not only the inner drive, but the natural talents to succeed. In Europe (and most other countries in the world) medical students are younger than their American counterparts and are admitted after secondary school.

You're basically saying that commitment is impossible with anything because you might change your mind.

Starting medical school at 25? Ridiculous! Let's assume the USA needs thoracic surgeon- after 4 years of medical school, 5 years of surgical residency, and 2-3 for a cardio fellowship, you're looking at a 37 year old finished product. That seem's pretty unfair if you knew you wanted to be a doctor at a much earlier age! Just because you're having a change of heart doesn't mean you should suggest an age limit to entering school. That's bogus! Why would you push your insecurities on others?
You know you can get accepted to medical school and defer your matriculation? Sometimes even up to two years.

You claim that the primary attributes necessary to become a doctor are, among others, "devotion" and "natural talent." Yet you are proving my point exactly: many doctors have become like well-oiled machines, who often have few distinct qualities of their own besides an incredible "drive." What ever happened to judging one's character, one's ethics, one's social conscientiousness, one's passion for knowledge, or one's desire to advance scientific research? Certainly a good work ethic and high scores are desirable in every profession, but medicine is the only vocation I know that uses these as the primary measuring stick of compatibility. Maybe every profession should ignore most personal qualities, goals, and values and only examine one's test scores because, by your logic, they must be a good match to get as far as they did. In France (and the former USSR I presume), the kids who score above 95% in a state-wide standardized exam have the option of going into medicine, regardless of whatever else is on their plate. This is an outdated model. Is that really what you're advocating for?

Also, the analogy to professional athletes (I'm thinking Olympics here) is not all that convincing: you've shown to me that your conception of medicine is a great gauntlet of personal ambition and not a tool to serve society, feed your curiosities, advance research, provide a better standard of living for your family, or anything else of tangible societal value. Lastly, the average age of starting medical school is in fact 25-26, so it's really not that ridiculous for your thoracic surgeon to be 37 post-fellowship.

1. "the average age of starting medical school is in fact 25-26"- So what is the issue then? It seems like these stats point to the fact that a lot of pre-med students do take 1-3 years off after graduation to conduct research, pursue other interests, etc.

2. "many doctors have become like well-oiled machines, who often have few distinct qualities of their own besides an incredible "drive."- That is just an insulting generalization. I know several doctors personally and they are good people with many and varied interests outside of medicine.

3. I would also argue that the long, arduous process of becoming a doctor and choosing "pre-med" at such a young age ensures that only the most dedicated and talented individuals graduate medical school and serve as MDs. A bright, hard-working graduate of a school like Tufts can make a lot more money going to a top law school, becoming an I-banker, or going into finance/Wall Street in general. The prospects of years of studying extremely challenging material, devoting 8-10 years of your 20's and 30's to a hospital or residency program, and then graduating to receive a salary (of which a large portion of which is taken away from you by malpractice lawyers and health insurers) tends to produce individuals who have quite a bit of devotion to their field. I commend my friends and classmates who are graduating to go to med school next year and I will be perfectly happy and grateful having them operate on me and/or safeguard my health. Somehow the fact that they missed out on one of Tufts' extremely rigorous religion, poli sci, english, art history, or american studies classes won't bother me (or them) in the least.

I really hope Paul Farmer reads this...or any MD affiliated with Doctors Without Borders/Medicin Sans Frontiers for that matter...another whiney pre-med dropout..there was an article just like this in the Daily last spring too

In response to Ian: 1) YES! That's exactly right. Most soon-to-be medical students engage the process the "correct" way by waiting several years before entering medical school. Previous career experience and post-bac applicants are common. This article is directed at those undergraduates who intend to enter medical school at age 22 or 23.
2) This is a typo on my part. I meant to say most pre-meds have become like well-oiled machines. Doctors are different because they have more time to cultivate other interests and qualities.
3) I disagree. I do not believe a good doctor is necessarily one who demonstrates knowledge only in the sciences and medicine. Certainly the best doctors demonstrate a panoply of qualities and interests (i.e. Paul Farmer), including strong character, ethical judgment, interpersonal skills, compassion and understanding, analytical skills, etc. Not a single responder to my article has recognized any of these criteria as being significant or worthwhile. Why not? Meanwhile, they have continued to praise an educational methodology and admissions process that rewards 22 year olds fundamentally for their hard work with minimal emphasis placed on these auxiliary qualities. When dealing with issues of health care, a system that permits students to become less-than-perfect physicians is flawed. The 26, 28, and 30 year olds, on the other hand, I'm less concerned with, because they are more likely to have demonstrated other kinds of important life skills and qualities through their "gap years." Many med schools themselves attest that the older and wiser medical students tend to be more passionate/focused, and (I suspect) become stronger doctors.

I do understand the pre-med backlash at your article- for those of us intensely studying mechanisms and theories and cell models in the library until late at night until the wee hours of the morning for who-knows-what reason, its incredibly unsettling when someone like you questions our motivations or our drive (our reason d'etre, to put it lightly). There is a reason why this debate still exists in our society, and its obviously because there is no clear answer. The field of medicine is an oddity in our world, simply because great medicine requires a precision like no other. If you think about it, medicine (I'm referring to intensive medicine here: cancer treatments, surgery, the like) should probably be practiced by robots, if anything. Humor me here- great doctors require skill, accuracy, an abunance of knowledge, precision- all things that human beings, in our weaknesses, are not fully capable of. There's a great piece by John Ruskin on this paradox (the Stones of Venice), about how you must choose whether to make man into a precise machine or into an inaccurate human being, because you simply cannot do both.

Face it- to practice medicine, or at least, responsible medicine, you need a certain degree of what the pre-med curriculum will incubate: drive, endurance, capability, intense motivation. You also need what will weed most people out of the pack: ambition, sheer talent, above average intelligence. Competition within the pre-med curricula forces you to have all of this, everything you may need to someday become a competent doctor for someone. You're questionning the system- which, by the way, in my opinion is partially accurate- but this is the very system that prevents horribly incompetent doctors from ever treating and perhaps harming an actual patient (your mother, lets say).

But you're entirely correct- there are way too many pre-meds who choose this path because they have no idea what else to do with their lives. Flawed as it may be- even in your case, the curricula has worked, and has taken people out of the system who were never meant to be there in the first place. If it takes someone twenty years to find that medicine is their passion- that's great. But don't punish those who have already found theirs by unnecessarily making them prolong the already burdensome process.