Jeremy was proud and confident when he shared that he was “pre-med” on his college applications as well as on social media posts and discussion boards as he applied and transitioned to college. After all, biology was his favorite class in high school, he liked being helpful, and wanted to make a difference in people’s lives. Also, the idea of having a lucrative career was certainly appealing. Becoming a doctor seemed like a no-brainer. His parents were thrilled; it was a source of great pride when they talked with extended family and friends. As J met more of his peers on campus, he was excited that so many of them were also “pre-med,” particularly those in the majors that were of greatest interest to him. He was relieved that he could answer with great assurance, “pre-med” when frequently asked, “what are you studying?”
While his first semester coursework was certainly challenging, J bonded with his classmates during study sessions and around the identity of being “pre-med.” J held his own academically and even managed a couple of A’s. During the second semester he continued taking the courses he thought he needed to stay on track for pre-med. Also, he started volunteering 3 hrs one afternoon each week at the reception desk of a free health clinic in the city as he knew it would look good on his application for med school. After a few weeks, he approached one of the doctors about the possibility of coming in an hour early each week to shadow her. She was happy to have him. During their time together, the doctor talked openly about her journey to and through medical school, as well as the pros and cons of the ever-changing profession. J often contemplated their conversations well into the night and realized the path would likely be longer and more difficult than he had anticipated.
If Not “Pre-med,” Then What?
As spring progressed, J realized he was really enjoying his two elective courses, Inequities in Healthcare and Macroeconomics. This along with his shadowing experience led him to start to question his “pre-med” ambitions. But, every time he thought about doing something other than medicine he felt a pit in his stomach. After all, he had been planning to go to medical school since early in high school and everyone knew it. The majority of people in his classes and many of his friends were “pre-med.” And, if he dropped “pre-med” he had no idea what he would do as a life science major. Additionally, if he decided to not do “pre-med” he didn’t want people to think he “quit” because he couldn’t hack it. J felt like he was being swept along in a current and wondered if he should ride it out. But, when he sat in bed at night and was really honest with himself, he was having serious second thoughts. J was less excited about his shadowing experiences and patient interactions than he had thought he would be. Simultaneously, he was increasingly curious about how concepts from his Econ course impacted healthcare as well as the multifaceted contributions to healthcare disparities in America. Jeremy wondered, “Now what”?
This is when I first met Jeremy. I asked him about his path to becoming a “pre-med.” J shared his background as well as his recent and increasing doubt. J also told me that he had always enjoyed literature and writing, but had pushed those interests aside because they didn’t seem compatible with his path to becoming a doctor. J had already registered for fall courses and expressed that he was stressed. I assured him that many students changed their fall schedules during the first week of classes from what they signed up for in the spring. I encouraged him to resist feeling locked in and asked him to commit to exploring this critical reflection point. I reminded him that he had months before fall classes started and he could use that time in ways that could be unbelievably valuable, informative, and transformative…and hopefully reduce his stress. I assured him that medicine would always be an option, even if his path diverged for awhile.
The Power of Information and Experiences
It was clear from my conversation with Jeremy that he had some misinformation about the path to medical school. We reviewed the required prerequisite coursework for most med schools and the range of competencies that applicants must develop and demonstrate. I let him know that the average age of students when they matriculate to medical school is 24 and that it is becoming less common for students to go straight to medical school after finishing undergrad (and some of the reasons why). I shared several different scenarios and alternate timelines with him. I suggested he use his unplanned upcoming summer to reflect on his first year and gain a variety of experiences. I encouraged him to try new things, evaluate, and remain open to modifying his “plan.” Despite wanting a clear undergraduate path and feeling pressure to stay on the pre-med track (without a “gap year”), J took my advice. I referred him to college career advisors. Within a few weeks, J developed a plan for the summer that included talking with more doctors and a week-long shadowing experience at his local hospital. Additionally, he outlined a plan to learn about other healthcare and healthcare-adjacent careers given his emerging interests related to his spring courses.
Jeremy came back to see me when he returned to campus in August. He was excited about what he had learned over the summer and comfortable sharing that he no longer planned to go to medical school. He indicated that he clarified he did want to major in biology and that he was relieved to learn that by developing a depth of knowledge in biology, taking courses in economics and business, and gaining experience he could have a variety of options. After the career conversations and research he did over the summer, he was most interested in healthcare consulting, healthcare policy, and health/science communication. He re-worked his fall schedule to include two courses towards the biology major, another economics course, a science writing course, and a course focused on the business of medicine.
Healthcare and Healthcare-Adjacent Career Options
That was two years ago. I just checked in with Jeremy who will graduate in May with a degree in biology. Additionally, by the time he graduates J will have completed 4 courses in the area of science communication and five courses from the business minor. J had an internship with his local health department after sophomore year and Bain consulting after junior year. Jeremy imagines he will eventually pursue an advanced degree, likely in business, public health, or public policy. He is currently exploring full time job opportunities ranging from working as a patient advocate, to being a public relations specialist for health advocacy groups, to being a healthcare policy analyst. J reflected on how impactful volunteering at the free clinic spring of his first year was and that without that experience (as well as his willingness to question his path), he thinks he likely would have pursued “pre-med” well into, if not for the duration of his undergraduate career. His advice for first-year “pre-meds,” is to get out there and connect with the world of medicine in whatever way you can, as soon as you can, to make sure you understand it and that it’s a good fit.
Awareness of The “Pre-Med Current”
While it’s impossible to know how many first-year undergraduates identify as being “pre-med,” I am willing to bet that it is likely the largest single career aspiration among entering college students across the U.S. most years. In my experience and like Jeremy, most first-year “pre-meds” have decided to become a doctor because of a fondness for biology, a genuine satisfaction they derive from helping people and the convenience of a well-charted career path.. And, once someone identifies as a “pre-med,” it can be easy to get caught up in the “pre-med current,” making it difficult to entertain other options. Yet, few first-year “pre-meds” arrive at their decision via a well-informed, experience-based, and reflective process. Many do not understand the pace at which the healthcare industry is changing, including the increased corporatization of medicine, and how these changes significantly impact doctors. Similarly, many “pre-meds” are unaware of the breadth of career options within healthcare and how some of those roles may be better matches for their interests, values, and strengths or better aligned with the type of patient impact, work environment, and lifestyle they are seeking. Therefore, no matter how strong their conviction is about becoming a doctor, I highly recommend that first-year “pre-meds” educate themselves about the “pre-med” path and process, gain experience in healthcare settings, and devote time to clarify and deeply reflect on their values, priorities, skills and interests. It can make the difference between proceeding with clarity and confidence or being swept up in the “pre-med current” and feeling apprehensive or stuck. When a person does take this time and does this reflection, even if they re-orient toward a career in medicine, they do so with greater confidence and commitment.
5 Tips For First Year “Pre-meds”
Prioritize getting acclimated to college.
- Develop strong time management and adapt your study skills.
- Explore and clarify your interests.
- Live in the present.
Get involved in 1-2 non-academic activities and find an opportunity to serve others.
- Involvement helps facilitate connection and a sense of belonging.
- Medicine is service. Identify an issue that you care about,find a way to be of service to others (does not have to be health-related) and make a difference.
Connect with academic, career, and pre-health advisors
- Educate yourself about the relationship between various majors and being “pre-med.”
- Very few schools offer “pre-med” as a major.
- Course requirements for some majors align more closely with the required “pre-med” coursework.
- Be thoughtful and informed before committing to a major (even if you were admitted to a major at the time of your application, you can likely change).
- Learn what coursework is required to meet the entrance requirements for most medical schools and to prepare for the MCAT. There will be significant overlap, and the coursework that you take specifically will be further informed by your individual situation.
- Become familiar with the Associate of American Medical College’s (AAMC) Pre-Professional Core Competencies and use this as a framework for your development throughout your undergraduate experience once you confirm your goal of going to medical school.
Gain exposure to healthcare.
- Increase your understanding of medicine and the healthcare industry by spending time in a variety of healthcare settings.
- Become familiar with the roles and responsibilities of doctors (as well as other healthcare and healthcare-adjacent professionals).
Run your own race at your own pace. Don’t get caught up in the “pre-med current.”
- Use your first year to become more self aware, gain clarity on your strengths, interests, and future ambitions.
- If you confirm your “pre-med” ambitions, your path and overall, undergraduate academic trajectory is more important than a single semester.
- Create your own and unique undergraduate experience and “pre-med” timeline.
I encourage all “pre-meds” to remember that college can provide great opportunities for discovery, to take ownership for your experience, and to resist your undergraduate education becoming simply a means to an end (medical school). Even if you entered college with great certainty about becoming a doctor, the suggestions above are a great way to confirm. If you entered college with a general interest in “pre-med” or find yourself pursuing “pre-med” because that seems like your most secure option, you feel you should (perhaps because you are a biology or other life science major), or you don’t know what else to do with your major/degree or as a career, I am confident the time you invest in the actions suggested here will be time well spent. If you want to talk more about your “pre-med” interests, path or possibilities please be in touch- I’d love to talk with you.
Beth A. Howland is founder of College Navigators, LLC and coaches college students to optimize their undergraduate experiences in support of their educational, personal, and career goals. She worked for close to 25 years in a variety of direct service and leadership positions in student support services at Cornell University, Duke University, Ithaca College, Tulane University, and UNC-Chapel Hill. Check out Beth’s previous posts about college student success.