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Last May, I reflected on my path from medical school to starting a health tech company in San Francisco. In an environment which fetishizes the “dropout founder,” I always met perplexment when I said I planned on returning to medical school. Now that graduation day is around the corner, I thought I’d shed light on my choice for clinical practice and what I learned on the other side.
Medical school is like a ship we board with a promised land far off in the distance, each of us filling in our own hazy contours of what doctoring will be like. Year by year, we start seeing through the fog until, at some point, the shoreline is not as hospitable as we imagined. My patients were pushed out the door, needlessly scanned or medicated, mocked and dismissed. I rejected the ship’s course and jumped. And the two years away taught me three things.
First, there is no getting around that sobering moment when the fog lifts off our ideals. The day-to-day work of medicine is imperfect. Whether trialing new therapies, training health coaches, auditing insurance claims, or cleaning bedpans, everyone who is trying to reform health care needs thick skin and an unerring sense of vision. There is no idyllic path to help the sick and dying, our tech start-up included.
Second, health care settings are more diverse than what we are exposed to in medical school. If there was something in your training you pondered could be done differently, you can probably find a clinician doing it that way. Our company took us to doctor’s offices around the country, and I saw the bright spots first-hand. I had the honor of meeting incredibly driven and satisfied clinicians, administrators, and entrepreneurs showing me that reform is happening.
And third, I feel profoundly blessed to see patients. I met people who are in their element when they are debugging code, pitching to an investor, or digging deep into clinical research. I returned to the exam room after all of this, and everything else paled in comparison. Everyone has a responsibility they want to rise to, and patients’ expectations is it for me.
I won’t join the camp arguing that clinical practice is the only way for someone interested in “healing” to fulfill their mission. The specifics — rural Alaska or Silicon Valley, family practice or cardiac surgery, medical devices or urban landscapes — are not the point to me. As the Buddha said, “There are many paths to the top of the mountain.”
None of these career paths are impervious to defeatism and mediocrity. We can’t go to the break room and say the system is broken, but not propose a new workflow, attend meetings with leadership, work with Congress, make a prototype. The choice is not which route; it is whether to keep your desired reforms to yourself.
I’m glad I stepped out of training for a Rumspringa. I got a chance reflect on my ideals and plot a less naive path to reaching them. The time helped me scout out the gems, innovative health systems I want to work at and exceptional colleagues I will team up with for my next venture. And it’s given me firm resolve in the value of residency, so I won’t have regrets on the long nights and dark days.
Wherever my generation ends up, industry or academia, research or the community, I know the cohort of thoughtful people who recently recited the Hippocratic oath with me can steer the ship in the right direction. As David Sable said, “Want to feel good about the future of health care? Spend an afternoon with first-year medical students.”
Gina Siddiqui is a medical student.