Is Medicine Right for Me? Start With an Ordinary Tuesday

At some point you typed is medicine right for me into a search bar. Then somebody told you to go shadow a doctor. Maybe you already have — a morning in a clinic, a badge that said OBSERVER, a physician who was generous with you and let you stand near the door.

Here is the trouble with that morning. You saw the part of the job that can be watched. That is the part that physicians like. Most of the job that cannot be watched is what pushed them to leave or reconsider their career choices.

I am a pediatric cardiologist at an academic children’s hospital, and I direct our cardiology division. Students have shadowed me. They watch me talk with families and look at hearts moving on a screen. They hear me explain what a murmur means to a parent who has been awake since four. Afterward they say it was the best day of their semester, and I believe them, because the watchable part of my work is the best part of it.

None of them has ever seen a full Tuesday.

Is medicine right for me? The question shadowing cannot answer

Every physician holds two jobs at once. The first is the one you are picturing: a person in a room with another person, doing something that matters. The second is everything that makes the first one legal, billable, documented, scheduled, and covered by insurance.

Shadowing shows you the first job. It cannot show you the second, because nobody invites a nineteen-year-old to sit beside them while they clear an inbox for ninety minutes.

There is a number for this. In 2016, a team led by Christine Sinsky published a time-and-motion study in Annals of Internal Medicine. Observers followed 57 physicians for 430 hours across family medicine, internal medicine, cardiology, and orthopedics, logging what each one was doing minute by minute. During the office day, 27% of that time went to face-to-face care of patients. Just under half — 49.2% — went to the electronic health record and desk work. Physicians who also kept diaries reported another one to two hours of computer work at home, most nights.

Two honest caveats, because you will see this study quoted without them. First, the observers gathered the data in 2015, so it is now a decade old. Second, the practices volunteered and performed well, so they were not the worst case. Neither caveat moves the number anywhere near what a shadowing morning suggests.

What a Tuesday holds

Take the day apart and you get four kinds of hours.

The hours you would want to watch

Clinic. A family in a room. This is the reason anyone does this work, and it is as good as it looks from the corner.

The hours that look like nothing

I read echocardiograms — ultrasound studies of the heart. On the screen they are loops of grey and colored flow, and they mean nothing to you until you have looked at several thousand of them. From outside the room, this is a person staring at a monitor in the dark, clicking. It is close, careful, tiring work. No shadowing student has ever asked to watch it twice.

The inbox

Results to release. Messages from families. Refills. Prior authorizations, which means asking an insurance company for permission to do the thing you already decided your patient needs. The inbox does not empty. It accrues.

The chair

Schedules, budgets, recruitment, and a conversation with a colleague that neither of us wanted to have. Division work is not what I trained for. Still, it is a large part of what I now do.

So I am not telling you that the invisible job is the bad job. I chose this work and I would choose it again. I am telling you where the leaving starts. Nearly everyone who walks away from medicine points at the invisible half — and that is the exact half no shadowing day will ever show you.

Something you can use this week

Stop counting shadowing hours for a moment. Change what you do with them instead.

The next physician who lets you observe will ask whether you have questions, and you will ask something polite. Ask these instead.

1. What did you do yesterday that nobody in this room would recognize as doctoring?
2. What part of this job did you not know about when you were my age?
3. When you are home at nine at night, what work are you doing?
4. What would have to change for you to leave?

Most people answer the fourth one honestly, as long as you hold still afterward. That answer is worth more than another forty hours in a clinic.

Then go get a job. Not another observership — a job where something tedious belongs to you and somebody is worse off if you skip it. Scribe. Nursing assistant. EMT. Unit clerk. Front desk in a busy practice. Shadowing tests whether you like watching medicine. A job tests whether you like the parts nobody would ever watch.

What this does and does not settle

You will not reach certainty. Nobody applies to medical school certain, and the people who say they were have edited the memory. What you can reach is a decision made with the real thing in front of you.

So look at the whole week, the visible hours and the invisible ones. If the answer to is medicine right for me is still yes, that yes is far sturdier than the one you started with. If it wobbles, then you found out at twenty-one instead of thirty-two, and that is a good outcome rather than a failure.

Medicine is also not the only door into this work. Nursing, PA, respiratory therapy, and public health all put you in the room, and each one carries a different mix of the two jobs.

For the longer view, I have written about what the steps to becoming a doctor look like end to end and about how to plan an undergraduate premed path without wasting years. And if you want to hear how physicians describe the stages of this career among themselves, the Evolution Ladder was written for doctors rather than applicants — which is exactly why it is worth reading before you commit a decade.

Frequently asked questions

Is medicine right for me if I have only shadowed once?

One morning is real evidence about the visible half of the work, so treat it that way and then go find evidence about the other half. A single good day tells you that you liked watching. It cannot tell you whether you would like doing it on a Tuesday in February.

How many shadowing hours do I need?

There is no single national number. Schools set their own expectations, and most state them on their admissions pages, so check the schools you care about rather than trusting a figure from a forum. What you can say about what you saw matters more than the total.

Does the time-and-motion data mean medicine is a bad career?

No. It describes how a physician’s hours are distributed. It says nothing about whether the work is worth doing. Plenty of people look at that split and still want the job. I did.

What if I go looking and decide I do not want this?

Then you saved yourself years and a great deal of money, and you did it with information instead of a guess. That is the point of looking.

If you want a second opinion

I built The Premed Second Opinion for the person who needs someone to look at the whole picture and say plainly what they see. It is a full review of your application, an hour of real conversation, and a written opinion and action plan you keep. $500, or two payments of $250.

I do not publish an acceptance rate. I don’t control that outcome, and neither does anyone who quotes you a number.

Ben Reinking, MD, is a pediatric cardiologist and division director at an academic children’s hospital. He served eight years on a medical school admissions committee and now interviews candidates for medical school.