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He Who Gets Out of Medical School First, Finishes Last

Four years of undergraduate education, four years of medical school and then residency—that is the winding road to becoming a doctor in the United States.  It is long, expensive, and compared to just five years of medical school followed by residency in Pakistan, seemingly ridiculous. Why would anyone come to the United States from Pakistan to be a doctor, when they could stay back home in Pakistan, go straight to medical school after high school and essentially save three years of their life?

And yet here I am, a premed student at the University of Pennsylvania, having chosen to embark on this journey. I have been asked multiple times by various people why I chose this path which requires more work to be put in to reach the “same” ultimate goal. However, it is not the same goal. In Pakistan, you save three years, but miss out on knowledge you will never get the chance to acquire again.

Irreplaceable knowledge lies within an undergraduate degree. It is that Jane Austen novel you read in your English class. It is that dance club you join, which teaches you how to do Salsa or Bhangra. It is that all-nighter you pull to finish a history research paper on coinage in the Byzantine Empire. All these seem like random glimpses of a college student’s life, in no way relevant to a person who will, for example, be a neurosurgeon one day. But a close look shows their utility.  

These experiences teach you how to interact with people, which is a skill every doctor must possess. In his book, The Last Lecture, Randy Pausch wrote about how impressed he was with the way his oncologist would talk to him about his malignant cancer; so calm, reassuring but at the same time, realistic. This skill to communicate effectively and empathetically but also without too much embellishment is not something medical school teaches you. On the contrary, medical school is often criticized for being too mechanical and devoid of feelings. This is something that an English seminar that is discussion based or a writing class teaches you, because you learn to write and talk in an appropriate-to-the-situation way. And that is why many doctors in Pakistan come off as socially awkward, vague, assertive or even offensive. The latter is a very common occurrence, because a large number of Pakistanis are very dependent on religion and the doctor’s advice can be misinterpreted as a direct attack on their religious beliefs.  A good example of this is that of prenatal screening of thalassemia, a genetic blood disorder that is prevalent in Pakistan. Recently, the government initiated a thalassemia eradication program, which includes encouraging pregnant women whose families have a history of the disease to get a prenatal screening done. If the fetus is diagnosed as a thalassemia major, the mother is either encouraged to get an abortion, or guided as to how to take care of her child after it is born. Of course, many people perceive interfering with an unborn child to be unislamic. It is up to the doctors to talk to their patients and explain to them effectively why it is imperative to get the screening done, no matter their stance on abortion. In a case like this, a doctor’s communication skills can significantly improve the quality of a sick child’s life.

The theories of biology, chemistry, physics and the other sciences are incorporated in medical education in Pakistan, and in medical and undergraduate education in the States. These mandatory introductory courses rely heavily facts, that one often needs to reproduces on paper for examinations. In Pakistan, medical students are used to facts. They know what is in the textbooks, and so the ‘doctors are always right’ mentality arises- doctors know their sacred medical textbooks by heart, and even if the patient claims to be experiencing something not in the books, it may not considered important. Many cases of negligence arise, where the doctor would follow his or her own suit instead of focusing on what the patient has to say, leading to serious consequences.

In addition, creativity is what leads a doctor or researcher to think outside the box. It is what leads to stepping out of the limited medical education one has, and exploring what else is out there. It is what leads to doctors coming up with clinical trials and ideas that seem to amalgamate everything from biology to mathematics to engineering. It produces thought leaders like Drs. Sanjay Gupta and Atul Gawande, who manage to combine medicine with something else they are passionate about and thus revolutionize the realm of healthcare.

One can criticize the American medical education for its longevity, cost and emotional and physical drainage. But I have found that , some of the best doctors are in this country. The critical and social skills, dedication, persistence, creativity and work ethic that is ingrained into premeds and medical students carries them through, and helps them reach the peak of their career. As I see it, what’s an extra few years?

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