Not everyone can-—or should—grow up to be a doctor.

By Marion Franck

Many a freshman begins his or her college career with the end already decided. “I’m going to be a doctor,” says the student, flanked by proud parents who share this worthy goal.

Rachel Rollins, now a junior at UC Davis, was one of those students. Strong in science, she also knew she loved working with people. Being a doctor sounded just right. Then, halfway through freshman year, she took an internship in an emergency room and started feeling a little uneasy.

“It was the lack of interaction that bothered me. A lot of doctors have this title, but they spend very little time with patients. I came home for the summer and did a lot of thinking. I realized I didn’t need to have an M.D. after my name in order to change people’s lives.”

New plans emerged. “I got into nutrition. I love it. If you’re really passionate about something, you’re going to do so much better in it.”

Rollins, who works in the Internship and Career Center at UC Davis, knows that when she dropped out of medicine she became a statistic. Although no one keeps precise data, UC Davis advisers estimate that some 1,000 freshmen—around one quarter of the class—intend to become physicians. Over 500 of them are so certain of their plans that they ask to be placed on a “health sciences floor” in the residence halls.

Yet, in a typical year, only 325 UC Davis students apply to medical school. These numbers indicate that at some point between moving into the residence halls and moving on to medical school, two-thirds of the once-future doctors have changed their minds.

This shouldn’t be a problem. Everyone knows that students change majors. Yet when it comes to medicine, the angst level is high.

While other students shift cheerfully between history and design or math and geology, pre-med students often describe a period of agonizing uncertainty, painful separation from other pre-med students and a deep fear of disappointing their parents.

In many families, the student’s plans for medical school are a point of pride, not easily abandoned. And there’s no denying the status conferred on physicians, even in these days of managed care and shrinking salaries. You may not get the house on the hill anymore, but becoming a doctor still means you’re smart.

Changing plans

Janice Morand, coordinator in the Internship and Career Center, sees every stage in the process. She recommends that all pre-med students undertake internships (although not during their first quarter), and she helps students find them. She’s also a source of advice and comfort when the student decides to change goals. Sometimes, as in Rollins’ case, the internship itself is the deciding factor.

“Students have said to me, ‘I didn’t know that seeing blood would make me sick’ or ‘I didn’t know it would upset me so much, being in the room when someone dies,’” Morand reports.

In other cases, students enjoy their internships but falter at the sophomore-year hurdle of organic chemistry or find themselves longing for a less-competitive college experience. “Your first year you are adjusting and trying to figure out your road through college,” says Morand. “Then you get to the second year and say, ‘Oh my goodness, this is not getting any easier, and my grades are not going up.’”

Morand notes that young women, in particular, sometimes veer toward a career that offers a better balance between work and child-rearing.

No matter what the reason, the switch from medicine to something else is a difficult announcement to make at home.

“I clearly remember those phone calls,” says Jenny Shaw, a 2002 graduate now studying social work at Columbia University in New York. “From the time I turned 7, I had insisted I was going to be a pediatrician. I was expecting shock.”

Instead, she reports, “everyone was very supportive.” They pointed out that she could still be Dr. Jenny, if she wanted, by going for a Ph.D., but no one pushed her in that direction. Despite their kind response, Shaw privately wondered, “Did I waste my time for a year and a half?”

Now happily preparing for a different career, Shaw doesn’t need a Ph.D., and she’s proud of the way she made the switch. “It was useful to go through that year and a half. I explored science and did the work. I needed to demonstrate to myself that I had come to a conscious decision on my own, not influenced by parents. I didn’t want to give up quickly on something I had engrained as a career path.”

Seeking what’s “right”

Although Rollins and Shaw have never met, they share certain fortunate experiences. Both had parents who were supportive of their decisions. Both found other fields that they loved more than medicine. Both feel relief as they look back at the life they might have led.

“Having the ability to be involved in other things, clubs and so on, that’s important to me,” says Rollins. “I see a drastic difference between the way I live now and the way I lived before.”

“After I decided not to be a doctor,” echoes Shaw, “a weight lifted.”

Does that mean that all students would be happier with a less-grueling career?

Not at all, says Coordinator Morand. When the goal is right for the student, the burden doesn’t feel as heavy. And although organic chemistry is required of everyone, perfection is not. Students who do poorly in a few classes can be accepted to medical school, if the rest of their record reflects their passion for medicine.

But it needs to be the student’s passion, not the parents’.

And for those who decide against medicine, the key to happiness is choosing a new goal.

“If you say you’re pre-med and you change your mind, you haven’t failed,” says Morand. “You just changed your mind. There’s no rule that says when you’re 19 you know what you want to do for the rest of your life.” Morand helps students identify the many careers that draw on the same strengths that made them choose medicine.

The parental response

For parents, it can be frightening to hear your son or daughter say, “I’ve switched out of medicine. I don’t know what I’m going to do,” but Morand says the student’s uncertainty is often brief.

“They go into teaching. They go into research. They go into public health.” Some switch to genetic counseling, pharmacy or optometry—fields closely related to medicine. Often students have to get over the need for the stamp of approval that says “doctors are smart.”

Morand says, “I always feel proud of the student who says, ‘I came in pre-med, but now I’ve considered everything and that’s not going to work with the kind of life I envisioned. I’m going to be a nurse.’”

Wise parents go through the same process, asking themselves, “Does high status guarantee a happy life? Is medicine the only field that pays well?”

Rollins says she was lucky to have very supportive parents. “I think I could drop out of school and beg for change and my parents would still love me.”

Few parents need to accept that alternative. But to be supportive, parents need to listen when their children face hard decisions and be proud of them when they redefine their dreams.

Marion Franck is a Davis writer and regular contributor to campus publications for parents.