Roughly ten months ago, I decided not pursue residency. You can check out my previous post for more details on that decision. Since then, a number of medical students and residents have asked me for advice as they grapple with their own decisions for the future. I wrote the following post largely from the conversations I had with those individuals. Hopefully what I have shared will be relevant to anyone thinking of starting a company, and not just those in the medical field.
(If you have specific questions feel free to reach out directly. One of the things I love most about the startup community is the willingness to help others, and I always want to pay forward the advice I have gotten.)
Question #1: Should I be practicing medicine at all?
This is a difficult question to ask yourself, but it is necessary and worthwhile. The question is made all the more difficult by those within the medical community who look down upon anyone with an interest outside of the hospital.
It is nearly impossible to get through the required training without complete dedication. You can’t do it half heartedly, so many people fall into the fallacy that if you stop to make sure you are really in the right spot, you will lose motivation and quit. I believe that questioning everything in life and not just accepting something as fait accompli is the only way to live, even if it is difficult. I applaud your soul searching.
Most students/residents/doctors that I have talked to have had doubts about medicine at some point along the way.
I would suggest rather than avoiding the question, dive deeper into it: What do you dislike about medicine? Can it be fixed or changed? Will it get better or worse as you move forward? There are a number of avenues for different careers within the confines of traditional medical training, and answering these questions might help direct you to your dream profession even if it’s not as a practicing physician.
After considering the questions above, you should also talk openly with anyone who knows you well. When I went through this process myself, I dealt with a fair bit of criticism from people I really respected. It hurt. And if I had continued down the path of traditional training, a few may have even held it against me. In the end, it is far better to go through the process of self exploration and end up where you belong even if you have to deal with a little blowback as a result of openly discussing your decision.
The people who really matter will want what is best for you. Even those who initially disagree will come around (though it might take some longer than others).
Question #2: What should I do if I don’t want to practice clinically?
For all the sacrifice, there are a lot of awesome things about being a doctor. Don’t give them up easily. If you fully break away, it is tough to undo that.
As I’ve indicated, I chose not to pursue residency, so I can’t offer much perspective on the experience of it. That said, for those of you in medical school, here’s my individual insight:
The preclinical years are nothing like the clinical years. Only you know for certain what is best for you, but my advice is to push on to third year and see if you like being on the wards. If you are absolutely certain that medicine is not for you, then it’s probably best to quit now. The sacrifice both in terms of debt and opportunity cost are too great to continue down the medical school path if you don’t plan to practice.
If you are in clinical years, complete an internship year. If I knew what I know now, I would have done a one year internship before breaking away to pursue my startup. Having an MD without a medical license is like going to law school but not taking the bar exam. You lose a lot of the value of having a professional degree. Practically speaking, this limits your career options when it comes to job opportunities such as working for a clinical research organization or moonlighting at an urgent care clinic while keeping yourself afloat financially to launch your company. I would have loved to work weekends while starting Orderly, but I didn’t give myself that option.
Question 3: I want to start my own company. How do I get the skills need to do that?
First and most importantly, you need to be absolutely certain that that’s what you want to do.
If you are, congrats! Go for it. I love what I do!
Medical school prepared me for many of the challenges of entrepreneurship. I love how much I get to learn each day while starting this company. The late nights and long hours cramming for tests helped foster an intellectual curiosity and discipline that helps me cope with the many challenges we face daily trying to get our business off the ground. Medical school turned me into a learning machine with an immense amount of mental stamina. That is your competitive advantage, embrace it.
The biggest challenge for me is the lack of structure. There are no rules, no syllabus, no multiple choice questions when it comes to starting a company. There is no standard of care when it comes to hiring philosophy or how to raise your seed round. The best thing that happened to me was finding a co-founder that I can trust. The only additional advice I can give is use your scientific mindset, research the relevant background, develop hypotheses, test them quickly and adjust your course even faster.
At the end of the day, I would like to pass along the best piece of advice I have received: Trust your instinct. Yossi Feinberg, a Stanford Graduate School of Business professor, relayed that to us during our last day at the Ignite program. You know more than you give yourself credit for, and the best tool you have in an unfamiliar situation is your intellect. If you are an academic like me, your natural tendency is to study the problem. In startups, as in life, often the information is incomplete and the timing is limited.
When it comes time to decide, make a decision. You will be glad you did.