Somewhere along the way, pre-med stopped being a college path and became a teenage identity. If a student is considering medicine, there are many steps, requirements, and signals of seriousness. They take the right classes, demonstrate aptitude, and show commitment over time.
They join organizations which exist, in part, to shepherd students through the process. And then, at some point, they can spend a day in a hospital. One day. They dress in business casual, follow a physician, observe, and absorb. They have a sandwich and ask a few questions, if there’s time. And then they go back to their lives. On paper, it is a perfectly reasonable system. You can’t commit to something you’ve never seen.
There’s a sense that becoming a doctor is all about a strategic set of moves
Last week, sitting on the sidelines at a water polo tournament, I found myself in a typical parent conversation with another freshman mom. The chat turned to summer plans. Her daughter is going back to the camp she attended as a child, now as a counselor in the health office. It will count, she said, as clinical hours for pre-med. I remember thinking, almost immediately: How? There was a simple answer. Timing. Age. Not every path is available at every moment. But it also felt, briefly, like something we had missed.
There is this sense that it is all about a strategic set of moves, a way to do this correctly. Some people seem to understand the system better than others. If you miss an exit, will the GPS recalculate? How much time will that cost?
Next came years of careful planning, classes chosen for trajectory
My daughter has always leaned toward medicine. She is drawn to science, but also to the human side of things. The inequities in health care and school readiness have long-reaching effects, and they bother her. She started down this path many years ago. Some might say she was on it as early as preschool, sitting on my lap at story time, exercising her empathetic heart.
Next came years of careful planning, classes chosen not just for interest but for trajectory. Summers that built toward something, activities that signaled commitment. A steady accumulation of the kinds of experiences that, taken together, tell a story of seriousness and care.
The system punishes exploration when that is exactly what teens need
We call it pressure. But it’s also a system that rewards early certainty and penalizes exploration, even though exploration is exactly what they need. What is harder to sit with is how early that pressure begins, and how continuous it becomes. Each step up only brings you to the next hurdle. And then, at a certain point, the question shifts. Is this the right path for her?
After all, there are the other versions of her, pieces that don’t fit as neatly into a track of med school prerequisites, clinical patient-facing hours, internships, fellowships, specialties. During the long months of the pandemic, she and her father watched Grey’s Anatomy from beginning to end. She absorbed the characters, storylines, and music. The way a scene could turn on a single song. The way a fragment of a song, placed at exactly the right moment, could lift something ordinary into something unforgettable. Her thoughtful questions turned into research. As it turns out, there is a job for that: music director.
My daughter is also artistic, she plays multiple instruments and sings
In this other version of her, not the science-driven one, but the artistic one, she plays multiple instruments, sings a little, and her soul is moved by the way sound and story intersect. I can imagine her here, but unfortunately, there is no pre-med track for this version of her. At her college teaching hospital, undergraduate students can shadow a physician once per term, just one day at a time. She signed up in the winter and listed her preferences on specialty.
There is, I think, a lottery element. She was assigned to the emergency department. At some point during that day, someone died. A heart attack, brought on by something as ordinary as shoveling snow. At the end of the shift, someone sat with her to talk about it. To make sure she had support, if she needed it.
And then she came back to her life, and reminded my husband not to lift the shovel too high above his heart. Somehow, that day is supposed to count as enough. Where does an 18-year-old hold this kind of experience? And at the same time, the absence of it is even less helpful in the discernment process. There are days when nothing is clearly revealed.
There are specialties and paths my daughter has not seen yet
There are specialties you haven’t seen and paths you haven’t had time to explore, or maybe the shadow assignment just didn’t come your way. How does one student get assigned pediatrics and another radiology? And still, the expectation is that you will begin to decide.
If she had shadowed the emergency department on any other day, it would have been a totally different set of experiences and patients. She will shadow again this term. She added neurology to her list this time, shaped in part by the work she is doing in her lab job; unpaid, without academic credit, another strategic step.
Her day in neurology will be another snapshot. Another attempt to see something clearly with limited time and perspective.
Maybe this is how it has always worked, but I don’t think so. Physician friends of ours laugh that they mowed lawns in high school and scooped ice cream on their undergraduate summers. It’s never been easy to become a physician, but it didn’t always look like this. We do our best to help.
We try to help our daughter as best we can
I edit her resumes, set LinkedIn alerts for summer internships, and suggest connections in our network she can tap. Try to ask in a non-pushy way: “Oh, how’s your pre-health mentor this term? Did her visa come through for that job?” Thinly veiled way of me saying you’re meeting with her, right? Right? She sees right through me and sighs.
I am a rookie parent once again. It feels a little like choosing a life partner after a handful of
dates, with everyone assuring you that you have enough information. As parents, my husband and I would never bless such a flimsy plan. I can’t quite shake the imbalance. The years of preparation. The cost, in time and money. The weight of the decision. In the middle of all of it, we are asking them to decide, in part, based on fragments, and calling it clarity.
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