Yucky question huh?
Well, contrary to popular belief, I don't think it has anything to do with taking the MCAT a certain number of times, or with how many times you've applied to med school. I personally know a physician that I used to work with that applied 12 times to medical school. Granted, that must have been at least 20 years ago... I am not even sure if you can do that now... but the point is that the time to give up has nothing to do with how many times or how long you've tried to get in.
But there is a time when you SHOULD give up. I bet you didn't think I was going to say that, did you? Well, there is. It's when you know, in your gut, that your priorities in life have changed... and pursuing doctordom is more about ego and proving you can do it than it is about actually becoming a doctor. The main thing I want to convey is that THAT IS OK! Nothing to be ashamed of. Everyone changes everyday... as do your wants and goals. I look back on lists of things I said I wanted to do in life. Many of them I've done. Many I haven't. Like "get my pilot's license". I haven't done that. But I don't consider it a failure because I no longer have any desire to do it. What-so-ever.
I think it takes true courage to be able to detect the difference between being determined and feeding your ego. I struggled with this alot because I think I was on the cusp when I applied the last time. Thankfully, I still really want to be a physician and I am loving it. But maybe 5 years from now I wouldn't have felt the same about the admissions process.
So ask yourself the tough questions. And assess your true desires. The REAL ones. Would you rather get married asap? Have a family now? Let things stay simple? Pursue a creative or entrepreneurial career? Do you REALLY want to give up the next 10 years for this? Any answer is ok... as long as it really reflects you and not your ego.
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