Why it Has to be so Hard to Get into Medical School

Last night, while preparing for today's lecture and cadaver dissection, I had a revelation: I finally understand why it has to be so hard to get into medical school.

I think that medical school can be analogous to marrying a very difficult person who sucks all the life, time and money out of you, but has the potential of being a wonderful life-long partner.

First, you have the courtship period where you follow around other people who have married a similar difficult person many years ago. They acknowledge that the first few years of the marriage is difficult, but admittedly proclaim how wonderfully happy they are now. They dearly love and care for their spouse and feel they are making a difference in the world. They say that by being married to this person they are able to do so much more than they were alone. You are hooked. You begin to court this difficult individual. The privilege of becoming a life long partner to this person becomes your all-consuming desire. Your thoughts continually dwell on how you can show yourself to be a good enough person to marry this individual. You prepare yourself for years. When you finally think you are ready, you apply to the individual's family to ask for permission for the marriage.

Before the marriage, everybody says, "It is going to really suck marrying this person. Are you sure you want to do this? You aren't going to have time to do anything you used to enjoy. You aren't going to be able to spend time with your other friends and family. You won't be able to get enough sleep. You will question this decision again and again." You have to respond, "Yup, I am sure I want to marry this really difficult person." You have to write an essay telling why you want to marry this person. You describe how wonderful you think it will be once you go through the difficult time with this person and you finally get to the stage where you finally enjoy spending time with him/her. In your essay you might even describe some of your experiences spending time with people who have married a similar person many years ago. You have to have an interview with this person's parents and tell them how much you want to marry this person. How committed you are to making this relationship work. How you are willing to go into debt, have no time, and be completely miserable for a number of years to be with this person.

If you finally convince the individual's family/marriage approval committee that you will be a good spouse and that you can put up with this person, they give you approval for the marriage. When you get the approval you are so excited you can barely contain your joy. You almost forget that there are going to be many difficult years ahead before wonderful side of your partner predominates. The individual's family gives you pre-marriage orientation and tells you how bad it is going to be. They say oh, by the way, you won't have time for anything that you used to enjoy, but take care of yourself and stay healthy. Then they ask you to take your oath/marriage vows to be a good spouse to this person no matter what happens.

Then you enter into the difficult marriage. It is different for each person. However, for you it is even worse than the most horrible situation you imagined before the wedding day. Not only do you not get enough sleep and not have any time for other activities or friends, you are constantly worried about not being able to make the relationship work. You constantly doubt yourself – you worry that you won't be able to survive and make it to the good years of the relationship. Or you think that the difficult early years of the relationship will turn you into a different person who won’t be the kind of loving spouse that you wanted be to be once you reach the good years. To add on to all of that, this difficult person is spending all of your money! Unexpected costs come up everywhere and you have had to take out loans to keep this individual's financial appetite satisfied.

Why don't you give up on this taxing relationship? Just say, "Forget this!" Ask for a divorce, and go your separate ways. Oh, to bask in the joy of having time again, of not being stressed, of having a money again, of getting plenty of sleep every night. There are two things that stop you: First, you remember how badly you wanted to marry this person. You remember everything you had to go through to convince the individual's family that you were worthy of him/her. Secondly, you occasionally get a glimpse into what your relationship will be in the future. For a couple hours a week in your "Introduction to a Mature Relationship with a Difficult Person" course you experience what some of the potential of your relationship with this person. For those couple hours, everything seems to make sense. You realize how much good you can do in the world with this person once your relationship matures and you remember why you go through the daily struggle of surviving the relationship.

Just in case you all were wondering, the Introduction to a Mature Relationship with a Difficult Person course is really the Introduction to Clinical Medicine Course that we have every week. (I have written about it a little in earlier blog posts. It is supposed to develop our clinical skills and our listening, compassion and empathy towards patients. I think this class really offers a window into what medicine is suppose to be like while we are going through the horrors of medical school.