How rewarding is a degree in medicine?

Secondary school students who have their hearts set on studying medicine have to perform exceptionally well in the Leaving Cert, as well as score highly in the Health Professions Admission Test (Hpat) – requiring about 730 points in total to earn a place.

To that end, you might assume that by the time a 17- or 18-year-old makes it to medicine at third level, they are well prepared for the exhausting workload and academic demands of their course. Colin Doherty, head of the School of Medicine at Trinity College Dublin, explains that there are plenty of new challenges to negotiate, but that no course is rewarding in quite the same way as medicine.

New students, he says, tend to see themselves as future practitioners delivering care. While that is a positive pursuit, the school hammers home the idea of doctors as scientists as well – custodians of medicine who will be responsible for producing new therapies and treatments down the line, and for bringing about fairer and more effective medical systems.

“I believe there’s a culture of application for the students that get those 625 points,” Dr Doherty says. “They are students that have applied themselves, but have they done anything really creative with their intelligence? Probably not yet. When we bring them in, we say look – all that rote learning, there is a bit of that here but we’re trying steadily to chip away at it and do away with it. We want people who can think.

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“When I was walking around the wards in the ’90s, I had to remember stuff. I couldn’t look it up. I had to remember the dose of the drug or whether it was given intravenously or orally. I didn’t have a reference … Nowadays, you can just look this up. So, we tell them, knowledge is no longer the issue. The question of how you access knowledge and deploy it, where you find it and how trustworthy it is – these are the important things now.”

Medical students of today have different concerns about the world than those Dr Doherty and his classmates faced in the 1980s. He references climate sustainability, artificial intelligence and political instability as particularly relevant megatrends, and argues that medicine empowers graduates to tackle these broad, contemporary problems in ways other degrees cannot.

“You can become a doctor and treat patients in any environment you like,” Dr Doherty says. “You can go to Africa and deliver care to thousands of people in vaccination clinics. Or you can come in and work in an academic medical centre where you’re the only person in the world who can remove this type of tumour from the brainstem. That’s what’s brilliant about medicine – you can go any direction you want.”

Medicine is often described as a calling. The pressure of the job and the high standards it demands are reason to imagine you would need to be extremely passionate about the work to pursue it. It is not always essential for a doctor to feel that draw, and it can be necessary to approach medicine as a job with its own demands and expectations.

Dr Doherty believes, though, that there are fewer students entering the field based on traditional notions of societal prestige. Ultimately, it is appropriate to view the role as something loftier and more important, given its extraordinary capacity for good.

“You can have a good doctor either way and you can have a bad doctor either way,” he says. “I would say nowadays, because of the availability of other roles in society in business, you can get that social cachet in a whole range of roles. In remuneration terms, being a doctor is not the pathway to being one of the richest people in society any more. You’re certainly well paid and in the upper echelons, but there’s a certain point at which it cuts off, whereas in business, you can obviously become very wealthy.

“I would say there’s more of a move towards the calling side of medicine now. I may be wrong, but looking around at our students, most of them come in and they have a very clear vision that they want to be a doctor. They want to practise medicine. They want to deliver care.”