Prerequisites:

Before answering this question, the student should:

• Undergo sufficient self-reflection to be capable of articulating the reasons for undertaking Medicine,
• Make a fully-informed decision about Medicine by taking the initiative to research about the attractions and hardships of becoming a doctor,

Self-reflection:

The student is expected to have undergone some introspection before the interview, as choosing Medicine as a career path is not something to be taken lightly. Moreover, the introspective answer will resonate within the interviewers more than a pure theoretical or philosophical answer.

Some helpful questions to facilitate this self-reflection are:

• When did you first consider a career in Medicine? What happened at the time?
• Who has encouraged you to become a doctor? How did they affect your choice? How are your motivations different or similar from theirs? Account for these differences or similarities.
• What do you know about the attractions and put-offs of being a doctor? Which ones resonate with you, and why? How did you come to learn about these?
• What are your experiences with doctors? Have they been favourable, or not?
• What qualities do you have that would help you to be a doctor? What qualities would hinder you? What, if any, measures have you taken to overcome these deficiencies?

These questions, when considered singularly, do not directly address the question, but some universities, such as University of NSW, may ask you these questions as a lead-up.

Research about medicine

It must be again emphasized that you are not expected to think of or even put pen to paper to write an answer to this question, the main reason for which is that you would not at all familiar with the daily tasks with a doctor.

The common stereotypes of doctors portrayed on modern media may be sufficient for the average person, but for someone contemplating becoming a doctor, it is wholly insufficient, and indeed, misleading.

A simple example is the idea of doctors “curing” patients, where a single medication or operation can restore someone’s health to a normal level. The reality is that most operations leave patients with some residual impairment – facial reconstruction always leaves some visible blemishes, and one has little hope of playing piano after breaking the bones in one’s hands, despite all the surgical expertise in the world – and most medications for chronic diseases must be taken for life, and not infrequently with side-effects that must be tolerated. Complications in surgery do occur, and sometimes the patient does end up worse off than before.

If you have a relative or friend who has faced this situation, then you may have already realized this, that medicine does not aim for perfection, but to restore a patient some dignity to live a life of good quality – that we can intervene into someone’s suffering to ensure that he or she can eat, sleep, dress and function well in society without unnecessary pain or suffering is reason enough to do Medicine.

Our focus, therefore, is on improving the patient’s functioning in life, as opposed to the tackling the disease itself – in other words, we deal with the suffering and functional impairment caused by the disease as our primary goal, not the disease.

Here is another example. A small effort to ensure that an elderly patient is able to mobilize with a wheelchair or metal frame so he can visit his wife in a nursing home sometimes has a more noticeable effect than the slight improvement in cardiac function that is achieved by keeping his blood pressure under control. You might have been the disgruntled relative or friend of such a patient, realizing this before the short-sighted doctor did, who was rather focused on other details.

It must be said, however, that for most minor ailments, the cure is the best way to improve the patient’s function, such as antibiotics for the streptococcal infection in his lungs causing pneumonia that is in turn causing him to be short of breath. The change is very noticeable as there is a sign of relief from the patient as his labored breathing improves. The glorified idea of the “knight in shining armor to the rescue” comes to mind in most people thinking about what makes a doctor, especially a surgeon, great.

This, however, is but one small part of Medicine – for the practical needs of the patient, the doctor represents more than a “prescription vending-machine”, for why would one bother to see the doctor if one knew the exact ailment that afflicted us? Had you been following the news over the last few years, you would have realized that pharmacists are clamouring to Governments to gain more and more autonomy to prescribe medications to patients without a need to see a doctor, and Governments are listening. Does this signify the beginning of the end of doctors?

No, of course not (not least because, I would soon be unemployed). Let us go back to the example of the man with pneumonia – think about why he was so anxious about his shortness of breath? What if this particular fellow was a pack a day smoker for the last twenty years, and his father, who was also a smoker, passed away from lung cancer at the age of 57? His anxiety can be explained by the patient’s recollection of his father being diagnosed of cancer after presenting to the doctor with a similar episode of shortness of breath. Perhaps you have known someone close to you in this situation, or perhaps you yourself have been in a similar situation, where it was not the cure itself that mattered, but the reassurance from the kind understanding doctor that the symptoms were not from a serious illness.

What doctors do, therefore, is bring reassurance and hope to the fears and anxieties that patients have about their conditions, to discern what fears are being left unsaid, to reassure the patient with their years of experience and expertise, and be a constant source of information and certainty as they come to terms with the effect of their illness on their lives.

One can now see that it is a travesty of the greatest proportions to say that doctors merely “help people.” Psychologists and nurses help patients too, but not in the same manner as the physician. Psychologists may help people to sort out their mental anguish and confusion by reflecting back their tangled and distorted thoughts and beliefs, and nurses provide the daily reassuring presence in the care of the patient, but they do not aid in dispelling the patient’s fears of their illness, nor give them hope that their suffering can be alleviated.