Becoming a Doctor in 2026

Is it still worth becoming a doctor?

I get asked this more than any other question now — by students, and lately by my own colleagues about their children. I will answer it honestly, because the question deserves honesty rather than encouragement dressed up as an answer.

First, the case for the doubt, because it is real. Medicine is long. The training is longer than it was, the exams are heavier, and the years when your non-medical friends are earning and settling, you are still studying. AI can now retrieve in seconds what took us years to memorise. Other fields look faster and, on the surface, easier. A student who feels all this is not being weak. They are seeing clearly.

But here is what does not change.

A patient in front of you is frightened, and no model and no search result sits with them. Medicine is the meeting of knowledge and a human being at their most vulnerable, and that meeting still needs a person who understands what is happening and can be trusted to act. That role is not shrinking. If anything, in a world full of fast, confident, unverified information, the doctor who actually understands becomes more valuable, not less.

So my honest answer is in two parts.

It is worth it — if you come to it because the work itself draws you. The science, the responsibility, the privilege of being useful to a stranger on their worst day. Those people do well, and they do not regret it.

It is not worth it — if you come to it for status, or because it was expected, or because it once looked like a safe income. Those reasons were never enough, and they are less than ever now. A student pulled into medicine by pressure rather than pull will feel every long year of it.

The honest test is not "is medicine still prestigious." It is: do I want to do the actual work of it? If yes, it remains one of the most meaningful lives a person can choose. If you are unsure, that uncertainty is worth taking seriously now, before the years are spent — not a weakness, just information.

My own son joins medical school this year. I did not push him toward it, and I have not hidden the hard parts from him. I told him what I will tell you: this is a wonderful profession for the person who genuinely wants it, and a long road for the person who does not. Be honest with yourself about which you are. That honesty is the most useful thing you can bring to the decision.

Choosing medicine for the right reasons

How do you know if you actually want to be a doctor, or if you have only been carried toward it?

This is harder to answer than it sounds, because by the time a student is choosing, many forces have already been pushing in the same direction for years — family hopes, school expectations, the simple fact that your marks were good enough. Pressure does not always feel like pressure. Sometimes it feels like your own decision, because you have heard it long enough to think you chose it.

A few honest signs you can look for in yourself.

When you imagine the day-to-day work — not the title, not the white coat, the actual work — does any part of it draw you? The smell of a hospital, the puzzle of a difficult case, the patience of explaining something to a frightened person. If something there pulls you, that is real. If only the idea of being a doctor appeals to you, and the actual work feels distant or uninteresting, that is worth noticing.

When you imagine telling someone you chose a different field — engineering, business, teaching — does it feel like a relief or a loss? A relief is information. So is a loss.

When you struggle with a hard subject, do you want to understand it, or do you only want to pass it? The student who wants to understand will be a doctor. The student who only wants to pass will spend many years passing things.

None of these are tests you fail or pass. They are mirrors. The point of looking into them now is not to talk yourself out of medicine, and not to talk yourself into it. It is simply to choose with your eyes open.

The students who do well in this profession are not always the brightest. They are the ones who chose it for reasons that survive a hard week. That is what makes the difference, twenty years in.

If you are reading this and weighing the decision — what is the honest answer you give yourself when no one else is listening?

A word to the parents

Many of you were my students once, or you trained in the same years I did, and now your own children are choosing — or being chosen for — medicine. I want to speak honestly to you, because the decision in your house this year is not the same decision you made in yours.

When we entered medicine, the calculation was simpler. A medical seat was a hard thing to get and a settled life on the other side of it. The path was long but the destination was clear. Your parents may have pushed you, and time proved them right.

The same push, applied to a child today, is a different instruction. The path is longer than it was. Postgraduate competition is harder. The years of training stretch further into a young person's life before independence arrives. And the world your son or daughter will practise in will be reshaped by tools — AI, new diagnostics, changing systems — in ways neither of us can fully predict.

This does not mean medicine is the wrong choice. For the right young person, it is still one of the most meaningful lives a human being can live. But it means a child entering medicine only because the family expects it will feel every one of those extra years, and may arrive at thirty wondering why they spent their youth on a path they did not choose.

So I would gently suggest two things.

First, ask your child what they would choose if your approval were already guaranteed. Many young people cannot separate their own want from their parents' hope; the question makes the separation possible. Their answer tells you something useful, whatever it is.

Second, if they do want medicine, support them as fully as your own parents supported you — but support a doctor, not a status. The young people who do well now are the ones whose families backed the work, not the title.

Our generation was raised to value the destination. The generation entering now needs to value the road, because the road is longer and only the ones who care about the work will walk it well.

The first year is hard, and that's not a warning sign

If you are starting medical school this year, I want to tell you something I wish someone had told me at your stage.

The first year will feel harder than you expected. Not because you are not capable — you would not be there if you weren't — but because medicine is the first subject in most students' lives that cannot be conquered by being clever. School rewarded quick understanding. Medicine rewards a kind of slow, repeated, patient learning that almost no one walks in already knowing how to do.

You will sit with an anatomy chapter that took your senior an evening, and it will take you a week. You will memorise something perfectly on Monday and not be able to recall it on Friday. You will look around the lecture hall and quietly assume everyone else has understood, and they are quietly assuming the same about you.

None of this means you have chosen wrong. It means you are learning to learn in a new way, and that adjustment is the real first-year subject, even though it is not on the timetable.

A few honest things to hold on to.

The students who finish well are almost never the ones who started fastest. They are the ones who did not panic in the first six months, and who kept showing up after each setback.

Confusion is not the same as failure. Most of medicine is understood the second or third time you meet it, not the first. If you give up on a topic the first time it resists you, you will give up on most of medicine.

The book that confuses you in October will make sense in February if you keep returning to it. The slide that "covers" the topic in five bullets will not, because there was nothing there to return to.

And you do not need to enjoy every subject. You need to respect the work, show up to it, and trust that understanding follows effort with a delay. The delay is the hardest part. Most students who quit, quit during the delay.

If you are starting this year — welcome to a long and worthwhile road. The early months are not the measure of you. They are the measure of whether you are willing to keep walking when the road is new.

"I didn't get the marks for medicine"

Every year at this time, I hear from students who did not get a medical seat — by a few marks, by a difficult interview, by an admission system that did not go their way. Some are devastated. Some are quietly relieved and do not know how to say so. Most are caught somewhere in between, watching classmates begin a road they thought they would be on.

I want to say a few things to all of them.

First, the painful truth: the admissions process is not a perfect measure of who will be a good doctor. It measures a narrow set of marks taken on a narrow set of days, and it cannot see patience, judgement, character, or how a person will sit beside a frightened patient ten years from now. Many fine doctors I have known did not enter on the first attempt. Some entered through other countries, other routes, longer paths. Their careers are not lesser. In some ways they are stronger, because they had to want it more than the easy entrants did.

Second, the honest qualifier: not getting in is also information, and it is worth letting yourself hear it. If you are relieved, that is worth listening to. If you are devastated, that is also worth listening to. Both feelings tell you something true about the decision, and both deserve a quiet week before you act on them.

If medicine is genuinely what you want, there are still routes. Repeating the entry exam with a year of real preparation. Entering medicine in another country and returning. Beginning in an allied health science — dentistry, pharmacy, biomedical sciences, nursing — and either building a fine career there or crossing over later, as some do. A year is not the disaster it feels like at eighteen. At forty, no one will ask which year you entered. They will ask whether you became a good doctor.

If medicine is not what you want, and the entry result has given you permission to consider that honestly for the first time, then that result was not a closed door. It was a question. The young people I have seen flourish most are not always those whose first plan worked. They are those who answered the question honestly when life forced it on them.

To anyone reading this in the difficult days after a result that did not go your way — you are not behind. You are at the beginning of a longer conversation with yourself about what you want your life to be. Take the time. The decision is worth more than the speed.

What kind of doctor the world will still need

A student asked me last month whether AI would make doctors unnecessary in twenty years. I have been thinking about the question since, because I do not think the honest answer is the comfortable one.

The honest answer is: AI will make some doctors unnecessary, and others more valuable than they have ever been. The dividing line will not be where most students think.

It will not be procedural skill alone. A surgeon's hands are not yet replaceable, but routine procedural work has always been the part most exposed to automation when automation matures. It will not be sheer memorisation. A doctor who knew more facts than the next doctor was valuable in 1995; today a phone holds more facts than any of us, and the patient knows it. It will not even be diagnosis on classic presentations, where pattern-matching systems already perform very well on certain images and lab patterns.

What will the world still need a doctor for?

The patient who does not fit the pattern. The presentation that is half one thing and half another, where the model has no confident answer and someone has to decide anyway, with incomplete information, in real time, while a worried family waits.

The conversation that follows a serious diagnosis. No system delivers that conversation. The doctor who can sit, slow down, and explain a frightening reality in a way a frightened person can hold — that doctor is not being replaced. That doctor is becoming rarer, and therefore more valuable.

The judgement that integrates everything a screen cannot see. The patient's home situation. Their fear of a particular treatment because of a relative's experience. The clue in how they walked into the room. Medicine has always been more than data, and the part that is more than data is the part that does not automate.

And — perhaps most importantly — the doctor who can use these tools well without being fooled by them. AI gives fluent, confident answers that are sometimes wrong, and a doctor who cannot tell the difference is dangerous. The doctor who can is the one hospitals will want.

So the choice facing a student today is not whether to enter a profession that is disappearing. It is what kind of doctor to become inside a profession that is changing. The narrow, mechanical, fact-recall doctor of the old model is in trouble. The thinking doctor — who understands the foundations well enough to question a confident answer, who can hold a difficult conversation, who can decide under uncertainty — has never been more needed.

That is good news, for the right student. It means the work that is meaningful is also the work that is durable.

Money, time, and the years your friends move ahead

Let me speak to the part of this decision that students rarely say out loud, and that parents sometimes refuse to discuss honestly.

The years.

If you enter medicine this year, you will study while your school friends earn. You will train while they buy their first car, marry, settle. There will be a stretch — sometimes a long stretch — when a classmate who went into business or engineering or computing seems to be living the life you are postponing. This is not an illusion. It is true, and it is one of the hardest parts of the profession that no admissions brochure prints.

I will not tell you it does not matter. It does matter, and the students who pretend it does not are usually the ones who feel it hardest later. So let me tell you what I have actually seen across decades.

The financial picture eventually evens out for most doctors, and for the dedicated ones it more than evens out — but "eventually" can mean your mid-thirties or later, and that is a long time to be patient. If your motivation depends on income arriving quickly, medicine will feel like a betrayal. Choose accordingly.

The settling-down years are harder in medicine than in most fields. Marriage, children, the small ordinary stability of a life — these arrive later for trainees than for their peers, and it puts real strain on relationships and on the person inside the white coat. This is worth your family understanding, not just you.

But here is what I have also seen, and what the comparison usually misses. At fifteen years in, the friends who got ahead financially are often less satisfied with their work than the doctors are with theirs. Not all of them, but many. Money compounds, and so does meaning, and the second one is rarer than the first. The doctors I know who chose medicine for the work itself — even the ones who struggled financially for years — do not envy their peers. The ones who chose it for the income they were promised, and then did not get fast enough, do envy them, often bitterly.

So the honest question is not "will I earn as much as my friends." It is: if the answer turned out to be no for ten years, would I still want the work?

If yes, you will be fine, and probably more than fine. If no, you have time now to consider another road, and considering it now is a kindness to your future self.

This is the part of the decision adults often pretend does not exist. It does exist. Look at it clearly, and then decide.

A letter to the student starting this year

You will receive a great deal of advice in the coming weeks, much of it well meant, some of it contradictory. Let me add one more letter to the pile, and then I will let you start.

You do not need to be the brightest student in your class. You need to be a student who shows up, who is honest about what you do not understand, and who returns to a difficult topic instead of running from it. The brilliant student who cannot tolerate confusion will struggle. The ordinary student who can sit with confusion and keep working through it will become a fine doctor. I have watched this for decades. It is true.

You will be tempted by shortcuts. Slides that promise the chapter in twenty minutes. Notes that promise the exam in a weekend. They will work, briefly, for the next test. They will not build the foundation you will stand on in your third year, in your final year, in your postgraduate exam, in your first night on call. Build the foundation. The students who skip it pay for it later, and the bill arrives at the worst possible moment.

You will compare yourself to classmates. This is human, and it is also a slow poison. Compare yourself to the student you were last month. That is the only useful comparison medicine offers.

You will have weeks when you doubt your choice. So did I, and so did every doctor you respect. Doubt is not a sign you chose wrongly. It is a sign you are taking the choice seriously. Sit with it, do the next day's work, and let the doubt pass on its own — most of them do.

You will encounter teachers who inspire you and teachers who do not. Learn from both. The ones who inspire you show you what kind of doctor to become; the ones who do not show you, sometimes more clearly, what kind not to become. Both lessons matter.

And one last thing, the most important. You are entering a profession whose work is, in the end, looking after another human being when they are most afraid. Whatever the noise of training, whatever the pressure of exams, whatever changes in the technology around the bedside — that is the work. Keep that in view, and the long road becomes a road worth walking.

I wish you well. The profession is glad to have you. Welcome.