Advice to a premed and high school STEMM entrepreneurs

Happy Graduation.

Thank you for inviting me to address your graduating class. I know it's hot out there sitting in your living room on Zoom and the pot is kicking in, so I'll keep this short.

Congratulations on making the cut, particularly if you are a Pell grant recipient, because the deck is really stacked against you and you beat the odds. Your former classmates who didn't finish but are up to their eyeballs in debt are ready to take you back to your hotel in their Uber and Lyft vehicles after this event The other bad news it that the ROI graduating from this university and going into medicine is not so hot. Have you considered getting a data science certificate this summer instead of wasting time looking for sex in those piazzas in Italy?

Here is the latest physician compensation report. Things will most likely change once we account for all the post-COVID healthcare layoffs and furloughs.

For that and other reasons, many parents and students are scratching their heads when it comes to choosing medicine as a career choice. There is all the noise and naysayers, grumpy doctors, student debt averaging $200,000 a year, opportunity costs of the time it takes to become a doctor and all the rest. By now, most of you have either been accepted or rejected to medical school, so what I am about to say is too little, too late, but bear with me. Even the 1% is getting squeezed because of your debt load, high cost of living and stagnant income when corrected for inflation.

Maybe you have already decided to "let it rot" and get out of the rat race to be an influencer on YouTube and head for greener pastures.

In 2018–2019, 21,622 applicants were accepted to allopathic (MD) medical schools out of the 52,777 who applied, for an overall acceptance rate of 41%.

This year there are a record number of applicants to US medical schools and some attribute it to the "Fauci effect".

Even if you get accepted, there is about a 4-6% non-graduation rate and there are few if any exit ramps.

So, it comes as no surprise that some medical students are deciding to pursue non-clinical careers after medical school and not doing a residency.

Here's what most will advise if you are a premedical student interested in an entrepreneurial career.

Here is a sample of some advice for premeds. Much or this applies to high school students interested in STEMM (science, technology,engineering,math,medicine) entrepreneurship as well.

I recently had a dental school faculty colleague ask me to talk to his nephew about medicine as a career. Here was the gist of the conversation:

1. There has never been a more exciting time to become a healthcare professional if you have an entrepreneurial mindset.Not so much if you are a technician.

2. Given the quality and quantity of medical school applicants, getting into medical school is a numbers game. About 75% has to do with aptitude and the rest is luck. The criteria to select applicants is not predictive of outcomes, so just accept the fact that it is what it is. Just continue to memorize stuff.

3. Don't take rejection personally. Failure builds character. But, only if you take personal responsibility and move forward with lessons learned.

4. Always, always have Plan B. You never know when you will be one of the white coats that gets the pink slip. Hosptial consolidation is increasing as is the numbers of employed physicians, now at about 75%. At some point, you might find you will feel like a cog in a corporate wheel, hit a career advancement ceiling, and, actually find that taking care of patients is the least interesting and satisfying part of your job.

5. The only thing that will be more challenging than getting rejected will be getting accepted.

6. Choosing a specialty is like dating. It will mostly depend on the people you meet and how they have influenced you. Each specialty has a different personality that, like dating, will take about 30 sec to determine whether you like it or not.

7. Self selecting a specialty is remarkably efficient if you follow your heart. Very few residents change specialties in mid-training.

8. There are many more opportunities now to help patients than seeing 20 a day for forty years. Build a portfolio career and invest in it often and early just as you would your retirement plan.

9. Interviewing is usually done by unskilled interviewers interviewing unskilled applicants. It's a performance. Know your lines and practice, practice, practice. Usually, people choose others who are just like them, so be prepared to improvise.

10. As a psychology major, you could create an entire career around patient/consumer behavior and social media.

11. The sick care jobs of the future have yet to be created. Be sure you have the knowledge, skills and abilities that involve problem solving, team building, creativity and empathy so you can create them for yourself. Could you get these new sick care jobs based on your Linkedin profile?

12. Corporate loyalty is dead. The only person you can count on to take advantage of opportunity is yourself.

13. If and when you get invited to interview, here are some things not to say. In addition, do not say, "I really don't want to do a residency after medical school. I only want to get my MD/MBA so I can work for a digital health startup or go to work for McKinsey or Google."

14. The odds are that many of you didn't get accepted to medical school despite taking the advice of your pre-med advisor. Rest assured there is Plan B. Consider the many ways you can add value by pursuing biomedical or clinical entrepreneurship.

15. Being a healthcare professional always has been a dangerous job. Thousands have died from COVID. Others are assaulted or murdered. The dark underbelly of medicine is not pretty.

16, Get business experience as an undergraduate. Here's how and where.

17. Do a micro-internship

18. There is a chance that once you actually start medical school, you will have second thoughts and start looking for an alternative exit ramp. It is unlikely your school will have one, so carefully consider your options instead of being shackled by the golden handcuffs.

19. If you are going to do an internship, consider doing one in data analytics or artificial intelligence. instead of a conventional biomedical research one.

20. If you are a woman, you face significant gender disparities in the tech industry. Find mentors to help you overcome them.

Here are some medical schools to consider if you are interested in entrepreneurship

That said, if you are applying to medical school, you need to do so with both eyes open. Sick care is changing rapidly and, given the long training cycle, you cannot predict what you will encounter when you have finished your training 8-10 years after your first day of med school. In fact, there might be a medical school bubble.

Medical school applications are at an all time high and it's called physician entrepreneurship for a reason.

I could have given you all the graduation platitudes-achieve work-life balance, tell truth to authority, ask for forgiveness, not permission, set measurable goals, and that other nonsense, but I thought better than to blow more smoke in your already smoky section.

Don't let medical careerism ruin college.

How to prevent medical careerism ruining college:

1. Build your growth and entrepreneurial mindset

2. Have plan B

3. Ask yourself if this is really want you want to do?

4. What is the why of your why? Parental or peer pressure? Money?

5. Get a job preview

6. Becoming a doctor comes with a heavy price. Are you willing to pay it and make the required sacrifices?

7. Accept the fact that not getting an A in organic chemistry is not the end of the world

8. Put the Fuh back in fun

9. Don't let college get in the way of your education

10. Be kind and take care of yourself

11. Make it personal but don;t take it personally

12. Be serious, but don't take yourself seriously

Getting into medical school is a numbers game. Like innovation, the prime determinant of success is the number of times you try. Like I said, go in with an entrepreneurial mindset. Just don't tell the medical school interviewer that you have no intention of practicing medicine because you just want the MD after your name for the credibility in the biotech start up community. That's a non-starter.

Arlen Meyers, MD, MBA is the President and CEO of the Society of Physician Entrepreneurs on Substack