Every applicant to medical school has to write a personal statement. It does not have a prompt, but the understood question has always been, "Why do you want to be a doctor?"
Being a physician has always been considered a noble and honorable profession, but ever since COVID-19, physicians, along with the nurses and other healthcare professionals working on the front lines, have become bona fide heroes. The public now sees these courageous men and women risking their lives for others (sometimes without the protective equipment they need) while isolating themselves from their own families to do so.
In photos, their battle-tested faces reveal compassion and fatigue, but, perhaps more than anything, resolve. These pictures and the accounts that come with them have commanded respect and admiration, and have elevated medical professionals to new heights.
But with this adulation has come an enormous cost. As of last month, more than across the world have died from the novel coronavirus. Such grim numbers have shocked both the public and those already in or considering a career in healthcare. Yes, these careers involve hard work, life or death levels of responsibility, and many stressful situations, but actual danger -- that's only been there in the fine print and has been mostly avoidable for those wishing to do so, at least for those practicing in the U.S.
Until now.
In New York City hospitals and other places that have treated high numbers of COVID-19 patients, many doctors who might have reasonably believed that their career paths would have circumvented close contact with deadly viruses are finding themselves being called into action. Psychiatry residents are working in ICUs, and outpatient primary care doctors are getting enlisted to staff overflow units and field hospitals. For more risk-averse people thinking that being a physician was a cerebral and predictable line of work, it may be time to look elsewhere.
According to the Association of American Medical Colleges (AAMC), the number of applicants to medical school has been a roller coaster over the past 40 years. Since about 2003, however, there has been a steady increase in numbers. The current rise in applicants has occurred through both economic booms and recessions and has occurred despite what many have observed as an erosion in the level of trust and prestige afforded to physicians due to factors such as ties to the pharmaceutical industry and the public's increasing attraction to "alternative" types of treatment. This rediscovered respect for doctors could make the number of applicants rise even more steeply, but there's certainly no guarantee.
"I think with COVID-19, we just don't know," says Geoffrey Young, PhD, who is the AAMC's senior director of Student Affairs and Programs and has worked on three medical school admission committees. He does not, however, predict that the current pandemic will scare off a significant amount of applicants as many applicants "at their core, have a service orientation" and "have a desire to have a positive impact on the environment around them," he said.
For these individuals, "it's not just a profession, it's a calling," Young said, noting that he wonders if there well could be an influx of medical school applications similar to the increase of people joining the armed forces after 9/11. This makes sense, as physicians have, especially lately, often been compared to soldiers, with their healthcare workspaces likened to battlefields.
On social media, a number of actual and future medical students have weighed in on this conversation. The opinions are expectedly mixed, but the majority view the pandemic as a reason to enter medicine if mostly to become an advocate for changing the system.
For example, one , "Perhaps this reflects my bias, as someone aspiring to EM, but I feel like this is going to inspire a lot of people. Particularly people who know things could have gone better, need to go better, and want to work on making that possible."
Another agreed, stating that "the next generation of doctors ... tend to be enraged by the status quo. If they had an existing predilection to medicine, they'll be even more enticed because of the opportunity for radical change." A , "I know we all see an issue and think we can change it, but this really is unprecedented and if this isn't time to try to push the field in the right direction idk what is."
A few premedical undergraduate students agreed, voicing that their interest and desire to go into medicine had increased as a result of COVID-19. One , "This has motivated me even more to be a doctor -- we clearly need more physician-activists and more healthcare workers in positions of power." A mom of a 16-year-old interested in medicine by stating, "My 16-year-old daughter has always flip-flopped on [the] idea of going into medicine (infectious disease specifically) & she is now more energized & feels more sure this is what she wants to do. (I realize she's 16 & may change, but...) I think it feels more meaningful now than ever."
One physician poignantly , "My hope is that the outpouring of support will restore the feelings of the honorable profession that it is, rather than having people feel like replaceable worker bees. More inspiration, less desperation. One thing[s] for sure -- expect change."
Some, however, have begun to question their specialty choice or motivation for medicine altogether. A fourth-year medical student , "I can imagine the numbers for Emed and IM going down for the next few years, people are naturally going to want to avoid the frontlines. Also, this might affect applications to med school as a whole. These are unprecedented times and people are rightfully spooked ...Fear drives people's actions more than anything else. Also, who wants to be in a position where you're begging your employer for proper gear, and might be reprimanded for speaking out."
A third-year , "It was discouraging for ME (and I'm an MS3!) to see the mistreatment of my future colleagues ... I think this will discourage those who are in it for monetary reasons or familial pressure but fuel the flame for those w/humanitarian goals."
The last comment speaks to the possibility that while the number of applicants may not vary significantly due to the pandemic, the characteristics of those applicants will. While applicants to healthcare professions are hardly monolithic when it comes to their personality or motivations, a from 2016 found that most medical students fit one of two personality profiles. One was labeled "resilient" and described students who were vigorous and industrious but a bit more on the materialistic side. The other was labeled "conscientious" and included those with higher levels of anxiety.
People with either of these profiles could get pulled in different directions when it comes to how attractive a career in medicine appears post-COVID-19. Noted personality researcher and psychiatrist Robert Cloninger, MD, PhD, who was the senior author of this study, speculates that those with the resilient profile may be "more likely to risk a dangerous job" but are also "unlikely to do things involving sacrifice for others."
The second profile, by contrast, could be further inspired by the pandemic to help others but more concerned about their own safety. Putting it all together, it would certainly be reasonable to expect a decrease in applicants looking for secure and safe ways to make a good living and an increase in those who, as they say, like to run towards the fire.
Of course, there's nothing wrong with the applicant pool we already have, who tend to be smart, dedicated, and compassionate people -- many of whom are looking for that magic balance of a meaningful career and good job stability and security. That said, the stirring demonstrations of bravery, sacrifice, and persistence coming from the physicians and other healthcare professionals who have answered the call against the coronavirus is going to be a tough act to follow. Many of course will try, and the new crop that does may well be even more prepared to step up to our next major healthcare threat while simultaneously changing the way that healthcare is delivered.
In the years to come, there may well be a number of applicant essays that read "I want to be a doctor because of COVID-19."
, is an assistant professor of psychiatry at Washington University in St. Louis and she is on the 51˶ editorial board. Her writing has appeared in The New York Times, Slate, The Washington Post, Vox, and STAT. David Rettew, MD, is an associate professor of psychiatry and pediatrics at the University of Vermont Larner College of Medicine in Burlington. His writing has appeared in Psychology Today and Forbes, among others, and he is the author of the book .