“So, what do you want to specialize in?”

This is invariably one of the first three questions asked once someone discovers you are a med student. At best, it is a way to connect with you; at worst, it is a way to judge you. If you answer “Pediatrics,” they share how outstanding their child’s physician is. If you answer “Neurology,” they comment that you must be really, really smart. If you answer “I want to be in the pharmaceutical industry and probably start in sales,” they initially respond with a confused squint and tilted head—bonus points for pursed lips.

Invariably, the next segment of the conversation, whether it be long or short or very, very protracted, is about why I’m not practicing. Followed by the next segment of why I have no intention of ever practicing. Yes, I’m delighted that your cousin, sister, brother, aunt, and/or uncle who studied medicine in the Philippines is now practicing in the US. No, I have never regretted my decision to not practice. Yes, my parents know about my decision, and they actually support me.

To write this article, I caught up with two friends who are also non-practicing physicians to compare stories and as a legitimate excuse to catch up. I met Oliver in medical school but in different years. In contrast, fellow Fil-Am Isabel and I met in the Poblacion Makati arts scene. Both have been a source of encouragement and humor since my first year of medical school. Neither Oliver nor Isabel is their real name, and answers are heavily modified with permission (and funny sidebars removed) to protect their privacy.

For my non-physician readers, I will take you on a tour through every doctor’s mind by creatively following the format of taking a History of Present Illness (HPI), aka all those annoying questions they ask you at every doctor’s visit.

Hello, my name is Dr. Frankie Aguinot, and I will be your physician today.
Make yourself comfortable, and let’s have a chat.

Frankie: I decided in my second year of med school that I didn’t appreciate the toxic mentality, but I was so far in I didn’t know what to do. Who quits med school if they’re not failing? Serendipitously, I later ran into a former medical school professor who left teaching and practice to become a medical science liaison, MSL, in the pharmaceutical industry. He encouraged me to look into it. I never took the board nor practiced.

Oliver: I didn’t take the board or practice either. The main reason why I’m hesitant to practice is the inconceivable load that society expects of us. Not to mention all the toxic beliefs and practices they have for our profession. That includes toxic bosses and the power-tripping they have here in the Philippines.

Isabel: I wanted to practice medicine here, but the Philippines doesn’t recognize foreign medical licenses, even from the US. I even applied to another medical association, and after a year of following up with the board they never met, reviewed, or acknowledged my application.

F: I live and work in the US as a virtual pharmaceutical sales representative for a small pharmaceutical company, but I am working towards being an MSL.

O: I work as a virtual physician assistant to clinics and practices in the United States.

I: I’m a corporate executive for a group of corporations and focus mainly on problem-solving and legal contracts.

O: It’s helped me in a lot of ways. I have an edge in job interviews, respect from my co-workers, and fantastic opportunities outside the Philippines.

I: My grasp of concepts and logical reasoning has helped me problem-solve in the corporate world. Since I have a different perspective of systems, positive and negative feedback loops, I can gather information and data and analyze them to predict potential outcomes.

F: Funnily enough, my advantages are similar to both of yours. I sell the benefits of the pharmaceuticals I represent to healthcare providers, HCPs, but we connect on a peer level. I have conversations with HCPs that other sales representatives are unlikely to have. For territory management, I use disparate data sets to develop a sales strategy.

I: Mainly negative review because many potential patients wish more doctors in the Philippines had my specialty that merges traditional and alternative medicine. I have tried to partner with other physicians, but they are understandably protective of their licenses since they aren’t trained in my discipline.

O: Most are negative responses. It includes “Sayang ka”, “Sayang pinagaralan mo”, and other stuff in that vein. I don’t think it’s a waste at all. The knowledge and skills that I gained from my medical education helped me get to where I am now, helps me every day, and I’m confident it will help in all my future endeavors.

F: I get a lot of the “Ay sayang/What a waste” responses from people too. I wasn’t too surprised when it was from Filipinos, but I heard it many from Americans, too. Even when I say that my current job is a stop to my overall goal is to one day inform medical legislation to save millions of lives, I still get, “But wouldn’t you want to practice?” Though I must say, I’m flattered when the HCPs I sell products to try to sell me on their specialty. They don’t say it’s a waste; they say how good I’d be at it.

O: GO WITH WHAT MAKES YOU HAPPY! DO NOT LET SOCIETY DICTATE WHAT YOU NEED TO BE. YOUR CHOICES MATTER. THAT INCLUDES YOUR PEACE AND MENTAL HEALTH.

I: Ultimately, a job is something you do to earn money. If a person sees medicine as a job for a salary only, they won’t last long in the medical field. The constant mental, emotional, and physical strain of dealing with sick people is not for the faint of heart. But if medicine is truly your passion, then I hope you find an environment that will nurture you and give you the support you need to thrive and maintain that passion. In the end, there is no shame in choosing an alternative path. The skills you’ve learned will be invaluable in other pursuits.

No, really. There’s nothing wrong with you. Taking the outlier path in your career simply means you chose to do something different. Different doesn’t always mean bad. My personal patron saint of non-practicing physicians is Dr. Kendrick Jeong, M.D., most popularly known as the Korean-American comedian Ken Jeong. I bet you at this point in his career, people aren’t telling him he wasted time going to medical school. (Dr. Ken, if you’re reading this and I’m wrong, please call and let me interview you!)

Prognosis: You are going to be astonishing at whatever you choose.

You are the embodiment of transferable skills. While I have written this through the lens of a physician, this is true for all of you who have invested time, money, and energy into education. You are not your degree. You are what you do with the skills you learned from your degree.

Course of Treatment: Be boldly you.

You don’t have to know right now what you want to be when you grow up. However, it helps to have a personal mission or branding statement to follow. My current tagline is “Pharmaceutical sales powered by the heart of a physician.” As I grow and develop, so will this tagline. In being boldly you, the opportunities you want will more easily find you. Not everyone is going to be negative. The following person you tell that you want to do comedy might know an agent.

In my second to last year of medical school I met with a good friend of both my parents, esteemed professor Dr. M. After inquiring as to the health of my parents he asks, “What do you want to specialize in?” I mentally steady myself and reply, “I want to be in the pharmaceutical industry and probably start in sales.”

Instead of the confused squinted, head tilted, and pursed lips combination, he brightens. “That’s a really good industry to get into.”

“Can you tell my dad that? He supports me, but he also regularly says that it’s a shame I don’t want to be a pediatrician since I’m so good with kids.”

“Oh, really? I’ll make sure to give him a call and let him know. That’s a very smart decision.”

And you know what? Dr. M really did call my dad. If I hadn’t been boldly me, I wouldn’t have found the champion my cause needed. I hope you find the champion that you need, but until then – I am proud of you and I support you.

HPI photos by Cedric Fauntleroy on Pexels.