I am a first-year medical student, and just like some of you once did, the primary reason I am becoming a physician is to really make a difference for my patients by [insert x, y or z].

“Wow, that’s really great, but we’ll see how you feel about it in a few years.”

“That’s not how it works once you’re actually out there.”

“Trust me, medicine isn’t what it used to be, get out while you can.”

Why do conversations I have with upper-class medical students, residents, fellows, and physicians usually deteriorate to an inevitable pessimism? For many in the medical community, it seems that to see idealism is to mistake it for naivety often.

You’ve heard the spiel : physicians, especially in primary care, are overworked, underpaid and don’t have the time to be a doctor. Forced to spend more of time completing tasks indirectly related to their patient’s care, doctors have relatively few empty moments in which actually to care for their patient. It’s nothing new. So why are we surprised that the experienced health care superhero chose to scoff at my well-rested goals to, you know, save the world? Honestly, I see how hard you work, and I’m not surprised. But it needs to stop.

In order to achieve the goals that are deemed too ambitious, you must maintain or reignite your idealism.

Life, medical school is no exception, will invariably chip away at your determination. It’s human nature to be brought down, to question our resilience, despite our best intentions. And unfortunately, in healthcare, it’s inevitable. Which is why you entirely should be overly idealistic about the goals you want to achieve, if you really want to achieve them.

Picture this:

After a full night’s sleep, you’re in your seat 15 minutes before the start of your first medical school lecture, and you’re 100 percent sure that you want to help underserved and socioeconomically disadvantaged people. Probably as an internist or maybe a pediatric oncologist — depending on your board scores.

After a volunteer experience during your second year, you smell a homeless man for the first time. You see your glorious future of saving sick and starving children, probably of color, and you think to yourself, “Wow, that might be a tough road. That really smelled awful.” Now, you’re only 90 percent sure that you want to spend your career working with said underserved population.

After the second internal medicine rotation of the year at an inner city hospital, you are left feeling exhaustion you had never felt before. You wonder if you’re even physically capable of doing this, and your determination starts to wane to 70 percent.

Mid-fourth year, you hear from fellow classmates going to audition rotations for specialties whose lifestyle provides a great work-life balance. Meaning: they eventually get to be home by five or six with twice as much in the bank. You begin to realize that you could have that too if you so wanted. You’ve worked so hard, don’t you also get to deserve that balance? When the pivotal moment comes, and it’s time to rank sites for residency — when it’s time to decide what you want to do with your life, your commitment is at an all time low, 51 percent.

But guess what 51 percent means. It means you’re surer than not. It means you’re sticking to your guns. It means to have just enough audacity to commit to that original, scoffed at reason you went into medicine. Fifty-one percent is the difference between you squeezing in an extra appointment at 5:15 p.m. to help a single mother of two who hasn’t seen a doctor in five years versus you squeezing out of work an at 4:45 p.m. feeling you haven’t actually helped anyone in the meaningful way you had once imagined you would.

Imagine if you started your journey with more realistic expectations. What percentage would you be at during pivotal moments? Less than 51 percent?

To be idealistic is not a form of false optimism, it is simply a necessary component in achieving the goals you set out to accomplish before finding out how hard those goals actually are to achieve.

If your goals are tough  —  be idealistic.

Gaurav Jain is a medical student and can be reached at his self-titled site, Gaurav Jain.

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