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Early in my sophomore year of college, I was taking an organic chemistry test. Halfway through the exam, a classmate a few rows behind me stood up and started shouting in an agitated state. He was escorted from the class. I found out later he had consumed a large amount of caffeine during the last few days while studying around the clock. Fortunately, he went on to become a doctor, and we all learned a lesson about the dangers of excessive caffeine use and lack of sleep. That memory stays with me as a reminder of the intense pressure we pre-meds were under to perform, particularly in organic chemistry, which was considered the “weed out” class.
Having worked as a psychiatrist providing care to university students for several years, I have witnessed pre-med pressure rise. Medical school admissions in the US are highly competitive, and to make matters more challenging, schools have added requirements on top of outstanding grades and high MCAT scores. According to the AAMC (Association of American Medical Colleges), medical school requirements may include many hours of extracurricular activities such as volunteering, shadowing, working, and doing research in a health-related field. Medical school applications request documentation of the hours worked and the experiences around these activities.
Gap Year Before Medical School
I’ve seen many pre-med students in my office overwhelmed by the pressure to “do it all” in four years. But it’s extremely challenging to complete those pre-med requirements. The cost of trying to do it all in college without sufficient sleep can be a sense of burnout as well as depression and anxiety. When I see pre-med students struggling in their classes and sleeping minimally as they study, participate in extracurricular activities, and work a job to help them pay for school, I encourage them to consider a gap year. In fact a recent article in the American Journal of Medicine states that 75% of medical students are taking at least one gap year after college, up from 58% in 2014.
During that year, students can complete their requirements and perhaps work in a doctor’s office or hospital as a scribe or medical assistant, learning about healthcare and solidifying their wish to pursue medicine. They can take the MCAT and complete their applications. A gap year can be especially beneficial for someone with a weak science background from high school. It gives the students time to spread out their pre-med classes over the four years of college rather than taking them all in the first two years. They will have the time to study and obtain the tutoring they need to enhance their success.
When It’s Time to Explore Other Careers
Pre-med classes require an aptitude for science and a great deal of discipline. Some college students are not ready to take on the challenge. It is possible to come back to pre-med classes later, even after college. But if your student has failed chemistry three times and wants to take it again for pre-med requirements, they might want to explore other options instead.
I’ve seen pre-med students pursue wonderful careers in public health. I’ve also seen students shift into non-health careers such as journalism and advertising. Many schools have a career resource center that offers an interests assessment to help students understand which careers best suit them. Schools can also help students obtain job and volunteer experiences to hone their interests. Ask your children about what classes and activities they like at school and guide them in that direction.
What Parents Can Do to Take the Pressure Off
Being pre-med is a major life commitment, and becoming a doctor requires a great deal of time and energy. I love what I do; learning new ways to help people as medical knowledge evolves is exciting. However, the pressure continues in a variety of ways including providing top-level care while satisfying licensing, insurance, and specialty board requirements. Finding the right practice that provides for a good work-life balance can be a challenge.
You are essential in teaching your child healthy habits now that can reduce pressure for a lifetime. Here are some methods that will allow for a happier medical career:
- Get adequate sleep. Maintain a regular sleep schedule that includes 7-8 hours of sleep a night. While some parts of medical training may not allow for sufficient sleep, training programs have set limits on the number of hours trainees can be awake and on total number of hours worked per week
- Exercise. A survey of doctors and medical students shows exercise is their top choice for stress relief. Exercise can elevate levels of feel-good neurotransmitters like serotonin, norepinephrine, dopamine and the endocannabinoids.
- Make time for friends. Numerous studies have demonstrated that social connection decreases risk for depression, anxiety, and suicide. Social connections both at work and at home are good for our general health.
- Keep alcohol use to a minimum. Some studies suggest doctors, particularly surgeons, consume more alcohol than the general population. This can be problematic, as drinking is not a good long-term coping strategy for stress. Alcohol is a brain depressant, and there can be rebound anxiety the day after consumption.
“Drink lots of water.” This is the first bit of advice I received at my internship orientation right after medical school. I think the message was: take care of yourself as much as possible during this difficult year. And I would advise all pre-meds, medical students, and physicians to use self-care as a tool to enhance your journey through an exciting and challenging career.
©2026 Marcia Morris
Details have been altered to protect patient privacy.
