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My Regrets about Quitting Medicine

2022-12-27 · Long video (solo, talking head or whiteboard) · Ali, Ali Abdaal (channel) · recording, 48:30 · watch on YouTube

Topic: Medicine and his doctor years (also: Work and career, YouTube, writing online and creators) · mode: Reflection and life update · tags: His own numbers, He changed his mind, Aimed at students, Lesson from a book, His own products discussed

A year after leaving medicine for good, Ali reviews the decision: money, fun and autonomy are its good parts; career anxiety, the fear that the business dies and doubts about his usefulness are its bad parts. He advises applicants not to do medicine if unsure, unhappy doctors to build skills that give them options, and would not recommend being a creator as a first career.

What is said

The parts of the video and what is said in each (★ — how much it matters to the video).

00:00:00 — A year after leaving medicine: the four parts of the video

  • ★★ About a year after leaving medicine for good, Ali reflects on the regrets he has about that decision. — 00:00:00
  • ★★ In 2012 Ali joined Emmanuel College, Cambridge, at 18 to study medicine for six years; in 2013 he started SixMed, a business helping people get into medical school, his first business to succeed. — 00:00:55 · Emmanuel College, 6med, Cambridge

00:01:04 — The backstory: Cambridge, SixMed, the channel, junior-doctor years, the pandemic break and the five reasons to work

  • ★★ Ali started his YouTube channel in 2017, his fifth of six years at medical school, with videos on the BMAT and medical school interviews, then vlogged his final year at Cambridge, when the channel got traction: 1,000 subscribers after 52 videos, 10,000 after 90. — 00:01:25 · BMAT, Cambridge
  • ★ After graduating in June 2018, Ali stayed in Cambridge in a flat he had bought with his brother and lived there with his friend Molly for two years. — 00:01:25 · Taimur Abdaal, Molly Hunt, Cambridge
  • ★★ In his first year as a junior doctor Ali worked full-time at Addenbrooke's Hospital in Cambridge, from 2019 at West Suffolk Hospital, making videos in the evenings, at weekends and on annual leave. — 00:01:54 · Addenbrooke's Hospital, Cambridge
  • ★★★ In August 2020, after his foundation years, Ali took a break from medicine to travel and perhaps work in emergency medicine in Australia; the pandemic wrecked those plans, so he made videos at home in Cambridge and the channel took off. — 00:02:23 · Cambridge
  • ★★★ In mid-2021 Ali decided to move to London and most likely leave medicine for good; he has not worked a day in clinical practice since. — 00:02:52 · London
  • ★★★ Ali left medicine mainly because his business became phenomenally successful: once his YouTube channel made more than he needed to live, he asked what the point of his day job was if not money. — 00:03:21
  • ★★ Ali weighs work by five reasons people do it: money, fun, helping people, purpose and meaning, and social status and prestige. — 00:03:21
  • ★★ Money was no longer a reason for Ali to stay a doctor, because he was making more money outside medicine than inside it. — 00:04:25
  • ★★ Ali enjoyed working as a doctor, but a life designed as he wished would have no hospital in it: he enjoys YouTube, the podcast, writing and teaching, and would perhaps teach medical students. — 00:04:50
  • ★★ Ali suggests asking of your job: given the option to do anything, would you spontaneously choose it for your ideal life? For some of his doctor friends the answer is hell yes; for him it is probably not. — 00:05:16
  • ★★ Helping people was the hardest reason for Ali to square: he still wonders whether quitting medicine to make YouTube videos makes him net negative to society. — 00:05:37
  • ★★ Ali finds purpose and meaning in writing, making videos and giving talks, and in people telling him a video helped them, such as one whose video on imposter syndrome helped them take a risk and get a raise. — 00:06:06
  • ★★ Ali did not want his career decision to rest on being wedded to the social status and prestige of being a doctor. — 00:06:38

00:07:14 — The good parts: money, asymmetric upside, regret minimisation and the real risk of quitting

  • ★★ As a junior doctor Ali earned about £40,000 a year; had he specialised and stayed in the UK, he would earn about £100,000 a year as a consultant from about age 34. — 00:07:24 · United Kingdom
  • ★★ Ali is candid about his earnings because he thinks people considering other career paths benefit when others say how much they earn and how they got there. — 00:07:53
  • ★★★ Filming in November 2022, Ali expects his business to make around £2 million in profit in 2022, before corporation tax. (hedged) — 00:07:53
  • ★★ To test his decision, Ali imagines earning only £50k a year from YouTube, the same as from continuing in medicine, and asks whether he would still leave. (hypothetical) — 00:08:50
  • ★★★ Ali's first consideration is asymmetric upside: quitting a job for something riskier, such as a business, a YouTube channel or a book, carries more risk but potentially more reward. — 00:09:20
  • ★★ Even a really good doctor has capped upside, Ali says, because the medical system does not much reward individual contribution. — 00:09:50
  • ★★★ The downside of leaving a stable job is capped, Ali says: at worst you get another job; he can still always go back to medicine, so leaving it is not really a risk. — 00:10:19
  • ★★ Many friends earning £50k–60k fear that leaving their job leaves a gap in the resume so that no one will hire them again; Ali says that is not really a thing. — 00:10:19
  • ★★★ When making decisions Ali looks for the asymmetry: quitting your job to start a business goes really well if it works, and if not, provided you have enough money to survive, you just get another job. — 00:11:03
  • ★★★ Ali's second consideration is regret minimisation: he was clearly more likely to regret not taking a break from medicine to try his side hustle than doing it. — 00:12:07
  • ★★ Given a risk with asymmetric upside, Ali says, you are more likely to regret not doing it: deathbed regrets are generally for things not done, a common one being not taking a business opportunity. — 00:12:28
  • ★★ When he left, Ali's burn rate was about £1,500 a month, which two locum shifts as a doctor could cover. — 00:13:08
  • ★★★ Quitting a £50k job to do your own thing is never a £50k risk, Ali says: the risk is only the gap to the next job you could easily get, say £10k if that job pays £40k, assuming savings to live on. — 00:13:32
  • ★★ Ali says stats show that one of the best ways to get a pay rise is to quit your job and then apply for new ones, since experience earns a raise wherever you go next. — 00:13:55

00:14:31 — The good parts: looking forward to work, and the team

  • ★★★ As a doctor Ali never looked forward to going to work; in his two years full-time on YouTube he has, waking on weekdays excited to start. — 00:14:54
  • ★★ Ali is focusing on finishing the second draft of his book and loves the work. — 00:14:54 · Feel-Good Productivity (book)
  • ★★★ Had he kept believing that work is not supposed to be fun, Ali says, he might have spent 80,000 hours of his life on unfulfilling work and convinced himself that this is just what a job is. — 00:15:23
  • ★★ In medical school Ali looked forward to lectures ending so he could tinker with his first company's website, course materials and Google Sheets automations, never to going into hospital to see patients. — 00:16:04 · 6med, Google Sheets
  • ★★ Most doctors Ali knows enjoy parts of their job but do not look forward to going to hospital to talk to patients. — 00:16:34
  • ★★★ Ali does not regret giving up the enjoyment of medicine: he enjoyed the job, but it is nothing compared with doing his own thing; the one thing he used to miss was his colleagues. — 00:16:34
  • ★★ Working in person with his own team since the pandemic gives Ali the social contact at work he missed from medicine. — 00:16:34
  • ★★ Being a YouTuber is not all roses, Ali says, filming a sponsored video can feel like work, so he is not telling everyone to quit their job to become a YouTuber. — 00:17:21
  • ★★ If Ali does not feel like filming a sponsored video, even on a deadline, his general manager Angus emails the sponsor to put it off a week, and sponsors are usually fine with that. — 00:17:47 · Angus
  • ★ Ali calls Cal Newport's So Good They Can't Ignore You really good on finding a career and job you love. — 00:17:47 · Cal Newport

00:18:05 — The good parts: autonomy

  • ★★★ Cal Newport (quoted): In So Good They Can't Ignore You, Cal Newport cites evidence that autonomy, a sense of control over your time, what you do and how, is the most important determinant of job satisfaction. — 00:18:20 · Cal Newport
  • ★★ Junior doctors have little autonomy, Ali says; as a registrar and then consultant he would have had more say over the plan. — 00:18:20
  • ★★★ A main gain of leaving medicine is autonomy over his time: Ali wakes when he wants, meets friends for coffee, and has just spent ten days working from Bali on his laptop. — 00:19:24
  • ★★ People Ali has met who left medicine, law, engineering or consulting to run their own businesses tell him they do not miss their old lives, because they have autonomy. — 00:19:53
  • ★★ Medicine gives a clear, certain career path, Ali says: once you are in medical school you are basically guaranteed an income for life. — 00:20:29

00:20:32 — The bad parts: career anxiety and the pathless path

  • ★★★ Ali genuinely misses medicine's certain career path: since leaving he has had far more existential crises about his career and life than while in it. — 00:21:28
  • ★★ Ali recommends his friend Paul Millerd's The Pathless Path to anyone feeling lost in their career and unsure whether their path makes sense. — 00:21:28
  • ★★ Ali still struggles a little with uncertainty but is getting better at approaching his career with wonder and curiosity rather than fear. — 00:21:57
  • ★★★ Ali thinks his internet influencer career is probably fairly short-lived, like an athlete's few years in the limelight before views and revenue dwindle. (hedged) — 00:22:48

00:22:58 — The bad parts: the fear that the business dies, and going back to medicine as a last resort

  • ★★ Ali thinks a lot about his channel declining and sometimes over-obsesses about view counts, though these days he says he does not look at them at all. — 00:23:15
  • ★★ The fear that his business would crumble kept Ali up at night for months after his break from medicine; he reminds himself he has money in diversified investments and can always go back to medicine. — 00:24:08
  • ★★★ To people thinking of quitting their job, Ali says there is always the option of going back or getting another job, a pretty good worst case to have. — 00:24:29
  • ★★★ As an entrepreneur doing everything yourself, Ali says, whether things go well or not you learn many skills you can use for something else later. — 00:24:52
  • ★★★ If his business crumbled and he lost all the money and followers, Ali would probably not choose to go back to medicine. (hypothetical, hedged) — 00:24:52
  • ★★ Starting again, Ali would strike out on his own with a tech startup, software or a faceless animated YouTube channel, using his skills in media, coding, design and running a team. (hypothetical) — 00:25:19
  • ★★ For Ali, going back to medicine is a last-resort option, for instance if he needed a regular income to support a wife and children. — 00:25:57

00:26:53 — The bad parts: is he being useful? Teaching, giving and quantifying impact

  • ★★★ Saving lives one at a time is one kind of impact, Ali says, and teaching is another: his videos teach and inspire people, and his Deep Dive podcast tells how inspiring people started their businesses. — 00:27:44 · Deep Dive
  • ★★ Ali gets emails and Instagram DMs every day saying his videos or podcast changed someone's life, such as helping them into a university or to better grades. — 00:27:44 · Instagram
  • ★★★ Ali has taken the Giving What We Can pledge, part of the effective altruism movement, and donates 10% of his income every year to cost-effective charity. — 00:28:18
  • ★★ Ali says about $3,000 donated to the Against Malaria Foundation saves a child's life on average. — 00:28:47
  • ★★★ Donating 10% of about two million a year, Ali says he probably saves more lives in a year through the Against Malaria Foundation than he would in a whole career as a doctor. (hedged) — 00:28:47
  • ★★ Citing Gregory Lewis's statistical analysis, Ali says a doctor saves about eight lives on average over a whole career. — 00:28:47
  • ★★★ To those who say a doctor's impact cannot be quantified, Ali replies that it can: given the choice of saving one life or a hundred, unless the one is close family, you would save the hundred. — 00:29:33

00:30:16 — Should you apply to medicine, and should you quit it?

  • ★★★ Asked whether he recommends medicine to applicants, Ali says it depends: if you really want it, go for it; if you are on the fence, he would not advise doing a medical degree. — 00:30:30
  • ★★ If your aim is money, Ali says, computer science or engineering and coding lead to jobs that pay far more than medicine, with less debt and more autonomy than in the struggling NHS. — 00:30:30 · NHS
  • ★★★ A medical degree no longer opens doors to jobs at McKinsey, consulting firms or Google: so many UK doctors now apply to consulting that friends find it really hard to get in, so the arbitrage is gone. — 00:31:48 · Google, United Kingdom
  • ★★★ Ali used to think anything a doctor does is more interesting for being a doctor (a doctor-YouTuber, a doctor-chef); now so many medics run side hustles and channels that it is no longer an edge. — 00:31:48
  • ★★ Going to medical school without wanting to practise takes a place from someone who wanted to be a doctor, Ali says, and costs the state money. — 00:33:06
  • ★★ UK medical students pay £9,000 a year in fees but training costs far more and is funded by taxpayers, so Ali calls getting through medical school intending from day one to leave really bad. — 00:33:32 · United Kingdom, NHS
  • ★★★ Nowadays Ali tells 16- and 17-year-olds unsure about medicine not to apply, since it is probably a bad idea, and to work out first what lifestyle they want, what they optimise for and what interests them. — 00:34:00
  • ★★ Ali finds it amazing how many doctors and medical students he speaks to really do not like their jobs. — 00:34:25
  • ★★★ Philosophically, Ali sees nothing wrong with a doctor who finds after medical school that they do not enjoy it changing their mind: the years already spent are a sunk cost. — 00:34:53
  • ★★ The health system is better off without doctors who hate being doctors, Ali says, and better with doctors whose hearts sing when they practise. — 00:34:53
  • ★★ The moral equation of leaving medicine is maybe a little different before entering medical school than after the sunk cost is spent, Ali says, so the decision deserves more thought. (hedged) — 00:35:59
  • ★★★ Ali's general advice: do not feel you must keep doing a job you hate because you committed to it ten years ago. — 00:35:59
  • ★★ Quitting to start something works if you have savings, Ali says: with a year of living expenses as runway you can try it for a year and get another job if it fails. — 00:36:58
  • ★★ Doctors can cover their expenses as part-time locums, Ali says: people he knew worked three days a month at £1,000 a day, making £3,000 a month and leaving 27 days for side hustles or family. — 00:37:28
  • ★★★ Rather than quitting a job on a whim for a side hustle, Ali recommends first getting to where at least your living expenses are covered for a few months. — 00:37:57

00:38:19 — Being a creator as a career path

  • ★★★ Asked whether he recommends being a creator as a career path, as many school leavers want, Ali says hell no: it is really hard to succeed when everyone else is trying too. — 00:38:26
  • ★★ The YouTubers who succeed, Ali says, are rarely career YouTubers but people who did something interesting first, such as medicine or coding, and started a channel second. — 00:38:26
  • ★★ Ali says about 6 million people a month try to stream, of whom about 0.01% will ever make money on the platform. — 00:39:02
  • ★★★ Ali would not recommend being a creator as a full-time career from day one, but would recommend trying it once you already have a way of making money. — 00:39:31

00:39:39 — Advice to medical students: gather data, have an exit plan, build skills

  • ★★ Ali's spirit comes alive teaching, writing in a flow state and building websites; it did not in medicine except when teaching medical students on the wards or giving physiology supervisions. — 00:40:01
  • ★★ Many doctors Ali knows disliked the foundation years but began enjoying medicine as registrars in dermatology, emergency medicine or gastroenterology, with more autonomy, mastery and purpose. — 00:41:04 · Foundation Programme
  • ★★★ To medical students and doctors who do not enjoy medicine but hope it gets better, Ali advises gathering data: speak to people in the specialties you want, a few years ahead of you, and see whether they are having a great time. — 00:41:45
  • ★★ Most dermatologists and anaesthetists Ali knows, and most doctors working two or three days a week, enjoy their jobs; very few other doctors seem to. — 00:41:45
  • ★★ In medical school Ali was hired by med tech startups to do user interface design at £100 an hour, which gave him an exit plan out of medicine. — 00:42:22
  • ★★★ An exit strategy from medicine, Ali says, requires building skills on the side during medical school beyond those of a doctor. — 00:43:04
  • ★★ Doctors who leave medicine can still get jobs in product management, consulting and other fields, Ali says: it is competitive, but a doctor's skills are somewhat transferable. — 00:43:04
  • ★★ Ali would rather be treated by a doctor who wants to practise medicine than by one who has to. — 00:44:26
  • ★★★ Ali's advice for medical students and almost anyone: you create more options for yourself with skills, especially in-demand ones, so it is worth building them. — 00:44:26
  • ★★ In the UK the decision to go for medicine is made at about 16, and Ali says the person you were at 16 is probably very different from who you are now. — 00:45:07 · United Kingdom
  • ★★ Ali advises doctors to explore other careers beyond the obvious consulting and banking, by looking at any jobs board or careers fair. — 00:45:54
  • ★★ Medics Ali knows have left medicine to run a hedge fund, work in consulting, start companies, work in the pharmaceutical industry, do biomedical research or become YouTubers. — 00:46:23
  • ★★★ Against the defeatist view of some UK medics that medicine is all they can do, Ali says there are always options: many jobs pay as much or more, and a pay cut is worth taking for a job you enjoy. — 00:46:53 · United Kingdom

  • ★★★ Whatever your age, Ali says, you can teach yourself skills; skills give you optionality, and optionality lets you build a life you love. — 00:47:17

    “And the skills give you optionality. And optionality lets you unlock this idea of building a life that you love.”

  • ★★ Ali's advice to medical students is to build skills, which synergise with a medical career, for example for a med tech startup, as well as giving optionality. — 00:47:43

00:48:09 — Sign-off

In the description and comments

  • ★★ Ali Abdaal (channel): Asked which specialty Ali would have chosen had he stayed in medicine, the channel replies: part-time emergency medicine. — creator comment

Threads in this video

Where the stories that moved here went next

Mentioned

Central: asymmetric upside · optionality · regret minimization

Also: People: Angus · Cal Newport · Gregory Lewis · Molly Hunt · Paul Millerd · Taimur Abdaal

Projects: Deep Dive

Works: BMAT · Feel-Good Productivity (book) · So Good They Can't Ignore You · The Pathless Path

Organizations: 6med · Addenbrooke's Hospital · Against Malaria Foundation · Emmanuel College · Giving What We Can · Google · Instagram · McKinsey · NHS · Twitter · West Suffolk Hospital

Concepts: effective altruism · Emergency medicine · Flow state · Foundation Programme · imposter syndrome · sunk cost fallacy

Places: Australia · Bali · Cambridge · London · United Kingdom

Products: Google Sheets

Also centred on optionality: Answering your Questions

Also centred on regret minimization: Jeff's Regret Minimisation Framework 💭

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