There is a version of this conversation that happens at every medical school graduation, at every holiday dinner where a cousin announces pre-med intentions, and almost never in public: would you do it again, and would you want this for your children? Sheetal Khedkar Rao, an internal medicine physician, does not sidestep the question. "I'm proud and excited for them," she says of any child who might follow her path, "but also a little bit worried, because it can be challenging to find joy in an often dysfunctional healthcare system." The worry is real. So is the conviction that it is not insurmountable.
What sets Rao's framing apart is where she plants her flag. The dysfunctions of the system are acknowledged, not minimized, but they are the beginning of the conversation, not the end of it. She would tell a child entering medicine that patients will hand over something irreplaceable: their trust, their deepest vulnerabilities. "That is a great privilege," she says, "that should always be honored and respected." In a moment when online discourse about the profession leans heavily toward grievance, she makes a point of saying that most people still value physician expertise. That belief, in her telling, is not naive optimism. It is something worth holding onto deliberately.
The word she reaches for is "calling." Medicine, in Rao's view, is not simply a career or a credential. It is a vocation in the older sense, something that calls a person toward it. But she is careful not to let that language become a trap. "I am convinced that medicine is a calling," she says, "but we are much more than our profession and productivity." The identity collapse that flattens physicians into their output, the inability to locate a self outside of the work, is a live concern, and she names it directly.
Asked whether she would do it again, Rao says yes, with one significant revision. She would have tried harder to stay in academics. She would have pursued an MPH and gotten involved in healthcare policy earlier. The implication is clear: the problems she has witnessed in the system are not purely personal burdens to manage. They are structural, and structural problems require people working on them at the level of policy and institutions, not only at the bedside. That is the path she might have taken more aggressively, and it is, implicitly, the path she might point a child toward.
The through-line in everything Rao says is intentionality. Joy in medicine is possible, but it does not arrive automatically. It requires going in aware, being deliberate about the kind of career you build, and refusing to let the system define what the work means to you. Whether that counsel will be enough for the next generation is a question the healthcare system has not yet answered.
