Introduction

Many undergraduate students begin their academic journey as pre-medicine, but less than 50% of applicants to U.S. medical schools are admitted each year and even more end their pursuits prior to applying. For students who have purposefully chosen to step off the pre-medicine path to pursue alternative careers, coming to terms with their decision and realigning their career goals may be rife with emotion, shame, and a sense of failure. Using the Social Cognitive Career Theory (SCCT), this qualitative, exploratory study aimed to (1) identify factors that lead to pre-medical students changing their career path, (2) explore ways that previous pre-medical students come to develop and adjust to a new career aspiration, and (3) examine the role that higher education faculty, administrators, and staff who advise pre-medical students may play to support them in this process.
 

Methods

Using convenience and snowball sampling, pre-health advisors and previous pre-medicine students were recruited to participate in 30-45 minute, recorded interviews conducted via Zoom. Transcripts were subject to thematic analysis using NVivo. 
 

Results

Twenty (20) advisors and 15 previous pre-med students were interviewed. Advisors and students revealed that multiple factors, including family pressure, first-generation aspirations, or personal experiences with limited medical access, influence the decision to pursue medicine. Although advisors stressed students should have a commitment to help others, they believed that many students were driven more by prestige. Yet only a few students interviewed mentioned prestige or financial stability as their driving factors and more often spoke of their desire to help others. Advisors and students both attributed career transition to factors like academic struggles or misalignment with one’s envisioned lifestyle. Advisors suspected that students were not comfortable with medical procedures and had a stronger passion for alternative careers like writing, engineering, or fashion. Yet students reported remaining interested in health-related fields, like physician assistant, clinical ethics, dentistry or veterinary medicine. Advisors recognized their crucial role in providing emotional, mental, and academic support, facilitating discussions to clarify decisions and next steps, and exposing students to professionals in alternative career fields. In contrast some students reported lack of guidance and family expectations as contributing to emotional and logistical challenges. Advisors highlighted the availability of resources such as transfer advising centers, career studios, and international career advising to aid students in their career transition. However most students noted being self-directed and gaining exposure to alternative careers through their own efforts.
 

Conclusions

These findings provide valuable insights for academic advisors, helping them understand students' reasons for leaving the pre-med track, the emotional challenges they face, and the best ways to support them—transforming setbacks into opportunities for success. Academic advisors emphasized students who want to pursue pre-med should have a love for science and a shadowing experience, whereas students highlighted the need for holistic advising and improved accessibility to career exploration resources. In conclusion, both advisors and students emphasized that open-minded career exploration can reveal diverse, fulfilling paths to serve others and achieve success beyond medicine.