What is it really like to be a doctor?

What is it really like to be a doctor? John Erik is a GP at Lundamo, grew up in Alta and trained in Warsaw. The conversation turns out to be less about diseases than you would expect, and more about communication, uncertainty, prioritising, and what you do when there is no right answer.

A choice that was never a single moment

He does not remember deciding. It was something he had settled on fairly early, and from lower secondary school onwards he worked deliberately towards the grades he needed.

It is worth noting what he does not say: he was not pushed. He experienced little pressure at home about education and career. He did see it in others, though – some of his fellow students had parents with clear expectations about medicine, even where the student might have wanted something else. That theme comes back right at the end of the conversation, and not by accident.

Outside work he describes himself as a son, a brother, a friend, a climber and a traveller. The profession is an important part of his life, but not his whole identity.

What it actually takes to get in

There is a distinction many people run together, and it is worth making clearly: the formal subject requirements are one thing, the points threshold is quite another.

Two requirements that are not the same

The formal requirement

Subjects you must have

• General university admissions certification
• Mathematics R1, or S1 and S2
• Physics 1
• Chemistry 1 and 2

The real requirement

Enough points to make the cut

• Very high competition for places
• The threshold varies between institutions
• The threshold varies between quotas
• The threshold varies from year to year

The degree itself is six years and 360 credits in Norway. After that, Norwegian authorisation is required in order to practise, and anyone who wants to specialise adds several more years on top.

Why Poland

The answer is not the one you expect. It was not about points.

John Erik had been an exchange student in the United States, and wanted to study abroad again. So he looked for medical degrees taught in English. Warsaw won out because the city was large and international, and the university had an English-language programme.

Moving from Alta – around 20,000 inhabitants – to a European capital was a big change. He describes it as a positive one all the same, and the student environment as international, with both Norwegian and foreign students.

Studying abroad and Norwegian authorisation

1. No advance approvalThe Norwegian Directorate of Health does not pre-approve foreign health education programmes. You do not get a yes before you go.
2. You complete the degreeThe whole programme is taken abroad, in the language it is taught in.
3. Then you apply for authorisationThe application is assessed under the rules in force at the time you apply.

The degree, and the worst of it

He found his programme very theory-heavy, and has the impression that Norwegian medical students get more independent patient contact and practical training earlier. This is his personal experience, not a full comparison of every medical degree in the two countries.

One practical problem was obvious: the patients spoke Polish. The solution was to split students into groups where at least one person had the language. That person could talk to the patient and help the rest of the group. It made placements possible – but also more group-based and less independent.

The hardest subject was biochemistry.

What the subject covers: chemical processes in the body, amino acids, and how the body converts energy.
The example he singles out: the Krebs cycle, also called the citric acid cycle – the body's central loop for energy metabolism.
A curiosity from the work on this episode: the machine transcription heard something else entirely. It is a good reminder of why technical terms have to be checked against a source rather than against an audio file.

He did think about quitting, but never seriously considered it. The first year was particularly demanding: many subjects, frequent tests, long days and large volumes of information.

And here is his answer to the question most people ask – do you have to be exceptionally academic? Good academic foundations help, but he thinks the ability to absorb large volumes of information matters at least as much. The degree demands structure, stamina, independent work and the ability to keep going when the workload is high.

What it cost

These are numbers that are easy to underestimate. Tuition at his university was around 110,000 Norwegian kroner a year. On top came loans for living costs.

Six years of tuition

One yearAround 110,000 kroner in tuition

The whole degreeSix years of tuition – living costs come on top

One academic yearQualified doctor

The biggest shock after graduating

Not the workload. Not the responsibility, really. Something far more fundamental:

Exam against reality

At university

There is a right answer

• The question is set so that one option is the most correct
• The information you need is given
• You are measured on whether you hit it

At work

Several answers can be defensible

• Two doctors can choose differently and both act correctly
• Experience and probability come into it
• The patient's situation comes into it
• The risk of waiting is weighed against the risk of treating

Five questions instead of one diagnosis

Something surprising follows from that: it is not always necessary to find the exact diagnosis. With many common respiratory infections, for instance, the doctor does not need to know precisely which virus it is, if the treatment and the advice end up being the same either way.

What the doctor does have to answer is something else:

The assessment that comes before the name of the illness

1. Could this be dangerous?The first and most important filter.
2. Does it require treatment?Not everything with a name should be treated.
3. Does it need rapid investigation?Is it urgent, or can it wait?
4. Is watchful waiting defensible?Waiting is an active decision, not the absence of one.
5. What should the patient watch for?What should make the patient get back in touch?

And then there is what he says about the content of the job, which surprised him: it involves more handling of people than he had expected. Medical knowledge is the foundation, but general practice is just as much about listening, explaining, reassuring, setting boundaries, and helping people understand their own situation.

The day

He starts around eight. His appointment book is set up with roughly 20 minutes per consultation, with some slots left open to absorb delays.

It is worth being clear that this is not a standard: the time varies between practices, doctors and the type of appointment booked. Simple problems take less time. Mental health, long-running symptoms or complex presentations can take considerably more.

Why the GP runs late

What happens	Why it costs time
The appointment develops differently	The symptoms are more serious than expected
More than one problem	The patient has brought more than the booking said
Need for acute follow-up	Something has to be handled now, not later
Calls and test results	They arrive between consultations
Contact with the hospital	Often has to happen while the patient is still there

And then comes everything that is not a patient in the room:

The work that is not in the appointment book

1. 1Patient notesWritten and checked.
2. 2Test resultsRead and assessed.
3. 3PrescriptionsRequests processed.
4. 4ReferralsWritten.
5. 5Discharge summariesRead and followed up.
6. 6Messages from hospitalsHandled.
7. 7Electronic enquiriesAnswered.
8. 8Sick notesAnd other documents.

A discharge summary, for the record, is the medical summary sent after a patient has been treated at a hospital or an out-of-hours clinic: why the patient was examined or admitted, what was found, what treatment was given, which medicines the patient should take, what happens next, and what the GP has to follow up.

If the practice is covering daytime emergency duty, something quite different comes on top: the doctor receives information from the emergency medical communication centre about acute incidents locally, and assesses whether the patient should be seen at the surgery, whether an ambulance should be sent, or whether the patient needs to go straight to hospital. The details vary between municipalities and local arrangements.

When the doctor does not know

He answers no to the question of whether doctors always know what is wrong. Rashes, symptoms and presentations he does not immediately recognise do occur.

What is interesting is what happens then – and that it is a system, not an embarrassment.

The ladder when the answer is not obvious

1. Examine furtherMore information before more action.
2. Watch and waitWhere it is medically defensible.
3. Ask a colleagueLow threshold, and entirely normal.
4. Ask for a second assessmentThe colleague sees the patient themselves.
5. Contact a hospital specialistWhen the problem calls for it.
6. Refer onwardsThe investigation is taken elsewhere.

Do doctors google?

Yes, but not the way you do. The difference is not that the doctor avoids looking things up. The difference is where they look.

The reference works he names

Source	What it is used for
Norsk Elektronisk Legehåndbok	General medical reference work
Legevakthåndboken	Acute presentations
The antibiotics guideline	Antibiotic use in primary care
The driving licence guideline	Health requirements for driving licences
Hospital procedure manuals	Procedures and local guidance
RELIS	Medicines, side effects and interactions

On artificial intelligence the answer is nuanced. Use varies from doctor to doctor. Some use approved documentation tools that can listen to the consultation and draft a patient note. John Erik does not use one himself: he writes fast enough, and thinks that checking and correcting an automatic note could potentially give him more work.

And one boundary that is absolute: sensitive health information must not be entered into ordinary, open language models. Any tool used has to be developed and approved for processing patient data.

The patient who has googled

He is gentler here than you might expect.

When searching helps, and when it does not

Useful

You learn about your own body

• Can this be handled at home?
• Should it be raised with the GP?
• Does it need faster help?

Problematic

You have landed on a diagnosis

• The conclusion came before the examination
• The diagnosis is often rare or serious
• Forums and language models list possibilities without weighing probability

When he meets someone who has already decided, he tries to listen to the worry and explain why he sees the situation differently. The patient’s own information can be valuable – it is the conclusion that is the problem, not the effort.

On angry patients the answer has two parts: he tries to stay calm and explain the reasoning behind his assessment. Some need a thorough clinical explanation. Others need clear boundaries. A doctor should not answer with anger, but neither should they accept harassment or unacceptable behaviour at work.

On reviews on Legelisten, the Norwegian doctor review site, he tries not to think about it too much. A negative review does not necessarily mean the treatment was poor – a doctor sometimes has to say no to a prescription, an examination or a sick note. Patient satisfaction and clinical quality are not always the same thing.

Why more tests do not give a safer answer

This is the most counterintuitive part of the whole conversation, and it is worth doing the arithmetic.

The reference range for a blood test is usually built to cover about 95 per cent of a healthy reference group. That means around 5 per cent of healthy people get a result outside the range – with nothing wrong with them. (Source: legeforeningen.no)

Take one test, and the chance of such a deviation is small. Take many, and the picture changes quickly:

The chance of at least one deviation in a perfectly healthy person

It is also why healthy people without symptoms or known risk factors usually do not need a comprehensive health check every year. Targeted checks can still matter at certain ages, or with particular illnesses, medicines, family history or risk factors – and you should follow public screening programmes and recommended vaccinations. (Source: legeforeningen.no)

A test result has to be assessed alongside symptoms, medical history and other findings in any case.

A few other myths he clears up

• Antibiotic resistance affects the bacteria, not you. It is the bacteria that become resistant to one or more antibiotics. Unnecessary and incorrect use helps resistant bacteria develop and spread. Antibiotics also do not work against viruses. (Source: Helsenorge)
• Most adults need about seven to eight hours of sleep. The need varies, but a stable sleep rhythm and good sleep quality matter too. Persistent sleep problems can affect mood, concentration, physical health and daily functioning. (Source: Helsenorge)
• A glass of wine a day is not a health measure. It is not possible to set a completely safe lower limit for alcohol intake. The risk depends on quantity, frequency, drinking pattern and state of health, and rises with consumption. (Source: Helsenorge)
• Supplements should be used where there is a real need. Vitamin D may be relevant for those who get little from diet and sunlight, and some groups are advised to take it. Iron supplements should normally be used where iron deficiency is established or likely – too much iron can also be harmful. A varied diet covers the need for many vitamins and minerals for most people. (Source: Helsenorge)
• Travel vaccinations depend on the trip. Destination, length of stay, activities, season, previous vaccinations and your own health all decide. Check the recommendations for the specific country well before departure. (Source: Helsenorge)
• Doctors can write ordinary prescriptions for themselves – but should be careful. It can be hard to assess your own health objectively. The Norwegian Directorate of Health advises that doctors should not prescribe addictive medicines to themselves or to close family, and a doctor cannot prescribe medicines on the reimbursed scheme for their own use. (Source: the Norwegian Directorate of Health)

On smartwatches he is personally sceptical about using them as a general health tool. The measurements can confirm something the person already knows, or cause unnecessary worry. They can motivate activity and pick up certain patterns, but a measurement is not a diagnosis. Alerts that cause concern should be assessed together with a health professional.

How to get the most out of your appointment

This is the most directly usable part of the episode, and it costs you five minutes in the waiting room.

Eight questions to have answers to before you go in

1. What is the main problem?One problem first, not all of them at once.
2. When did the symptoms start?A date, or roughly when.
3. Better or worse?The direction often says more than the state right now.
4. What makes it better or worse?Activity, rest, food, time of day.
5. What have you tried yourself?And did it work?
6. Medicines and supplements?All of them, including over the counter.
7. What worries you most?Say it. It is often what the appointment is really about.
8. What do you want help with?Get the expectation on the table early.

Who the profession suits

No, you do not need to be highly extroverted. John Erik does not describe himself as particularly outgoing in private, but steps into a professional role at work. Communication can be learned and developed. Some specialties also involve less continuous patient contact – radiology and pathology are the examples he gives.

Two lists worth reading honestly

May suit you

This sounds like you

• Interested in people and health
• Can take a long and demanding education
• Can work in a structured way over time
• Wants responsibility
• Enjoys continuous learning
• Can live with there not always being a right answer

Think twice

This is your motivation

• You are mainly after status
• You are mainly after a high salary
• You are choosing medicine because of pressure at home
• You do not enjoy working closely with other people

Asked whether status and pay are motivation enough, he says no. The profession can give security, respect and a good income, but the training is long and the responsibility is heavy. Status and money alone will probably be weak motivation the day the degree or the job becomes genuinely hard.

What he wishes he had known beforehand

Not more medicine. Study technique.

The memory palace, in three layers

What you need to rememberThe material itself – names, sequences, systems, connections.

A place you know wellYour childhood home, the walk to school, a route you have taken a thousand times. The rooms are already stored.

The linkThe information is placed in the rooms as images. Retrieving it becomes a walk through the house.

Would he choose it again?

Yes. He thinks the training has given him an interesting profession, a secure job, a good income and plenty of options. Had he not become a doctor, he might have considered becoming a pilot.

And asked what he hopes patients remember him for, the answer is strikingly undramatic: that he took them seriously. That he met them well, made thorough assessments and gave the right treatment.

That may be the whole point. Medicine is about far more than making diagnoses and writing prescriptions – it is about communicating, handling uncertainty, prioritising time and meeting people in very different situations in life. And his most important piece of advice is the same as the first section of this article: choose it because you want it. Not because of pressure, status or other people’s expectations.

This episode connects thematically with the Learn something new episode on sleep.

Health information is discussed in general terms. No identifiable patient stories are shared. This content is not individual medical advice and cannot replace examination, diagnosis or treatment by a qualified health professional.

Main topics

• The road into medicine
• Studying medicine in Poland (Warsaw)
• Everyday life as a GP
• Meeting patients, and communication
• Responsibility and uncertainty in medicine
• Psychiatry
• Pay and working conditions for doctors
• Study technique and memory technique

Questions this episode answers

• How do you become a doctor in Norway, and what subjects do you need from upper secondary school?
• What is it like studying medicine abroad?
• What does an ordinary working day look like for a GP?
• What does a doctor do when they do not know what is wrong with a patient?
• Who is medicine right for – and who should choose something else?
• Are status and a high salary reason enough to become a doctor?
• What should you consider before applying to medical school?

Key points

• Medicine is as much about handling people as it is about medicine itself.
• There is often no single right answer – a large part of the job is handling uncertainty.
• Asking colleagues for help is a normal and important part of the work.
• Choose the profession because you want it, not for the status or because of pressure.
• Good study techniques, such as the memory palace, make a demanding degree more manageable.