Hong Kong’s DSE results were released recently. This year, there were 24 top scorers, a record. Of them, 20 plan to stay in Hong Kong to study medicine—more than four-fifths. The others chose fields such as computing, law, politics and business.
Seeing so many outstanding students willing to enter medicine is, of course, a good thing.
But as a GP who sees patients in clinic every day, I cannot help wondering:
Why do most of the very best students ultimately choose the same path?
There is also a rather contradictory phenomenon within medicine.
People outside are trying desperately to get in, while quite a few doctors tell their own children:
“Look at other professions first. Don’t decide on medicine so quickly.”
Why is medicine still the default answer for top students?
The reasons are not hard to understand.
The career path is clear, social recognition is high, the risk of unemployment is relatively low, and income is usually not too bad.
In Chinese families, when a child says they want to start a business, parents may first ask:
“Will the company still be around in three months?”
When a child says they want to study medicine, the dinner-table mood is usually much more peaceful.
At its core, medicine’s greatest attraction may not be the highest return, but a relatively high floor.
It is a little like a low-volatility investment. The process is hard, but if you complete it smoothly, the future is broadly visible.
These top scorers are not unable to do the sums.
They may be calculating how to reduce risk in life.
Why do quite a few doctors not want their children to study medicine?
A survey of 7590 US physicians found that 63% of respondents did not want their children to enter medicine. Healthcare systems differ between countries, so this figure cannot be directly applied to Hong Kong or Singapore, but a similar mindset is indeed not uncommon within medicine.
This does not necessarily mean doctors regret their choice.
People outside see the eventual income, status and career stability of doctors; doctors themselves see the long road before that.
Study, rotations, examinations, training and on-call duties.
When their peers have already begun working, investing or even starting businesses, young doctors may still be slowly moving through the training system.
Moreover, doctors’ income still largely depends on showing up in person.
There are only so many patients one can see in a day, and only so many operations a pair of hands can perform. It is income earned through hard work.
A doctor seeing sixty patients in a day is not called scalability. It is usually called back pain, headache, and soon needing to make an appointment oneself.
A high income does not necessarily mean the highest return
In 1994, the New England Journal of Medicine calculated education costs, training duration, opportunity costs and working hours together.
The study estimated an annual return on educational investment of about 15.9% for primary care physicians and about 20.9% for specialists. In the same comparison, lawyers were at about 25.4%, and business-school graduates about 29%.
This was a US study from more than three decades ago, and naturally cannot be directly applied today.
But the figure of 15.9% remains interesting.
Taking two large US index funds as examples, as at the 2026-6 month-end, Fidelity Total Market Index Fund had an annualised return of about 15.04% over the past ten years, while Fidelity 500 Index Fund had about 15.49%.
This is not to say that if fund returns exceed 15%, everyone should stop studying medicine and go home to buy funds.
They are fundamentally not the same thing.
Investing requires capital and entails market fluctuations and losses; medicine brings professional qualifications, earned income and relatively stable work. Fund performance over the past ten years also does not mean it can be repeated in the future.
But viewed together, they can at least illustrate one point:
The economic return from studying medicine is not so high that other choices are wholly incomparable.
Medicine is more like a prudent route.
The floor is decent, but the ceiling may not be the highest; income is not low, but the time, pressure and opportunity cost behind it are also high.
With AI arriving, are doctors still secure?
Doctors will, of course, still be needed in the future.
AI can organise medical records, analyse information and offer suggestions, but patients’ circumstances often have no standard answer.
Who will make a judgement in the real world, communicate with the patient, carry out treatment, and bear the final responsibility?
For now, all of these still require people.
However, some of the advantages doctors once built through memorised knowledge and information asymmetry may become less valuable.
What will be harder to replace in future may instead be complex judgement, practical skills, communication, resource coordination, and willingness to take responsibility when something goes wrong.
So medicine will not suddenly disappear, but neither may it be as it once was: get in, and the coming decades are automatically secure.
See the world first, then decide whether to study medicine
I once met a student from the Lee Kong Chian School of Medicine.
After secondary school, he did not enter medical school immediately. Instead, he spent a year undertaking internships and work-shadowing in different industries.
After seriously comparing several different paths, he still decided to study medicine.
When I heard this, I was genuinely impressed.
Because when our generation chose medicine, we often had not thought it through so clearly.
Your grades were good, your marks were sufficient, your family thought doctors had stable careers, and so you entered.
The two choices are somewhat like this:
One is an arranged match: both sides have good credentials, it seems workable, and so they marry.
The other is to have dated seriously and seen the world outside, then still decide to marry this person.
The first is not necessarily bad. Many doctors only gradually come to like the work after entering medicine.
But if a young person has seen other industries, understands the long training, limited freedom and economic returns that may not be the highest, and still wishes to take this path, I would find that choice very grounded.
So I am not advising high-achieving students not to study medicine.
I simply think:
Do not choose medicine automatically just because your grades are good enough.
See the world outside first, then ask yourself seriously:
“Now that I know what this path requires, am I still willing to take it?”
If the answer is still yes, then that is a genuine desire to study medicine.
Sources and scope
The following authoritative pages were independently checked by a human during import. A platform poll is not a nationally representative sample; a historical career-return model does not represent current general returns; and past fund performance does not represent future performance.
- Doximity physician platform poll (public page; not a nationally representative sample)
- Original New England Journal of Medicine paper (historical US career model; working-hours-adjusted internal rate of return)
- Fidelity total-market index fund official performance page (past performance does not represent future performance)
- Fidelity large-cap index fund official performance page (past performance does not represent future performance)
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