Maybe not the plan….. Definitely a dissertation.
- Zohaib Akhtar MD MPH
- Jun 11
- 4 min read
Updated: Jul 28
In hindsight.......... everything feels like a plan.
I am in a sarcastic mood, and this writing is unfiltered. So maybe its best to stop reading now.
(But if you’re still here, I’m guessing our sarcasm might overlap.)
Some people know exactly what they want to do with their life. The rest of us apply to grad school, many more than once. I was thinking about all the different professional programs I’ve been in (or around), and honestly… every single one feels like a group project with yourself, where the deadline keeps changing and no one is quite sure who’s in charge.
Let’s just start with med schools. They basically starts the same way as a bad gym membership. You sign up once with good intentions, and years later, you’re still sweating, broke, and unsure how to cancel.
There is no some deep calling. It just a GPA, and maybe a vague desire to “make a difference” without knowing what that actually meant.
Med school is less about healing and more about proving you’re willing to suffer for credibility. You memorize the Krebs cycle, forget it, memorize it again, and still end up Googling it during rounds. You diagnose yourself with a new diseases every month and pretend crying is just “part of the growth process.” You get through it not because you’re passionate..... but because you can’t imagine explaining the family that you dropped out to “pivot into something more human-centered.”
And just when you’re done with it, someone says:
“You know, if you really want to fix the system… you should look into public health.”
Public health school is where med students (plus professionals) go when they’ve seen enough to know the system is broken, but not enough to know how to fix it. It’s where people trade their stethoscope for a spreadsheet and start saying “social determinants of health” with alarming confidence. You spend your days learning that the real enemy is structural inequality, and your nights figuring out how to make a bar graph that feels emotionally impactful.
You’ll meet someone studying “malaria prevention in left-handed Pakistani teenagers” and realize you’ve never cared about anything that deeply. You’ll attend lectures on health equity while silently wondering if your professor is okay. And you’ll discover the one universal truth of public health: you will spend more time on logic models than on logic.
Eventually, you get tired of writing papers no one reads and policies no one implements. So you do what every over-educated idealist eventually tries:
You start a company.
Entrepreneurship is what happens when you’ve seen the flaws in the system and think, “What if I just… made a better one?” You have a solution. You have a deck. You have the energy of someone who still believes systems can be redesigned by caffeine and optimism alone.
You launch something scrappy. You call it “tech-enabled,” even if it’s mostly just a fancy Google Form. You spend two years duct-taping features together, explaining your solution to mostly parents, and slowly realizing that “being your own boss” mostly means you get to do all the work while refreshing the bank's dashboard every 30 minutes.
Eventually, the thing kind of works. Or kind of doesn’t. You want to keep building....... but maybe not like this.
You think: "Maybe the idea wasn’t wrong, Maybe it was the approach"
Enter: design school.
Design school is where you go when you’ve tried solving real problems with spreadsheets and roadmaps, and now you’re hoping that sketching on a whiteboard will feel more human. You show up expecting to learn how to design better systems.... and slowly realize the system you’re redesigning is probably yourself. You hear the word “empathy” more than in therapy, but no one makes eye contact. You start using Post-its like a second language. You learn that asking “why” five times in a row qualifies as research, and that “reframing the problem” often just means accepting you have no idea what the problem is.
You learn a lot. And the strange part is, its mostly about the old you.
It’s beautiful. It’s fragile. It’s well funded.
And just when you finally feel like you understand people, problems, and systems… A voice in your head says: “This is amazing. Have you thought about how to scale it?”
And that’s when you find yourself in business school.
B-school is what happens when you’ve cycled through impact, burnout, idealism, user research, and now just want a health insurance plan and a big seed round. It’s less about learning and more about rebranding. Every conversation starts with “What’s your background?” and ends with “We should definitely connect.”
You relearn frameworks you once tried to dismantle. You sit through case studies about better wine and beer companies and tell yourself it’s all transferable, and have leadership classes that feel like group therapy but with with better snacks. You’re surrounded by people who want to change the world, but first need to finish this deck for McKinsey.
It is a very expensive summer camp with Patagonia vests, its polished and full of people trying to justify the cost by calling it “transformational.”
I don’t know what engineering or law school are like, but I’m guessing they’re not that different — just a different scale, same existential Wi-Fi..... unless you’re in art school, where you finally find yourself (and wish you hadn’t.)
Whatever the program, grad schools are basically a long, expensive way to figure out which WhatsApp group to choose actually belong in. And if you still haven’t figured that out… maybe it’s time to consider a PhD. :)
((Z))
