Good Intentions, Poor Results

Medicine draws in people who want to make a positive impact on their communities and the world. This, happily, leads to a good number of active, enthusiastic young individuals putting in a lot of work for others' benefit.

However, with that enthusiasm comes a degree of naivete and, particularly in the generally intelligent, capable group of students considering medicine, perhaps a bit of overconfidence. The combination of these traits has led to more than a few instances of students putting their efforts and resources towards well-intentioned, but ultimately ineffective or even detrimental activities. A fair bit of attention has been paid to one such example, the voluntourism industry.

Faulted not just as way for wealthier students to build their CVs, volunteering abroad has also come under significant scrutiny for providing far more help for students to feel like they're doing something positive than actually helping them to do something positive. Some medical schools are actively discouraging volunteering abroad due to concerns about unequal access to these opportunities, harm to developing countries from voluntourists, and comparative lack of skills development when compared to other extra-curricular activities.

However, I'm noticing a trend of closer-to-home activities that often fall into the same category of well-intentioned but ineffectual efforts to help out others. I'm talking about becoming a "founder". Often this takes the form of a student founding a club or new initiative at their undergrad school, or striking out in the community and founding a non-profit.

Just as with volunteering abroad, these are not inherently bad activities - approached properly, by the right individuals with a long-term focus, founding a club or non-profit can be an enormously enriching endeavour, both for the community and the individuals involved. However, as with voluntourism, the typical execution is far from ideal. Student founders often lack either the skill or experience to make their new organizations effective. They may not have the time to give their project the necessary attention. New clubs or non-profits may be trying to fill roles in the community already ably filled by established organizations. Or, they might be trying to fill a role that doesn't really need filling in the first place, resulting in wasted or inefficiently used resources.

I also see clubs or non-profits being started, but then fizzling as the founders transition to other activities. Those founders may have done a fine job with the organization initially, but without a long-term approach in mind or even without a decent transition plan, the next set of leaders may not be properly equipped or motivated to maintain or grow the organization. These groups then hang around in the background, consuming resources ineffectively, before ultimately fading out.

This is hardly an issue unique to students. Heck, entire charitable sectors operate off of good intentions with poor results - this is a very common, very human failing. I'm not immune to it either - a club I helped start at my school just last year looks like it could well end up folding before I even graduate, since we failed to develop enough interest in the classes below us.

Because of these outcomes, I want to encourage students trying to contribute to their community/country/world to consider joining and improving existing organizations first. Take over a club and push it forward. Volunteer at a non-profit and make it better. Get on the inside where you can lobby charities to be more efficient and more evidence-based in their work. And learn what they do right! These experiences within established institutions can be extraordinarily valuable in a student's future career, including for those who ultimately decide further down the road that it's worth starting a new group. Improving what already exists isn't as exciting as starting something new, but in many cases, it can be more meaningful for both students and communities.