Gita Venkat always wanted to be a doctor — until she saw what the career entailed outside of the classroom.

“My sophomore year I volunteered at UPMC Shadyside,” Venkat said. “I saw blood and freaked out and figured that was a good indicator that I wasn’t meant to be in that field.”

Venkat, who graduated in 2016 with a psychology degree, was on the pre-med track for her first year at Pitt but changed majors after getting some volunteer experience.

Venkat, like many other students, found an area in the health and helping professions that she enjoyed even more than medicine: industrial psychology. As an industrial psychologist, Venkat will analyze the strengths and weaknesses of employees within companies.

Andrea Abt, director of health professions advising through the Honors College, said more than 1,000 students register for and attend a pre-med information session before the beginning of each school year.

By the time sophomore year rolls around, many of those students, like Venkat, have dropped the designation. While there are numerous reasons a person might switch majors, pre-med hopefuls, typically at the tops of their classes in high school, are often put off by the sudden difficulty of college biology and chemistry classes. Abt said in the end, about 250 Pitt students actually apply for medical school each year.

Laura Zapanta, a biology and biochemistry lecturer at Pitt, said about 50 percent of the students in her Biology 1 class are pre-med. The average grade in Biology 1 is between 75 percent and 78 percent, meaning around half of the students who take the class end up failing.

By the time the students reach biochemistry — typically junior or senior year for the pre-med track — Zapanta estimated only about half are still pre-med.

According to a 2011 New York Times article, data from the University of California, Los Angeles showed up to 60 percent of STEM and pre-med students either switched their majors or did not earn any degree, which is twice the rate of loss for all other majors.

While it’s not uncommon for a student to switch majors during college, there is no complete data on how often students outside of pre-med do so at Pitt, according to the registrar’s office.

Zapanta said it is common for pre-med students to find other avenues in health care, rather than going to medical school.

“Sometimes they discover that they like something [else] better,” Zapanta said. “They decided, ‘Oh wait, maybe I don’t want to be an MD and spend all that money at med school. Maybe I can do what I want to do and interact with patients as a PA [physician assistant].’”

The U.S. Department of Health and Human Services projects that by 2020, the country will face a shortage of 20,400 primary care doctors, which contrasts with data from the Association of American Medical Colleges that show medical school — about $120,000 for public schools and about $225,000 for private schools, according to the AAMC — enrollment is expected to increase by more than 30 percent by 2019.

Some students, such as Sandhya Subramanian, don’t even make it to the tuition before classwork deters them from continuing along the pre-med track.

Subramanian, a senior health services major, attended a number of pre-med workshops — which teach students about medical school through activities like tours and panels — before coming to Pitt.

She loved biology and chemistry in high school and did well in her high school classes. The prestige of the medical field and the idea of helping others drew Subramanian to the pre-med track.

But when she arrived at Pitt, Subramanian found that science courses beyond biology and chemistry were too challenging.

“I was also very intimidated by labs,” Subramanian said. “I did really well in the big courses, but the labs were way over my head.”

Subramanian’s difficulty in labs matches up with a recurring theme students and advisors notice — the difference in workload and the expectations of exams and labs overwhelm students who were at the tops of their classes in high school.

Zapanta said many students struggling with pre-med courses come into her office hours for informal advising.

“There is a subset of [pre-med students] who just never had to study [in high school], so they don’t have good study skills,” Zapanta said. “They’re very good at regurgitating facts, but they’re not very good at synthesizing that information into a conceptual context.”

McKenzie Warshel, a junior neuroscience major, said she’s known nearly her whole life she wanted to be a physician. Warshel is currently applying to medical schools but remembers having a rough time entering college classes after skating by for so long.

“[The transition] was very difficult,” Warshel said. “You went from having to study for 10 minutes in high school and getting an A to … I actually failed my first two exams: chem and bio. I had to relearn how to study.”

Granted, becoming a doctor shouldn’t be easy. The idea of “weed-out” classes — or difficult courses students take early on that can effectively whittle the pre-med pool down to only the very best — is popular, but maybe over-exaggerated, Zapanta said.

“I hate that word,” Zapanta said. “We don’t intentionally make it in such a way that we’re weeding anybody out. Having said that, it tends to give students a really good gauge of how they will fare in the biological sciences and how they’re going to have to change if that’s really what they want to do.”

Whether it’s a weed-out class or not, Biology 1 is a future doctor’s first major hurdle.

“I see them start to reconsider after the first exam,” Zapanta said.

Getting into med school takes a substantial amount of work outside the classroom.

For the Health Professions Committee of Pitt’s Honors College to write a letter to an admissions committee on behalf of a student, that student must complete 13 hard science courses, 20 hours of shadowing, 100 hours of clinical exposure, 50 hours of community service and have five strong letters of recommendation.

Sneha Iyer, a junior majoring in psychology on the pre-med track, said she spends most of her free time shadowing, volunteering and acquiring research experience.

“The one thing I don’t like is there’s just so much to do,” Iyer said. “It’s just so competitive, and people can be harsh toward each other and I wish it wasn’t like that.”

For the few who aren’t squeamish and can elbow their way through the undergraduate years and into med school, Iyer said, it’s all a matter of keeping the faith.

“If I could tell my freshman self anything, it would be to have confidence in yourself and things will turn out OK,” Iyer said. “Have faith in your testing abilities. Don’t doubt. Keep on going, and you just need to have confidence.”