You can probably have a bigger impact on health as an entrepreneur than a doctor. I'm working on a start up addressing the medication adherence problem. I thi

You can probably have a bigger impact on health as an entrepreneur than a doctor. I'm working on a start up addressing the medication adherence problem. I think a solution to a problem like that helps more people then an MD in most circumstances would and represents the exciting lifestyle you love. I think you got yourself a false dichotomy set up. It sounds to me like you have a passion for technology and a guilt issue around helping people with health care. You're saying "on one hand, I feel obligated towards A, and on the other, I've dreamed of B." From what you said, I think you should stick with tech and find a way to work on a start up that could produce equal health benefits to an MD. I particularly think you shouldn't get an MD. You sound like you really don't want to get one. Feeling like most of web 2.0 would be a waste of your life bodes well for you. It means you have high personal standards and clearly perceive the big picture when most people are distracted. You should feel fine belittling almost the whole field. Most of them are wasting their lives on completely frivolous things. Especially the ones who get by on ads. If you don't feel comfortable clearly criticizing people without sentimentality, you will never be able to manifest your high standards. But the frivolity and lack of moral vision common to most start ups are not a prerequisite to starting a company. It's false that giving up medicine costs you a chance to truly help people. Apply technology in such a way that it has medical import, with high standards, and you can have your dream and help more people than you would as an MD.