Of Human Bondage by William Somerset Maugham

Philip's ideas of the life of medical students, like those of the public at large, were founded on the pictures which Charles Dickens drew in the middle of the nineteenth century. He soon discovered that Bob Sawyer, if he ever existed, was no longer at all like the medical student of the present.

It is a mixed lot which enters upon the medical profession, and naturally there are some who are lazy and reckless. They think it is an easy life, idle away a couple of years; and then, because their funds come to an end or because angry parents refuse any longer to support them, drift away from the hospital. Others find the examinations too hard for them; one failure after another robs them of their nerve; and, panic-stricken, they forget as soon as they come into the forbidding buildings of the Conjoint Board the knowledge which before they had so pat. They remain year after year, objects of good-humoured scorn to younger men: some of them crawl through the examination of the Apothecaries Hall; others become non-qualified assistants, a precarious position in which they are at the mercy of their employer; their lot is poverty, drunkenness, and Heaven only knows their end.