Ask HN: When to give up on dreams?

I think you should talk to a therapist. They will help you work through issues like burnout, self-perception, self-acceptance, self-sabotage. Life is not easy and getting through a PHD program is not easy. Rewards do no scale linearly with aptitude or work effort. Our dreams usually do not reflect reality and it's easy to chase a fantasy and catch it to find nothing there. This will be a lifelong learning process.

In school?

It sounds like you feel your dream is unachievable, not that it's the wrong dream. I'd at least spend some more time exploring how else you can achieve it. Transfer to a different school without switching fields? Do the 5 year program in six years? Do a different program that still leads to a career in machine learning? Just take a break and go back to school in a few months?

Just throwing some thoughts out, but it sounds like you're burned out because you've lost touch with what made you passionate about this in the first place and it seems a pity to abandon it without exploring other paths to the same goal.

If you have knowledge both in biology as a physician and can code, you can also become a bioinformatician, where you can still apply ML. Maybe the difference will be that it will be more on the application side of the ML rather than the theoretical part.

Also, I will be cautious about "... landing a PhD position at a good US school", from my experience and others, I've found out that it's more important to look after a supervisor with whom you can resonate rather than chasing a reputable institution.

(Disclaimer, I'm a PhD student in the UK)

Having my feet in both worlds, I can say medicine is definitely not a light workload. However, I do think some of that is self-inflicted and unnecessary (in terms of medical organizations doing unnecessary things for the sake of hubris and/or impression management and/or exploitation and/or rent seeking). I also think the costs of academics in terms of work demands aren't generally acknowledged in public discussions, so there's kind of a "default relative assumption" about the two that's a little distorted. Medicine also varies a lot by location, so what's involved in different places is really different (this isn't to say some places are subpar, just that I think training philosophies etc can be really different).

Finally, in a broad sense, the OP is probably right that pursuing academics will be more difficult. In a hours per week sense, maybe maybe not (it's probably about the same), but academics is so completely broken that it's going to be a lot less straightforward and fraught. Europe, from what I get from my colleagues, is much more sane in both areas, but similar costs and benefits probably are involved.

I agree with others that the OP is probably burned out. But I think that's the nature of his problem. I'm more concerned about the fact he's saying that he doesn't have the interest for the math. That might be a function of that program, or might be a clue he's not interested.

Some random thoughts:

1. I might reconsider the goal of going to the US. There's plenty of great places in Europe, and (speaking as an American), academics are screwed up in the US. It's a bubble if there ever was one.

2. The OP might reach out to people in medicine and see if there are projects in medicine they could help out with, in terms of research etc. Even if it's remote I imagine there might be things they could do? It might help figure things out and/or open doors.