Doctors underpaid

[MinnyGophers]

I don't buy this for a second. Sure, everyone in med school is smart and motivated. But some people are much smarter than others. That's just a fact. It's not like everyone in medical school is equal. So, like I said, a derm residency won't be a problem if you're smart and motivated enough.

Technically speaking, that is true.
However, in the real world, you need a lot more than smart and motivation to land in dermatology. It's not like it's one of the most cut throat residency program to get into. Oh wait, it is.

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[Law2Doc]

Not yet. But I still don't buy this. GPA and MCAT have both been shown to be pretty strong predictors of USMLE performance and residency placement.

They have been shown to be predictors, but I wouldn't go as far to say "pretty strong". In fact the correlation is not enough to get excited about, in my opinion. In med school, you will meet more than a few high MCAT scorer/low USMLE scorers, and vice versa, guaranteed. How you do in your second year of med school is going to be a far better predictor of how you fare on Step 1.

You definitely have to keep posting when you get to med school -- it will be curious to see if you still hold the same views. (especially about derm). I'd bet not.

 

[Towelie]

Technically speaking, that is true.
However, in the real world, you need a lot more than smart and motivation to land in dermatology. It's not like it's not one of the most cut throat residency program to get into. Oh wait, it is.

I'm not saying it's easy. It may be extremely difficult. But, the derm residency spots still have to go to someone. If you do well enough in your class, on the boards, and with research, you can put yourself in a position to get whatever residency spot you want. It's hard, but possible if you're smart and motivated enough.

 

[cgscribe]

Yeah, I think most, if not all, medical students who are matriculating are expecting a huge growth curve. It's just realistic to expect to not be the #1 student anymore when you're surrounded by people who have been doing research, have advanced degrees, etc. on the subjuects you'll be learning at an insane pace during the first couple years.

 

[DoctorPardi]

Not yet. But I still don't buy this. GPA and MCAT have both been shown to be pretty strong predictors of USMLE performance and residency placement. I have confidence in my ability to succeed in medical school and on the boards, and to go where I want for residency. I'm not saying that it won't take a ton of work and motivation. But I have confidence in my ability to do it.

There are differences between medical students in their abilities. Not everyone has the same undergrad GPA, the same MCAT, the same talent for research, the same IQ, etc. There are ranges for these things, and my guess is that they are very good predictors of medical school success.

First of all, I think L2D has shown there is no really good trend between anything and USMLE scores. So don't count on doing well because you have a good gpa or mcat.

Second of all, why argue with people who are in the trenches fighting the good fight? You haven't been there and you don't know, why not take someone's word for it?

You think Prowler or L2D had bad GPAs and MCATs and so they just can't relate to your specific all star situation? Look be hopeful about your chances, but never go into something you haven't experienced assuming you'll knock it out of the park. You'll come off as arrogant, immodest and probably make few friends. On top of all that, you'll likely embarrass yourself after coming off so arrogant, to end up with a mediocre grade after the first test.

 

[BNSN]

I have a question about derm residencies...

Why are they so sought after? I hope this doesn't offend anyone, but it seems to me derm is not very intellectually stimulating.

Psych, surgery, neurology...those I can see as being stimulating. But I don't really see where the intellectual appeal comes in for derm.

 

[cgscribe]

I think having a back-up plan to Derm. residency is a good plan. It's like saying, if I do well in school, get a good MCAT, I'll definitely get into HMS, etc. On another note, can anyone post the link to Panda Bear's blog? As someone who works in an E.D. and has had some jading experiences, I'm eager to read.

 

[MinnyGophers]

I have a question about derm residencies...

Why are they so sought after? I hope this doesn't offend anyone, but it seems to me derm is not very intellectually stimulating.

Psych, surgery, neurology...those I can see as being stimulating. But I don't really see where the intellectual appeal comes in for derm.

They are basically 9-5. That is why.
High salary for a job that is not too stressful and does not require you to be on call every couple nights.

 

[Towelie]

They have been shown to be predictors, but I wouldn't go as far to say "pretty strong". In fact the correlation is not enough to get excited about, in my opinion. In med school, you will meet more than a few high MCAT scorer/low USMLE scorers, and vice versa, guaranteed. How you do in your second year of med school is going to be a far better predictor of how you fare on Step 1.

You definitely have to keep posting when you get to med school -- it will be curious to see if you still hold the same views. (especially about derm). I'd bet not.

Here is a direct quote from Academic Medicine in 2002:

"Consistent with findings from previous studies, this study demonstrated that undergraduate science GPAs and MCAT scores are strong predictors of standardized test performances during medical school..."

Notice the use of the word "strong."

 

[DoctorPardi]

I have a question about derm residencies...

Why are they so sought after? I hope this doesn't offend anyone, but it seems to me derm is not very intellectually stimulating.

Psych, surgery, neurology...those I can see as being stimulating. But I don't really see where the intellectual appeal comes in for derm.

Because a Dermatologist has a great life style. You can work 9-5's with minimal call, and little stress. There aren't too many skin emergencies (short of burns). Plus they get paid pretty well. So you have great hours, great pay and low stress.

 

[cgscribe]

I agree, I don't think derm. would be the MOST intellectually stimulating. The skin is pretty amazing though, and some of its abnormalities can definitely intrigue. Having said that, I think derm. would be mostly skin biopsies and acne-consults. I think it's appeal is certainly it's pay and lifestyle.

 

[Law2Doc]

I have a question about derm residencies...

Why are they so sought after? I hope this doesn't offend anyone, but it seems to me derm is not very intellectually stimulating.

Low hours, less night call (the ultimate lifestyle specialty), high pay. Your patients with skin problems never get better and rarely have emergencies or die, so lots of repeat business. Not particularly hard work. People who want to spend time with family get to do so. Very cushy -- But I agree, it wouldn't rock my world, intellectually speaking.

 

[Towelie]

First of all, I think L2D has shown there is no really good trend between anything and USMLE scores. So don't count on doing well because you have a good gpa or mcat.

Second of all, why argue with people who are in the trenches fighting the good fight? You haven't been there and you don't know, why not take someone's word for it?

You think Prowler or L2D had bad GPAs and MCATs and so they just can't relate to your specific all star situation? Look be hopeful about your chances, but never go into something you haven't experienced assuming you'll knock it out of the park. You'll come off as arrogant, immodest and probably make few friends. On top of all that, you'll likely embarrass yourself after coming off so arrogant, to end up with a mediocre grade after the first test.

I am hopeful about my chances. I'm not even thinking about going into derm, so it's not really relevant for me anyway. But I am confident in my ability to succeed in medical school. Hopefully I'll be at a P/F school, and won't have to worry about any of this anyway.

 

[zimmie256]

I think having a back-up plan to Derm. residency is a good plan. It's like saying, if I do well in school, get a good MCAT, I'll definitely get into HMS, etc. On another note, can anyone post the link to Panda Bear's blog? As someone who works in an E.D. and has had some jading experiences, I'm eager to read.

http://www.pandabearmd.blogspot.com/

Panda's the man. I really enjoy his blog... Informative and entertaining. Plus I appreciate his discussion of the negative aspects of medicine. Hasn't scared me off yet. Actually my imagination has done worse than his dose of reality so far...

Happy reading.

 

[Law2Doc]

Here is a direct quote from Academic Medicine in 2002:

"Consistent with findings from previous studies, this study demonstrated that undergraduate science GPAs and MCAT scores are strong predictors of standardized test performances during medical school..."

Notice the use of the word "strong."

Read beyond the title. The article hardly says that having done well in undergrad you are home free.

 

[dutchman]

Maybe for you. Not for everyone.

A little confident eh? You think you are any better than the 38% therwise qualified candidiates that failed to match derm here http://www.medfriends.org/match_statistics/2005 Match Outcomes.pdf

Derm is the second most competitive specialty, and decieving yourself that it is no big deal to match derm is foolish.

 

[MinnyGophers]

A little confident eh? You think you are any better than the 38% therwise qualified candidiates that failed to match derm here http://www.medfriends.org/match_statistics/2005 Match Outcomes.pdf

Derm is the second most competitive specialty, and decieving yourself that it is no big deal to match derm is foolish.

Especially when you are not even in med school yet.

 

[Towelie]

Read beyond the title. The article hardly says that having done will in undergrad you are home free.

Um... that's not from the title. Here's another quote: "There were substantial correlations between individual MCAT scores and USMLE Step 1 scores."

Obviously, a strong correlation is not a guarantee. It might mean nothing. But obviously, performance on two standardized tests are related.

 

[Towelie]

Especially when you are not even in med school yet.

I'm not going into derm. But I think that I could, if I wanted to. Is that really so crazy? Are all of you just completely lacking in confidence?

 

[Vox Animo]

The average medical debt for 2006 med graduates was 169,000. This is skewed, because many medial students have school paid for.

IF you have no outside help, and you entered in 2010, your dept will be over 250,000. The interest on that alone will be close to 20,000 a year.

When you are looking at primary care salaries that are 140K and dropping, it makes things look alot differnt.

if this trend continues for another 10 years, and debt gets around 400K-500K, it will not be cost effective to go into medicine for half of medical students that end up in primary care.

You will need 150K just to keep your head above water.

 

[MinnyGophers]

I'm not going into derm. But I think that I could, if I wanted to. Is that really so crazy? Are all of you just completely lacking in confidence?

No, but you come off as arrogant saying that you can beat 99% of med students (even if true)when you aren't even one yet.

 

[Towelie]

No, but you come off as arrogant saying that you can beat 99% of med students (even if true)when you aren't even one yet.

Sorry.

 

[MinnyGophers]

Sorry.

No you are not.

Arrogance is good sometimes, but often should be kept to yourself if you do not want to alienate your peers and future colleagues who often have been through things before you yourself experienced it and voice a strong opinion on it.

 

[Law2Doc]

Um... that's not from the title. Here's another quote: "There were substantial correlations between individual MCAT scores and USMLE Step 1 scores."

Obviously, a strong correlation is not a guarantee. It might mean nothing. But obviously, performance on two standardized tests are related.

Sure they are related, but I certainly wouldn't get excited about the degree of relation, if you look at the data in that, and several other studies you can find on pubmed. If med schools really thought there was a huge correlation, less weight would be given to the non-numerical things in admissions than currently are, because med schools would love their students to kill the boards and snag the cushy residencies. FWIW, I actually wouldn't be upset if you were right, but from what I've seen and heard, every ballgame starts anew. It's like baseball -- just because your sluggers hit really well TWO YEARS AGO doesn't mean you're the favorites today.
Your second year grades are going to be a far better correlation.

 

[Towelie]

No you are not.

Arrogance is good sometimes, but often should be kept to yourself if you do not want to alienate your peers and future colleagues who often have been through things before you yourself experienced it and voice a strong opinion on it.

Good point. I wasn't trying to be arrogant at all. Obviously it's never a sure thing to get into something so competitive. But if you start off thinking that you have no chance, then that will probably be a self-fulfilling prophecy.

 

[Towelie]

Sure they are related, but I certainly wouldn't get excited about the degree of relation, if you look at the data in that, and several other studies you can find on pubmed. If med schools really thought there was a huge correlation, less weight would be given to the non-numerical things in admissions than currently are, because med schools would love their students to kill the boards and snag the cushy residencies. FWIW, I actually wouldn't be upset if you were right, but from what I've seen and heard, every ballgame starts anew. It's like baseball -- just because your sluggers hit really well TWO YEARS AGO doesn't mean you're the favorites today.
Your second year grades are going to be a far better correlation.

I'll be sure to focus on those second year grades then

 

[Law2Doc]

Good point. I wasn't trying to be arrogant at all. Obviously it's never a sure thing to get into something so competitive. But if you start off thinking that you have no chance, then that will probably be a self-fulfilling prophecy.

But then again if you start off thinking it's a good chance, you aren't really any better situated. Until you know what's what, it's best to stay grounded and realistic, I think. You do your best. Sometimes that's good enough for things like derm. Sometimes it's not. Life goes on either way.

 

[pyrois]

I'm not saying it's easy. It may be extremely difficult. But, the derm residency spots still have to go to someone. If you do well enough in your class, on the boards, and with research, you can put yourself in a position to get whatever residency spot you want. It's hard, but possible if you're smart and motivated enough.

Per medical school there are, on average, less than 1 derm spot available.

That means that AMONGST MED STUDENTS, you have to be in the 99th percentile.

So let's assume, first of all, that you got into a top 20 medical school. And let's say, for simplicity sake, that your class is composed of 100 people.

At minimum, you must be the best in your class to grab that derm spot.

Of course this is a rather poor statistical analysis, since in some med schools you actually have a 0% chance of getting a derm residency, while other schools you have greater than 1%.

When it comes down to it, sure you can say "work harder, be smarter, come out better" but if you think getting into medical school was hard, aiming for a derm match makes med apps seem about as hard as getting into a low-end state school for undergrad.

 

[pyrois]

I'm not going into derm. But I think that I could, if I wanted to. Is that really so crazy? Are all of you just completely lacking in confidence?

Prior to actually entering medical school, even if you are the absolute best medical student with respect to every category of selection, you may not be able to get into derm.

You not only have to perform excellently academically, but you have to meet the right people who are doing the right research who can write a pulitzer-prize winning letter of recommendation for you while also being prominent enough in their own field to have their name recognized by the derm residency people.

I'm not saying it's impossible. All I'm saying is that nobody really knows if they're going to get at derm match until right when they are applying. Saying you can get into a derm residency prior to entering medical school is like claiming you're pretty sure you can get an Ace high straight flush in a texas hold 'em game before you've even seen the flop.

 

[Zyeist]

Beyond the usual neccesities such as covering bills, mortgages and other monthly expenses, covering the kids' diaper and daycare years, high school, college, first car, etc and anything else one can possibly think of to take care of and provide for, how much money does one neccessarily need to feel what? it was worth it? to feel accomplished? to live a 'lifestyle'?

We all pursue medicine for our own reasons that helps us sleep at night. We all need money to live, but how much money to make us happy is a personal choice. 250k can seem pitiful if you're living large(must live in a house, drive a car commiserate with your status, etc). For those who don't care as long as the neccessities are met, that same 250K can be more than plenty.

 

[BNSN]

Per medical school there are, on average, less than 1 derm spot available.

That means that AMONGST MED STUDENTS, you have to be in the 99th percentile.

So let's assume, first of all, that you got into a top 20 medical school. And let's say, for simplicity sake, that your class is composed of 100 people.

At minimum, you must be the best in your class to grab that derm spot.

Of course this is a rather poor statistical analysis, since in some med schools you actually have a 0% chance of getting a derm residency, while other schools you have greater than 1%.

When it comes down to it, sure you can say "work harder, be smarter, come out better" but if you think getting into medical school was hard, aiming for a derm match makes med apps seem about as hard as getting into a low-end state school for undergrad.

Umm, you're assuming the top student in all of those classes wants to become a derm. Most probably want to do something else.

So, no, your post is rejected on grounds of illogic.

But, I want to become a psychiatrist, and everyone tells me people will look down on me for that. Is that true?

 

[Law2Doc]

Umm, you're assuming the top student in all of those classes wants to become a derm. Most probably want to do something else.

So, no, your post is rejected on grounds of illogic.

But, I want to become a psychiatrist, and everyone tells me people will look down on me for that. Is that true?

I agree that not all top students even want derm and so the prior poster's analysis is not spot on, but it's still a pretty small percentage of any given med school who get derm (whether by choice or not). It is a field that strictly limits its spots, and for family reasons a ton of high credentialed people are seeking that lifestyle.

 

[BNSN]

I agree that not all top students even want derm and so the prior poster's analysis is not spot on, but it's still a pretty small percentage of any given med school who get derm (whether by choice or not). It is a field that strictly limits its spots, and for family reasons a ton of high credentialed people are seeking that lifestyle.

I have no friends, so lifestyle considerations = not relevant for me.

 

[cgscribe]

I don't think you'll be frowned upon as much as derm. I think psych. is to medicine what psychology is to science. It holds its own, but it's questioned as serious.

 

[pyrois]

Umm, you're assuming the top student in all of those classes wants to become a derm. Most probably want to do something else.

So, no, your post is rejected on grounds of illogic.

But, I want to become a psychiatrist, and everyone tells me people will look down on me for that. Is that true?

My argument wasn't illogical, it simply relied on a large number of assumptions. Given that it was simply a proposed "model" for dermatology acceptances, it was greatly simplified.

If you were looking for something more accurate, I'd want to get paid for the analysis

And no, nobody is going to look down on you for becoming a psychiatrist if you really like the work. Most will be envious that you found a profession that you connect with so well, and wish they had found the same passion.

There may be the occasional prick who looks down on 'lesser professions' but nobody cares what they think anyway.

 

[pyrois]

Beyond the usual neccesities such as covering bills, mortgages and other monthly expenses, covering the kids' diaper and daycare years, high school, college, first car, etc and anything else one can possibly think of to take care of and provide for, how much money does one neccessarily need to feel what? it was worth it? to feel accomplished? to live a 'lifestyle'?

If you absolutely love your job and get all the satisfaction/happiness you need in life from helping others (which shouldn't be excessively far from the truth), then technically you don't need to even get paid for the work you do. Just live in the hospital. I'm sure nobody would even notice

 

[BNSN]

I don't think you'll be frowned upon as much as derm. I think psych. is to medicine what psychology is to science. It holds its own, but it's questioned as serious.

I think that's true to some extent. Psych is just trying to find its footing. Where psych ends up is really dependent on how much those neurobiologists can figure out in the upcoming decades. Please, someone figure out the biological basis of emotions!

But, my point is, the conceptual footing for psych is serious. I mean, does anyone doubt that the brain is what determines mood and behavior? If biological processes determine mood and behavior, and if you believe those processes can become abnormal, then psych is perfectly acceptable as a science.

 

[pyrois]

I have no friends, so lifestyle considerations = not relevant for me.

Go into surgery.

 

[dutchman]

I have no friends, so lifestyle considerations = not relevant for me.

 

[cgscribe]

I agree that Psych. definitely has a place in medicine. I'm just letting you know that I think, in general, others view it as a pill-pusher that's more on the outskirts of the medical field (not that that should affect anybody's choice).

 

[dutchman]

I agree that Psych. definitely has a place in medicine. I'm just letting you know that I think, in general, others view it as a pill-pusher that's more on the outskirts of the medical field (not that that should affect anybody's choice).

all specialties are there for a reason and we should respect everyone. This will not happen though because inter-specialty bashing has always existed. For some reason PM&R,psych,path and even derm are always on the recieving end.

 

[BNSN]

all specialties are there for a reason and we should respect everyone. This will not happen though because inter-specialty bashing has always existed. For some reason PM&R,psych,path and even derm are always on the recieving end.

I agree, we should let PM&R, psych, and path off the hook.

I'm not so sure about derm

 

[cgscribe]

I agree with both of you. I'm just saying that specialty bashing happens, and will continue to happen.

 

[Eric Lindros]

I am not stuck in family practice. I matched out of it into Emergency Medicine last March and am currently a full-fledged Emergency Medicine resident at an undisclosed location in the Midwest. I don't know how anybody could get the idea from my blog that I dislike Emergency Medicine. Now, it's true that, as Law2doc points out, I present the field warts and all but that's only because it has so many warts. You either like the warts or you don't but many on SDN think they don't exist.

Oh, and I'm currently working on an article tentatively titled "Gatekeeper" about a day in a family practice clinic. I apologize in advance because it is very realistic and may talk you out of family practice. You will at least gulp and say, "Golly, I'd better look into this some more."

Again, my apologies for not sugar-coating things.

Yours is probably the best blog I have read in a long time. You're a very talented writer, and you keep it real (not that I really know yet) Keep up the good work!

 

[cgscribe]

Yes, kudos to Panda Bear. Your honesty and humor are much appreciated.

 

[45408]

Not yet. But I still don't buy this. GPA and MCAT have both been shown to be pretty strong predictors of USMLE performance and residency placement. I have confidence in my ability to succeed in medical school and on the boards, and to go where I want for residency. I'm not saying that it won't take a ton of work and motivation. But I have confidence in my ability to do it.

There are differences between medical students in their abilities. Not everyone has the same undergrad GPA, the same MCAT, the same talent for research, the same IQ, etc. There are ranges for these things, and my guess is that they are very good predictors of medical school success.

You're still stuck in the pre-med mindset, dude. I had a 3.8/35Q, and I got my ass handed to me during the first round of exams. Royally. I didn't fail anything, but it felt kinda humiliating to be under the class average. Now, I'm in the 60th percentile or so, but nothing amazing. Same goes for an M2 friend of mine who had a 38S on his MCAT. Don't ride your high horse so comfortably.

 

[45408]

Here is a direct quote from Academic Medicine in 2002:

"Consistent with findings from previous studies, this study demonstrated that undergraduate science GPAs and MCAT scores are strong predictors of standardized test performances during medical school..."

Notice the use of the word "strong."

Notice that the exams you take for all your courses tend to be NOT standardized. There may be a shelf exam thrown in for good measure, but that's it. The only guy I know with a Step 1 over a 250 had a 28 on his MCAT.

 

[Avrelian]

hello guys. Just wanted to put a word about us doctors, their money and healthcare in general. Now I dont want to offend anyone, i dont want to imply that you dont deserve your salaries, but it will be always "you" or "them".
Doctors with money or people with healthcare.
In my native country healthcare was and is free, regardless whether you pay taxes or not, whether you citizen or not, tourist, ets. And guess what-- doctors actually make less than their patients in general. They actually make less than many professions which do not require any education at all. Only very good surgeons and highest class specialists are making decent money. Under the table. And guess what-- its not easy to get to a medschool there either.

 

[BigBoyOrtho]

hello guys. Just wanted to put a word about us doctors, their money and healthcare in general. Now I dont want to offend anyone, i dont want to imply that you dont deserve your salaries, but it will be always "you" or "them".
Doctors with money or people with healthcare.
In my native country healthcare was and is free, regardless whether you pay taxes or not, whether you citizen or not, tourist, ets. And guess what-- doctors actually make less than their patients in general. They actually make less than many professions which do not require any education at all. Only very good surgeons and highest class specialists are making decent money. Under the table. And guess what-- its not easy to get to a medschool there either.

welcome to capitalism.

viva la America.

 

[Avrelian]

there are capitalist countries with free healthcare. In fact US is probably the last developed country without accessible healthcare. In fact the country I talk about nowdays 10 times more capitalist than US nowdays.