How did you go from PharmD to MD?

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That's not a bad idea, and I've thought about it myself. If pharmacy ever gets to the point where I want to bail, then it is probably likely that healthcare in general isn't the field for me. It's just hard to think of a field where I could make the same money and have the same level of interest. If I could do it again I would probably become a software developer, but my fear is I would enter into another bubble on the verge of bursting if I started now.

I think we'll know after this next downturn what happens in IT. I went to school right after the first dot-com crash with a bunch of second career classmates in pharmacy (and a decade later, they are still are ok with it even with the tech industry recovering). It's a field like law where there are superstar performers ($400k+ with options in Silicon), major contributors ($200k) which constitute 30%, a second tier of jobbers hovering around the $80-150k range, and warm bodies less than that. Everyone things about the superstars where most everyone really is a second-tier or a warm body.

I just don't think for most people (us included) that we are normally not going to have the luxury of having a single career without having to make personal compromises on lifestyle, or work environment, or work location. Even those who are in "safe" jobs, like me in government, don't remember or appreciate that RIF (the government's way of layoffs) happens every twenty years or so, and I think VA's turn is upcoming within the next two administrations. I think if you're not willing to compromise, you should plan for retraining for a second career in your future. Luck has quite a bit to do with it as well, who would have thought that being a factory worker was a bad idea in the 1970s considering that it paid the equivalent of $80k today back then with a high school diploma? And on top of that, health care is in a bubble which will have to shatter unless the politicians intend to make health a funding priority over defense (I think not possible given the constituencies involved).

To the OP, I know of plenty of pharmacists (both BS and PharmD) who made happy lives as physicians, and there are plenty on the boards. As a contrast to the idea that you could have gone straight to med school, unlike physicians who just went through, you do have the advantage of knowing how the relationships work and you are more likely to know what sort of survival difficulties exist in medicine. There is a catch though of too much education, every MSTP (MD/PhD) I know who was a PharmD undergraduate ended up not being happy with their research careers as they sank too much time and lost that prime era of their thirties to school where your research creativity is usually at its highest (which is different than research productivity which is normally the 40's following through acting on the ideas thought in your 30's).

You might as well try to be satisfied with your work though, since not even the money beyond a certain point can be a justified end in itself (physicians and dentists have to confront that reality too and make peace with it, but quite a bit later than pharmacists and unfortunately if their answer is negative, not necessarily enough time to change occupations considering their investment). Don't get me wrong, money is extremely important, and making more than your lifestyle should be in everyone's goal list, but you will need existential justification for your work sooner or later. I hope sincerely that your practice serves as that existential justification (You like being a physician in the same way that I like mixing radiopharmaceuticals). More than anything, finding that meaning in work may be the only compensation that's enduring in the end, if pharmacy is not it, then you should go look for it.

I echo the others on having a reason for switching, but would note that like nursing, pharmacy has a harder admissions bar into medicine as there is strong bias against admitting allied health.

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