Med school - costs/benefits for nontrads

[optopia]

I'm on the fence as to whether to become a doctor or do something else. I'm in a position where I feel strongly that if I was to make up my mind to go to medical school, I could. But I have to make that decision, I'd like to make that decision so I can stop mulling over it all the time.

I'm 25 years old, single, and have a day job that pays just over 100K. If you're wondering what I do, I'm a dismal scientist. I'm very much focused on costs and benefits, and though there's plenty of costs and benefits to look at with medicine, I've read enough posts about unhappy docs to know that it can't all be broken down to dollars and cents. Doesn't mean I haven't tried crunching the numbers.

In college, I flirted with the idea of becoming a doctor/optometrist, so I took a lot of science courses (although I still need to take freshman physics and a second semester of org chem). I have a GPA of 3.9+ in my science/econ undergrad, and haven't written the MCAT yet - but I tend to be good at taking tests, so I'm confident I'll do well.

I didn't go ahead with medicine/optometry because I enjoyed my economics classes better, and went on to grad school. Now I've been out and working for 3 years. Thing is, I'm losing interest in my job fast because I don't like sitting in front of a computer for 10 hours a day while talking to a grand total of 4 people.

I'm interested mainly in being a primary care doc (although I haven't ruled out specialties with lots of patient contact) because I really like talking to people and getting personal with them. I want to run my own clinic and handle the business aspects such as what to charge, whether to take insurance, innovative ways to let people book appointments, rewarding patients who are compliant, etc.

What puts me on the fence is that I don't have an innate interest in diseases or the science of medicine. I'm a strategic, conceptual thinker with a knack for business (I ran my own business to pay for senior year of college and grad school), and the idea of being a doctor, running a small practice appeals to me more than the day to day treatment of diabetes, hypertension, asthma, etc.

Direct Costs

Med school is costly, and I estimate the opportunity cost for someone in my shoes to be in the range of $6-700,000 (after-tax dollars), depending of course on a number of different factors. If you're making $100K and take home about $65K (in high tax California), you are forgoing all that income for at least 4 years of medical school, or about $260K. If you take an extra year off for pre-reqs, that's another $65K. In my case, taking a couple pre-reqs at the local community college could force me to work fewer hours, which means less pay and bonus. Let's say the total amount of lost take-home pay is $325K.

Assuming one pays $45K tuition (one of the worst case scenarios, but then again we don't control where we get in), that's $180K of debt assumed. I don't factor in living costs here because that's already included in losing $65K/year of take-home pay.

On top of that, there's 3 years of residency, taking home about $30K (after tax), which means losing out on $35K/year as a salary differential, or about $105K.

We're up to $600,000, maybe factor in more for student loan interest. The fact that I'm most drawn to primary care (IM or FM, the lowest paying specialties) also means that there's a relatively small future salary differential I'd receive on top of what I'm already making, so it could be many years before even the direct costs are recouped, if ever.

Intangible Costs

The above assumed I'll stay in the same job/level of pay. If in the meantime I get promoted/switch jobs and make $130K, $150K, or $170K, then opportunity costs rise.

There are also costs associated with lost free time, and spending several years in my late 20's, early 30's with little to no income to enjoy the finer things, such as being able to travel, eat out, expensive sports, etc.

I might also have to move away from San Francisco and live in a small city or town where it snows and which isn't as gay or minority friendly.

Doctor compensation

Doctors do complain about declining reimbursements and generally poor pay, but come on, they are still on average in the upper 5% of income earners, sometimes 1-2%. Unlike people working in regular jobs, doctors don't have to fear long bouts of unemployment (which these days can average upwards of 12 months) or even job instability for that matter.

Doctors also get lots of fringe financial benefits - being able to mortgage houses with smaller downpayments and more favorable interest rates, lower car insurance rates, etc. all for being part of a respected, stable profession whose members are on average one of the richest and most responsible groups of people in the nation.

People on these forums often say that you can do better financially in other professions. While there's certainly more income *potential* in other fields, I don't think there's a single industry out there that, on average, provides its members with such high incomes and stability. We like to focus on outliers and extreme cases, but the vast majority of people who attend medical school graduate, then the vast majority of those get residencies and become attending doctors with salaries well into the six figures. Can you say that about law, or finance or business?

The real reason I'm looking into medicine

• It's a well-paying, stable job with many intangible benefits. (which we don't get as economists)
• I think it's important, meaningful work.
• I think it makes good use of my brain. I want to keep learning and growing and I'm looking for a challenge.
• I like to work hard, and don't mind long hours
• There are opportunities to be creative and entrepreneurial if I run my own practice.

I'm hesitant because

• I'm not fascinated by the body and diseases. I'm not uninterested, but it's not the most exciting thing in the world to me.
• I don't like being on call. I'm a sensitive sleeper who suffers from sleep anxiety, and the possibility of being called out of sleep would prevent me from falling asleep all night. I could do night float and 16 hour shifts, but not 24 or 30.
• It's a long, costly training process, and I'm afraid of losing interest or becoming disenchanted along the way and regret that I didn't give up the things I already had - a well-paying job, living in a great city (SF), having the income and some spare time to do things on the side.

At the end of the day, I'm not sure what else to do. Only that medicine has been a fascination of mine for several months now to the point that it's distracting me from life.

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[PharMed2016]

I'm on the fence as to whether to become a doctor or do something else. I'm in a position where I feel strongly that if I was to make up my mind to go to medical school, I could. But I have to make that decision, I'd like to make that decision so I can stop mulling over it all the time.

I'm 25 years old, single, and have a day job that pays just over 100K. If you're wondering what I do, I'm a dismal scientist. I'm very much focused on costs and benefits, and though there's plenty of costs and benefits to look at with medicine, I've read enough posts about unhappy docs to know that it can't all be broken down to dollars and cents. Doesn't mean I haven't tried crunching the numbers.

In college, I flirted with the idea of becoming a doctor/optometrist, so I took a lot of science courses (although I still need to take freshman physics and a second semester of org chem). I have a GPA of 3.9+ in my science/econ undergrad, and haven't written the MCAT yet - but I tend to be good at taking tests, so I'm confident I'll do well.

I didn't go ahead with medicine/optometry because I enjoyed my economics classes better, and went on to grad school. Now I've been out and working for 3 years. Thing is, I'm losing interest in my job fast because I don't like sitting in front of a computer for 10 hours a day while talking to a grand total of 4 people.

I'm interested mainly in being a primary care doc (although I haven't ruled out specialties with lots of patient contact) because I really like talking to people and getting personal with them. I want to run my own clinic and handle the business aspects such as what to charge, whether to take insurance, innovative ways to let people book appointments, rewarding patients who are compliant, etc.

What puts me on the fence is that I don't have an innate interest in diseases or the science of medicine. I'm a strategic, conceptual thinker with a knack for business (I ran my own business to pay for senior year of college and grad school), and the idea of being a doctor, running a small practice appeals to me more than the day to day treatment of diabetes, hypertension, asthma, etc.

Direct Costs

Med school is costly, and I estimate the opportunity cost for someone in my shoes to be in the range of $6-700,000 (after-tax dollars), depending of course on a number of different factors. If you're making $100K and take home about $65K (in high tax California), you are forgoing all that income for at least 4 years of medical school, or about $260K. If you take an extra year off for pre-reqs, that's another $65K. In my case, taking a couple pre-reqs at the local community college could force me to work fewer hours, which means less pay and bonus. Let's say the total amount of lost take-home pay is $325K.

Assuming one pays $45K tuition (one of the worst case scenarios, but then again we don't control where we get in), that's $180K of debt assumed. I don't factor in living costs here because that's already included in losing $65K/year of take-home pay.

On top of that, there's 3 years of residency, taking home about $30K (after tax), which means losing out on $35K/year as a salary differential, or about $105K.

We're up to $600,000, maybe factor in more for student loan interest. The fact that I'm most drawn to primary care (IM or FM, the lowest paying specialties) also means that there's a relatively small future salary differential I'd receive on top of what I'm already making, so it could be many years before even the direct costs are recouped, if ever.

Intangible Costs

The above assumed I'll stay in the same job/level of pay. If in the meantime I get promoted/switch jobs and make $130K, $150K, or $170K, then opportunity costs rise.

There are also costs associated with lost free time, and spending several years in my late 20's, early 30's with little to no income to enjoy the finer things, such as being able to travel, eat out, expensive sports, etc.

I might also have to move away from San Francisco and live in a small city or town where it snows and which isn't as gay or minority friendly.

Doctor compensation

Doctors do complain about declining reimbursements and generally poor pay, but come on, they are still on average in the upper 5% of income earners, sometimes 1-2%. Unlike people working in regular jobs, doctors don't have to fear long bouts of unemployment (which these days can average upwards of 12 months) or even job instability for that matter.

Doctors also get lots of fringe financial benefits - being able to mortgage houses with smaller downpayments and more favorable interest rates, lower car insurance rates, etc. all for being part of a respected, stable profession whose members are on average one of the richest and most responsible groups of people in the nation.

People on these forums often say that you can do better financially in other professions. While there's certainly more income *potential* in other fields, I don't think there's a single industry out there that, on average, provides its members with such high incomes and stability. We like to focus on outliers and extreme cases, but the vast majority of people who attend medical school graduate, then the vast majority of those get residencies and become attending doctors with salaries well into the six figures. Can you say that about law, or finance or business?

The real reason I'm looking into medicine

• It's a well-paying, stable job with many intangible benefits. (which we don't get as economists)
• I think it's important, meaningful work.
• I think it makes good use of my brain. I want to keep learning and growing and I'm looking for a challenge.
• I like to work hard, and don't mind long hours
• There are opportunities to be creative and entrepreneurial if I run my own practice.

I'm hesitant because

• I'm not fascinated by the body and diseases. I'm not uninterested, but it's not the most exciting thing in the world to me.
• I don't like being on call. I'm a sensitive sleeper who suffers from sleep anxiety, and the possibility of being called out of sleep would prevent me from falling asleep all night. I could do night float and 16 hour shifts, but not 24 or 30.
• It's a long, costly training process, and I'm afraid of losing interest or becoming disenchanted along the way and regret that I didn't give up the things I already had - a well-paying job, living in a great city (SF), having the income and some spare time to do things on the side.

At the end of the day, I'm not sure what else to do. Only that medicine has been a fascination of mine for several months now to the point that it's distracting me from life.

Took me some time to read this post and here is what I would advise: do not go into medicine.

You have a well paying job already and you know that the material in medicine doesn't interest you. There's not really much more to say beside that. I'm in a similar financial situation to yourself although I haven't graduated yet. My starting salary will be about 100-120k as a pharmacist in a year depending on whether I want to work hospital or community. I calculated my numbers similarly to yours and found that if I became a GP - it's most likely I will not break even in terms of earnings with that of a pharmacist. It's quite possible that even as a specialist that I might not break even due to higher taxes. But money isn't everything and I find the personal satisfaction in scope worth the lost income.

 

[sindadel]

Start a new business and get obsessed with it. You could even start a (chain of) clinic(s) and hire doctors.

I think you need a strong and abiding interest in medicine to proceed, and I also think that being sleep-sensitive is a pretty big contraindication.

 

[LifeTake2]

Ok, I am currently living the costs you outline, and with a family.

If you are not 110% dedicated to medicine, I can tell you don't do it. The price is just too high. I don't regret my decision, and even if I don't get in I'll be ok. But there have been MANY nights where I sat trying to balance the checkbook and asked WTF did I do. If I wasn't committed to what I was doing I would have quit months ago.

 

[wholeheartedly]

I have to say, I'm also getting a do not go into medicine vibe on this one as well.

The fact that you aren't really interested in diseases and disease processes and also don't see yourself managing hypertension, diabetes, asthma, etc is a bit of an issue. Is it really being a doctor and all that entails that you see as being satisfying or something else. I guess I'm getting a "something else" vibe.

With respect to the reasons you are interested, like wanting to do meaningful work, medicine can provide that, as can a lot of other things. While medicine is constant continual learning, I've heard a lot of people say it isn't the deep creative thinking and learning that some are looking for when they go into medicine. I've heard some say that if that's what you're looking for, you'll be disappointed. I'm not far enough in to have any personal experience with that.

I think I'm just getting a "something else" vibe from you. What do you see yourself doing that's creative an entrepreneurial in medicine? Could you do that without the MD degree? Have you looked into things like healthcare administration, other types of research (biomedical, public health, etc), public health programs (policy/research/administration), etc? Without having a lot of details about your other interests those are questions/options that you might want to look into as well.

 

[Dzerzhinsky]

Short form: Don't do it, OP.

Long form: There is the oft-repeated axiom "If you can be happy doing anything but medicine, do it." I don't agree with the letter of this, because I know I can be happy doing other things--heck, I'm pretty happy with my current career--but I agree with the spirit. Maybe amend to "more happy." You have to want it, and you have to want it bad. I don't think you want it bad.

Maybe I'm wrong. I might well be. But here's the deal. You're a well-paid professional with some specific lifestyle requirements/concerns who's contemplating going into medicine because it's a challenge, not really wanting to do the real work that's at the end of the tunnel, but interested in the ancillary bits (the running of the practice rather than the practice itself.)

Now, I'm also a well-paid professional with sleep issues who's always looking for the next challenge, and who has flirted with the idea of medicine for quite some time, and I'm doing this. But here's the crux of the differences between us. There are two.

One: I've been doing this postbacc thing for about a year now. Before I started, as a prerequisite to starting, I decided I'd rather do this than have the lifestyle stuff--free time, spare cash, opportunities to travel--and that I'd rather do this for its own sake and for the intrinsic value of the challenge itself. Even if I never make it to medical school. There was a point in my life where I wanted those opportunities and had those lifestyle concerns (yes, in my twenties, and yes, I had the opportunity to do them, and yes, I wound up finding them ultimately hollow, but that's a story for another day.) I don't anymore. Last month, I had a couple weeks when I was working sixty hours a week, volunteering twelve, and in class five nights a week--and I wouldn't have traded it for anything in the world. Why? Not because I loved Physics that much. I didn't. Not because I was happy about not getting enough sleep. I wasn't. But because I wanted to be a physician so much that I'd rather be doing this and moving towards that goal, rather than getting enough sleep, having lots of "fun", and not moving towards the goal. This is my fun now.

Which brings us to point two: I want what's at the end of the tunnel. All of it. Everything about it. Not just one ancillary component I can get somewhere else--because make no mistake, OP, you can get the things you want somewhere else, without a decade or so of process in front of it. I can't. Or, rather: There are other ways for me to get the combination of intellectual and environmental challenges I want, but I've already done one of them to its highest level, and I want a new and shiny toy, and in several years of searching I haven't identified any other new and shiny toys that are as awesome. And I want this. I'm sure. I wouldn't be doing it if I wasn't.

So that's why I'm doing it, and that's why I think you shouldn't do it.

There are a million other things you can do, OP. If you want to help people and you're business-minded, start your own business helping doctors with practice management--Lord knows that there are a ton who will happily hire you. If you want an intellectual challenge, go to graduate school in a different field on the side while you keep your current job. If you want to help people, there are so many ways you can do that, too.

But if you're unsure about doing this, the answer is automatically "don't."

Is that a forever thing? No. If five years down the road, nothing else has changed, but you're sure you want to do this? Then do it, OP. Medicine will still be here for you, and you will be sure, and you will be ready. But if you aren't sure, don't do it, because it will chew you up and spit you out.

Now, you might read all of this and go "Okay! I'll not do this thing!" And that's great. But I don't think you will go "Okay! I'll not do this thing!", because you're a highly-intelligent overachiever who thinks this might be a good plan. So now that I've given you my opinion, and now that you still aren't sure what to do, here's what you do to find out if you're sure. Again, two recommendations.

One: Read "Intern", by Sandeep Jauhar. I don't normally recommend this book, because I read it, and I thought "Man, talk about whining." I read parts of it out loud to the attending I was dating, and we bonded over the shared mocking we did of his unrealistic expectations. A line that came up frequently was "Dude, how could he possibly decide to do this without knowing what he was getting into?" But I think that's exactly what you need, OP, because his story is uncannily similar to yours. Read it and decide for yourself if this is what you want to do. (He even did internal medicine, like you're contemplating. I read it knowing that I'd rather shoot myself than do an internal medicine residency.)

Two: Get experience with patients in the role of provider. And I don't mean stocking blankets. I did it by becoming an EMT, and I recommend that because it was a great experience for me, but you can do it any way you can. But it has to be as a provider, because being responsible for someone--albeit on an incredibly limited scale with baby medicine--is a completely different beast from bringing someone a blanket.

I knew that dealing with actual patients was going to be the hardest point for me, because I too come from a career not known for its client contact. I had confidence in my intellectual abilities; I had less confidence in my ability to be good at, or to enjoy, the patient contact components. So I decided to find out sooner rather than later--"later" potentially being the third and fourth years of medical school. Because, when it comes to patient contact, you will either love it or hate it, and you will either be good at it, be terrible at it but determined to become good at it, or be terrible at it with no desire ever to improve. Initially, I loved it and was terrible at it with vast reserves of determination to become good at it. Now I love it and I'm getting better at it. And I would much rather do that, know that, and go through that process now. I recommend the same to you.

Whatever you decide, OP, good luck to you.

 

[sharmi]

If diseases or the human body does not interest you, don't go into medicine. You will end up wondering how to get out this if you don't. But then, you will be worse off, in debt, w/o a job, lost wages and a lost life. I would not do this, if I were you.

I make good money over 150K + bonus which is at least 30 K a year in engineering. I have been out of grad school over a decade back and have applied this year for med school. But I love to learn about diseases, what causes it and all that goes with it. It is this interest that keeps me driving and I know I will thrive once I get there. I am not saying that I hate engineering, I am good in math and like my job, but I like medicine way more.

I have kept my full-time job all along my post bacc classes spanning 3 years - did around 70 credits - its difficult but not impossible - and most definitely possible if you don't have children. And I plan to keep working till I matriculate.

I have enough savings in company stock options - so hopefully, I won't have to take loans, but I have to save up for my children too - so we will see.

But none of this would make sense if I was in this only for the business aspect. There are other ways to do it. Save up money, take loans, buy a small practice and run as it your own business. Or you can do an MBA and/or start up another business of some sort. I agree that doctors enjoy a job protection that very few other jobs do. But that can't be motivation enough to get into this for 8-12 years, before you can even start to practice on your own. If you are bored by your job now, you will be more so in medical school and thereafter if you don't like the disease/treatment aspect of medicine.

 

[dmf2682]

Sharmi, since we're all anonymous here I don't feel weird about asking, but you don't have to answer. Are you planning on tapping into your retirement? I'm thinking about this but wasn't sure what is usually done. Anyone feel free to answer

 

[sindadel]

I tapped retirement to pay tuition. It's an interest free loan and with the way the market has been, I won't miss the "growth".

 

[sharmi]

Sharmi, since we're all anonymous here I don't feel weird about asking, but you don't have to answer. Are you planning on tapping into your retirement? I'm thinking about this but wasn't sure what is usually done. Anyone feel free to answer

Not really. I don't plan to tap into my 401K or any of my pension/retirement plans. The only time I did in the past was a buying a house but its been paid off. I plan to use my stock grant / options to pay for med school.

 

[QofQuimica]

OP, I have to agree with the others: medicine is not the right career for you. I'm not saying that because you're a bad person, or because you're not intellectually capable of learning medical science. I'm not even saying that because you don't love to learn about disease processes; the wonders of the human body ain't my thing either. But medicine is a service-oriented profession. Unless you want to treat patients, you will be very unhappy in this career.

I had to look up what a "dismal scientist" is, and the gist I get is that you're an economist of some sort. Ok, so that's a useful skill set to bring to medicine, but not as an MD. What you should consider instead is getting an MS in health economics, like this. Someone with your background would be awesome in a career like that.

 

[Scottish Chap]

I'm hesitant because

I'm not fascinated by the body and diseases. I'm not uninterested, but it's not the most exciting thing in the world to me.

I don't like being on call. I'm a sensitive sleeper who suffers from sleep anxiety, and the possibility of being called out of sleep would prevent me from falling asleep all night.

Both of these issues will destroy you if you enter medicine. Good luck in your decision.

 

[optopia]

Took me some time to read this post and here is what I would advise: do not go into medicine.

You have a well paying job already and you know that the material in medicine doesn't interest you. There's not really much more to say beside that. I'm in a similar financial situation to yourself although I haven't graduated yet. My starting salary will be about 100-120k as a pharmacist in a year depending on whether I want to work hospital or community. I calculated my numbers similarly to yours and found that if I became a GP - it's most likely I will not break even in terms of earnings with that of a pharmacist. It's quite possible that even as a specialist that I might not break even due to higher taxes. But money isn't everything and I find the personal satisfaction in scope worth the lost income.

I apologize for unnecessary lengthiness of the OP...
If you make $120 as a pharmacist and $350 as a specialist, you're probably still better off as a specialist even if it takes 10 years of training, especially if you're young and plan to work a long time. Remember also that your effective tax rate doesn't go up that much past $100K due to social security topping out.

Short form: Don't do it, OP.

One: Read "Intern", by Sandeep Jauhar.

Two: Get experience with patients in the role of provider. .

Book ordered from Amazon. And yes, planning to shadow some docs soon.

If diseases or the human body does not interest you, don't go into medicine. You will end up wondering how to get out this if you don't. But then, you will be worse off, in debt, w/o a job, lost wages and a lost life. I would not do this, if I were you.

I make good money over 150K + bonus which is at least 30 K a year in engineering.

Wow, that is a lot of income to forego for your medical training. But alas, even though I'm not enthralled with diseases or the human body, I still like working with people and helping them, and medicine does that while paying better and with more respect than most other service professions. But I get it - it may not be worth it. Still, I'm obsessed...

Ok, I am currently living the costs you outline, and with a family.

If you are not 110% dedicated to medicine, I can tell you don't do it. The price is just too high. I don't regret my decision, and even if I don't get in I'll be ok. But there have been MANY nights where I sat trying to balance the checkbook and asked WTF did I do. If I wasn't committed to what I was doing I would have quit months ago.

I admire you. A lot. That takes balls. Sounds like, with your dedication, you'll get in.

OP, I have to agree with the others: medicine is not the right career for you. Unless you want to treat patients, you will be very unhappy in this career.

The thing is, I want to work with patients... I'm mostly interested in primary care, maybe ER but not anes, radiology, etc. even though they pay well, I wouldn't be able to do without patient contact. It's just that I don't particularly find the diseases themselves very interesting. I'd rather hear about the lives of my patients (as long as they give me a 2 minute rendition)...

I sometimes have these country doctor fantasies. The person who's a bit of a jack of all trades, delivers babies, does minor surgeries, has to make do with what he has. Because I'd play such an important role where I am, people look up to me, and I use my training and resourcefulness (probably more of the latter) to help them as best I can. Diabetes is boring to me, but, it's a way to get into peoples' lives.

Both of these issues will destroy you if you enter medicine. Good luck in your decision.

Even with the 16 hour intern workday and a family medicine residency with night float call?

 

[optopia]

BTW... thank you all for your replies. I'm amazed at how nice you are volunteering your time to help out.

 

[gunito]

I'm hesitant because

• I'm not fascinated by the body and diseases. I'm not uninterested, but it's not the most exciting thing in the world to me.
• It's a long, costly training process, and I'm afraid of losing interest or becoming disenchanted along the way and regret that I didn't give up the things I already had - a well-paying job, living in a great city (SF), having the income and some spare time to do things on the side.

If the thought of the human body and how it works doesn't make you excited and intrigued, then don't even think about becoming a doctor. The interest you have is already minimally, so if you became in more disinterested, you would hate it with a passion.

 

[Dzerzhinsky]

Book ordered from Amazon. And yes, planning to shadow some docs soon.

Shadowing isn't good enough. You need to actually get some hands-on Dealing With Patients. Watching As Someone Else Deals With Patients isn't enough.

And you'll need clinical experience to get in if you decide to go, so might as well start now!

Even with the 16 hour intern workday and a family medicine residency with night float call?

Honestly, I don't think the sleep issue is necessarily a dealbreaker for you; I used to take call in my current field, and if you get sufficiently tired, you can sleep anywhere on anything. On the other hand, Scottish Chap is a resident and I'm a pre-med, so his advice is worth considerably more than mine. Also, one of the reasons I want the specialty I want is because I won't have to take call--whereas either of yours, you will. And the sleep issue is certainly not an asset.

 

[NuttyEngDude]

Both of these issues will destroy you if you enter medicine. Good luck in your decision.

• I'm hesitant because I'm not fascinated by the body and diseases. I'm not uninterested, but it's not the most exciting thing in the world to me.
• I don't like being on call. I'm a sensitive sleeper who suffers from sleep anxiety, and the possibility of being called out of sleep would prevent me from falling asleep all night.

I'm quoting someone else's quote because he and others beat me to the punch and I want to underscore the importance of it.

 

[PharMed2016]

I apologize for unnecessary lengthiness of the OP...
If you make $120 as a pharmacist and $350 as a specialist, you're probably still better off as a specialist even if it takes 10 years of training, especially if you're young and plan to work a long time. Remember also that your effective tax rate doesn't go up that much past $100K due to social security topping out.

I would imagine being in a higher tax bracket as a doctor compared to a pharmacist. But it could be that pharmacist and doctors are in equivalent tax brackets which would make the differences less appreciable but still substantial. I subscribe to the theory of decreasing returns the more money that you make. However, I will defer to your judgement there.

I would like to note that most specialist unless your ROAD - make about 200k which is what I based my assessment on. Not to mention, if I decided to work as many hours a week in pharmacy as a medical resident - I would make 2(100-120k) whereas the resident would make 35k for his 80hours/week.

 

[DrArete]

A lot of your concern seems to be opportunity cost and financial considerations.
That is a good thing, it shows maturity, it shows you understand how important quality of life considerations are.
Don't pin your hopes on ROAD, most don't match into them, and unless you are a savant, I think it would be nearly impossible to ace 3rd yr clinicals and destroy Step 1(240+), when you aren't fascinated by the material.
Also, no one really knows where physician salaries are headed, there is a disturbing trend of cost controls in every area except for medical school tuition.

If I were you, I would stick with your well paying job, and focus on wealth accumulation (read Millionaire Next Door). You can then focus on volunteering in your free time, maybe even get certified as an EMT and do 12 hr shifts on the weekend.

You could take some of your money and become involved in health projects in Latin America, and help more people than you ever could as a doctor, and get to know them well.

There's a lot of ways to find meaning, and medicine is not a unique promised land, it is a stressful profession, but ultimately worth it for people who are fascinated by science and how the human body works and who like treating patients. If you have doubts about these areas, they will chew you up. Personally I am thinking of dropping it (am in a post bacc now), and never would have started if I had a 150K job.

 

[optopia]

I would imagine being in a higher tax bracket as a doctor compared to a pharmacist. But it could be that pharmacist and doctors are in equivalent tax brackets which would make the differences less appreciable but still substantial. I subscribe to the theory of decreasing returns the more money that you make. However, I will defer to your judgement there.

I would like to note that most specialist unless your ROAD - make about 200k which is what I based my assessment on. Not to mention, if I decided to work as many hours a week in pharmacy as a medical resident - I would make 2(100-120k) whereas the resident would make 35k for his 80hours/week.

Ok, touche, $350 may be a bit on the generous side for what a full-blown specialist makes on average, but according to this, not unachievable (yes it's wikipedia but they cite the source):

http://en.wikipedia.org/wiki/Specialty_(medicine)#Physician_compensation

 

[optopia]

A lot of your concern seems to be opportunity cost and financial considerations.
That is a good thing, it shows maturity, it shows you understand how important quality of life considerations are.
Don't pin your hopes on ROAD, most don't match into them, and unless you are a savant, I think it would be nearly impossible to ace 3rd yr clinicals and destroy Step 1(240+), when you aren't fascinated by the material.
Also, no one really knows where physician salaries are headed, there is a disturbing trend of cost controls in every area except for medical school tuition.

If I were you, I would stick with your well paying job, and focus on wealth accumulation (read Millionaire Next Door). You can then focus on volunteering in your free time, maybe even get certified as an EMT and do 12 hr shifts on the weekend.

You could take some of your money and become involved in health projects in Latin America, and help more people than you ever could as a doctor, and get to know them well.

There's a lot of ways to find meaning, and medicine is not a unique promised land, it is a stressful profession, but ultimately worth it for people who are fascinated by science and how the human body works and who like treating patients. If you have doubts about these areas, they will chew you up. Personally I am thinking of dropping it (am in a post bacc now), and never would have started if I had a 150K job.

As one gets older, the idea of keeping life up in the air as a student becomes orders of magnitude less appealing. Unless it's balanced with some decent returns at the end of the rainbow. What makes things difficult is that some people who've gone this path say DON'T do it (Panda Bear and sacrament are good examples). But even they acknowledge that medicine is a good job once you've done the training. Most people who go down this path do graduate from med school, finish a residency and find good jobs.

Why are you thinking of dropping your post-bacc?

 

[DrArete]

As one gets older, the idea of keeping life up in the air as a student becomes orders of magnitude less appealing. Unless it's balanced with some decent returns at the end of the rainbow. What makes things difficult is that some people who've gone this path say DON'T do it (Panda Bear and sacrament are good examples). But even they acknowledge that medicine is a good job once you've done the training. Most people who go down this path do graduate from med school, finish a residency and find good jobs.

Why are you thinking of dropping your post-bacc?

If you get through the training, and find a branch of medicine that appeals to you, then yes, it may be worth it to you in the end. Another very real consideration is that for most people, once you are well into your first year, and certainly by second year, it is too late to quit because of the debt, and the feeling that you might as well push forward and hope for the best since you have already invested heavily in terms of time and money.
It is also very hard to understand what medicine is, until you are doing it. It is fundamentally, and necessarily, a highly technical and scientific job.

I'm thinking of quitting because I don't really like the science classes, and at 31, have suddenly realized just what it will mean to be living like a student and taking out loans until I'm 40+. I sort of burned bridges at my old job when I moved from Europe to the USA to do the post bac, which is a primary reason I haven't quit already. I may move back home, work in real estate with my father, which would be less than ideal, but in a year or two could put me in position to move back to a major city.

 

[optopia]

I'm thinking of quitting because I don't really like the science classes, and at 31, have suddenly realized just what it will mean to be living like a student and taking out loans until I'm 40+. I sort of burned bridges at my old job when I moved from Europe to the USA to do the post bac, which is a primary reason I haven't quit already. I may move back home, work in real estate with my father, which would be less than ideal, but in a year or two could put me in position to move back to a major city.

Do you still want to be a doctor at the end of the day? It sounds like you've made a lot of sacrifices already, would be a pity if you quit just because you didn't like the post-bacc courses?

 

[dmf2682]

If you're running a 26.2 mile marathon and decide you don't like running after the first two miles, you should really stop because the other 24.2 are going to be incredibly painful, long, and full of self doubt. And in the end, if you finish, all you'll have is a pretty finishers medal to hang on your wall but you'll never run again.

 

[yankswin2011]

Look, as a non-traditional applicant, you have to really make a decision as to whether you can accept the fact that you'll be 40 with no real assets and no retirement savings and possibly $200K in debt (assuming you start medical school at 30s and go all the way through residency). From a rational financial standpoint, being 40s without assets or any meaningful retirement savings with $200K in debt is a BAD IDEA. You are essentially worse off than people with just a HS diplomas who have worked at mundane jobs (i.e. government jobs) where they have at least some savings and a VERY GOOD retirement pension plan. However, if you are independently wealthy, then it this does not apply to you.

Bottom-line is, the older you get, the more it is about passion because you'll be working into your 60s to pay off the loans, do you want that?


"Unlike people working in regular jobs, doctors don't have to fear long bouts of unemployment (which these days can average upwards of 12 months) or even job instability for that matter." That is true but you're giving up 8 years of real income and taking out loans, I think the 12 months of unemployment is nothing compared to 8 years lost of real income (assuming you earn $100K a year, and taking on $200K in loans), do the math.

 

[PharMed2016]

It all boils down to: do you like medicine enough to go into if we remove the financial incentive? Can you imagine yourself learning the patho well enough to be able to diagnosis your patient? There is a hell of alot of information to learn and it would be ashame you have to be miserable in the end.

 

[ChemMed]

BTW... thank you all for your replies. I'm amazed at how nice you are volunteering your time to help out.

The non trad forum is incredibly helpful. Most the people here will give you good advice. I'm glad you found your way to. I can't really add to what the others have already said so I simply wish you good luck in your decision. Cheers.

 

[EdLongshanks]

Ok, touche, $350 may be a bit on the generous side for what a full-blown specialist makes on average, but according to this, not unachievable (yes it's wikipedia but they cite the source):

http://en.wikipedia.org/wiki/Specialty_(medicine)#Physician_compensation

Nearly everyone who goes into medical school thinks that they will graduate at or near the top of their class. It's a Lake Woebegone profession - all the students are above average. I knew this fact in the back of my mind, but didn't really believe it - after all, until a few months ago, I had never met anyone smarter than me and I am in a DO school with fairly unimpressive MCAT stats (mine is the highest score).

Now I have taking 2 tests and will take my 3rd in a few minutes. Admittedly, I am in a class where I have 0 previous training (histology with some anatomy) and I have had an introduction to neither of these subjects. My grade is just barely above the class average. I hope to change that with this test in a few minutes(I expect to), but my fellow students are just as incredibly motivated as I - and they have more prior knowledge.

If you go into medicine you will be in the same position, academically, as I. You are far above average in general intelligence, but do not have an extensive biological science background. Your experience leads you to believe you will be able to match into a specialty. I can tell you that - without an incredibly interest or prior experience in science - you probably will not.

 

[theseeker4]

Nearly everyone who goes into medical school thinks that they will graduate at or near the top of their class. It's a Lake Woebegone profession - all the students are above average. I knew this fact in the back of my mind, but didn't really believe it - after all, until a few months ago, I had never met anyone smarter than me and I am in a DO school with fairly unimpressive MCAT stats (mine is the highest score).

Now I have taking 2 tests and will take my 3rd in a few minutes. Admittedly, I am in a class where I have 0 previous training (histology with some anatomy) and I have had an introduction to neither of these subjects. My grade is just barely above the class average. I hope to change that with this test in a few minutes(I expect to), but my fellow students are just as incredibly motivated as I - and they have more prior knowledge.

If you go into medicine you will be in the same position, academically, as I. You are far above average in general intelligence, but do not have an extensive biological science background. Your experience leads you to believe you will be able to match into a specialty. I can tell you that - without an incredibly interest or prior experience in science - you probably will not.

That is an interesting point of view. You really think that the prior knowledge makes the students so much better at the courses you take? General opinion online seems to be that everything you need to know to both excel in the classes and the Step exams is taught in the courses, as long as the pre-reqs were successfully completed. I know you are early in your med-school career, but do you really think the prior knowledge is that vital?

 

[optopia]

Nearly everyone who goes into medical school thinks that they will graduate at or near the top of their class. It's a Lake Woebegone profession - all the students are above average. I knew this fact in the back of my mind, but didn't really believe it - after all, until a few months ago, I had never met anyone smarter than me and I am in a DO school with fairly unimpressive MCAT stats (mine is the highest score).

Now I have taking 2 tests and will take my 3rd in a few minutes. Admittedly, I am in a class where I have 0 previous training (histology with some anatomy) and I have had an introduction to neither of these subjects. My grade is just barely above the class average. I hope to change that with this test in a few minutes(I expect to), but my fellow students are just as incredibly motivated as I - and they have more prior knowledge.

If you go into medicine you will be in the same position, academically, as I. You are far above average in general intelligence, but do not have an extensive biological science background. Your experience leads you to believe you will be able to match into a specialty. I can tell you that - without an incredibly interest or prior experience in science - you probably will not.

I get your point. I did the first year of an Econ PhD program (which are known for requiring you to work on problem sets until midnight most days of the week), and even though I entered as one of the top students of my undergrad class, I was only one or two spots above average after midterms (our class was about 15 people). Though in my case, it was largely lack of interest that held me back from the top. I would not have matched into the top jobs after graduation had I stayed.

So let's assume that you become the average doctor, who makes $200K a year. I'll assume that the choice is between $120K a year in a job or $200K a year as a doc. In California, your net pay would be $75K in the job, or $118K as a doc. The different is $43K a year. At that rate, it would take 14 years as a practicing doc to recoup the $600K in opportunity costs. So if you start at age 30, become a full-blown doc at age 38, you'll break even at 53.

Of course, you also lose a lot of intangibles, and money has time value too. You make a huge upfront investment and only recoup it over time - there's a loss there from forgoing the money, the lifestyle, and the added stress... plus, it's risky because if you drop out/don't like it or if something happens to you along the way, you're screwed. Plus, that's many years of missing out on saving for retirement, and the benefits of compounding returns.

If your previous career trajectory was promising and you were likely to be promoted, that stretches out the cost recovery period. You're right - it may never be worth it from a financial point of view...

 

[Nasrudin]

That is an interesting point of view. You really think that the prior knowledge makes the students so much better at the courses you take? General opinion online seems to be that everything you need to know to both excel in the classes and the Step exams is taught in the courses, as long as the pre-reqs were successfully completed. I know you are early in your med-school career, but do you really think the prior knowledge is that vital?

I agree wit Ed. It's serious job of work to be average. If you pass all your courses and perform at the national mean on the Step exams....that is a hell of an accomplishment.

I came to the realization really quick that the amount of effort required to perform at the top of a medical class is a heavy toll to pay. I really don't believe people who say otherwise. Sure, there's variabilty in how fast people can learn. And there is an intelligence to studying smart and executing on exams--which is the real task of your rirst year. How to keep yourself humming along a whizzing pace. And keep your balance.

Gathering and maintaining a massive store of information is the job of the medical underclassman. Using it, sure. But obtaining it comes first. I wish I had realized the sheer monolithic gravity of this during my first year. Now I'll have to work harder to review that stuff under a stiffer pace of studying what's in front of me.

Because of it's mountainous nature. Yes. Absolutely background knowledge in the biological sciences can be very helpful. Shoot. I got some stuff right on some things that I forgot to review based on my experience in pediatrics. I forgot to review a lecture on vaccines. But because I had given the shots to babies and kids thousands of times i knew the vaccine schedules.

Some people may have just graduated from an SMP, busting their butt to outcompete medical students. And now they're at all over again with you as weaker competition.

The basic sciences are all that is needed. But is one of the stranger premed myths that the other course work doesn't help. It all helps. Clinical experience can give you a common sense about pathology that will help you make sense of things faster and more intuitively than those who thought shadowing a dermatologist would suffice.

Now. We will eventually all end up in the same boat. At some point. Our various backgrounds except those with useful ward skills like nurses have will equalize. And then when it comes time to paddle on our own. Who knows if all this academic work will end up being the differntiating criteria in the end.

But it is for now. And the race is fast. The first group has already sprinted into the distance. Derm, Ortho, plastics, and rads etc. If you want those. When the gun goes off. You better sprint. And never stop till match day.

 

[DrArete]

Do you still want to be a doctor at the end of the day? It sounds like you've made a lot of sacrifices already, would be a pity if you quit just because you didn't like the post-bacc courses?

I'm just not so sure about it anymore. My first passion was to do surgery, but repeated bouts of back problems make that an unlikely course.
I never really had the dream of doing anything else in medicine, even though many aspects of patient care appeal to me.
I have indeed made a lot of sacrifices already, but it is not too late to get out if I can come up with a workable alternative.
I realize the post bacc classes are not medical school, but I am already finding it a chore to sit down and focus for hours on science that does not hold my interest.

 

[Nasrudin]

I'm just not so sure about it anymore. My first passion was to do surgery, but repeated bouts of back problems make that an unlikely course.
I never really had the dream of doing anything else in medicine, even though many aspects of patient care appeal to me.
I have indeed made a lot of sacrifices already, but it is not too late to get out if I can come up with a workable alternative.
I realize the post bacc classes are not medical school, but I am already finding it a chore to sit down and focus for hours on science that does not hold my interest.

I hear you. On many levels.

It is a chore. Kept biochemical scientists will teach you in perfect monotone about the importance of maple syrup disease and the nifty smells it's even rarer cousins create in the urine. And will test you on it.

Nevermind that you'd be very very lucky to ever see a case. Or even luckier to have an observant parent report urine smells. And a straight up freak to smell samples by the hundreds of thousands in the hope of pulling a House-type Dx.

Scientists.

And yes. Like you. With chronic back pain. Surgery is out. Especially at 6'5''. I don't think they set the table for the intern's height.

But you know. I've gotten through the worst of the banal sections. And it's alright. Tons of work that never let's up. But I finally made it to the other side of the mental canyon. And am happy with the decision to stick it out. Depsite the struggles on and off the court. With injuries and relationship stresses and everything else.

It's worth it. For me.

 

[optopia]

It all boils down to: do you like medicine enough to go into if we remove the financial incentive? Can you imagine yourself learning the patho well enough to be able to diagnosis your patient? There is a hell of alot of information to learn and it would be ashame you have to be miserable in the end.

I'm not sure. And that's mainly because I don't yet have experience in a clinical environment. But if we removed the financial incentive, I'm not sure we'd see nearly as many med school applicants. Money is a big factor because of the time and energy and opportunity costs involved. If I could wave a wand and become a doctor tomorrow, then sure, I'd be *less* concerned over income and costs.

 

[yankswin2011]

But if we removed the financial incentive, I'm not sure we'd see nearly as many med school applicants. Money is a big factor because of the time and energy and opportunity costs involved.

Of course. It's the same argument people make for "Why go to college?" right? To get a better training, get a better job (i.e. higher paying job), etc. But if you're independently wealthy, then the financial incentive don't apply to you.

 

[EdLongshanks]

That is an interesting point of view. You really think that the prior knowledge makes the students so much better at the courses you take? General opinion online seems to be that everything you need to know to both excel in the classes and the Step exams is taught in the courses, as long as the pre-reqs were successfully completed. I know you are early in your med-school career, but do you really think the prior knowledge is that vital?

Look this is only 3 weeks in, at a online course. But let me explain what this course is like - I suspect that this is typical.

The information is incredibly well organized. The professors don't come to class unprepared, they don't come with one set of documents for one chapter and a different type of documents for the next. If the first chapter was Lecture Handout + Lecture Powerpoint, they won't show up in the next chapter with just a powerpoint and a badly typed up set of notes that some student made for them three years ago.

The organization is necessary, because the amount of information is incredible. In the last 7 days we did an anatomical overview of the nervous system. Memorize the divisions of the spinial nerves and the plexuses along with the target organs, the dermatomes, the reflexes. Memorize the cranial nerves and their modes along with the names of the sypathetic and parasympathetic ganglia. memorize the cranial foramen exits of each nerve. Memorize the origin in the brain of each nerve.

If you had anatomy or histology in undergrad then you know what a cranial nerve is - or the divisions of the spinal nerves - or what a foramen or dermatome or ganglia is - or even where the cerebellum is. I did not. So in addition to memorizing the facts (I created and memorized 250 flash cards this week) I had to learn the simple 8th grade anatomy of the brain and spine.

Your top of the class fellow students either already know these things or are so interested in it that they soak up the information like sponges. I'm interested, but my fellow students are both interested and have a head start. Just being average is a challenge.

So you are not going to rise to the top in medical school based upon your brilliance while being neither interested nor previously educated. In order to be the creme-de-la-creme you need at least 3 of the 4: Brilliance, drive, interest, and previous knowledge. You have fellow students who have all 4.

 

[tao13]

no longer available

 

[yankswin2011]

The challenge of being a non-traditional applicant is that you have to tougher story to sell with respect to why you want to, all of a sudden, become a doctor. For those going straight from college, they don't have to be as "authentic." As a pre-med undergrad, my other pre-med friends kept bragging about how they're going to make all this money, date hot chicks, drive fancy cars, etc., everything that does not have to do with medicine, and yet they all got into medical school based on their strong stats and the basic BS story about how they always wanted to become a doctor. So in a roundabout way, if you can convince the ADCOMMS as a non-traditional applicant, you have done an extraordinary job. Good luck.

At the end of the day, a good, smart doctor is a good, smart doctor (results is what I look for) -- whether that doctor is truly passionate about it -- well, a lot of people are in professions that they are not too psyched about but everyone needs to make a living. That's their personal choice -- so long as their "disinterest" in medicine does not cloud their ability to be an effective doctor -- that's what I look for in a doctor. You may have "passion" one day and not 10 years from now, but if you're smart, effective doctor, you are like a smart, effective doctor 10 years from now. People don't become "dumb" all of a sudden.

Bottom-line: I rather have a smart, effective (albeit not as passionate) doctor over a passionate but very incompetent one. And yes, just because you graduated medical school does not mean you're "competent" --- I have seen some suspect people slip through the cracks, as in any profession.

 

[Nasrudin]

The challenge of being a non-traditional applicant is that you have to tougher story to sell with respect to why you want to, all of a sudden, become a doctor. For those going straight from college, they don't have to be as "authentic." As a pre-med undergrad, my other pre-med friends kept bragging about how they're going to make all this money, date hot chicks, drive fancy cars, etc., everything that does not have to do with medicine, and yet they all got into medical school based on their strong stats and the basic BS story about how they always wanted to become a doctor. So in a roundabout way, if you can convince the ADCOMMS as a non-traditional applicant, you have done an extraordinary job. Good luck.

At the end of the day, a good, smart doctor is a good, smart doctor (results is what I look for) -- whether that doctor is truly passionate about it -- well, a lot of people are in professions that they are not too psyched about but everyone needs to make a living. That's their personal choice -- so long as their "disinterest" in medicine does not cloud their ability to be an effective doctor -- that's what I look for in a doctor. You may have "passion" one day and not 10 years from now, but if you're smart, effective doctor, you are like a smart, effective doctor 10 years from now. People don't become "dumb" all of a sudden.

Bottom-line: I rather have a smart, effective (albeit not as passionate) doctor over a passionate but very incompetent one. And yes, just because you graduated medical school does not mean you're "competent" --- I have seen some suspect people slip through the cracks, as in any profession.

hmmm. I suppose. But for me. My authenticity for whatever I saw and wanted out of life only got easier and more direct as I got and continue to get older. I felt no pressure to sell anyone anything but simply explained my actual choices that lead to medicine. I mean an 18 year old has to be convincing. If I'm convinced I just tell them about it. I don't see how that is harder as you get older--more confident and comfortable in your own skin.

Secondly. I've heard this sort of thing about preferring talent over passion or something along those lines. Trouble with that is. Who's that freakin guy. Totally passionate but incompetent. I've never seen that guy. And I've been scribbling notes to myself about this game from a variety of angles for some years.

I've seen some callous pricks. Maybe they were talented. How does one know? Is Tom Cruise a talentd race car driver? Or a Samurai? I imagine relative talent in a physician might be measured accurately by .001% or less of the population and only slightly more than that if enromous outcome data was available to a talented analyst.

I've found that much of what is considered a good physician can be the same criteria as....today is a lovely day wouldn't you agree sir? I've worked with physicians who I knew for a fact went the extra mile off the clock and against the grain of HMO management to get the job done right every time and sometimes people woould complain about the service they got. And of course some would give praise.

There's a lot of showbiz to that part of it.

And being treated well by a passionate person who loves they're job is always nice. So I tend to go with that. And whether or not they treat people well around them. And just trust that everyone who becomes board certified is competent.

I might dig harder if I or a loved one was getting a surgery done. And presuming I had the financial options to do so.

And so with regards to the OP. If a career in patient care doesn't make satisfying intuitive sense to you. As an inseparable part of your identity. Then you're not cut out for medicine. Or even the study of medicine--for without some kind of flickering passion for--would be a death march.

 

[Nasrudin]

deleted

 

[DrArete]

I read these comments, as I struggle with my own decision the past few days, and I have come to no conclusions.
Part of me wants to get out now. Part of me thinks most jobs have a suck factor, with the training phase being the worst, and that if I stick with it, it will eventually get better.

 

[tkim]

At the end of the day, I'm not sure what else to do. Only that medicine has been a fascination of mine for several months now to the point that it's distracting me from life.

A medical career is your escape fantasy from a job you've grown to dislike. Poor excuse to go into medicine.

 

[Law2Doc]

OP, I have to agree with a lot of the others. Your post reads like the statements of the countless folks who are miserable in medicine. The short answer is that if you have to weigh the pros and cons, it's probably not the right career for you. You need to do it only if it's going to be interesting and fun for you such that you are prepared to embrace it, warts and all. You aren't. There are a few things you like about medicine, but it's not an overwhelming drive. Based on your post, I would say you would have a better life in another field.

 

[NSOLOGIST]

A medical career is your escape fantasy from a job you've grown to dislike. Poor excuse to go into medicine.

I know it's been five years, but THIS sums it all up.

 

[TallPreMed]

Mother of god I didn't realize this original post was from 5 years ago. What a freaking necrothreadmancer.