My Story - Advice Appreciated

[adviceappreciated]

I guess I am what you would consider a non-traditional student. I am 25 years old, and graduated with a Bachelor's in Mechanical Engineering in May of 2013. Since then (actually since March 2013, I started working at my current position part-time before graduation), I have been working in Research and Development for an industrial equipment manufacturer.

I decided to major in Mech. Engineering when I was 17, before I entered undergrad, for no good reason other than the fact that I got A's in high school physics, and enjoyed the subject a great deal, and considered Mech. E a logical extension of the rigid-body mechanics I enjoyed in high school physics. I really didn't put much thought at all into my choice of major.

About six months into my budding career as an R&D engineer, I was already considering a career change to Medicine. The work felt unbearably impersonal. I knew if I stayed that course I would spend the next 40 years in a cubicle hating 90% of my working hours. I wanted to work with people, to help people, as directly as possible, while maintaining my sanity and some semblance of work-life balance (which is the root of my current uncertainty). Both of my parents are PM&R physicians, as are three other members of my extended family, so medicine has always been on my mind as a possibility. What attracted me initially about medicine was the high job satisfaction they reported; they loved what they did, they loved seeing and helping patients, and found it very rewarding. I wanted that! I wanted (and still want) to come home at the end of every day knowing that I made a direct positive impact on someone's life. Moreover, I want to do so in a technical field - I have strong affinity for the sciences, enjoy academic learning, and want to use my scientific and technical knowledge towards the betterment of other's quality of life.

So, to initiate the process of entering Medicine, I started taking additional pre-reqs at the local community college at night after work, while keeping my day job in R&D. I took a year of Physics in undergrad, as well as quarters of Psychology and Sociology. I took a quarter of General Chemistry in undergrad, but without a lab component. My undergrad GPA was good but by no means stellar - 3.46. I struggled in my first year and a half (lowest quarterly GPa was ~2.8) but did pretty well my last few years (it was a 5 year program with a year of mandatory internship experience). So far at CC, I have taken General Chem I & II, Gen. Bio I & II, (over the 2014-2015 academic year) and Organic Chem I (this past fall), with Organic Chem II slated for this spring. I have received solid A's/4.0 GPA in all of those night courses. I am confident that I can continue that trend in Orgo II.

I am spending the intersemester period doing some shadowing at a major university hospital, seeing PM&R (which I loved) and OR/Anesthesiology (which I'm pretty sure I am not interested in as a career).

I've spent the last two years in night school with constant doubt about this career choice. Not because I'm not sure I want to be a doctor (I definitely do, if I could start tomorrow), but because of concerns about stress, work/life balance, and uncertainty about my future. A few things I know for sure:

- I want to work in a personally fulfilling technical career with a positive social impact.
- I want to be financially stable and secure. I don't need wealth, but I want to be comfortable. I know from personal experience that money cannot buy happiness.
- I don't want to spend my adult life drowning in debt. I am currently debt free, and while I understand I can't stay that way forever and enter medicine, the idea of taking out hundreds of thousands of dollars in loans scares the bejeezus out of me.
- While I can handle stress, I get stressed relatively easily and I don't like the idea of living under a high level of "steady-state" stress for the rest of my career.
- I want reasonable working hours. 50 hours a week is the high end of what I would put up with for the long term. I have worked 70+ hour weeks in the past, and can do it while succeeding, but not for the long term. A year maybe, a couple years max.
- I want to go to school, work, and live near a major metropolitan area, at least at this point in my life. Until I start a family (and maybe even not then) rural living is not for me. Been there, didn't like it.

Right now, the only other career option I am seriously considering is seeking a Master's in Biomedical Engineering with the aim of becoming either a researcher (probably seeking a PhD after the Master's) or an R&D engineer in the Medical Device or Biomechanics field, working in industry for a manufacturer or for a university. What attracts me about that option is the potential for overlap with my current R&D engineering experience, the ability to work on products that excite me and improve people's lives and well being, the somewhat reduced debt load, and what I perceive to be a better work-life balance versus medicine. I currently work 40.00 hours per week, and love that amount.

Which brings me to questions. These are mostly intended to be for current med students, interns/residents, and/or attending physicians.
1) How satisfied are you with your career choice? Would you change anything, given the opportunity?
2) How satisfied are you with the work/life balance afforded to you in your career in Medicine?
3) How many hours a week do you work on average?
4) What have you sacrificed to pursue a career in medicine?
5) What other careers did you consider before entering Medicine?
6) Would you recommend Medicine as a career choice to your own family members?
7) Do you have a good sense of job security in your current position?
8) What is/was your approximate debt load after Med School, and how long do you anticipate it will take to pay it off?
9) Are you currently living/working where you want to be, geographically, or did you settle for "where the jobs were"?
10) Did you enjoy medical school as an experience in an of itself, or did you see it merely as a means to an end?
11) Do you consider yourself highly stressed in your current position? Do you see that getting better or worse in the future (after graduation or residency, etc.)?

A heartfelt thanks to all who have stuck with me through this wall of text. Please feel free to answer none, some, or all of the above questions, and provide any advice you wish.

---

Members don't see this ad.

 

[thatwouldbeanarchy]

After reading this whole thing, I figure the least I can do is tag some docs/med students who might be able to offer some advice. @mimelim @Law2Doc @Ismet @DrMidlife

 

[Law2Doc]

I guess I am what you would consider a non-traditional student. I am 25 years old, and graduated with a Bachelor's in Mechanical Engineering in May of 2013. Since then (actually since March 2013, I started working at my current position part-time before graduation), I have been working in Research and Development for an industrial equipment manufacturer.

I decided to major in Mech. Engineering when I was 17, before I entered undergrad, for no good reason other than the fact that I got A's in high school physics, and enjoyed the subject a great deal, and considered Mech. E a logical extension of the rigid-body mechanics I enjoyed in high school physics. I really didn't put much thought at all into my choice of major.

About six months into my budding career as an R&D engineer, I was already considering a career change to Medicine. The work felt unbearably impersonal. I knew if I stayed that course I would spend the next 40 years in a cubicle hating 90% of my working hours. I wanted to work with people, to help people, as directly as possible, while maintaining my sanity and some semblance of work-life balance (which is the root of my current uncertainty). Both of my parents are PM&R physicians, as are three other members of my extended family, so medicine has always been on my mind as a possibility. What attracted me initially about medicine was the high job satisfaction they reported; they loved what they did, they loved seeing and helping patients, and found it very rewarding. I wanted that! I wanted (and still want) to come home at the end of every day knowing that I made a direct positive impact on someone's life. Moreover, I want to do so in a technical field - I have strong affinity for the sciences, enjoy academic learning, and want to use my scientific and technical knowledge towards the betterment of other's quality of life.

So, to initiate the process of entering Medicine, I started taking additional pre-reqs at the local community college at night after work, while keeping my day job in R&D. I took a year of Physics in undergrad, as well as quarters of Psychology and Sociology. I took a quarter of General Chemistry in undergrad, but without a lab component. My undergrad GPA was good but by no means stellar - 3.46. I struggled in my first year and a half (lowest quarterly GPa was ~2.8) but did pretty well my last few years (it was a 5 year program with a year of mandatory internship experience). So far at CC, I have taken General Chem I & II, Gen. Bio I & II, (over the 2014-2015 academic year) and Organic Chem I (this past fall), with Organic Chem II slated for this spring. I have received solid A's/4.0 GPA in all of those night courses. I am confident that I can continue that trend in Orgo II.

I am spending the intersemester period doing some shadowing at a major university hospital, seeing PM&R (which I loved) and OR/Anesthesiology (which I'm pretty sure I am not interested in as a career).

I've spent the last two years in night school with constant doubt about this career choice. Not because I'm not sure I want to be a doctor (I definitely do, if I could start tomorrow), but because of concerns about stress, work/life balance, and uncertainty about my future. A few things I know for sure:

- I want to work in a personally fulfilling technical career with a positive social impact.
- I want to be financially stable and secure. I don't need wealth, but I want to be comfortable. I know from personal experience that money cannot buy happiness.
- I don't want to spend my adult life drowning in debt. I am currently debt free, and while I understand I can't stay that way forever and enter medicine, the idea of taking out hundreds of thousands of dollars in loans scares the bejeezus out of me.
- While I can handle stress, I get stressed relatively easily and I don't like the idea of living under a high level of "steady-state" stress for the rest of my career.
- I want reasonable working hours. 50 hours a week is the high end of what I would put up with for the long term. I have worked 70+ hour weeks in the past, and can do it while succeeding, but not for the long term. A year maybe, a couple years max.
- I want to go to school, work, and live near a major metropolitan area, at least at this point in my life. Until I start a family (and maybe even not then) rural living is not for me. Been there, didn't like it.

Right now, the only other career option I am seriously considering is seeking a Master's in Biomedical Engineering with the aim of becoming either a researcher (probably seeking a PhD after the Master's) or an R&D engineer in the Medical Device or Biomechanics field, working in industry for a manufacturer or for a university. What attracts me about that option is the potential for overlap with my current R&D engineering experience, the ability to work on products that excite me and improve people's lives and well being, the somewhat reduced debt load, and what I perceive to be a better work-life balance versus medicine. I currently work 40.00 hours per week, and love that amount.

Which brings me to questions. These are mostly intended to be for current med students, interns/residents, and/or attending physicians.
1) How satisfied are you with your career choice? Would you change anything, given the opportunity?
2) How satisfied are you with the work/life balance afforded to you in your career in Medicine?
3) How many hours a week do you work on average?
4) What have you sacrificed to pursue a career in medicine?
5) What other careers did you consider before entering Medicine?
6) Would you recommend Medicine as a career choice to your own family members?
7) Do you have a good sense of job security in your current position?
8) What is/was your approximate debt load after Med School, and how long do you anticipate it will take to pay it off?
9) Are you currently living/working where you want to be, geographically, or did you settle for "where the jobs were"?
10) Did you enjoy medical school as an experience in an of itself, or did you see it merely as a means to an end?
11) Do you consider yourself highly stressed in your current position? Do you see that getting better or worse in the future (after graduation or residency, etc.)?

A heartfelt thanks to all who have stuck with me through this wall of text. Please feel free to answer none, some, or all of the above questions, and provide any advice you wish.

Very long post-- will likely limit the help you'll get. Having read that, I actually think medicine won't be a great career path -- most of your non-negotiables are deal breakers here. First, in medicine you won't go home every day thinking you made a positive impact on someone's life. That will happen sometimes but it's not realistic to put doctoring on a pedestal like that. Second, yes you will have constant stress in this career. Emotional stress is part of the deal when people's lives and wellbeing are in your hands. Third, you can't career change to medicine but say you don't want to work 50 hours a week or more. The average in a lot of/most fields is higher than that. Fourth, you will incur lots of student loans on this path unless your parents or the armed forces are paying. Fifth, you are going to have a more drastic work life balance and more trade offs than I think you are contemplating. Sixth, at the end you will not necessarilly control geography or other job parameters. Don't go into this saying I want to do X specialty in Y state. You may not get either.

For those reasons I think you'll need to be a lot more flexible or don't bother. You'll rack up lots of debt, work longer hours than you've stated, need to make many life trade offs, and have a great deal of stress-- unless that's all taken as a given I wouldn't bother.

 

[mimelim]

PGY4 Resident...

1) How satisfied are you with your career choice? Would you change anything, given the opportunity? Very satisfied. I would do every step almost exactly the same. I was a traditional applicant, but was married when I was 23 and my life outside of medicine has proceeded at warp speed.
2) How satisfied are you with the work/life balance afforded to you in your career in Medicine? I sleep 4-5 hours a day and it affords me more time to do other things, despite working 60-100 hour weeks. I rock climb 3-4 days a week. I run to the hospital every day. My wife and I share most of our hobbies and so we spend a lot of time together doing them. Otherwise we wouldn't have much time together. On the other hand, I do not have children or plan to, at least for several years. The resident above me who is graduating took a private job instead of the academic one she was offered because she has two young children and didn't think that you could 'have it all'.
3) How many hours a week do you work on average? When on research ~60. When on clinicals 80-100.
4) What have you sacrificed to pursue a career in medicine? I don't know how to really answer this question. There are only so many hours in a day. I enjoy law/politics, but I wouldn't say that I've sacrificed a career in them to do medicine.
5) What other careers did you consider before entering Medicine? If I didn't go to medical school, I would have gone to law school.
6) Would you recommend Medicine as a career choice to your own family members? I'm walking one of my brothers through the application process right now. I forced him to do a weekend call with me among other shadowing experiences to make sure that this is what he really wants to do. This is a highly individualized career. Not everyone will be happy in it, no different than most professional jobs. I would recommend to my younger self to do this, but I would not universally recommend being a physician to everyone.
7) Do you have a good sense of job security in your current position? Yes. I also have 3 years until I graduate and have several job offers both in the US and outside. That is also not counting McKinsey who came recruiting yet again just before the holidays.
8) What is/was your approximate debt load after Med School, and how long do you anticipate it will take to pay it off? Between my wife and I, several hundred thousand dollars. It will take 3 years after residency completes for me to pay it off. Either through public service forgiveness (I am heading into academics more than likely) or via simply paying it off on a private attending salary.
9) Are you currently living/working where you want to be, geographically, or did you settle for "where the jobs were"? I matched my #1 program, so I 'picked' where I am right now. In the last year, I have been offered jobs in CA, MO and China. I'm not worried about job prospects. But, I am also at a very strong residency program and have a lot to sell besides my clinical acumen.
10) Did you enjoy medical school as an experience in an of itself, or did you see it merely as a means to an end? I enjoyed medical school immensely. I didn't find it particularly difficult or onerous. It helps to go to a pass/fail pre-clinical school.
11) Do you consider yourself highly stressed in your current position? Do you see that getting better or worse in the future (after graduation or residency, etc.)? I think you would be an idiot to think that where I am isn't a 'high stress environment'. I covered the vascular service for New Years weekend (3 days). There was the emotional stress of having 2 patients die, one on the operating room table. Then there was the organizational/administrative stress of doing 7 cases with the 'holiday' team, ie. the random people stuck in the hospital trying to get things done while also managing 10 ICU patients and 30 floor patients. Then there was the physical stress of being in the hospital for 65 of the 72 hours I was on call for. I slept reasonably well every night, but I slept at the hospital.

This however is the most important: These are MY responses to your questions. I am very happy where I am. I run to the hospital at 5am every day and I am literally smiling when I show up. Every day. There is no question that I am an extreme example in many ways. But, by the same token, I think that you have to be at least a little like me in order for medicine to be the 'right' way to go. I think these are my generic points of advice:

#1 Medicine is stressful in many ways. There are many ways to go through medical school/residency and then design a practice that minimize those stresses, but those are the exception, not the rule. You are going to have paperwork. You are going to have bureaucracy. You are going to have non-compliant patients.

#2 You are going to professionally lose, a lot. I had a patient die 2 days ago, another one the day before. I sat at one of their bedside for several hours managing their care and then they died attempting heroic measures in the OR. They were very sick when I first met them and yes, they were not likely to do well regardless of what was done. But, that is hard for many to accept. Failure is a part of this job. Sometimes it is your fault or it is at least something you can do better on. The vast majority of the time, there is literally nothing you could do differently, and that is very difficult to handle for some.

#3 Training is long, hard and expensive.

Specific commentary...

- I want to work in a personally fulfilling technical career with a positive social impact. Personal fulfillment is about you, not the profession. Medicine like any other profession can be incredibly rewarding. Yes, medicine, no matter how cynical you are has a positive social impact.
- I want to be financially stable and secure. I don't need wealth, but I want to be comfortable. I know from personal experience that money cannot buy happiness. You will be financially stable and secure as a physician.
- I don't want to spend my adult life drowning in debt. I am currently debt free, and while I understand I can't stay that way forever and enter medicine, the idea of taking out hundreds of thousands of dollars in loans scares the bejeezus out of me. You will not be in debt forever. While there is a very small group of physicians that are incredibly poor money managers, even taking out max loans for medical school is certainly not insurmountable. You will never starve.
- While I can handle stress, I get stressed relatively easily and I don't like the idea of living under a high level of "steady-state" stress for the rest of my career. There are many avenues to decrease stress in any profession, medicine is not an exception.
- I want reasonable working hours. 50 hours a week is the high end of what I would put up with for the long term. I have worked 70+ hour weeks in the past, and can do it while succeeding, but not for the long term. A year maybe, a couple years max. This is what most people are like.
- I want to go to school, work, and live near a major metropolitan area, at least at this point in my life. Until I start a family (and maybe even not then) rural living is not for me. Been there, didn't like it. This depends entirely on your specialty and frankly, how good you are. Less competitive specialties generally pay less and are easier to find jobs in a particular location. Others, not so much.

 

[Gurby]

Failure is a part of this job. Sometimes it is your fault or it is at least something you can do better on. The vast majority of the time, there is literally nothing you could do differently, and that is very difficult to handle for some.

I think the former is scarier than the latter... As a paramedic, I tend to beat myself up over every little inefficiency in a call. I'm sure this only gets worse as a surgeon, where you have (I assume) much more room for error. Do you just get used to it? Or is your performance generally as close to perfect as can reasonably be expected after training 100 hours a week for 5 years?

If there is literally nothing that could have gone better or differently, it seems like that would be easier to deal with: "Well, we did everything we could, his prognosis was poor from the start, oh well sometimes these things happen" as opposed to "if only I had done X better, done Y instead of Z, maybe the outcome would have been different."

 

[mimelim]

I think the former is scarier than the latter... As a paramedic, I tend to beat myself up over every little inefficiency in a call. I'm sure this only gets worse as a surgeon, where you have (I assume) much more room for error. Do you just get used to it? Or is your performance generally as close to perfect as can reasonably be expected after training 100 hours a week for 5 years?

If there is literally nothing that could have gone better or differently, it seems like that would be easier to deal with: "Well, we did everything we could, his prognosis was poor from the start, oh well sometimes these things happen" as opposed to "if only I had done X better, done Y instead of Z, maybe the outcome would have been different."

You get used to living with the threat of hurting someone, but at least from talking to our surgeons, when it happens, it still eats at you crazy. Personally, I have faith that I'm doing everything that I can to minimize my risk of hurting (or not helping) someone. When something bad has happened, I usually replay it a bunch in my head and invariably come to the same conclusion: This could have (possibly) been avoided and should be at all costs in the future. I try not to beat myself up too much, but I also haven't had anything particularly egregious.

A few weeks ago, I closed after doing a fem-pop bypass and the patient developed a groin hematoma. Certainly not unheard of, but it weighs on you when you are the only one to blame. I was the senior most person in the OR for the last 30-45 minutes of the operation. I lay every single suture on every single layer. If someone was going to prevent (or not cause) that complication, it was going to be me, and I didn't. The reality is, these things do happen and you simply can't prevent every single one, no matter how good you are. That incision was bone dry when I closed it. If anything, I was more worried about the distal incision (but not really). I didn't really change anything that I do after that, but it definitely sticks with you, especially after you talk with patient's and their families and explain to them that you need to take them back to the OR.