Still Worthwhile to Pursue the Career of a Physician?

[SkipJunior]

I would like to ask this question on behalf of all pre-meds. I have recently heard some disturbing news that makes me question my decision to become a physician.

I love medicine. I, like most applicants, have spent hundreds of hours with patients and have shadowed physicians. The reason I started this thread though is because I've heard that the compensation and general lifestyle for physicians will go down gradually in the future. Is that true?

Before you answer, I request that you don't tailor your answer to my specific situation, which is quite unique and is not applicable to most pre-meds. Let this thread be a resource for all pre-meds applying to US MD and DO schools for the next several years, not just a resource for me.

Here are some questions:

1. Will the salary of physicians in general go down due to the rise in the number of physician extenders, poor economy, and the rise in the number of new MD and DO schools? My time frame is after 5-15 years.

2. Will loans remain at the same level or possibly go even higher i.e tuition levels?

3. Will lifestyle deteriorate? By that, I mean will the number of hours of work per week increase in the future?

4. Will the healthcare/hospital administration make life even worse for physicians? Will physicians be forced to go through unbearable amounts of paperwork and lose significant autonomy?

5. Will it be financially viable to open up a private practice in the future?

6. Is it still worthwhile to take huge amounts of loans (assume applicant pays private medical school tuition) now as an incoming M1 so that the applicant can be an attending physician in the next 8-11 years? By this, I mean will the finances and lifestyle deteriorate to such a point in the future that even people who are passionate about medicine will still hate their lifestyle as a physician and wish they hadn't become physicians?

Again, I request that this thread be a general information thread for pre-meds. If there are any points I've missed, please include them.

Also, I know salaries differ by specialty. I know certain specialties are saturated and others are not. I know there are huge variances in tuition costs for US medical schools. I ask for your best most widely applicable answer despite these hurdles.

Here is a link for pre-meds and anyone else who want to find out more about physicians who leave their medical training due to problems with the current healthcare system:

http://commonhealth.wbur.org/2013/10/why-i-left-medicine-a-burnt-out-doctors-decision-to-quit

Thank you everyone who decides to make a contribution to this thread. It will certainly help thousands of pre-meds chart their life. Please let's keep the thread civil and on point.

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[NontradCA]

Yes, yes, yes, yes, yes, maybe.

 

[SnakeOilForSale]

All of the skepticism and doubts you have are warranted. Really, anything could happen. That is why it's not advised to pursue medicine for money and only if you can't see yourself doing something else. But yes it scares the **** out of me as well, as I imagine the case is for most who are not independently wealthy.

 

[Lucca]

The viability of private practice will depend on your specialty, geographic location, and business sense. Physician owned groups/hospitals need to become the new trend - I think this need will be met, physicians are historically very entrepreneurial.

Tuition will go up and so will the total
student debt but medicine will still have a positive return of investment as long as you are at a US MD or DO school. Berkeley recently did a study and found medicine will only be a net loss if the cost is 1 million dollars for the whole degree. Financially, medicine will always be a sound and responsible decision but it should, of course, not be the only reason you go into the profession.

I disagree with the premise that the economy will worsen in the future. There are a number of military and political conflicts we have to resolve multilaterally in the near future and military spending will give the economy a temporary stimulus - enough for people to feel more confident with their spending.

Salary and autonomy is something that will depend on practice type and specialty but specialists will find themselves with lower salaries and bosses more often than they did in the past. No one knows this for sure or to the extent that it will happen. Anyone that says they know is a liar. All we know is that this is the current political rhetoric being thrown around in legislation.

 

[Make Or Break]

Skip, I dont think anyone will have definite answers. I am just hoping that you are not trying to sort of compensate this reasoning because of the situation you were in.

With that being said, there are a number of other opportunities out there if you end up not wanting to be a doctor but still have the MD.

 

[zaben]

The pay/lifestyle of everybody except a few investment bankers/ceos will be going down over the next few decades. I don't think it is declining any faster for doctors compared to the rest of the normal population.

 

[Make Or Break]

The pay/lifestyle of everybody except a few investment bankers/ceos will be going down over the next few decades. I don't think it is declining any faster for doctors compared to the rest of the normal population.

I have a feeling something is going to give sooner or later. The gap between the rich and the poor is becoming too big to sustain itself.

 

[SkipJunior]

All of the skepticism and doubts you have are warranted. Really, anything could happen. That is why it's not advised to pursue medicine for money and only if you can't see yourself doing something else. But yes it scares the **** out of me as well, as I imagine the case is for most who are not independently wealthy.

I agree. I don't pursue medicine for the money but when one has to take huge loans, one wonders if they can pay it off in a reasonable time period and still be able to buy a house, car, retirement savings, children's college fund etc. I unfortunately have to pay either private or OOS tuition. So jealous of texas residents!

 

[SkipJunior]

Skip, I dont think anyone will have definite answers. I am just hoping that you are not trying to sort of compensate this reasoning because of the situation you were in.

With that being said, there are a number of other opportunities out there if you end up not wanting to be a doctor but still have the MD.

I understand, I'm looking for opinions more than definite answers. I am after all, asking for predictions of the future.

Interesting you brought this up, would a consulting group like McKinsey or BCG hire you if you have a DO instead of a MD? Could you join right after med school or would you need to do a residency first?

 

[SkipJunior]

I have a feeling something is going to give sooner or later. The gap between the rich and the poor is becoming too big to sustain itself.

Countries like Brazil or India have a wider gap than we do and there hasn't been a big revolution in those countries yet. Countries like Greece and Spain have had a much greater economic collapse than the US and their citizens are still plodding on. Things are not as bad as they seem.

 

[Make Or Break]

I understand, I'm looking for opinions more than definite answers. I am after all, asking for predictions of the future.

Interesting you brought this up, would a consulting group like McKinsey or BCG hire you if you have a DO instead of a MD? Could you join right after med school or would you need to do a residency first?

I would think a residency would probably be beneficial for joining a consulting group since they see you have actual experience being a doctor and can consult on any problems they might be having.

 

[Make Or Break]

Countries like Brazil or India have a wider gap than we do and there hasn't been a big revolution in those countries yet. Countries like Greece and Spain have had a much greater economic collapse than the US and their citizens are still plodding on. Things are not as bad as they seem.

Point taken.

Though, I do not think lifestyle in India or Brazil is close to what ours is like in the states.

 

[deleted407021]

The viability of private practice will depend on your specialty, geographic location, and business sense. Physician owned groups/hospitals need to become the new trend - I think this need will be met, physicians are historically very entrepreneurial.

But not necessarily the best at representing themselves in the legislative process, as far as I've been able to gather. Improvements could be made there, as well.

 

[deleted407021]

@SkipJunior , I thought you already graduated from a Carib med school. Or am I mistaken?

 

[SkipJunior]

@SkipJunior , I thought you already graduated from a Carib med school. Or am I mistaken?

No you are correct. However, I didn't match 2 years in a row so I'm applying to US MD/DO schools. I don't want a discussion of my very unique situation to derail this thread so please PM me if you have questions about my specific situation.

 

[DermViser]

Skip, I dont think anyone will have definite answers. I am just hoping that you are not trying to sort of compensate this reasoning because of the situation you were in.

With that being said, there are a number of other opportunities out there if you end up not wanting to be a doctor but still have the MD.

Really, like what?

 

[Doctor Bob]

Interesting you brought this up, would a consulting group like McKinsey or BCG hire you if you have a DO instead of a MD? Could you join right after med school or would you need to do a residency first?

Unlikely. Although, only McKinsey or BCG could answer this.
It has nothing to do with DO vs MD. It has to do with marketability. A fresh-out-of-med-school person, or even fresh-out-of-residency person don't have much value to a consultant group. What they're selling to their clients is experience. Go to them after working for a few years and you'll be more useful.

That being said, I'm not the HR person for these consulting groups.

 

[DermViser]

I understand, I'm looking for opinions more than definite answers. I am after all, asking for predictions of the future.

Interesting you brought this up, would a consulting group like McKinsey or BCG hire you if you have a DO instead of a MD? Could you join right after med school or would you need to do a residency first?

McKinsey is more likely to hire MDs from top tier schools.

 

[QofQuimica]

IMO, medicine is not worth doing solely for the money, or even primarily for the money. Even at my attending salary, I do not feel like the money alone is enough to compensate me for the decade of delayed gratification, the stresses, and the aggravations of the job. And had I known ahead of time what intern year in particular was going to be like before I started, I would not have gone to medical school. That being said, hopefully you are not going into medicine solely (or even primarily) for the money. For people who feel something of a calling to go into medicine, that is the extra "compensation" that can make a career as a physician "worth it."

The best pieces of advice I can give to those of you are just starting out are the following:
1) If you would not characterize yourself as someone who has a streak of altruism, then medicine is not the right career for you. You may be smart and hard-working, but you will not be happy as a physician if you do not derive any pleasure from helping other people.
2) The unhappiest physicians I know are people whose earn-and-spend lifestyles trap them in their current job, working more hours than they want. No matter what you go into, but especially if you go into medicine, LIVE BENEATH YOUR MEANS. If you spend everything you earn, you will struggle to make ends meet even on a six figure salary. (I know it's hard for many college students to conceive of such a thing, but believe me, it happens shockingly often.) Similarly, if you do go to medical school, go to the cheapest American school you can get into, and minimize your loans as much as possible.

 

[DermViser]

Unlikely. Although, only McKinsey or BCG could answer this.
It has nothing to do with DO vs MD. It has to do with marketability. A fresh-out-of-med-school person, or even fresh-out-of-residency person don't have much value to a consultant group. What they're selling to their clients is experience. Go to them after working for a few years and you'll be more useful.

That being said, I'm not the HR person for these consulting groups.

Not true. They've hired Harvard MD grads who've chosen not to pursue residency.

 

[mimelim]

Unlikely. Although, only McKinsey or BCG could answer this.
It has nothing to do with DO vs MD. It has to do with marketability. A fresh-out-of-med-school person, or even fresh-out-of-residency person don't have much value to a consultant group. What they're selling to their clients is experience. Go to them after working for a few years and you'll be more useful.

That being said, I'm not the HR person for these consulting groups.

Not true. They've hired Harvard MD grads who've chosen not to pursue residency.

They recruit non-residency trained MDs for sure as DV points out. But, it is all about marketable skills. People with an MD (even from HMS) and nothing else are useless to a consulting firm.

 

[Psai]

medical school sucks
residency looks like it sucks
don't do it op

if you want to make money, be an administrator or get high up in an ancillary company related to medicine such as the people who make those ugly EMRs that are not user friendly
the real way to make money is by making terrible decisions that negatively affect the people you are leeching off of

 

[DermViser]

medical school sucks
residency looks like it sucks
don't do it op

if you want to make money, be an administrator or get high up in an ancillary company related to medicine
the real way to make money is by making terrible decisions that negatively affect the people you are leeching off of

http://www.kevinmd.com/blog/2012/04/medical-residents-abused-chinese-factory-workers.html

 

[QofQuimica]

http://www.kevinmd.com/blog/2012/04/medical-residents-abused-chinese-factory-workers.html

Yes, residency totally sucks. However, these comparisons of residency to slave labor make me

 

[LabMonster]

If you love medicine and have been shadowing physicians, you must realize that change in the US healthcare system is constant and larger change is imminent. I echo Q - this is not a job for people without an altruistic bone in their bodies...

This is a difficult job, one you would learn in medical school, crash-practice in residency then attempt to perfect as an attending physician.

The financial aspects of medicine are in flux, constantly. They will be for years to come. At some point, this country will learn that we cannot continue to give a small amount of our population the majority of our medical care without significant detriment to the general population health and financial stability. Do not make your decisions on a financial basis alone - it is multi-factorial. Make your decision to enter medicine on the desire to help people and navigate the best financial way for you to do so. If you think there is too much financial uncertainty; the decision is simple, choose another profession. There are too many unpredictable variables governing healthcare in the US right now. No one on SDN or in this country can make that prediction. This job decision is made by your personality and your gut.

"The future is uncertain and the end is always near." - Jim Morrison

 

[SkipJunior]

If you love medicine and have been shadowing physicians, you must realize that change in the US healthcare system is constant and larger change is imminent. I echo Q - this is not a job for people without an altruistic bone in their bodies...

This is a difficult job, one you would learn in medical school, crash-practice in residency then attempt to perfect as an attending physician.

The financial aspects of medicine are in flux, constantly. They will be for years to come. At some point, this country will learn that we cannot continue to give a small amount of our population the majority of our medical care without significant detriment to the general population health and financial stability. Do not make your decisions on a financial basis alone - it is multi-factorial. Make your decision to enter medicine on the desire to help people and navigate the best financial way for you to do so. If you think there is too much financial uncertainty; the decision is simple, choose another profession. There are too many unpredictable variables governing healthcare in the US right now. No one on SDN or in this country can make that prediction. This job decision is made by your personality and your gut.

"The future is uncertain and the end is always near." - Jim Morrison

Thank you. If say I take out a $400,000 loan (including interest) and I find out the US healthcare system has collapsed and I have no viable job, can I be forgived of my loans? Can I declare bankruptcy and start life anew?

I am a young chap and the prospect of burdening myself with such a huge loan frightens me to no end. What if I can't pay it off? What if the debt collecters come and beat me up because in the future, US doctors are only paid $50,000 per year and there's no way for me to pay off my huge loans?

 

[deleted407021]

Thank you. If say I take out a $400,000 loan (including interest) and I find out the US healthcare system has collapsed and I have no viable job, can I be forgived of my loans? Can I declare bankruptcy and start life anew?

I am a young chap and the prospect of burdening myself with such a huge loan frightens me to no end. What if I can't pay it off? What if the debt collecters come and beat me up because in the future, US doctors are only paid $50,000 per year and there's no way for me to pay off my huge loans?

**** hitting the fan scenarios aren't helpful to fixate on. Most people agree that doctors will pretty much always be secure financially and in their jobs. The concerns surround work environment and responsibility, etc. Additionally, it's unlikely that you would need a loan like that.

 

[DermViser]

Thank you. If say I take out a $400,000 loan (including interest) and I find out the US healthcare system has collapsed and I have no viable job, can I be forgived of my loans? Can I declare bankruptcy and start life anew?

No. Student debt is non-dischargeable even in bankruptcy. They are with you till the day you die or when you pay it completely off, whichever comes first.

 

[SkipJunior]

**** hitting the fan scenarios aren't helpful to fixate on. Most people agree that doctors will pretty much always be secure financially and in their jobs. The concerns surround work environment and responsibility, etc. Additionally, it's unlikely that you would need a loan like that.

If I'm fortunate enough to start medical school next year, I will be paying private and/or OOS tuition. Add to that living expenses, all those years of interest added on top of the loan and $400,000 is not such a unreasonable figure. Heck MSUCOM charges $80,000 for just tuition per year. If I go the MSUCOM route, my loan will be $500,000 after residency if you include interest.

This is why I'm concerned about the financial aspect. I do have a altruistic side and helping patients is a reward by itself but I need to be realistic and understand the financial side. I don't want a fancy sports car or a mansion like some of the surgeons and dermatologists of today have, I just want a comfortable financially secure lifestyle.

 

[deleted407021]

No. Student debt is non-dischargeable even in bankruptcy. They are with you till the day you die or when you pay it completely off, whichever comes first.

Or you are totally disabled, I think.

 

[DermViser]

Or you are totally disabled, I think.

Yeah, pretty much permanently disabled in which you can never hold any other job ever in your lifetime.

 

[SkipJunior]

Don't think it will be the same for everyone. Some people will have undergraduate loans. Some people will live cheaply by eating in, others will maintain a lifestyle throughout training. Some people won't pay a dime for their training.

There is a lot of inherent uncertainty but there is a lot you can figure out and do on your own. It won't help you to worry about those things that are out of your control.

People are always going to get sick and need someone to fix them up. In terms of paying back loans, doctors as a whole will always make six figures.

You could also try to invest on the side with rental homes. Basically, after you've lived in a home for a few years, just rent it out. Also putting whatever money you can into a roth ira asap will be very valuable down the road when it is untaxable at 60.

Basically, you will be financially secure if you do the right things. Eating in is pretty big in my opinion.

Thanks for the advice. I will make sure I eat in and live frugally throughout medical school, residency, and also several years after residency (until I've paid off my loans). Do you recommend that I pay off all my loans in the first 2-3 years after residency (live frugally and give $100,ooo+ every year towards loans) or should I just give the minimum 10% of income and enjoy life right after residency?

As for your rental home idea, that sounds really nice! So I should first start buying homes right? I guess I need to save up to buy the houses and then rent them out.

 

[DermViser]

Thanks for the advice. I will make sure I eat in and live frugally throughout medical school, residency, and also several years after residency (until I've paid off my loans). Do you recommend that I pay off all my loans in the first 2-3 years after residency (live frugally and give $100,ooo+ every year towards loans) or should I just give the minimum 10% of income and enjoy life right after residency?

As for your rental home idea, that sounds really nice! So I should first start buying homes right? I guess I need to save up to buy the houses and then rent them out.

Your questions here are probably better directed at residents and attendings, rather than premeds, esp. when it comes to student loan repayments in residency.

 

[Goro]

Skippy, the sky is not falling.

"Never take counsel of your fears"
Gen'l George S. Patton

Thank you. If say I take out a $400,000 loan (including interest) and I find out the US healthcare system has collapsed and I have no viable job, can I be forgived of my loans? Can I declare bankruptcy and start life anew?

I am a young chap and the prospect of burdening myself with such a huge loan frightens me to no end. What if I can't pay it off? What if the debt collecters come and beat me up because in the future, US doctors are only paid $50,000 per year and there's no way for me to pay off my huge loans?

 

[IgEdoc]

Medicine will always offer a secure six-figure job with certain degree of autonomy, at least between you and your patients. OP's article link was more on one obsessive-compulsive, paranoid physician than a healthcare system in trouble.

 

[SkipJunior]

Medicine will always offer a secure six-figure job with certain degree of autonomy, at least between you and your patients. OP's article link was more on one obsessive-compulsive, paranoid physician than a healthcare system in trouble.

It feels so good to read that.

 

[Mad Jack]

1. Will the salary of physicians in general go down due to the rise in the number of physician extenders, poor economy, and the rise in the number of new MD and DO schools? My time frame is after 5-15 years.

Salary will likely decline through health care salaries not keeping pace with inflation over the next decade and a half. I doubt there will be an absolute salary decrease that is all that great, but your effective purchasing power will likely be diminished.

2. Will loans remain at the same level or possibly go even higher i.e tuition levels?

They're going to keep going until they hit about 500k is what I'm betting. No proof behind it, but I just think that's the upper limit of what most will pay to enter medicine.

3. Will lifestyle deteriorate? By that, I mean will the number of hours of work per week increase in the future?

Work hours will probably stay pretty static. Some physicians might work longer hours to help deal with income loss, but there's no reason to believe that hours worked will increase for the majority of physicians in the near future. The whole reason we have midlevels being integrated into the system is to allow physicians to do more work in the same amount of time.

4. Will the healthcare/hospital administration make life even worse for physicians? Will physicians be forced to go through unbearable amounts of paperwork and lose significant autonomy?

Of course. Regulations always get added and never go away. Hospital administrators want control, something they are rapidly acquiring thanks to a generation of physicians that don't want to bother with the hassles of private practice. Government bureaucrats think they know better than the people actually practicing medicine in the trenches. This will only get worse and will never go away until there's some kind of societal/governmental collapse.

5. Will it be financially viable to open up a private practice in the future?

For most types of practice, no. Psychiatry, dermatology, and cosmetic practices will likely remain highly viable private practice opportunities, but overhead and the like will make it very difficult for most fields to engage in PP in the future.

6. Is it still worthwhile to take huge amounts of loans (assume applicant pays private medical school tuition) now as an incoming M1 so that the applicant can be an attending physician in the next 8-11 years? By this, I mean will the finances and lifestyle deteriorate to such a point in the future that even people who are passionate about medicine will still hate their lifestyle as a physician and wish they hadn't become physicians?

Only you can answer that for yourself given the information above and what you want out of life.

 

[sashka1]

no one knows what tomorrow will bring. it's all speculation anyway

 

[LabMonster]

Thanks for the advice. I will make sure I eat in and live frugally throughout medical school, residency, and also several years after residency (until I've paid off my loans). Do you recommend that I pay off all my loans in the first 2-3 years after residency (live frugally and give $100,ooo+ every year towards loans) or should I just give the minimum 10% of income and enjoy life right after residency?

As for your rental home idea, that sounds really nice! So I should first start buying homes right? I guess I need to save up to buy the houses and then rent them out.

Going into medicine requires some financial savvy - I say this because though I may have needed the money in medical school, I most certainly would have found ways to borrow less using my current retrospectoscope...

Be aware that most docs know very little about finances and if you are fresh out of college and have not had a career (financial responsibilities such as life insurance, thoughts of LTD insurance, dependents etc), you are likely in this category. It's not a bad thing, you've just been devoting your life to other things, and money management wasn't one of those things. There are good resources for docs - remmeber that to solve a problem, it must first be recognized. So if you want to do medicine because it's what you want to do - then great, just recognize many docs have a financial blindside.

Start here for some perspective: http://whitecoatinvestor.com/tag/financial-advisor/

 

[makingthejump]

IMO, medicine is not worth doing solely for the money, or even primarily for the money. Even at my attending salary, I do not feel like the money alone is enough to compensate me for the decade of delayed gratification, the stresses, and the aggravations of the job. And had I known ahead of time what intern year in particular was going to be like before I started, I would not have gone to medical school. That being said, hopefully you are not going into medicine solely (or even primarily) for the money. For people who feel something of a calling to go into medicine, that is the extra "compensation" that can make a career as a physician "worth it."

The best pieces of advice I can give to those of you are just starting out are the following:
1) If you would not characterize yourself as someone who has a streak of altruism, then medicine is not the right career for you. You may be smart and hard-working, but you will not be happy as a physician if you do not derive any pleasure from helping other people.
2) The unhappiest physicians I know are people whose earn-and-spend lifestyles trap them in their current job, working more hours than they want. No matter what you go into, but especially if you go into medicine, LIVE BENEATH YOUR MEANS. If you spend everything you earn, you will struggle to make ends meet even on a six figure salary. (I know it's hard for many college students to conceive of such a thing, but believe me, it happens shockingly often.) Similarly, if you do go to medical school, go to the cheapest American school you can get into, and minimize your loans as much as possible.

Wow, #1 and #2 may be the thing I have agreed with most on SDN. If you know how to live a normal lifestyle or below your means, the financial burden of medical school will be non-existent in the long run. In addition, if you genuinely derive satisfaction from giving back and helping others, this may be a good route. However, if you equate success with amount of money earned, then this will be a long and unsatisfying path.

 

[Mr.Happy]

wow, thanks again @SkipJunior for starting another excellent thread. I'm glad that these questions were answered.