hi onco, congrats. having read your mdapp profile, i suspect i might have met you as well. out of curiosity, what brought you to medicine at this point in your life? you seem pretty successful by any set of standards.
I'm not sure if this is the right thread to answer that question ... but maybe a brief diversion is OK.
There are many reasons why I made the switch. I'm religious, and a big part of me going into medicine at age 38 of it is a kind of "calling"; I'm not sure if you can relate to that. I could talk about that offline if you wish.
In secular / philosophical terms: in my professional career, I learned to look for the niche where I can serve for the most benefit. This modus operandi helped me in engineering and business and is moving me into a new area now. In a nutshell, while I was in the business world, I dealt first-hand with paying for health insurance and employees trying to work their way through healthcare. I knew there was plenty of room for improvement in healthcare and I know myself well enough now to know how and where I can make a difference. My wife is a pharmacist, so I have some insight into what goes on in healthcare from her perspective as well.
In the 80s, I was the oil & petrochemical industry, 1990s until now, I was mostly in electronics, semiconductors, and pharmaceuticals. Engineering and technology (my former career) is currently doing very well globally from a technical (problems solved) and business standpoint (profits are up and costs to customers are down) and if I were to remain in these fields, I feel like I would be in a sustaining role. Sure, I could take it easy and have fun with all the cool systems and products and people for the rest of my life and coast along, but that's just not me -- I need challenges to keep me going. It's how I'm wired up inside.
Engineers are cranking out new gadgets, products, services faster than we as a society can handle. Nobody complains about not having enough stuff, technology (the ranks of the "technology underserved" are shrinking every year). As a benchmark, computer performance doubles every year and cost goes down as well. Yes, gasoline prices are going up, but that's because it's in the financial best interest of certain powerful people who have global influence on governments. Since I'm not a politician there is really nothing I can do about the price of gasoline or the complexities of managing armies in the Middle East, for example.
So ... where to serve? In business, I saw that every year that my company's health insurance cost went up and our coverage was being reduced as well. Cost of healthcare to our society is going up every year and many people argue that the quality of healthcare is not improving sufficiently (perhaps even getting worse). I saw this as an opportunity to contribute. As an engineer and businessman, I learned how to decrease cost and improve quality. I also love people and see hundreds of potential cost and quality improvements small to large that I could personally implement in my own practice if I was a doctor (starting with electronic health records -- if you want to know what engineering was like in the stone age, visit a doctor's office or hospital and look at all the nice mountains of paper files that are impossible to manage well). Such improvements wouldn't be for bragging rights or personal enrichment ... they actually make life better for many people.
Volunteer and research opportunities helped validate for me that healthcare is where I want to be. Once the number of healthcare patients treated effectively in the world doubles every year, accuracy of diagnosis and efficacy of treatments consistently increases, and the cost of health care goes down every year (yes, it looks like it might take a while to reach this point ... not in my lifetime?), maybe I'll move on to the next pressing need where I can serve with the abilities I have (to the public educational system perhaps?). I'm not naive about the challenges of working in healthcare, but there are many opportunities to make a difference in a lot of lives, and I will enjoy that.