Is becoming a doctor a good career choice?

futuredocmaybe said:

Hello everyone, I'll get straight to the point. I am current Accounting major in a private university in NYC where I am in my last year of my undergraduate studies. For the past year or so, after I completed my internship at a big 4 public accounting firm, I have come to really dislike corporate america. I dislike the office politics involved in this career, for where the game is if you want to move up you really have to go around kissing someone's you know what in order to do so, and if you don't, then you really have to work hard to maintain yourself at your current professional level and maybe get the opportunity to get promoted while someone else less qualified does. I was really not prepared for this because in school if work hard you are rewarded with a decent grade, and in the corporate environment is really all about who you know. On top of that, I really dislike having to work 60+ hours a week during busy season, or during an approaching deadline any other time of the year. I don't mind working long hours if the job is meaningful, but Accounting is really not. I am tied up to a cubicle all day if I am lucky, other than that I will be in a conference room with everyone else from the team who are on that particular project. Let me not even get started into the weird conversations that goes on. I chose Accounting because it was the fastest way for me to get out there and start making some money, and because it was a relatively stable job with a lot of job openings. However, given the current economic crisis, the last two reasons are gone, and I don't really see myself doing this career for the long-run because of the reasons I mentioned.

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Unfortunately, my friend, this is true in any profession, so if this is why you are jumping from accounting to medicine (or any other career,) you will likely be disappointed.

Chalk this one up to one of life's lessons that they don't (cant?) teach you in school, and when you finally accept it, think about what you really want to do (maybe it was accounting all along?) and do it.

Best of luck to you.

futuredocmaybe said:

I just think there is a lot less of that to a certain degree in the medical field than in corporate america.

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Absolutely untrue. Medicine is corporate America. Frequently worse.

If you seriously want to think about a medical career, you should start volunteering in a hospital or clinic, and you should start seeking out the old guys who are disgusted with the way things have changed, and you should be willing to let them talk you out of it. An elderly, angry male ob/gyn is the best source of painful truth you're going to find.

futuredocmaybe said:

so thats the way things are going?? that is very good to know. Just out of curiousity though, what made you choose medicine DrMidlife?

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I knew from my 15 years as an engineer that (a) my work had completely stopped mattering to me; (b) I was quite capable of making very difficult, technically complicated, quick decisions that required convincing of a skeptical audience, and was happiest doing so; and that (c) the only thing I could change about my career satisfaction, really, was the fundamental goal to which my efforts contributed. Medicine had an appeal, initially, because I'd been in the OR at the birth of my niece and envied the responsibility of those physicians, and I'd been exposed to the work of Paul Farmer, whose career I consider the highest standard to which I could compare my own (but to which I don't realistically hope to be compared). I am unencumbered by debt or debility or family obligations, so I have plenty of rope with which to hang myself. I've spent the last 4 years preparing for med school, looking for reasons to be talked out of it, finding that I had to make unexpected compromises, taking advantage of any and all opportunities to be in a clinical setting, reading NYT, WSJ, blogs and books about health care every single day. And now I'm six months into a year of cancer treatment, which has thoroughly solidified my ambition. I know about all the reasons I should want to walk away, and I have no desire to do so.

In a nutshell.

DrMidlife said:

I knew from my 15 years as an engineer that (a) my work had completely stopped mattering to me; (b) I was quite capable of making very difficult, technically complicated, quick decisions that required convincing of a skeptical audience, and was happiest doing so; and that (c) the only thing I could change about my career satisfaction, really, was the fundamental goal to which my efforts contributed. Medicine had an appeal, initially, because I'd been in the OR at the birth of my niece and envied the responsibility of those physicians, and I'd been exposed to the work of Paul Farmer, whose career I consider the highest standard to which I could compare my own (but to which I don't realistically hope to be compared). I am unencumbered by debt or debility or family obligations, so I have plenty of rope with which to hang myself. I've spent the last 4 years preparing for med school, looking for reasons to be talked out of it, finding that I had to make unexpected compromises, taking advantage of any and all opportunities to be in a clinical setting, reading NYT, WSJ, blogs and books about health care every single day. And now I'm six months into a year of cancer treatment, which has thoroughly solidified my ambition. I know about all the reasons I should want to walk away, and I have no desire to do so.

In a nutshell.

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Gosh, I just kind of want to make out with your brain today. You're amazing.

I'm going to agree that medicine is totally corporate, and you will see the same crap you saw in the office in any department - and sometimes it's mindbogglingly bad. You're ahead of the game in that you've already gathered some skills in dealing with it.

Nanon said:

Gosh, I just kind of want to make out with your brain today. You're amazing.

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Aww shucks. Can you tell I'm supposed to be studying for an exam right now? My kitchen has never been cleaner and I'm compelled to write one manifesto after another.

DrMidlife said:

Aww shucks. Can you tell I'm supposed to be studying for an exam right now? My kitchen has never been cleaner and I'm compelled to write one manifesto after another.

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Ya, I kinda wondered, but I wasn't going to say anything... Now, if we could only find someone for you to actually make out with, you'd be set!

It depends on how much you can tolerate accounting. For you to pursue medicine will require probably at least two more years of schoolwork and even after that you still may not get in. The Big 4 is a great opportunity. Personally, since you've done an internship, I think you should go for the full-time offer and get your CPA. It's an excellent fallback in case you don't get into med school.

Public accounting is really annoying but you won't have to stay forever. It's a grind and it consumes all your time (especially busy season) but med school and residency will be just as draining, if not more (you don't sit on your arse all day in residency) but at least you get paid throughout your time there instead of going into debt for more school.

Financially, sticking around to the experienced senior and manager level will open up exit ops that are as lucrative if not more, than low end medicine (primary care) and surviving to the senior manager or making partner will get you the same earning potential as most specialists. But remember: only the stubborn and mediocre stick around all the way to partner!

But ultimately, it's your choice. Career-wise, the Big 4 opens a lot of doors, especially any of the firms in New York. Unless you really hate accounting, you should just play the game, suck up to your senior/manager/partner and climb the ladder until you get that cushy in-house offer you can't refuse.

Source: My friend after 6 years in public has been hired by a small company as a controller, making into six-digits and is being groomed by the CFO, a baby boomer, to take over after he retires. He hated PWC but loves where it has gotten him. Public accounting is like a residency, slog through that crap for the training and experience and lateral yourself into a more interesting and lucrative position in industry or something.

Obviously there are plenty of pros and cons associated with both accounting and medicine, and I can't help with those, but have you thought about trying to find an internship with a very small accounting firm. Maybe the different feel would be encouraging. I think in many small offices, there's less politics and less ass kissing that goes on. Just my 2 cents.

futuredocmaybe said:

After much research, I have come to think that medicine would be more of a fit for many reasons in which I would post some other time. Currently I am 27 years old, which is not old but I am definitely not a traditional student, and I'll be getting married soon, and I have no kids. I would need to get my science pre-requisites completed which would be 2-3 more years of schooling, and that would make 29-30 when I get into med school, and then 4 more years which would make me about 34 years old when I graduate. I am not counting residency because at least I would get paid for that, and I know is not much but it will be enough to support myself somewhat. I have a 3.8 GPA, and I think I can improve that somewhat before I finish my degree. I wanted to know if becoming a doctor is worth it with all those extra years in school, plus the huge debt, plus the opportunity costs associated with not working. I would like to hear from people who have been in similar situations, or anyone who can give any insightful advice. All comments will be greatly appreciated.

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Alright, I'd just like to chime in here and you can take my comment for what it's worth. I'm 29 and will be just next to 30 when I start med school in the fall. So, I'm pretty much where you could be in 2 years or so. Just getting into medical school has proven to be stressful at times. I am married and have been for over 7 years without any kids. It cost me near 1000 dollars just to apply and I wasn't even sure I would get in.

Personally, I wouldn't worry about the cost though. Loans are always available and with proper budgeting (I'm sure as an accountant you will have no problem with that ) are easily able to be payed off. I also wouldn't worry about your age either. 34 really isn't that old. Another SDN'er was just talking about seeing an intern at 60 the other day.

What I would suggest doing is shadowing. That way you can see if this is something you really have a passion for. If it turns out you do have a strong desire then go for it.

I guess my point is, medicine is something you really have to want/be able to sacrifice for from day one (1000 bucks is a lot of money to me currently). And even though I haven't been through med school, internship, and residency I honestly couldn't picture myself doing anything else at this point in my life. Good luck with your decision.

Josh

Working as a private accountant is very different than working as a public accountant. It is much more interesting. Stick around in public for at least three years and you will have a significant boost to your career. Run the gauntlet, you'll have to do the same for a medical career.

If you've landed a full time job, don't give it up. Do you really want to spend an additional 2 years of your life and go further into debt, all for a chance at medicine in the wake of one of the worst recessions in our nation's history? Make sure you are aware of the risks. Shadow doctors and ask yourself if you are willing to risk it all for the opportunity to do what they do.

I agree mostly with some of the other posts in that if you are even the slightest bit interested in medicine you should shadow (a few different specialties if possible) and more important than that volunteer esp. a low/no income clinic usually you will be able to do a little more and see if medicine is of interest to you.

(Some) Sick people smell, can be mean, violent, rude or hate to take advice/medical opinions seriously. Of course, some will look at you with such gratitude/trust in their eyes or you help make a change in someone's life that adds years to their life or gives them a better quality of life. Obviously, it has it positives and negatives, as any job.

I imagine that rural medicine is not as much of a corporate america vibe; however, this comes with trade-offs that you may or may not be willing to make. Even with a corporate vibe medicine may be where your heart lies. Take the TIME to figure this out through all the advice you get on here.

Last, I don't think anyone should stay in a job where they dread getting out of bed each day. No matter the cost, hard work, ect. you never know when your time is up and it would be terrible to think back and feel like you wasted an opportunity. Temper this with the fact that all jobs are hard and I never advocate quick decisions. If your internship leads to a job in accounting then give it a few months while looking into volunteering and then re-evaluate all this then. Good Luck!

beckhunter116 said:

I agree mostly with some of the other posts in that if you are even the slightest bit interested in medicine you should shadow (a few different specialties if possible) and more important than that volunteer esp. a low/no income clinic usually you will be able to do a little more and see if medicine is of interest to you.

(Some) Sick people smell, can be mean, violent, rude or hate to take advice/medical opinions seriously. Of course, some will look at you with such gratitude/trust in their eyes or you help make a change in someone's life that adds years to their life or gives them a better quality of life. Obviously, it has it positives and negatives, as any job.

I imagine that rural medicine is not as much of a corporate america vibe; however, this comes with trade-offs that you may or may not be willing to make. Even with a corporate vibe medicine may be where your heart lies. Take the TIME to figure this out through all the advice you get on here.

Last, I don't think anyone should stay in a job where they dread getting out of bed each day. No matter the cost, hard work, ect. you never know when your time is up and it would be terrible to think back and feel like you wasted an opportunity. Temper this with the fact that all jobs are hard and I never advocate quick decisions. If your internship leads to a job in accounting then give it a few months while looking into volunteering and then re-evaluate all this then. Good Luck!

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all medicine is becoming corporate....it does not matter if it is rural or not. you have to deal with insurance companies no matter where you are...not to mention wal mart and cvs targeting these areas for money making clinics....keep in mind you could get on the power side and get into healthcare policy or healthcare finance with your accounting background

I was at a similar state a couple years ago - with me it was engineering.

I tried it out for a couple years, and though I found out I hated the work - the experience was invaluable. I started out thinking, "How hard can it be? 40 hours a week to make a decent wage, and then do what I want in my spare time."

Now I realize how excruciating it is to do something for 40 hours that you don't love. If I had gone straight into something like medicine, in the back of my mind I'd always be wondering if a cushy engineering job would've been comfortable. Finding out that it was a dead end is actually really helpful, helps me to be 100% committed.

So by all means go try accounting. Perhaps you find out you enjoy it, or can tolerate it. Perhaps you absolutely hate it - then you'll be that much more motivated for whatever the next step is. Either way you're moving forwards.

DrMidlife said:

Aww shucks. Can you tell I'm supposed to be studying for an exam right now? My kitchen has never been cleaner and I'm compelled to write one manifesto after another.

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DrMidlife, you are my hero! Anytime you write another manifesto, let me know. My kitchen will never be dirtier as I read it. Hope your treatment is going well.

Referring to that other thread on this board: you, my friend, ARE one of those who can make a career writing books.

Newmanium said:

I was at a similar state a couple years ago - with me it was engineering.

I tried it out for a couple years, and though I found out I hated the work - the experience was invaluable. I started out thinking, "How hard can it be? 40 hours a week to make a decent wage, and then do what I want in my spare time."

Now I realize how excruciating it is to do something for 40 hours that you don't love. If I had gone straight into something like medicine, in the back of my mind I'd always be wondering if a cushy engineering job would've been comfortable. Finding out that it was a dead end is actually really helpful, helps me to be 100% committed.

So by all means go try accounting. Perhaps you find out you enjoy it, or can tolerate it. Perhaps you absolutely hate it - then you'll be that much more motivated for whatever the next step is. Either way you're moving forwards.

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Hello Newman...

That is exactly where I am right now. I am approaching 2 years in engineering and feel the exact same way you do right now. I am starting to volunteer to get some clinic exp and going to shadow some physicans too. Then I will evaluate on whether I want to return to school to finish my pre-reqs.

It's good to know there are many others like us here contemplating the switch between corporate america and medicine.

There are going to be office politics in any profession you enter regardless of if you work in an office, clinic, or not even in an office, and they'll affect you in some way no matter where you are on the totem pole.

Here's what I think: if you are smart, determined, hard-working and resourceful, there are a lot of easier ways to make a decent living than medicine, especially if you are entrepreneurial. The other, easier ways, also typically do not have as long a training period or barriers to entry, i.e. a limited amount of seats at medical schools, then if you manage to get accepted somewhere, 4 years of med school plus a minimum of 3 years of residency, often longer.

Other people have said this, and I'd have to agree that if you can see yourself happy doing something else, you owe it to yourself to do that something else. In my opinion, medicine isn't a field you go into with reservations, you have to pursue it whole-heartedly because you want to. While it's natural I think to second-guess yourself, if you can't decide whether you want to pursue it in the first place, and you have that kind of doubt before laying any groundwork, that's pretty telling in many respects.

TecmoFootball said:

contemplating the switch between corporate america and medicine.

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Again, medicine is corporate America.

It's not just that medicine is corporate (they're right, it is), it's also that even in teeny little towns w/ your own practice, there are all the local politics and "stuff" like the gov't, the medical board...interested in telling you what to do and how to do it. A lot of people go into med school b/c they want to be the top of the food chain in health care. There just isn't a top of the food chain, b/c medicine is a hydra w/ a lot of heads, and MDs are the punier heads w/ not so sharp teeth compared to those like medicare.

And you still have all the silly intraoffice disagreements -like people griping about the way you organize your charts, or butting heads over admin decisions, and of course sometimes people just hate each others' guts. And you'll have pts come to you from other MDs you know, and you'll be irritated with the way that MD managed their care, and he'll be irritated that you disagree w/ his plans, but yet you'll be seated next to each other at some silly board meeting. And so it goes. People will spend hours of your life on meetings about consultants, electronic records, wringing more from insurance cos, etc etc.

On the other hand, there are lots of cool things to do too -like, you know, save people's lives and stuff.

Do it, if you don't care that there's so much BS involved. Otherwise, go be an accountant for a hospital : ) We need them!

Just like any other career, medicine isn't a particularly good or bad choice. It all really depends on what gets you up in the morning, what sorts of things bring you joy. If managing the heath care of patients really excites you, despite the headaches you may have to deal with along the way, such as insurance/billing, massive amounts of paper work, and other icky aspects of managed care, then medicine may be a good choice for you. There are some more unique aspects about medicine that other professions do not share. For example, there are lots of avenues for specialization in the field that you can choose from, to match your predilections and personality. There is also a lot of freedom within the profession/field that allow physicians do variable amounts of patient care along with research and teaching. Also, I think it's a real privilege to be in a service role that allows you to be your patient's primary health care advocate; it's a very special role.

I'm in a similar position as you, but about 3 years down the road. I'm 25 and spent 2.5 years in the big 4 before recently taking an in-house position with better hours (to potentially volunteer/shadow and apply to post-baccs). I assume you interned in audit and not tax, as you mentioned working in a conference room, which I did as well. I'll touch on a couple of discussion points from the thread and give you my opinion ...

1) Full-time audit will be worse than your internship. If you interned in the summer, then full-time, especially during busy season, will be much worse. If you were a busy season intern, your life as a full-time associate will still be worse, but at least you've seen some of busy season. In the recruiting process, this tends to get downplayed (for obvious reasons).

2) The work is NOT interesting. Speaking as someone with big 4 and in-house experience, accounting is in no way, shape, or form interesting to an intelligent, ambitious individual. This holds true at the controller and CFO levels as well. The money and respect get better, but it's still very mindless. If anything, the interpersonal contact (the only good part about being a big 4 auditor) declines when you move in-house. When you hear it described as "challenging," the "challenge" of accounting is similar to the "challenge" of staring at a wall for 10-12 hours, that is, not an intellectual challenge involving problem-solving and analysis, but the sheer will to fight through mindless tedium. The accounting stereotypes are there for a reason, and they hold very true in practice.

3) Getting your CPA before making a change might be a good idea. This is what kept me going. However, I'm starting to doubt this strategy. The four exams were much easier than many make them out to be, and there are a lot of accounting grads out there. If you were to use it as a backup plan, I'm not sure how much value it would have, given you'd also have to obtain the CPE credits to take it from inactive to active status. Since you're still in school, I'd think long and hard about sticking with accounting just until you receive your CPA, as you might end up staying longer than anticipated and regret it down the line.

4) Regarding the "corporate" mentality, office politics, and kissing ass, I did not see this too much in the big 4. Until the partner level, promotions are heavily based on billing hours and years of service, not office politics. Quality of work also did not appear to play much of a role. The guy with an average work product that bills 60 hours a week will get a higher rating than the guy with an amazing work product that bills 40 product, just because of the clients he staffed on. As you progress toward partner level, you have more control over this and office politics can become an issue, but that is at least 6-8 years out. Two years to senior, 3 more to manager, etc. is how it works.

In-house, on the other hand, is thick with office politics, kissing ass, etc. I don't see how anyone can say medicine is remotely as bad in this sense, that's absolutely absurd. Sure, there is the social component of "corporate" office politics in any line of work, medicine included, but medicine is notoriously meritocratic for a reason. Unless you're involved with administration of a hospital, to say office politics in medicine are as bad as they are in corporate America is a gross overstatement.

I hope that was somewhat helpful, and keep in mind these are just my opinions after working in big 4 and in-house for a few years. My basis for a comparison to medicine is based only on speaking with family members who are physicians.

As far as what to do now, I assume you have a full-time offer at the big 4 you worked at following your internship? Definitely hang on to that offer as a backup, but in the meantime take advantage for your last couple semesters of school.

Transitioning into medicine as a non-trad becomes significantly more difficult after you start working in another field (which is my situation now). As an accounting major in school I never spent more than ~25 hours/week on school, so use your free time to explore medicine. Volunteer, shadow, and take a pre-med class or two to make sure you can handle it (these will be much more difficult than your accounting/business curriculum). Maybe add on an extra semester to fit in Chem 1 and Bio 1.

Doing that should allow you to decide whether or not medicine is for you. If it isn't, take that big 4 job and starting thinking about what else you want to do.

2) The work is NOT interesting. Speaking as someone with big 4 and in-house experience, accounting is in no way, shape, or form interesting to an intelligent, ambitious individual. This holds true at the controller and CFO levels as well. The money and respect get better, but it's still very mindless. If anything, the interpersonal contact (the only good part about being a big 4 auditor) declines when you move in-house. When you hear it described as "challenging," the "challenge" of accounting is similar to the "challenge" of staring at a wall for 10-12 hours, that is, not an intellectual challenge involving problem-solving and analysis, but the sheer will to fight through mindless tedium. The accounting stereotypes are there for a reason, and they hold very true in practice.

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Wow, I love how you put that into words. I'm a CPA working in industry and I'm starting a formal postbacc in June. Futuredocmaybe- this is a decision only you can make. I took two years seriously contemplating it before I applied to my postbacc program. Like everyone else said, just do your research and try to make the decision based on what will make you happy in the long run.

Just a though, what about trying to take a couple pre reqs while working in your new job?? Not sure if they will pay for it or not. If it is abig enough firm, they might not pick up on what classes you are taking, especially if it is physics or the like. you could always say it is getting you ready for your MBA or soething??

You might have a lot of hours at work, though you may be able to fit it in. May seem like a lot, but it might be doable. This way you would not lose any time if you do deicde to go the medical route......easier to keepo in school mode then get back into it five years from now, especially after acquirig a mortgage and kids (how did that happen??)

Shadowing, obviously, is a great idea as well.

Either way, it might take a long time to decide. I am 38 and will be entering school in the fall. I look at my last career as successful and accomplished. It just stopped being fun and my desire to help others won out.

I guess my nutshell (thanks midlife) is to say never stop learning and reevaluating and you will be fine.

best of luck to you..........

I just became a paramedic. I did rotations in a major NYC hospital. I couln't believe the politics between different types of doctors, attendings versus residents versus interns, MDs versus mid-levels versus RNs, RNs versus paramedic students, paramedics versus the ER RNS verus the floor RNs etc etc etc. Lots of politics yet it looks nothing like Grey's Anatomy. Need a good sense of humor to get through it.

I join the pool of responding engineers. I am a chemical engineer in corporate America. My main reason for looking into medicine was simply that I reflect on what I accomplishe during the day everyday I drive home. No matter how you slice it everything came back to how much money that I made the company that day either through process improvements or other means. I would rather take my problem solving skills and be able to go home thinking about all the people I helped that day (not some corporate entity). On my time off currently I can do some volunteer work. However, I liken it to being a supply convoy supplying the front line (like in Iraq). There are so many needy people in America that I want to be on the front line as a physician (not as the supply convoy) not to get paid but to help those that cannot pay. I am very blessed in that my husband is also a very sucessful engineer in management so finances will never be a concern. However, he also works very long hours and works many times on the weekends. He has often said that he would explore medicine but does not feel he can because of the need to support his family. My point in sharing this is if ever your children choose engineering please encourage them to take Biology and Organic. It is just two classes. That way if they get into an engineering career they can easily transition into medicine by merely taking the MCAT. My husband is a mechanical engineer and lacks those classes. There is NO WAY he could take them at night even if they were offered at our local college.

Here are some other thoughts on corporate America.
Physicians I would think don't get laid off by insurance companies. Just recently our company "laid off" or forced to retire 44 director level to vice president level employees due to business conditions. Personally I think that really stinks to dedicate your life to a company merely to be kicked out the door when they don't need you.

When you get to retirement age, physicians can go part-time and make a nice retirement living. Engineers at least at our company cannot. It is 5 days a week 50-60 hours per week (with no overtime) until you retire cold turkey.

As an engineer you get paid what you get paid. There are no overtime options at our company. You are expected to do what it takes to get the job done. On a shutdown my husband worked 19 days STRAIGHT 13 hour days and didn't get a dime extra. At least as a physician those that are gun ho about money can explore locum tenens or other work to boost their income.

As a female physician who has a family it is common at least where I live to be able to work part-time. Our own pediatrician works 2 days per week and openly says she makes more than her husband who works 5 days per week. For those that don't want a 5 day work week, it seems like there are a lot of options that will put a decent amount of food on the table.

Personally I think there are a lot of perks about being a physician compared to the corporate America that I am exposed to in my own little world. I definitely believe that money should not be the reason to purse that career. The path is long and brutal.

I will never forget a TLC show that I saw profiling an OB/GYN and his father also an OB/GYN. It was so cool because they worked together one day per week. His Dad was 70+ years old. It showed the young doctor's wife and two young sons. You were completely drawn into the show thinking wow what a blessed family (father and son sharing their passon for medicine). Then at the end it said that the show was dedicated to the young doctor and his family. The young doctor was killed before the show aired because he had stopped to help a family in a car wreck. An oncoming car hit the physician and killed him instantly. That physician gave his life to help someone else. I want to have a love for helping people that strong- to potentially put myself in harms way to help someone else. The military does it everyday just so we can enjoy freedom.

My interview is Feb. 4. Wish me luck!

DrMidlife said:

I knew from my 15 years as an engineer that (a) my work had completely stopped mattering to me; (b) I was quite capable of making very difficult, technically complicated, quick decisions that required convincing of a skeptical audience, and was happiest doing so; and that (c) the only thing I could change about my career satisfaction, really, was the fundamental goal to which my efforts contributed. Medicine had an appeal, initially, because I'd been in the OR at the birth of my niece and envied the responsibility of those physicians, and I'd been exposed to the work of Paul Farmer, whose career I consider the highest standard to which I could compare my own (but to which I don't realistically hope to be compared). I am unencumbered by debt or debility or family obligations, so I have plenty of rope with which to hang myself. I've spent the last 4 years preparing for med school, looking for reasons to be talked out of it, finding that I had to make unexpected compromises, taking advantage of any and all opportunities to be in a clinical setting, reading NYT, WSJ, blogs and books about health care every single day. And now I'm six months into a year of cancer treatment, which has thoroughly solidified my ambition. I know about all the reasons I should want to walk away, and I have no desire to do so.

In a nutshell.

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Wow, if you can say that as eloquently in an interview as you did in your post you will have no problem getting into med school. It sounds like you have given your decision an immense amount of thoughful consideration, and I see what was missing in the response I gave when asked the same question in my interviews. Eventually I must have gotten it right, because I'm in med school now. Good luck, you sound like you would be a great colleague to work with.

skubdubdu said:

Wow, if you can say that as eloquently in an interview as you did in your post you will have no problem getting into med school. It sounds like you have given your decision an immense amount of thoughful consideration, and I see what was missing in the response I gave when asked the same question in my interviews. Eventually I must have gotten it right, because I'm in med school now. Good luck, you sound like you would be a great colleague to work with.

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I agree with this.

I also agree w/the comments above about medicine having just as much "office politics" as a lot of other fields, like the business world. However, in medicine, just an in accounting, there are places where the office politics and ass-kissing is worse, and places where it is better. Perhaps you just interned in a department that was particularly bad...or a firm that is particularly bad in this regard.

DrMidlife said:

Absolutely untrue. Medicine is corporate America. Frequently worse.

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LOL. no.

Studebug said:

As a female physician who has a family it is common at least where I live to be able to work part-time. Our own pediatrician works 2 days per week and openly says she makes more than her husband who works 5 days per week. For those that don't want a 5 day work week, it seems like there are a lot of options that will put a decent amount of food on the table.

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Wow. Maybe it's just my idealism speaking, but that really bugs me. I understand the need for flexibility especially when raising a family, but working only 2 days a week is a bit...much. It seems selfish to take up a spot in medical school and plan to work only 2 days a week, especially in the face of a national shortage of primary-care doctors...

I think, frankly the comparison between corporate america and healthcare is weak. It's not that it isn't meshed with corporate interests, but that there is a relationship at the square root of all the politics which when refined enough will be pure and unassailable.

Whereas in the corporate world that relationship is profits for investors whether your pedaling rubber dog **** or chinese plastics or portable missle launchers. In healthcare it is an individual who is being cared for. A person. Not a pie chart.

If I got to be low guy on a totem pole, I'll take the totem pole with a meaning and a purpose that I can dig. I wouldn't make it one day in B school let alone the Corporate world, but give me a wound kit and an infection and I'm cool for 20 minutes of satisfaction.

It's fraught with an atmosphere of BS and politics. But you can also get your satisfaction in bits and pieces. How anyone gets excited when Monsanto increases it's profit margin by a tenth of a point in a quarter is beyond my comprehension.

fizzle said:

Wow. Maybe it's just my idealism speaking, but that really bugs me. I understand the need for flexibility especially when raising a family, but working only 2 days a week is a bit...much. It seems selfish to take up a spot in medical school and plan to work only 2 days a week, especially in the face of a national shortage of primary-care doctors...

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Please just understand that everyone has there own personal situation. I merely said the flexibility exists which it does. Yes, our pediatrician is relatively fresh out of residency. What you didn't know is that she has a special needs child. She had no plans to work 2 days per week when she started medical school. She wasn't even married. But now that she has very small children and one with special needs, part-time is an option she needed to exercised. She is very young and has many years to practice medicine. There will be a time and a season in her life to contribute to the medical field at a higher level. Given what she has to juggle, now is not the time. I am thankful that she works with a practice of physicians that is willing to support her.

It is not just females. My OBGYN office had two MALE doctors that worked 2 days per week. If your comment was in reference to me, I never said that was my plan and it isn't. My mothering days will long be passed if I get the chance to graduate from medical school because my children are much older.

Nasrudin said:

I think, frankly the comparison between corporate america and healthcare is weak. It's not that it isn't meshed with corporate interests, but that there is a relationship at the square root of all the politics which when refined enough will be pure and unassailable.

Whereas in the corporate world that relationship is profits for investors whether your pedaling rubber dog **** or chinese plastics or portable missle launchers. In healthcare it is an individual who is being cared for. A person. Not a pie chart.

If I got to be low guy on a totem pole, I'll take the totem pole with a meaning and a purpose that I can dig. I wouldn't make it one day in B school let alone the Corporate world, but give me a wound kit and an infection and I'm cool for 20 minutes of satisfaction.

It's fraught with an atmosphere of BS and politics. But you can also get your satisfaction in bits and pieces. How anyone gets excited when Monsanto increases it's profit margin by a tenth of a point in a quarter is beyond my comprehension.

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Try telling that to the PBMs, the large insurance companies, and the admins at your hospital.

Studebug said:

Please just understand that everyone has there own personal situation. I merely said the flexibility exists which it does. Yes, our pediatrician is relatively fresh out of residency. What you didn't know is that she has a special needs child. She had no plans to work 2 days per week when she started medical school. She wasn't even married. But now that she has very small children and one with special needs, part-time is an option she needed to exercised. She is very young and has many years to practice medicine. There will be a time and a season in her life to contribute to the medical field at a higher level. Given what she has to juggle, now is not the time. I am thankful that she works with a practice of physicians that is willing to support her.

It is not just females. My OBGYN office had two MALE doctors that worked 2 days per week. If your comment was in reference to me, I never said that was my plan and it isn't. My mothering days will long be passed if I get the chance to graduate from medical school because my children are much older.

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No, no, my comment was not in reference to you. I don't make it a point to attack fellow SDNers . I was referring to your pediatrician, which from your previous description almost sounds like she just went into medicine for even below-minimal hours and high pay (this was before I knew she was a new mother ).

Those of you who think that medicine is not a business and that you won't be treated like a cog in the corporate wheel during residency are in for a rude awakening. Make sure that medicine is not something that you run to thinking that you will get away from "office politics". You will not.

all you MD's who think you're enlightening the plebes with sagely common sense....oh never mind, for is that not the bulk of what transpires here.

And if its the same go make the easier pay check and shut up about it.

I can definitely related to this thread.

I graduated with an accounting / finance degree and currently work for PricewaterhouseCoopers (big 4) but on the long run, its not me. I also did as an easy way out path but after long debate with myself whether to stay or not, I decided to go to med school.

Just make sure you know this is what you want to do, there is no backing out. You have to be in it in the long haul...good luck.

njbmd said:

Volunteering isn't going to give you much experience in the medical field. Sure, you will get some observations and if your program is good, you will get a chance to ask some questions of attending physicians who are practicing but don't kid yourself into thinking that you can make a comparision between the corporate world and the practice of medicine by volunteering as a patient contact. Still, some experience is better than none at all.

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Agree with mjb. As a volunteer and even a med student, you'll be shielded from much of what is corporate and business-oriented in medicine. It still sounds like a great volunteer program, though you won't be able to generalize your experience there and think it applies to the entire medical field.

futuredocmaybe said:

I agree, but it is true that some experience is better than none at all. I think it should be enough to base my decision on, and if I like it, I will even consider Physician Assistant school as a quicker route. The point is liking it better than what I am doing soon, Accounting, for I really hate it, and I cant see myself doing that for a long time. I spoke to a friend of mine that works in a big 4, and she told me that she has been getting out at 11pm-12am every day this week. It is busy season now, and that is going to continue through out April or March basically every day. Seriously, that is too much, and let me mention she does not get paid overtime, so thats insane. It is things like these that I am going to be observing in the volunteer program as well, not just the work itself.

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I feel ya'
If you are sure you are going to hate accounting, I don't recommend you staying with a career there. Just don't jump out before having a good exit plan, and don't jump to medicine unless you are reasonably sure medicine is the right exit strategy.

p.s. I would have loved to get to go home at 11pm or 12am a lot of the time when I was a med student and resident. Residency on call shifts were commonly 30 hrs+ so you may have to stay there all day, stay there all night then stay the next day until noon or 1p.m. This may change/decrease with the changing hospital and med school regulations in the next few years, though.

Titus Pullo said:

I'm in a similar position as you, but about 3 years down the road. I'm 25 and spent 2.5 years in the big 4 before recently taking an in-house position with better hours (to potentially volunteer/shadow and apply to post-baccs). I assume you interned in audit and not tax, as you mentioned working in a conference room, which I did as well. I'll touch on a couple of discussion points from the thread and give you my opinion ...

1) Full-time audit will be worse than your internship. If you interned in the summer, then full-time, especially during busy season, will be much worse. If you were a busy season intern, your life as a full-time associate will still be worse, but at least you've seen some of busy season. In the recruiting process, this tends to get downplayed (for obvious reasons).

2) The work is NOT interesting. Speaking as someone with big 4 and in-house experience, accounting is in no way, shape, or form interesting to an intelligent, ambitious individual. This holds true at the controller and CFO levels as well. The money and respect get better, but it's still very mindless. If anything, the interpersonal contact (the only good part about being a big 4 auditor) declines when you move in-house. When you hear it described as "challenging," the "challenge" of accounting is similar to the "challenge" of staring at a wall for 10-12 hours, that is, not an intellectual challenge involving problem-solving and analysis, but the sheer will to fight through mindless tedium. The accounting stereotypes are there for a reason, and they hold very true in practice.

3) Getting your CPA before making a change might be a good idea. This is what kept me going. However, I'm starting to doubt this strategy. The four exams were much easier than many make them out to be, and there are a lot of accounting grads out there. If you were to use it as a backup plan, I'm not sure how much value it would have, given you'd also have to obtain the CPE credits to take it from inactive to active status. Since you're still in school, I'd think long and hard about sticking with accounting just until you receive your CPA, as you might end up staying longer than anticipated and regret it down the line.

4) Regarding the "corporate" mentality, office politics, and kissing ass, I did not see this too much in the big 4. Until the partner level, promotions are heavily based on billing hours and years of service, not office politics. Quality of work also did not appear to play much of a role. The guy with an average work product that bills 60 hours a week will get a higher rating than the guy with an amazing work product that bills 40 product, just because of the clients he staffed on. As you progress toward partner level, you have more control over this and office politics can become an issue, but that is at least 6-8 years out. Two years to senior, 3 more to manager, etc. is how it works.

In-house, on the other hand, is thick with office politics, kissing ass, etc. I don't see how anyone can say medicine is remotely as bad in this sense, that's absolutely absurd. Sure, there is the social component of "corporate" office politics in any line of work, medicine included, but medicine is notoriously meritocratic for a reason. Unless you're involved with administration of a hospital, to say office politics in medicine are as bad as they are in corporate America is a gross overstatement.

I hope that was somewhat helpful, and keep in mind these are just my opinions after working in big 4 and in-house for a few years. My basis for a comparison to medicine is based only on speaking with family members who are physicians.

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This post is so accurate of public accounting, I had to register and respond to it. Maybe it'll help others decide on their fork in the road career choices. Here goes.

I can relate to this post 100%. I recently left my firm as a senior in one of the big 4 audit practices. Reflecting back on my decision to study accounting and make it a career, I realized it was all for the wrong reasons. It was just dollar signs in my eyes once the firms recruit you with free dinners and hints that at the partner level, you will make bank. But I firmly believe in the saying, its the journey not the destination:

"The road of life twists and turns and no two directions are ever the same. Yet our lessons come from the journey, not the destination."
Don Williams, Jr. (American Novelist and Poet, b.1968)

"Focus on the journey, not the destination. Joy is found not in finishing an activity but in doing it."

Greg Anderson (American best-selling Author and founder of the American Wellness Project., b.1964)

For me, the journey was 40 hours a week during summer months and 60 to 80 hours a week in January, February and at the end of every quarter (April, July and October). It just wasn't worth it. My biggest complaint about the profession is not just the hours, the inability to take vacation during certain months of the year or the office politics (minimal in NYC but I saw it was much more prevalent in smaller cities) but it was the work itself. At the end of the day, we are ensuring compliance with a set of rules that changes frequently, does not adhere to any logic and is prone to political forces.

Now I'm thinking about medicine because I'm interested in science, I'm one of the most empathetic people out of my friends and I don't care that much about money as long as I can live a middle class life. Also, I want my work to have some kind of meaningful purpose and outcome.