madglee

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Hi all,

I've read through a lot of these threads and thought I'd ask my question here. A brief summary:

At 27 I decided to change careers from web development/design and teaching. I got a BS in nursing, worked for a year, got a MS in nursing, completed my NP in psychiatry. Now I've been working for two years and am 36.

The problem is, I am continually frustrated in my attempts to practice, and also paid significantly less than psychiatrists who are doing the same job. I may have miscalculated.

The idea to go to med school is a constant idea in my mind, but it's hard for me to swallow that that would mean that I just spent the last 9 years of my life and 150k getting a degree I'm ready to throw by the wayside. Also, I'm 36, so if I need a year of organic chemistry and then apply I may not start until 38 or so, which means I'll be in my mid to late 40s when I finish residency, and have an additional 150k in debt.

Is this a worthwhile thing to do? The huge debt as well as the possibility NPs scope will continue to broaden in the coming years makes me wonder, as well as the possible decrease in MD/DO salaries. Even more worrisome is that I could be spending that time practicing as an NP and doing other things with my "young" years, like traveling, etc.

I realize this is a huge decision, but I'd like some input from med students, docs, whoever. One thing I don't want to do is make a decision like that, then be another 9 years down the road and think I made another bad decision.

Thanks.
 

Mindscrew

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I guess the hard question is to ask what difference you will recieve in your personal life. If you are already seeing the patients that you plan to serve in the future, what additional satisfaction will you get?

You can complete your pre reqs while working so you have a bit of time. Also you'll need to study for the MCAT. How are your prior grades?

From a financial point of view, you will have to give up at least 6 yrs of income to do this plus take on the 150k of debt. So even if you're making 100k a year, you're looking at a total cost of 750k. I gave up a six figure salary 2 years ago to follow my dream and it will cost me a lot of money by the time I'm done with school. I would have made more staying where I was, but I would have remained unsatisfied.
 
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madglee

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I guess the hard question is to ask what difference you will recieve in your personal life. If you are already seeing the patients that you plan to serve in the future, what additional satisfaction will you get?

You can complete your pre reqs while working so you have a bit of time. Also you'll need to study for the MCAT. How are your prior grades?

From a financial point of view, you will have to give up at least 6 yrs of income to do this plus take on the 150k of debt. So even if you're making 100k a year, you're looking at a total cost of 750k. I gave up a six figure salary 2 years ago to follow my dream and it will cost me a lot of money by the time I'm done with school. I would have made more staying where I was, but I would have remained unsatisfied.
That's a good question. To be honest, I suppose I would get more respect and more importantly, be able to do whatever I want without physician interference. Currently I can only do that in about 12 states, most of which I wouldn't want to live in. Obviously, as a physician, I could prescribe all schedules in all states and be more autonomous.

My grades are pretty good. Both my Bachelor's were magna cum laude around 3.8 and my master's I graduated highest honors with a 3.9. I didn't think about it like that - 750k but I suppose you're right, I lose out on the yearly income. Plus my loans continue to accumulate and I can't aggressively pay them like I am now.

Currently I make around 150k if I bust my butt and run around, as NP salaries aren't very good.
 
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If you're set into psyhiatry, the salary difference plus loans may take 20 years to even out - eg by the time you retire (remember it's eight years of lower income - residency as well).

So basically money wise it's a wash. Of course if the non monatary reasons are strong enough and you want to deal with the headaches of applying - go for it.

It's about being happy with yourself at the end of the day. You have the grades for it. Keep working and take the pre reqs and mcat. If your motivation falters when you have to start learning reactions - it'll won't cost you too much to stop.
 
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madglee

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If you're set into psyhiatry, the salary difference plus loans may take 20 years to even out - eg by the time you retire (remember it's eight years of lower income - residency as well).

So basically money wise it's a wash. Of course if the non monatary reasons are strong enough and you want to deal with the headaches of applying - go for it.

It's about being happy with yourself at the end of the day. You have the grades for it. Keep working and take the pre reqs and mcat. If your motivation falters when you have to start learning reactions - it'll won't cost you too much to stop.
I hear you. I suppose to make it monetarily worth it, something like radiology or dermatology would be the way to go. Unfortunately that seems terribly boring to me. Maybe I'll have to suck it up and beat my ego down with a stick.

Thanks for the advice guys.
 

Pons Asinorum

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Is this a worthwhile thing to do?
Is it worthwhile? Sounds like it could be for you with your frustration at your current scope of practice. But that isn't the question you're digging at. You want to know if it makes financial sense. No, it absolutely does not make good financial sense whatsoever for a 36-yr old NP to go back to school to pursue an MD regardless of specialty. Anyone who thinks that they can make the numbers work, post them and I'll refute. If you want to be a doctor because it will give you non-monetary satisfaction (i.e. worthwhile) that will compensate, then by all means sign up for that orgo class. Otherwise, if you want to put in the kind of hours you would as a med student/intern/resident/attending (aka 60-80 hour weeks), most on here would be shocked what an APN can pull down (there's a reason PCP's are pissed about how much they get paid.)
 

badb100d

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Just wanted to point out some logistics issues that you should consider. This has come up in other nursing to medicine threads so you may already be aware of what I'm going to say, if so I apologize for being repetitive. You may need to take more of the pre-med science courses if the gen chem, gen bio, and physics classes you have taken before were geared toward allied health students rather than science majors or pre-meds. A good gauge is whether or not your classes were filled with pre-meds or other nursing students. Definitely look into that as having to do more of the pre-med sequence will certainly lengthen your time line. I second the advice given to you on the rest of this thread. Good luck to you!
 

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I would definetly discourage the move. I changed careers and went to med school at 36. I left a great career that paid around 100K with great benefits and great hours. The path to becoming a physician not only is lengthy but hard to stomach for a mature adult. You are controlled like a puppet and treated like a young naive kid again. The debt is incredible and as a midlevel you have more flexibility and less responsibility. I would not do it again without any doubt.
 

Doctor Bagel

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Currently I make around 150k if I bust my butt and run around, as NP salaries aren't very good.
I'm not seeing where that's not a good salary. The average psychiatrist salary is somewhere around $160k last I looked, and most pcps make somewhere around $150k. As mentioned above, don't go into medicine expecting to make a lot more than that, especially if you want to stay in psych.
 

katiemaude

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I don't get the sense that the OP cares about having "Dr." in front of his/her name but cares instead about autonomy.

Only you can decide if it's worth it to sacrifice for another 8 years. It is a lonnnngggg hard road, and I am only just finishing the premed stage. I didn't have the lucrative, stable career that I had to wave goodbye to so I could go back to school. I thought about becoming a PA but I am 33 now and I don't have a husband or kids to think about; knowing I might have the same issues with scope of practice, I decided if I was going to want to go to medical school eventually, I might as well do it now. That said, if I were already an NP, I think I'd make it work. $150K+ and a stable job doing what you enjoy is nothing to sneeze at. You'd be giving up a lot to go to medical school. Your job is only going to increase in responsibility, from what experts predict... so you have something to look forward to. I don't see anyone predicting MD/DOs will earn more in the coming years and gain more autonomy (which they already have).
 

sassilysweet

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That's a good question. To be honest, I suppose I would get more respect and more importantly, be able to do whatever I want without physician interference. Currently I can only do that in about 12 states, most of which I wouldn't want to live in. Obviously, as a physician, I could prescribe all schedules in all states and be more autonomous.
Who do you want more respect from? If it is coworkers, maybe you need to work in a different office or clinical setting as opposed to changing roles. If it is patients, I am going to say the majority don't know the difference between an MD and an NP as it is.

Are you experiencing what you consider "interference" now? What sort of interference? Again, maybe you just need to move to a different group if the current one is not working out. On the other hand, maybe some of your decisions do need oversight. I'm not calling you incompetent, but there is a disparity in training of both roles particularly with regards to clinical time (i.e.weeks vs. years of residency).
 
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madglee

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Why are you complaining? I know a lot of psychiatrists in the Bay Area making around 160-180k. That's not a huge difference in salaries, and the cost of medical school means you might end up losing money over time.

Try moving to one of the 12 states that lets you act autonomous (I think California is one of them), and if all you want is to be called "Doctor" then do one of those part-time Psy.D. programs.
Thanks for all the helpful advice guys, that really clinches it for me. I didn't communicate well. I'd be really happy with 150k salary. NP salaries are typically like 75-100k max a year. I was saying that to make the 150k I have to run around, doing locum tenens and covering for docs on the side, rather than being able to settle nicely into a job with a 150k-200k salary. To my knowledge, unless an NP is in a private outpatient clinic and billing, they aren't going to be making that as a salary.

That was my point. Ha! You guys must have wondered what I was complaining about. Luckily I'm not married/no kids so I'm free to run about the nation.
 
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madglee

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Who do you want more respect from? If it is coworkers, maybe you need to work in a different office or clinical setting as opposed to changing roles. If it is patients, I am going to say the majority don't know the difference between an MD and an NP as it is.

Are you experiencing what you consider "interference" now? What sort of interference? Again, maybe you just need to move to a different group if the current one is not working out. On the other hand, maybe some of your decisions do need oversight. I'm not calling you incompetent, but there is a disparity in training of both roles particularly with regards to clinical time (i.e.weeks vs. years of residency).
I'm not sure - everyone who asks me things like, "Why didn't you just go to medical school?" As far as interference, I mean having docs come and change orders I've written, having to sign off on my stuff, things like that. Even in states where I'm autonomous, there are hospital by-laws, evidently run by the "old guard" to ensure this. I did just find out, though, that the medical director who is changing orders is doing it to other MDs who have practiced for 25 years, so it may in fact be location.
 

Pons Asinorum

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...rather than being able to settle nicely into a job with a 150k-200k salary.
I think that you need to do a little more investigation if you think it's as easy as "settl[ing] nicely into a job with a 150k-200k salary." I'm sure most physicians at that level of income, even psychiatrists, would say that they are earning every penny of it the old-fashioned way.
 

BestDoctorEver

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Hi all,

I've read through a lot of these threads and thought I'd ask my question here. A brief summary:

At 27 I decided to change careers from web development/design and teaching. I got a BS in nursing, worked for a year, got a MS in nursing, completed my NP in psychiatry. Now I've been working for two years and am 36.

The problem is, I am continually frustrated in my attempts to practice, and also paid significantly less than psychiatrists who are doing the same job. I may have miscalculated.

The idea to go to med school is a constant idea in my mind, but it's hard for me to swallow that that would mean that I just spent the last 9 years of my life and 150k getting a degree I'm ready to throw by the wayside. Also, I'm 36, so if I need a year of organic chemistry and then apply I may not start until 38 or so, which means I'll be in my mid to late 40s when I finish residency, and have an additional 150k in debt.

Is this a worthwhile thing to do? The huge debt as well as the possibility NPs scope will continue to broaden in the coming years makes me wonder, as well as the possible decrease in MD/DO salaries. Even more worrisome is that I could be spending that time practicing as an NP and doing other things with my "young" years, like traveling, etc.

I realize this is a huge decision, but I'd like some input from med students, docs, whoever. One thing I don't want to do is make a decision like that, then be another 9 years down the road and think I made another bad decision.

Thanks.
I personally know a physician (IM) who was a NP and she started medical school when she was 54. If going back to medical school at the age of 38+ will make you happy, do it and never look back...That is my $0.02.
 

jl lin

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Is it worthwhile? Sounds like it could be for you with your frustration at your current scope of practice. But that isn't the question you're digging at. You want to know if it makes financial sense. No, it absolutely does not make good financial sense whatsoever for a 36-yr old NP to go back to school to pursue an MD regardless of specialty. Anyone who thinks that they can make the numbers work, post them and I'll refute. If you want to be a doctor because it will give you non-monetary satisfaction (i.e. worthwhile) that will compensate, then by all means sign up for that orgo class. Otherwise, if you want to put in the kind of hours you would as a med student/intern/resident/attending (aka 60-80 hour weeks), most on here would be shocked what an APN can pull down (there's a reason PCP's are pissed about how much they get paid.)

OP, I know that you are thinking and batting this around out loud, but I have to say that I agree with the comment from Pons in that it seems like something more powerful is lacking from within in terms of the motivation. Maybe you are really are OK with what you are already doing and are just having a bad week, month, year, whatever.

I'm a RN w/ strong experience in some crazy areas. Having worked in these areas and w/ many different residents, fellows, and attendings, I don't think there is anywhere near the glory that some pre-meds think there is in medicine. I do think a fair number may well become either shell-shocked or jaded. And even where there is some shining go on, it's kind of sickening, b/c if you have a soul, deep inside you know it's really about another human being and his/her tragic or troubling situation/s. As a nurse and NP you well know what I mean. And the money issue, I mean, it's serious from a pragmatic POV. But it's more than any of that that motivates me, even though I am certain there will be tons of stuff that totally sucks about it at every step along the way. So I guess to me it sounds like the core drive maybe isn't there for you. I admit I could be wrong. For me at least, I don't care if it is or isn't worth it w/ regard to praise and money, b/c in the end that's all an illusion. I simply know its what I want to do more than anything else, and if I don't try my best to do this, I will regret it for life. There's more to it for me, but I'm sure you get my point. Good luck with whatever you decide. :)
 
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chinocochino

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The debt is of secondary importance in considering applying to med school. Your opportunity cost as an NP is higher than that of, say, a college biology graduate.

Opportunity cost should be incorporated in your financial analysis of the viability of a medical education. Even more importantly, if you'd actually enjoy it.

Hi all,

I've read through a lot of these threads and thought I'd ask my question here. A brief summary:

At 27 I decided to change careers from web development/design and teaching. I got a BS in nursing, worked for a year, got a MS in nursing, completed my NP in psychiatry. Now I've been working for two years and am 36.

The problem is, I am continually frustrated in my attempts to practice, and also paid significantly less than psychiatrists who are doing the same job. I may have miscalculated.

The idea to go to med school is a constant idea in my mind, but it's hard for me to swallow that that would mean that I just spent the last 9 years of my life and 150k getting a degree I'm ready to throw by the wayside. Also, I'm 36, so if I need a year of organic chemistry and then apply I may not start until 38 or so, which means I'll be in my mid to late 40s when I finish residency, and have an additional 150k in debt.

Is this a worthwhile thing to do? The huge debt as well as the possibility NPs scope will continue to broaden in the coming years makes me wonder, as well as the possible decrease in MD/DO salaries. Even more worrisome is that I could be spending that time practicing as an NP and doing other things with my "young" years, like traveling, etc.

I realize this is a huge decision, but I'd like some input from med students, docs, whoever. One thing I don't want to do is make a decision like that, then be another 9 years down the road and think I made another bad decision.

Thanks.
 
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madglee

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I think that you need to do a little more investigation if you think it's as easy as "settl[ing] nicely into a job with a 150k-200k salary." I'm sure most physicians at that level of income, even psychiatrists, would say that they are earning every penny of it the old-fashioned way.
I take your statement to mean that I am nonchalantly, uninformed, throwing out statements, which I am not. I was referring directly to the gentleman who said he knew several psychiatrists in the bay area at that salary. I never disputed that it's hard work. I work very hard, too, and that includes the 60-80 hours a week. The dichotomy was the set salary versus the hustling, although that goes along with psychiatry more so than other specialties.
 
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madglee

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OP, I know that you are thinking and batting this around out loud, but I have to say that I agree with the comment from Pons in that it seems like something more powerful is lacking from within in terms of the motivation. Maybe you are really are OK with what you are already doing and are just having a bad week, month, year, whatever.

I'm a RN w/ strong experience in some crazy areas. Having worked in these areas and w/ many different residents, fellows, and attendings, I don't think there is anywhere near the glory that some pre-meds think there is in medicine. I do think a fair number may well become either shell-shocked or jaded. And even where there is some shining go on, it's kind of sickening, b/c if you have a soul, deep inside you know it's really about another human being and his/her tragic or troubling situation/s. As a nurse and NP you well know what I mean. And the money issue, I mean, it's serious from a pragmatic POV. But it's more than any of that that motivates me, even though I am certain there will be tons of stuff that totally sucks about it at every step along the way. So I guess to me it sounds like the core drive maybe isn't there for you. I admit I could be wrong. For me at least, I don't care if it is or isn't worth it w/ regard to praise and money, b/c in the end that's all an illusion. I simply know its what I want to do more than anything else, and if I don't try my best to do this, I will regret it for life. There's more to it for me, but I'm sure you get my point. Good luck with whatever you decide. :)
I appreciate your comments and agree with you. The core drive is not there - it takes a certain type of person to traverse that road and perhaps I don't need to do so to help others and be satisfied. Appreciate all your guys'/gals' great advice.

Why does everyone keep calling me "OP?"
 

jl lin

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I appreciate your comments and agree with you. The core drive is not there - it takes a certain type of person to traverse that road and perhaps I don't need to do so to help others and be satisfied. Appreciate all your guys'/gals' great advice.

Why does everyone keep calling me "OP?"
OP is original poster. :)