Age at starting residency

[awhelkschance]

Am I too old? Does anyone have good examples of people who have been successful with this age start? Does anyone have good opinions from admissions? I am really looking for anyone to talk to about this and get some good perspectives!

So, I'm 32 and applying this upcoming cycle, so if I get in I will be starting at 33. My background is as a PhD and postdoc in a non-medical field (I work on software research for healthcare and biomedical science, with a phd in physics). My motivation stems from knowing how much I want to be able to provide hands-on care and with my background work as a physician who researches at the interface with technology and its applications. While researchers in my field certainly make some progress by working on collaborative teams with physicians, there's a huge limitation in not having true medical knowledge which I appreciate daily, and the people who have the dual backgrounds have managed to do amazing things. Besides, I really do want to be a physician -- I have loved all things I have done as a volunteer in ER and hospices but I want to be actually in the position of the doctors one day. I don't want a primarily desk-based job for the rest of my life, and it was a huge mistake for me to choose this, something I did because when I was younger I had zero careers advice/ came from a very disadvantaged background (literally didn't know anyone who had a 'professional' job -- very rural area).

Physically and mentally, I really don't feel different to years ago, although I know that will change over time. Financially, one of the reasons I have waited is to save money as it just didn't seem possible when I was finishing my PhD. Another reason for waiting is just not believing it could be done -- particularly where I am from where med school starts at 18 and graduate entry of any kind is relatively less common.

As a separate component -- I am a UK graduate and have to train in the UK as I am not eligible to train in the US as our degrees are not accepted, often nationality is a problem etc. Thankfully being from the UK means significantly smaller loans. However, for partner's job reasons we are considering whether to move to the US after I finish/ my moving out there to join him, and I will admit there are several attractive reasons such as reduced length of postgraduate training (even primary care is 5 years after med school in the UK, internal medicine is typically 7-8, as is radiology/anaesthetics. Surgery is a minimum of 12, and all of these involve moving several times during the first five years). I am aware of all the extra horror associated with trying to match into residency as an IMG, but I am prepared to push really hard during med school to be an attractive candidate (I am not planning to have children during med school, but I am planning to be USMLE focused and push hard to keep a research record going). However, I am concerned that my age will be a problem -- even though I would be a recent graduate. Is this likely to be a problem as an IMG? As in -- I know AMGs will probably be ok but does it add an even worse kick in the teeth when you're already fighting uphill?

I've come across examples of people starting med school at 30/ 28 as an IMG and going in to EM/anaesthesiology, but I don't know what difference that extra three years would make? I would really appreciate anyone's perspectives on this, or ideas for who I could talk to!

(EDIT: I am aware of the risks of leaving having children late, and have to accept that. In my current career, it would be difficult anyway, and more importantly I really don't want to be a mother if I am as unhappy in myself as I am, knowing what I truly want to be doing with my life -- if I am lucky enough to have a kid, I reckon they deserve a happier mother!)

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[DocJanItor]

I'll be in my early 40s when I graduate this year. While I might be half a step slower than my younger compatriots physically, I can tell you that the life experience and maturity more than make up for it.

That being said, if I was 5 years older I don't know that I would've made the same choice, but that's more to do with risk benefit from a financial standpoint.

 

[Mad Jack]

I didn't take the best care of myself and I'm doing alright in my mid-30s in residency. Though I must say it is far more challenging physically than it would have been in my 20s. At the same time, mentally I am more adept at approaching challenges throughout the day, so overall I'm probably better off

 

[Goro]

Some of my all-time best students have been in their 30s and 40s.

I graduated a stellar one at age 50 a few years ago, and she is now an attending

 

[labtech312]

I will be finishing a SMP this spring and applying this upcoming cycle at 28 yrs old. From working with the younger M1s at the medical school my SMP is affiliated with I can already see the advantages of being an older student. However, I cannot speak to those advantages in residency. I plan on having kids in med school or residency and I imagine it will be difficult, but not unmanageable. If it is what you are passionate about and you think the sacrifice will be worth it, go for it and don't look back.

 

[Drsecondchance]

I'll be 42 when I start residency. But, you know, I'll be 42 in 4 years and 2 months whether or not I'm graduating medical school at that time or not. Might as well be 42 and graduating from medical school. Depending in some small way on your viewpoint and religion, you don't get to be younger than you are right now, so go do what you've dreamed of doing.

 

[Dral]

I did the PhD route and started at 33 (med school).

I did a 4 year residency and didn't feel like it made a difference. I'm not sure I would want to do a few of the surgical specialties, but I would have been able to handle it if it was something I really wanted.

 

[awhelkschance]

I did the PhD route and started at 33 (med school).

I did a 4 year residency and didn't feel like it made a difference. I'm not sure I would want to do a few of the surgical specialties, but I would have been able to handle it if it was something I really wanted.

Awesome! So this is the situation I am in, and I feel pretty much the same -- unlikely to do a surgical specialty but you never know. Very unlikely to be able to do that as an IMG unless I did incredibly in med school exams and went to somewhere famous (eg. I know Cambridge sent someone into plastics at Johns Hopkins, but that requires pretty much a perfect CV and a lot of time spent being a postgrad researcher.).

Beyond age just being a general factor -- does being old + IMG make things worse? (I mean, beyond just being an IMG -- this is obviously A Thing in itself)

 

[Groove]

It's all relative and the challenges involved in attending medical school go farther than mere chronological age. I'm also an IMG (US) and turned 30 during my first semester in medical school. My roommate was 36 and an attorney from Georgia. We had a smattering of classmates that were in their 40s and one was early 50s. The guy in his late 40s/early 50s is now a practicing GP in Canada. My roommate ended up flunking out. One of the guys in his 40s couldn't pass the USMLE step 2 and married an ex pharmacist classmate who was also in her 40s and did fine though I'm not sure what specialty she went into. I'm currently a practicing emergency physician in the US.

In some ways, age is just a number and it truly just depends on your mindset and level of determination. Being thrown back into the rigors of academics can be jolting to say the least for someone who's been out of school for awhile. Unlike my classmates, I found the first 2 years of rigorous book work much more difficult than the last 2 years (clinical and hospital work). Then there's the financial impact. Unless you are independently wealthy, you'll accrue some significant medical school debt which will only grow in interest during residency. If you are an IMG, most of the higher paying specialties will be incredibly competitive and even more so for you who will be competing with AMGs and a larger medical school class over the past 10 years. I can't speak much about UK costs and I'm assuming you'll attending medical school there? If it's a lot cheaper then perhaps the financial aspect is less challenging. However, that's several years that you won't be able to save for retirement and will be making ~50KUSD as a resident.

As for children, I think you have a very unrealistic plan to be perfectly honest. Medical school is NOT the time to get pregnant or plan a pregnancy and intern year is not either. You'll be starting at 33, an age that many women would already feel nervous about not having children yet. That puts you past 38 and in the middle of residency at your first opportunity and I think that's a bit unrealistic though perhaps not impossible in today's modern age of science.

Also, I think you mentioned that you work in technology and don't assume that you will be able to merge the old career with your new one. My graduate degree and previous career was in IT and I struggled in vain for several years post residency to be able to merge the two and it's much more difficult to do than you think though not impossible. I had a great opportunity a few years ago but it would have meant giving up clinical medicine altogether and I didn't want to do that. Anyway, good luck. Keep us updated on your progress.

I think you have a lot of soul searching to do. Make sure this isn't an "early mid life crisis" and something that you truly want and need to do for yourself. Have you considered PA school in the US? That's only 2.5 years commitment followed immediately by a six digit income, great job security, a much more flexible schedule compared to a physician and an accelerated ability to start your "life" with realistic inclusion of children, family, etc..

 

[Dral]

The above is good advice. OP, I'd read through that and think through it.

I went through the whole thing single and had my debt paid off 3 years after finishing residency...but I had nobody else to support.

As Groove pointed out, there are many moving parts that go into becoming a physician. You have more moving parts than I did (family concerns and being a non-US citizen). It you need help getting info about any of the parts we can help, but you'll ultimately have to think it through for yourself.

 

[awhelkschance]

Thank you, this is all good advice.

Just to address the children thing — the reason I put it in an edit in my original post is because I realised I had inadvertently revealed my partner’s gender and knew to expect some discussion of it. As I say, I know having children during med school is a big no, and I have no intention of doing so. I accept the likelihood of not having them, and really wanted this question to primarily considered as though I were a man. This is definitely not an early midlife crisis: I’ve wanted to do this for literally ten years, but at every stage thought ‘I can’t do that, I’d be letting my family down/ I wouldn’t get in because I have the wrong degree (in the UK these things are set much earlier — things are less flexible)/ I need to focus on having a family because I am supposed to.’ The great irony of that is not lost on me. My current career actively makes me feel terrible most days, and I don’t expect to be able to seamlessly meld it in to work as doctor, but I hope that I can use it at some point so at least it wasn’t a waste of ten years.

The questions about debt and salary: university in the UK is 9k a year. In practice graduate entry medicine costs less than this, however, the salary of a consultant (attending) is 70-80k. Residency salaries are already far above what most UK doctors make while training to be consultants, and as I say, this can take up to 12 years post graduation.

 

[Groove]

Thank you, this is all good advice.

Just to address the children thing — the reason I put it in an edit in my original post is because I realised I had inadvertently revealed my partner’s gender and knew to expect some discussion of it. As I say, I know having children during med school is a big no, and I have no intention of doing so. I accept the likelihood of not having them, and really wanted this question to primarily considered as though I were a man. This is definitely not an early midlife crisis: I’ve wanted to do this for literally ten years, but at every stage thought ‘I can’t do that, I’d be letting my family down/ I wouldn’t get in because I have the wrong degree (in the UK these things are set much earlier — things are less flexible)/ I need to focus on having a family because I am supposed to.’ The great irony of that is not lost on me. My current career actively makes me feel terrible most days, and I don’t expect to be able to seamlessly meld it in to work as doctor, but I hope that I can use it at some point so at least it wasn’t a waste of ten years.

The questions about debt and salary: university in the UK is 9k a year. In practice graduate entry medicine costs less than this, however, the salary of a consultant (attending) is 70-80k. Residency salaries are already far above what most UK doctors make while training to be consultants, and as I say, this can take up to 12 years post graduation.

I sympathize with your disillusionment and demoralizing career situation. In some ways, it reminds me very much of myself. I was 6 years into my career with a post grad degree in IT nearing 30 with several promotions and a window office in corporate America wondering every day "Is this my fate for the rest of my life?". Every week was just so incredibly soul crushing and I couldn't shake the desire to be a physician and to enter medicine. For me, it was an obsession to be sure. Was it the responsible or financially prudent thing to do? Maybe not. I sacrificed my 30s, incurred tremendous debt and suffered a divorce during residency. The route that I took was very risky and luckily I was oblivious to that risk at the time. That being said, I wouldn't change anything. It was absolutely the right decision for myself. Has medicine been what I dreamed it would be? Of course not. You're bound to face some disillusionment within the field of medicine as well. That being said, accomplishing your greatest dream renders a deep and personal satisfaction that can't be qualified or quantified objectively. The only thing I can't speak about is how easy it will be for you to enter residency as a UK graduate. Given the large amount of residency spots, I think your chances would be good to at least obtain an IM residency somewhere but that's not guaranteed. I would not set your sites on EM or anesthesia which were mentioned in your previous post as those are moderately competitive specialties even for US graduates. It's easier to match as a US IMG but I can't speak for a citizen/graduate of the UK. I would seek out the advice of others who have traveled the path you seek. Good luck.