Applicants Down 12% Nationally

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In 2021, we had 17,881 applications. We were up 24% and applications were up nationally 18%. In this current cycle, we have 15,993 applicants, so we’re down 11%, nationally they’re down 12%.
 
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Assuming GTown is a surrogate for all schools (being one of the most applied to) my theory is COVID dipped into people who would have otherwise applied this cycle. Not sure how or why. Interesting trend nonetheless.
 
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No. More people are on to Georgetown getting an absurd amount of applications and don’t even bother applying. If you look at schools that have application trackers, most had an increase in applicants. Obviously I might be wrong but it’s kinda weird that many schools are reporting an increase. Unless this is referring to applicants rather than applications. Maybe people are just sending more secondaries

Edit: Isn’t this data not released to anybody until to fall? How would the Dean know.
 
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Assuming GTown is a surrogate for all schools (being one of the most applied to) my theory is COVID dipped into people who would have otherwise applied this cycle. Not sure how or why. Interesting trend nonetheless.
There’s likely a non-negligible amount of people previously interested in medicine that decided a global pandemic was enough to dissuade them from such a career. The increase during COVID was likely related to the economy spiraling and people trying to jump into academia. It’ll be interesting to see what impact that, as well as aforementioned generational changes in interests will have on the long term on application numbers.
 
It's because midlevel problems are gaining more traction. Doesn't affect people who are already set on med, but will have a greater and greater effect on people who are still deciding on a career path.

When I applied to med school, I knew PAs and NPs existed but I thought they knew their place and everyone knew who the real doctor was. As it becomes more and more apparent that this isn't the case, med school apps are gonna drop.

I actually think it's probably gonna take a pretty precipitous fall within the next 5 yrs.
 
There’s likely a non-negligible amount of people previously interested in medicine that decided a global pandemic was enough to dissuade them from such a career. The increase during COVID was likely related to the economy spiraling and people trying to jump into academia. It’ll be interesting to see what impact that, as well as aforementioned generational changes in interests will have on the long term on application numbers.
Wonder who they name that effect after bahaha
 
If you ignore 2021 and extrapolate 2022 from the article (down 12% from 2021), med school admissions have steadily increased at a little over 1% per year for the past few years. They're up 3.6% from 2020 (based on extrapolation). It's tough to make anything of 2021 because it was such a massive, extreme outlier - an 18% increase in a field where a 4% year-to-year increase is considered large. I'd call this regression to the mean.

I thought the most interesting thing about this article was that it looks like, statistically, about 30% of all med school applicants apply to Georgetown.
 
The economy is improving, hence other fields now look more enticing.
You really have to look at the economy of the top 1-5% wealthiest in the country. Med schools are (for now) competing for the top 1-5% most accomplished students, and those students are typically choosing between med, law, tech, or business, trying to cement their place in the upper middle class and satisfy cultural expectations.

Pre-COVID: Med school is the clearest path to the upper middle class. Income is the number one predictor of lifestyle. Doctors are respected and universally seen as well-paid professionals with satisfying work.

Mid-COVID: Invincible young people who don't feel COVID is a personal threat to them see doctors as heroes. Young people run to the profession with the same type of zeal as young men enlisting in the army in the 1940s.

"Post"-COVID: Doctors have been used and abused for two years in an extremely visible way. Meanwhile, 26 year old tech bros are working from home, buying investment properties, and driving Teslas. Management consultants got a pay bump and a break from the Mon-Thurs travel grind. Cravath scale compensation went up 20% since 2018. Maybe most importantly, people are acutely aware of how devastating not holding equity is in our current economy. As the housing market borders on the absurd, who in their right mind is going to take on a second mortgage and give up a decade of opportunity cost?

Between the threat of mid-levels, the long training pathway and growing debt burden, CMS refusing to acknowledge that inflation exists, and major talks of healthcare reform (that all focus on decreasing physician salaries), the one big "pro" of medicine (stable and reliable pay placing you in the upper middle class) is all but gone.

I genuinely believe that the only thing keeping med school even remotely competitive right now is many applicants' inability to see opportunity cost. The incomes still look nice, bolstered by older physicians who still own their practices, but most applicants don't understand that you need to chop those numbers in half when comparing to salaries in professions without the massive opportunity cost of medicine.

By the time we all retire, I believe American society is going to look on doctors the same way we look at professors, teachers, social workers, etc... We're becoming martyrs who work for "passion" and many younger people can see it. I work with them every day in the lab, tutoring, and TA'ing. The attitude towards medicine has changed dramatically.
 
A lot of schools have been pivoting towards health disparities and primary care to address the consequences of worsening social inequity. This points to lower / stagnant salaries in the aggregate.
 
You really have to look at the economy of the top 1-5% wealthiest in the country. Med schools are (for now) competing for the top 1-5% most accomplished students, and those students are typically choosing between med, law, tech, or business, trying to cement their place in the upper middle class and satisfy cultural expectations.

Pre-COVID: Med school is the clearest path to the upper middle class. Income is the number one predictor of lifestyle. Doctors are respected and universally seen as well-paid professionals with satisfying work.

Mid-COVID: Invincible young people who don't feel COVID is a personal threat to them see doctors as heroes. Young people run to the profession with the same type of zeal as young men enlisting in the army in the 1940s.

"Post"-COVID: Doctors have been used and abused for two years in an extremely visible way. Meanwhile, 26 year old tech bros are working from home, buying investment properties, and driving Teslas. Management consultants got a pay bump and a break from the Mon-Thurs travel grind. Cravath scale compensation went up 20% since 2018. Maybe most importantly, people are acutely aware of how devastating not holding equity is in our current economy. As the housing market borders on the absurd, who in their right mind is going to take on a second mortgage and give up a decade of opportunity cost?

Between the threat of mid-levels, the long training pathway and growing debt burden, CMS refusing to acknowledge that inflation exists, and major talks of healthcare reform (that all focus on decreasing physician salaries), the one big "pro" of medicine (stable and reliable pay placing you in the upper middle class) is all but gone.

I genuinely believe that the only thing keeping med school even remotely competitive right now is many applicants' inability to see opportunity cost. The incomes still look nice, bolstered by older physicians who still own their practices, but most applicants don't understand that you need to chop those numbers in half when comparing to salaries in professions without the massive opportunity cost of medicine.

By the time we all retire, I believe American society is going to look on doctors the same way we look at professors, teachers, social workers, etc... We're becoming martyrs who work for "passion" and many younger people can see it. I work with them every day in the lab, tutoring, and TA'ing. The attitude towards medicine has changed dramatically.
I don't think it has anything to do with COVID. Has everything to do with how bad med is relative to alternatives. Especially tech.

For example, if you're an Asian living in California, medicine and tech are probably the two top career pathways for you.

MEDICINE

PROS
/CONS
- High pay/only after 7+ years of grueling training. Constant stress/exams during this time. Also, gap years could be necessary due to unfavorable admissions environment for Asians, further lengthening the training time. Extremely high student debt burden.
- Can theoretically work anywhere in the country, esp. LCOL areas./Low likelihood of staying near friends and family in California. In most LCOL areas, you will be alienated as the only Asian.
- Historically stable job, even in old age./Threat of midlevel encroachment. Private practices are dying, and "not for profit" hospital system and private equity are taking over.
-Hospitals don't give af about giving you any more than the least possible.

TECH

PROS
/CONS
- High pay, on par with many attending physicians straight out of undergrad. Possibility of hitting the jackpot with a startup and making much more. Much lower student debt burden. Much easier to retire early.
- High likelihood of staying near friends+family. Can even work remote and live for cheap in Thailand or something if you so desire./If working in person, typically constrained to HCOL areas like SF, NYC, Seattle, Socal.
- Threat of younger graduates coming for your job once you're older.
- Workplaces have to entice you with benefits+perks to get you to join them.

If I hadn't already been 70k+ deep in student loans by the end of my first year, I for sure would have tried to pivot into tech.
 
I am a software engineer. I am applying to medical school this cycle or next. I am 29, an Asian male, and in an SMP right now. I am enjoying it so far.

My reasons:
Startup grind is tough.

Seeing major acquisitions and people's life change before your eyes does happen. It is not common. It takes some of the following (but not all): good pedigree, amazing self-confidence, an affinity for risk, connections, youth/time on your side (older founders are looked down upon). You need, most importantly...a product-market fit for whatever business you're launching. Very talented/smart engineers have shuttered down their companies and gone back to regular jobs after being jaded or not having the exit they wanted. Others do get that one acquisition and become set for the rest of their lives. This is not really a gamble, but the odds are against your favor, but fortune favors the bold.

From the point above, I have zero entrepreneurial skills. I went to a horrible state school, I have no connections. But more than that, I don't have the tenacity to develop those connections, and I cannot relate to the spark entrepreneurs have. So my option is basically climbing the tech ladder - which is still absolutely great. If you are a motivated person inspired by entrepreneurship, this is the field for you. Even before/after medical school. You can always change some existing market. Just look at ZocDoc as an example of an MD innovating in tech. Even MacRumors, an apple blog, is founded by a physician.

Ageism
You need to be set by 50. I don't care what anyone else says. Ageism is real. That doesn't mean you can't stop working, just that it becomes harder to keep up and make the same amount of money, comfortably, when everyone is younger than you and you're an at-will employee. The average software engineer age is like early thirties (which will go up over time - this field is exploding). Fortunately for the 22-25 year old getting started, they should have more than enough time in tech to make 3-4million+, assuming they don't do any startup stuff, if they stick to big companies throughout that time, and can then live off the dividends as they get older.

I was behind on retirement because I worked at startups for 3-4 years instead, and then 1 year of big tech, instead of just working at big tech right away and stacking that money. Even if I went back to big-tech and make 200-300k in the next year or so (and 400k+ in 2 or 3 years), I'd still be kind of behind for when the ageism years creep up. Tech stocks will continue to make gains in the coming decades and amplify your return from RSUs/stock packages given in the form of equity when you work.

Timing
My decision to begin transitioning into medicine was pre-COVID. I did not want to live in the city forever. COVID unexpectedly changed everything. If I was in the position of making this decision after COVID already happened and all these jobs stayed remote, I probably would have stayed in tech.

Non-money reasons
I love the impact physicians have. I was inspired by physicians in my own city and the kind of work they've done. I may be stupid but I want to work with people, and have an impact in my local community, away from the big city and tech bros. I don't want to be behind in sprint-cycles/development timelines behind my computer forever. I like the feeling of security and being more than employee #<insert number>. I was beginning to hate coding because it was mired in bureaucracy and I was just another robot. The challenges left me uninspired. After being an early employee and excited to work on cool things, after 4-5 years of this it just became a job devoid of meaning (to me at least). Nobody truly cares about what you do, as long as you can bring results. As such, this work is transactional.

I understand medical school is a huge opportunity cost. But I've learned to look at all of these costs as a part of a process. An extra million or two at a decade of age or younger is great, but I found the destination is just as important as how you get there (stupid cliche I know).

I know I rambled a lot but there's my reasoning when you inject a personal view into tech vs medicine. There is nothing wrong with either. If you're 21 and want to make the most out of your 20s, tech is there. You can do all the things you want and make a ton of money and within 4 years you will make well over 300k a year and can retire by the time you're 40-45.

In my gap year I will be returning to tech.
 
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I don't want to be behind in sprint-cycles/development timelines behind my computer forever. I like the feeling of security and being more than employee #<insert number>. I was beginning to hate coding because it was mired in bureaucracy and I was just another robot. The challenges left me uninspired. After being an early employee and excited to work on cool things, after 4-5 years of this it just became a job devoid of meaning (to me at least)
You're gonna love medicine, because it's totally different. 😊

In actuality, though, I wish you the best. I hope that you enjoy being in the medical world more than I have.
 
You're gonna love medicine, because it's totally different. 😊

In actuality, though, I wish you the best. I hope that you enjoy being in the medical world more than I have.
It won't in the beginning at least. I absolutely know how bad it is going to be. This is why I have my gap year where I go back to tech and see if it will change my decision at all. I do know I definitely do not enjoy the unnecessary barriers in academia and the intense, soul-crushing pressure.
 
It won't in the beginning at least. I absolutely know how bad it is going to be. This is why I have my gap year where I go back to tech and see if it will change my decision at all. I do know I definitely do not enjoy the unnecessary barriers in academia and the intense, soul-crushing pressure.
I see people switching into medicine for similar reasons sometimes, and I applaud your decision to dive in and make a positive (if 7+ year delayed) impact in your community.

As the poster above alluded to, keep in mind that the primary complaint from many if not most physicians as we head increasingly towards our wonderful dystopian venture capital investment driven healthcare world, is that physicians become more like cogs in a machine. The system is the impediment to providing good care in many physicians' eyes- e.g., insurance won't approve y or z until x has been done (which also devalues all of your knowledge because it's just an algorithm that you have to follow every time- you're just the gatekeeper). You see administrators making 6 figures working short hours due to your work- and they tell you what to do and how to work, all without any actual knowledge of medicine. You experience unprecedented encroachment into previously physician-only roles by non-physicians and witness legitimate harm to people as a result. You experience increasingly insane levels of competition from very bright colleagues for desirable specialties that often minimize (but usually not eliminate) what I just listed above. I have classmates that are incredibly hard working, bright, and people I would want treating my family... find that they did not match into desired fields. That's a bit of a bump in a road in your late 20s.

All of this to say, make sure you pursue medicine with open eyes and with an open mind for what you end up doing. I would strongly recommend considering fields that have an option of practicing on your own, with the possibility of escaping large health systems if you become disillusioned by them. Residencies like IM, FM, psych, ophtho, derm, PMR, and fellowships like pain or palliative can probably get you there most of the time. They all have unique challenges (I hear derm is experiencing expansion and other problems) but are more protected from midlevels and hospitals employing and squeezing you like EM, anesthesia, peds, or perhaps general surgery to a lesser extent. People typically recommend other surgical subspecialties too, but one needs to keep in mind those are usually extremely competitive and many years of long hours.

That all address the business side of medicine, which I don't think premeds and med students think enough about. The humanistic opportunities we have, though, are incredible. For that I would not trade this career for anything else.
 
If you ignore 2021 and extrapolate 2022 from the article (down 12% from 2021), med school admissions have steadily increased at a little over 1% per year for the past few years. They're up 3.6% from 2020 (based on extrapolation). It's tough to make anything of 2021 because it was such a massive, extreme outlier - an 18% increase in a field where a 4% year-to-year increase is considered large. I'd call this regression to the mean.

I thought the most interesting thing about this article was that it looks like, statistically, about 30% of all med school applicants apply to Georgetown.
Exactly, I'm wondering why people who clearly know this are not mentioning it. The conclusion to make in the grand scheme of things is that things are going back to business as usual, which is not a decrease in applicants, it is still an increase over the increase we see in residency spots each year.
 
Another thing that isn’t talked about in tech is COL. A doctor in a rural non income tax area makes effectively twice as much as his tech counterpart in Silicon Valley despite similar nominal salaries.
 
I see people switching into medicine for similar reasons sometimes, and I applaud your decision to dive in and make a positive (if 7+ year delayed) impact in your community.

As the poster above alluded to, keep in mind that the primary complaint from many if not most physicians as we head increasingly towards our wonderful dystopian venture capital investment driven healthcare world, is that physicians become more like cogs in a machine. The system is the impediment to providing good care in many physicians' eyes- e.g., insurance won't approve y or z until x has been done (which also devalues all of your knowledge because it's just an algorithm that you have to follow every time- you're just the gatekeeper). You see administrators making 6 figures working short hours due to your work- and they tell you what to do and how to work, all without any actual knowledge of medicine. You experience unprecedented encroachment into previously physician-only roles by non-physicians and witness legitimate harm to people as a result. You experience increasingly insane levels of competition from very bright colleagues for desirable specialties that often minimize (but usually not eliminate) what I just listed above. I have classmates that are incredibly hard working, bright, and people I would want treating my family... find that they did not match into desired fields. That's a bit of a bump in a road in your late 20s.

All of this to say, make sure you pursue medicine with open eyes and with an open mind for what you end up doing. I would strongly recommend considering fields that have an option of practicing on your own, with the possibility of escaping large health systems if you become disillusioned by them. Residencies like IM, FM, psych, ophtho, derm, PMR, and fellowships like pain or palliative can probably get you there most of the time. They all have unique challenges (I hear derm is experiencing expansion and other problems) but are more protected from midlevels and hospitals employing and squeezing you like EM, anesthesia, peds, or perhaps general surgery to a lesser extent. People typically recommend other surgical subspecialties too, but one needs to keep in mind those are usually extremely competitive and many years of long hours.

That all address the business side of medicine, which I don't think premeds and med students think enough about. The humanistic opportunities we have, though, are incredible. For that I would not trade this career for anything else.
Psychiatry was my target. Being older, I wouldn't be able to go as hard as someone who is a recent grad for a "top-tier" specialty, nor would I want to. Tech spoils in you in autonomy and life-work balance. I would never trade that for being a surgeon, or losing sleep to place into a highly-competitive specialty. I also have a genuine interest in the field, but I would be lying if independence of psychiatrists didn't play a factor. In some way I do still hope to keep a foot in the door in tech and this field has many more parallels that are easier to act on than say something like surgery.

Leaving tech is essentially a lateral move for mostly non-financial reasons while ensuring financial parity and longevity. And I have zero desire to be in a hospital system.
 
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Another thing that isn’t talked about in tech is COL. A doctor in a rural non income tax area makes effectively twice as much as his tech counterpart in Silicon Valley despite similar nominal salaries.

That's mostly negated by remote work. You can still make those insane numbers at the right company as a 24 year old.

See here (Coinbase Software Engineer Salaries | $191K-$583K+ | Levels.fyi). Coinbase is a remote-first company and pays competitively. You don't need to be in Manhattan.
 
In 2021, we had 17,881 applications. We were up 24% and applications were up nationally 18%. In this current cycle, we have 15,993 applicants, so we’re down 11%, nationally they’re down 12%.
Good
 
It's because midlevel problems are gaining more traction. Doesn't affect people who are already set on med, but will have a greater and greater effect on people who are still deciding on a career path.
What if they dont understand the magnitude of the problem?
 
I am a software engineer. I am applying to medical school this cycle or next. I am 29, an Asian male, and in an SMP right now. I am enjoying it so far.

My reasons:
Startup grind is tough.

Seeing major acquisitions and people's life change before your eyes does happen. It is not common. It takes some of the following (but not all): good pedigree, amazing self-confidence, an affinity for risk, connections, youth/time on your side (older founders are looked down upon). You need, most importantly...a product-market fit for whatever business you're launching. Very talented/smart engineers have shuttered down their companies and gone back to regular jobs after being jaded or not having the exit they wanted. Others do get that one acquisition and become set for the rest of their lives. This is not really a gamble, but the odds are against your favor, but fortune favors the bold.

From the point above, I have zero entrepreneurial skills. I went to a horrible state school, I have no connections. But more than that, I don't have the tenacity to develop those connections, and I cannot relate to the spark entrepreneurs have. So my option is basically climbing the tech ladder - which is still absolutely great. If you are a motivated person inspired by entrepreneurship, this is the field for you. Even before/after medical school. You can always change some existing market. Just look at ZocDoc as an example of an MD innovating in tech. Even MacRumors, an apple blog, is founded by a physician.

Ageism
You need to be set by 50. I don't care what anyone else says. Ageism is real. That doesn't mean you can't stop working, just that it becomes harder to keep up and make the same amount of money, comfortably, when everyone is younger than you and you're an at-will employee. The average software engineer age is like early thirties (which will go up over time - this field is exploding). Fortunately for the 22-25 year old getting started, they should have more than enough time in tech to make 3-4million+, assuming they don't do any startup stuff, if they stick to big companies throughout that time, and can then live off the dividends as they get older.

I was behind on retirement because I worked at startups for 3-4 years instead, and then 1 year of big tech, instead of just working at big tech right away and stacking that money. Even if I went back to big-tech and make 200-300k in the next year or so (and 400k+ in 2 or 3 years), I'd still be kind of behind for when the ageism years creep up. Tech stocks will continue to make gains in the coming decades and amplify your return from RSUs/stock packages given in the form of equity when you work.

Timing
My decision to begin transitioning into medicine was pre-COVID. I did not want to live in the city forever. COVID unexpectedly changed everything. If I was in the position of making this decision after COVID already happened and all these jobs stayed remote, I probably would have stayed in tech.

Non-money reasons
I love the impact physicians have. I was inspired by physicians in my own city and the kind of work they've done. I may be stupid but I want to work with people, and have an impact in my local community, away from the big city and tech bros. I don't want to be behind in sprint-cycles/development timelines behind my computer forever. I like the feeling of security and being more than employee #<insert number>. I was beginning to hate coding because it was mired in bureaucracy and I was just another robot. The challenges left me uninspired. After being an early employee and excited to work on cool things, after 4-5 years of this it just became a job devoid of meaning (to me at least). Nobody truly cares about what you do, as long as you can bring results. As such, this work is transactional.

I understand medical school is a huge opportunity cost. But I've learned to look at all of these costs as a part of a process. An extra million or two at a decade of age or younger is great, but I found the destination is just as important as how you get there (stupid cliche I know).

I know I rambled a lot but there's my reasoning when you inject a personal view into tech vs medicine. There is nothing wrong with either. If you're 21 and want to make the most out of your 20s, tech is there. You can do all the things you want and make a ton of money and within 4 years you will make well over 300k a year and can retire by the time you're 40-45.

In my gap year I will be returning to tech.
You're telling everyone that going into tech means you're making well into the 6 figure range? As in, most people will make this?

lol
 
You're telling everyone that going into tech means you're making well into the 6 figure range? As in, most people will make this?

lol
You don't need to believe me. The data speaks for itself. (+Another one here).

The average is 110k in the US. And it gets much higher than that. So yes...most people make into the six figure range, and getting well (I define this as >200K total compensation) into the six figure range is a matter of 2-4 years of experience and working at an enterprise level company. (Google, Amazon, Microsoft, Twitter, etc.). This isn't anything new.

🤷
 
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You don't need to believe me. The data speaks for itself. (+Another one here).

The average is 110k in the US. And it gets much higher than that. So yes...most people make into the six figure range, and getting well (I define this as >200K total compensation) into the six figure range is a matter of 2-4 years of experience and working at an enterprise level company. (Google, Amazon, Microsoft, Twitter, etc.). This isn't anything new.

🤷
If the average is 110k, that means 200k is not a very common income. On the other hand, 250k is an easy income to achieve as a family doctor who is not working too hard.
Also, most of these jobs will be in high cost of living areas and higher taxed areas too.

I understand there's a path in tech for money. But it isn't guaranteed like you're selling it.
 
If the average is 110k, that means 200k is not a very common income. On the other hand, 250k is an easy income to achieve as a family doctor who is not working too hard.
Also, most of these jobs will be in high cost of living areas and higher taxed areas too.

I understand there's a path in tech for money. But it isn't guaranteed like you're selling it.
Let me explain how this works. You can absolutely work remotely at a large company from home and make just as much without being in a high cost of living. Companies hire remotely, even the big ones.

And sure a family doctor can make that after 8 years. A software engineer can make that out of college working at a publicly listed company. It is very common. Does everyone do it? No. But a CS major can absolutely make that out of the gate.

You have to understand the compensation is not all cash. It is like 1xxK in cash and the other 1xxK in equity. That gives you your total compensation.

I don’t understand what you’re getting at when say I am saying it is guaranteed. It is not. So is getting into medical school. But first you said the average was not that high, which I refuted. Now you’re adding caveats - I clearly explained that the total compensation structure to make this amount is not some kind of anomaly. It is very common, albeit not guaranteed.

All that being said I’m not advocating for anyone to go into tech. I just listed like 5 reasons why I’m leaving. I am showing that the earning potential is not some extreme anomaly like you think. Getting a job at Google out of college for a CS major is not unusual at all, and staying there for 8 years will put you well above any family doctor anywhere. Does everyone do that? No.

Ultimately you do what career is right for you.
 
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xcept you don’t understand how this works. You can absolutely work remotely at a large company from home and make just as much without being in a high cost of living. Companies hire remotely, even the big ones.
Not at Google or Apple anymore. Same with Goldman, JPM, most other finance firms. I think WFH has maybe has a couple years left before ppl are back in the office on some sort of hybrid model for good. Middle management needs a reason to exist.
 
Tech and finance are not the same, despite some overlap because they both use code, technically.
Not at Google or Apple anymore. Same with Goldman, JPM, most other finance firms. I think WFH has maybe has a couple years left before ppl are back in the office on some sort of hybrid model for good. Middle management needs a reason to exist.
Comparing J.p. morgan or Goldman Sachs to Apple, or any other tech company, is nonsensical. Those are complete dinosaurs and are in finance. It’s like comparing Postmates to McDonald’s. And there are far more companies than just Apple willing to accept qualified remote workers and pay a premium.
 
If the average is 110k, that means 200k is not a very common income. On the other hand, 250k is an easy income to achieve as a family doctor who is not working too hard.
Also, most of these jobs will be in high cost of living areas and higher taxed areas too.

I understand there's a path in tech for money. But it isn't guaranteed like you're selling it.
Yes, but $110K is what the average software developer is earning. This means the average of everyone from CS majors at MIT/Stanford and people who did coding bootcamps and took a job at a poorly funded non-tech startup doing basic coding. Every single person I know who majored in CS at my college, albeit a pretty good one, wound up with jobs within 2-3 years that levels.fyi tells me makes $200K+ in TC.

Most successful applicants to med school have better options. Some don't, but these are a minority.
Except you don’t understand how this works. You can absolutely work remotely at a large company from home and make just as much without being in a high cost of living. Companies hire remotely, even the big ones.

And sure a family doctor can make that after 8 years. A software engineer can make that out of college working at a publicly listed company. It is very common. Does everyone do it? No. But a CS major can absolutely make that out of the gate.

You have to understand the compensation is not all cash. It is like 1xxK in cash and the other 1xxK in equity. That gives you your total compensation.

I don’t understand what you’re getting at. First you said the average was not that high, which I refuted. Now you’re adding caveats when I clearly explained that the total compensation structure to make this amount is not some kind of anomaly. It is very common.

All that being said I’m not advocating for anyone to go into tech. I just listed like 5 reasons why I’m leaving. I am showing that the earning potential is not some extreme anomaly like you think. Getting a job at Google out of college for a CS major is not unusual at all, and staying there for 8 years will put you well above any family doctor anywhere. Does everyone do that? No.

Ultimately you do what career is right for you.
Not to mention, making big money early will literally double your earning potential. Especially since people in their early 20s with no kids or external responsibilities have incredibly low expenses, it would be trivial to save $4-5M and retire in luxury by age 55 even as an average software developer on a single income starting at $80K and hitting $150K by mid-career (~40), and you can do all that at 40 hours/week, half of those hours spent playing Eldinring with Slack up on your other computer. As a specialist physician eventually earning up to $400K/year, you will still take at least that long to build up that sort of nest egg, and you'll work like a dog for it. It will balloon from there, but it's of limited utility at that point.

In terms of money, it's undeniable that being a software developer will lead to a better financial outcome. There is also risk in spending many years banking on the future. I recently had to put down a beloved pet because I didn't have the money for surgery. I can imagine far worse scenarios than that. These early years of limited/negative income have a very real cost.
 
I don't think it has anything to do with COVID. Has everything to do with how bad med is relative to alternatives. Especially tech.

For example, if you're an Asian living in California, medicine and tech are probably the two top career pathways for you.

MEDICINE

PROS
/CONS
- High pay/only after 7+ years of grueling training. Constant stress/exams during this time. Also, gap years could be necessary due to unfavorable admissions environment for Asians, further lengthening the training time. Extremely high student debt burden.
- Can theoretically work anywhere in the country, esp. LCOL areas./Low likelihood of staying near friends and family in California. In most LCOL areas, you will be alienated as the only Asian.
- Historically stable job, even in old age./Threat of midlevel encroachment. Private practices are dying, and "not for profit" hospital system and private equity are taking over.
-Hospitals don't give af about giving you any more than the least possible.

TECH

PROS
/CONS
- High pay, on par with many attending physicians straight out of undergrad. Possibility of hitting the jackpot with a startup and making much more. Much lower student debt burden. Much easier to retire early.
- High likelihood of staying near friends+family. Can even work remote and live for cheap in Thailand or something if you so desire./If working in person, typically constrained to HCOL areas like SF, NYC, Seattle, Socal.
- Threat of younger graduates coming for your job once you're older.
- Workplaces have to entice you with benefits+perks to get you to join them.

If I hadn't already been 70k+ deep in student loans by the end of my first year, I for sure would have tried to pivot into tech.

I wouldn't consider tech salaries to be, on average, on par with attending physicians. And definitely not straight out of undergrad and definitely not on an hourly basis. The higher paying jobs people hear about at the big tech companies like Facebook, Google, etc... aren't the norm and these difficult to get in and , and often require working insane hours to make those amounts (that are even longer than what most attending physicians work). Most tech engineer salaries are closer to $100-200k per year during the first few years out of school (with those making >$500k by far the exception than the norm), which is lower than what physicians make. While most would agree tech has lower barriers to entry than medicine and with less debt, the same reason makes tech more susceptible to international competition (and hence outsourcing of tech labor to foreign countries). Tech jobs are notoriously unstable and driven by cyclic changes in the economy, and most tech workers are much easier to replace than physicians; while a lot of changes in medicine have made it less stable in terms of employment nowadays, it's still a lot more of a guarantee than tech.

This isn't to say that one field is definitely better than the other, but most shouldn't go into tech with the expectation of making a big fortune and retiring early. Nor should you expect most tech employees to be financially ahead of physicians for duration of their entire career.
 
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It's always tech vs medicine vs finance in these debates. I understand they all require highly motivated and competitive personalities and can make money, so similar in that way, but I've never understood how in these conversations, in the way its talked about, people think that all premeds decide in high school between the three, like they are somehow related interest/subject wise. Like it's some widespread issue across the premed world, this decision between being a code monkey/suit or a doctor. Or is this just a predicament (talk about 1st world bitching) for people who are solely looking to maximize ROI and an efficient way to $$$?
 
It's always tech vs medicine vs finance in these debates. I understand they all require highly motivated and competitive personalities and can make money, so similar in that way, but I've never understood how in these conversations, in the way its talked about, people think that all premeds decide in high school between the three, like they are somehow related interest/subject wise. Like it's some widespread issue across the premed world, this decision between being a code monkey/suit or a doctor. Or is this just a predicament (talk about 1st world bitching) for people who are solely looking to maximize ROI and an efficient way to $$$?
I'd argue that the death of private practice, ever-increasing production pressure, decreasing respect for medical expertise, and completely inhumane training process puts you far more into the "monkey" category than a software engineer who is actually allowed to use a modicum of creativity in making their own startup.
 
I wouldn't consider tech salaries to be, on average, on par with attending physicians. And definitely not straight out of undergrad and definitely not on an hourly basis. The higher paying jobs people hear about at the big tech companies like Facebook, Google, etc... aren't the norm and these difficult to get in and , and often require working insane hours to make those amounts (that are even longer than what most attending physicians work). Most tech engineer salaries are closer to $100-200k per year during the first few years out of school (with those making >$500k by far the exception than the norm), which is lower than what physicians make. While most would agree tech has lower barriers to entry than medicine and with less debt, the same reason makes tech more susceptible to international competition (and hence outsourcing of tech labor to foreign countries). Tech jobs are notoriously unstable and driven by cyclic changes in the economy, and most tech workers are much easier to replace than physicians; while a lot of changes in medicine have made it less stable in terms of employment nowadays, it's still a lot more of a guarantee than tech.

This isn't to say that one field is definitely better than the other, but most shouldn't go into tech with the expectation of making a big fortune and retiring early.
It's extremely variable, obviously, but when my FAANG friends talk about getting worked to the bone, it is not on the same level as residency. Maybe similar to an attending, but even then most high earning fields (anything surgical, cards) are much worse. Plus, the money you make as a 20-something big tech employee vs. a resident means everything else in your life is easier. I remember a friend of mine, who makes well over $300K at 27, complaining to me, "I wake up on Monday morning feeling physically ill about the work I will have to do until Friday. It's not at all uncommon to be in the office until 9 or 10 pm." I know for a fact that his start time is 9 am, which means his absolute worst days are 12-13 hours, and he basically never works weekends. Also, those 12 hours include going to the gym and eating pre-made, free food. Then he gets to drive home in his Tesla and opine about how his cleaning service didn't do a great job on the toilet bowl or how his laundry service is late. He also gets a guaranteed two days of zero work every weekend. The point isn't to appear salty here. It's just to say that people have different ideas of what it means to be "worked to the bone," and that medicine/residency often opens up a whole new world of pain.

Even as an MD/PhD student, I'm making barely $40K and easily putting in 70 hours/week. When those 70 hours are done, I have to sit outside in the cold waiting for extremely unreliable public transit because I can't afford a car. Then I get home and rush to the grocery store, laundromat, or kitchen to take care of additional chores. Weekends mean absolutely nothing. It's a miracle if I can go a single day without working. Any additional time I have left there is a voice in the back of my head nagging me about the medicine I haven't studied as I prepare to go back to the wards.

Residency will be the same. 70-80 hour weeks. Low pay so you can't just pay to make daily annoyances disappear. Few weekends. Few breaks.
 
Yes, but $110K is what the average software developer is earning. This means the average of everyone from CS majors at MIT/Stanford and people who did coding bootcamps and took a job at a poorly funded non-tech startup doing basic coding. Every single person I know who majored in CS at my college, albeit a pretty good one, wound up with jobs within 2-3 years that levels.fyi tells me makes $200K+ in TC.

Most successful applicants to med school have better options. Some don't, but these are a minority.

Not to mention, making big money early will literally double your earning potential. Especially since people in their early 20s with no kids or external responsibilities have incredibly low expenses, it would be trivial to save $4-5M and retire in luxury by age 55 even as an average software developer on a single income starting at $80K and hitting $150K by mid-career (~40), and you can do all that at 40 hours/week, half of those hours spent playing Eldinring with Slack up on your other computer. As a specialist physician eventually earning up to $400K/year, you will still take at least that long to build up that sort of nest egg, and you'll work like a dog for it. It will balloon from there, but it's of limited utility at that point.

In terms of money, it's undeniable that being a software developer will lead to a better financial outcome. There is also risk in spending many years banking on the future. I recently had to put down a beloved pet because I didn't have the money for surgery. I can imagine far worse scenarios than that. These early years of limited/negative income have a very real cost.
I think you're still taking the top guys in the field and comparing them to the average doctor. This is a common method used to make medicine look worse than it really is.

I personally know family doctors making ~350k before turning 30 and other generalists clearing mid to high 400s in their early 30s. It genuinely is not rare. If we get into the "rare" in medicine, there are doctors into the 7 figure income range. But we can ignore them and focus on the ones making 300-500k at a relatively young age. If you compare those to the 150-200k tech guys, the doctor is still coming out ahead financially.

I agree with you though that banking on the future isn't always wise and it's ideal to live in the present. But I still think you're focusing on the less common cases/exceptions and making it out to be the norm.

The reality is that medicine has lots its prestige/status to a major degree, but financially it still leads all mainstream careers.
 
I wouldn't consider tech salaries to be, on average, on par with attending physicians. And definitely not straight out of undergrad and definitely not on an hourly basis. The higher paying jobs people hear about at the big tech companies like Facebook, Google, etc... aren't the norm and these difficult to get in and , and often require working insane hours to make those amounts (that are even longer than what most attending physicians work). Most tech engineer salaries are closer to $100-200k per year during the first few years out of school (with those making >$500k by far the exception than the norm), which is lower than what physicians make. While most would agree tech has lower barriers to entry than medicine and with less debt, the same reason makes tech more susceptible to international competition (and hence outsourcing of tech labor to foreign countries). Tech jobs are notoriously unstable and driven by cyclic changes in the economy, and most tech workers are much easier to replace than physicians; while a lot of changes in medicine have made it less stable in terms of employment nowadays, it's still a lot more of a guarantee than tech.

This isn't to say that one field is definitely better than the other, but most shouldn't go into tech with the expectation of making a big fortune and retiring early.
This is a pretty realistic take on things.
 
I'd argue that the death of private practice, ever-increasing production pressure, decreasing respect for medical expertise, and completely inhumane training process puts you far more into the "monkey" category than a software engineer who is actually allowed to use a modicum of creativity in making their own startup.
Code monkey ≠ software engineer making their own start-up. 🙊🤣🙉🤣🙈🤣🐵🤣🐒
But yes, I can see how I will be an exceptionally paid (and handsome) orangutan
 
Let me explain how this works. You can absolutely work remotely at a large company from home and make just as much without being in a high cost of living. Companies hire remotely, even the big ones.

And sure a family doctor can make that after 8 years. A software engineer can make that out of college working at a publicly listed company. It is very common. Does everyone do it? No. But a CS major can absolutely make that out of the gate.

You have to understand the compensation is not all cash. It is like 1xxK in cash and the other 1xxK in equity. That gives you your total compensation.

I don’t understand what you’re getting at when say I am saying it is guaranteed. It is not. So is getting into medical school. But first you said the average was not that high, which I refuted. Now you’re adding caveats - I clearly explained that the total compensation structure to make this amount is not some kind of anomaly. It is very common, albeit not guaranteed.

All that being said I’m not advocating for anyone to go into tech. I just listed like 5 reasons why I’m leaving. I am showing that the earning potential is not some extreme anomaly like you think. Getting a job at Google out of college for a CS major is not unusual at all, and staying there for 8 years will put you well above any family doctor anywhere. Does everyone do that? No.

Ultimately you do what career is right for you.
I don't think it's an anomaly, but I think it's just not an easy route at all. Out of all the people I knew who went into tech, just 2 had the type of financial success you describe. The others all do reasonable okay but are not remotely balling by any stretch.

Ultimately, what percentage would you say can go onto make around half a million without working >65-70 hours a week? This is a percentage of people who graduate from school.

Now if we take a step back, I'm not sure how you get into a medicine vs tech comparison. There are the occasional overlaps but the personality types and level of interest/passion for the different topics is so far apart that it's extremely hard to have a realistic comparison. Meaning that most people who like medicine, are pretty unlikely to like tech. And the vice versa holds true too. It sort of becomes a moot comparison in the end because I can't imagine the people I did residency or med school with would ever have the slightest interest in tech. And my tech friends would literally hate medicine.
 
lol i didn't mean to turn this into a tech vs medicine debate haha.

i appreciate everyone's perspectives as I am not a doctor, or medical student, and every comment is insightful. I agree with everyone here that medicine is the more stable, presumably easier in lifestyle as you age (not qualified to say so but that's what I gather).

As a developer, it's not that bad. The bad can sometimes get ugly, but not usually. I have colleagues at Facebook who show up whenever to get their work done and then leave. Coding can be fun - outside of work. Most people I know at their jobs don't love their jobs. They're just they're for the money before they go off to launch a startup or save to retire.

I know medical students who dropped out to go into tech, and engineers who went into medicine. There is really no wrong solution. If you really want to enjoy your twenties, tech is definitely it though. There's basically no pressure outside of work. I would be happier to go into medical school later in life than as a recent graduate because I would've never been able to handle it like you guys.
 
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I don't think it's an anomaly, but I think it's just not an easy route at all. Out of all the people I knew who went into tech, just 2 had the type of financial success you describe. The others all do reasonable okay but are not remotely balling by any stretch.

Ultimately, what percentage would you say can go onto make around half a million without working >65-70 hours a week? This is a percentage of people who graduate from school.

Now if we take a step back, I'm not sure how you get into a medicine vs tech comparison. There are the occasional overlaps but the personality types and level of interest/passion for the different topics is so far apart that it's extremely hard to have a realistic comparison. Meaning that most people who like medicine, are pretty unlikely to like tech. And the vice versa holds true too. It sort of becomes a moot comparison in the end because I can't imagine the people I did residency or med school with would ever have the slightest interest in tech. And my tech friends would literally hate medicine.
There is a strong amount of overlap for the type of person that goes into either field. I can point to some examples of ex-medical school or pre-med students who went into tech. The content matter - yes, very different. some off the top of my head.

1. David Eraker - a co-founder of RedFin
2. Harsh Patel - accepted into Rush medical school - declined to join, went into tech and eventually become CEO of Galvanize + sold
3. Krishna Subramanian - Dropped out of medical school to create an online ad network
4. Jim Buckmaster - Dropped out of medical school at the University of Michigan, began to code, became CEO of Craigslist

obviously these are extreme anomalies, but i just mention them to show that the interest/passion and ability to succeed in either field is not as far apart as you imagine. definitely not common either.

i think the average student deciding between the two, when all is said is done, would probably come out ahead in medicine.
 
It's extremely variable, obviously, but when my FAANG friends talk about getting worked to the bone, it is not on the same level as residency. Maybe similar to an attending, but even then most high earning fields (anything surgical, cards) are much worse. Plus, the money you make as a 20-something big tech employee vs. a resident means everything else in your life is easier. I remember a friend of mine, who makes well over $300K at 27, complaining to me, "I wake up on Monday morning feeling physically ill about the work I will have to do until Friday. It's not at all uncommon to be in the office until 9 or 10 pm." I know for a fact that his start time is 9 am, which means his absolute worst days are 12-13 hours, and he basically never works weekends. Also, those 12 hours include going to the gym and eating pre-made, free food. Then he gets to drive home in his Tesla and opine about how his cleaning service didn't do a great job on the toilet bowl or how his laundry service is late. He also gets a guaranteed two days of zero work every weekend. The point isn't to appear salty here. It's just to say that people have different ideas of what it means to be "worked to the bone," and that medicine/residency often opens up a whole new world of pain.

Even as an MD/PhD student, I'm making barely $40K and easily putting in 70 hours/week. When those 70 hours are done, I have to sit outside in the cold waiting for extremely unreliable public transit because I can't afford a car. Then I get home and rush to the grocery store, laundromat, or kitchen to take care of additional chores. Weekends mean absolutely nothing. It's a miracle if I can go a single day without working. Any additional time I have left there is a voice in the back of my head nagging me about the medicine I haven't studied as I prepare to go back to the wards.

Residency will be the same. 70-80 hour weeks. Low pay so you can't just pay to make daily annoyances disappear. Few weekends. Few breaks.

If medical school is a bad choice financially, MD/PhD is arguably even worse.

Anyway, things are not all that bad as a physician. This is my second career and I started medical school at 26. I’m now 38, roughly 3 years into practice, paid off my student loans of $425k in 1.5 years, and savings now approaching nearly 7 figures. I am ahead of all of my friends my age, tech, law, and finance. i expect that to grow significantly in 40s and 50s, as long I am healthy enough to work. Also, I get to nail femurs and Tibias and then see my patients walk. Doubt any excel jockey or tech types can have that kind of gratification.

TLDR; it’s not that bad.
 
Meaning that most people who like medicine, are pretty unlikely to like tech. And the vice versa holds true too.
Intellectually curious pragmatists exist. There's a lot of fascinating things to learn in every field. If all jobs paid the same, I'd probably be a mechanic. I don't even particularly like cars, I just think big machines are cool.
 
It's always tech vs medicine vs finance in these debates. I understand they all require highly motivated and competitive personalities and can make money, so similar in that way, but I've never understood how in these conversations, in the way its talked about, people think that all premeds decide in high school between the three, like they are somehow related interest/subject wise. Like it's some widespread issue across the premed world, this decision between being a code monkey/suit or a doctor. Or is this just a predicament (talk about 1st world bitching) for people who are solely looking to maximize ROI and an efficient way to $$$?
Unless you come from a wealthy family, this really isn't 1st world bitching. The process of training to become a physician in the US is unnecessarily long, brutal, and abusive. It's not unreasonable for people to let out their frustrations about a profession that has consumed their life on the back of some promises that are being reneged year by year.

The consequences of living overworked and underpaid for literal decades are very real. I already stated here that I lost a pet to this low-income lifestyle. All I could think when that happened was, "what if this were more than a pet?"

I mean let's not get too melodramatic. It's a good career. It will continue to be a good career. However, it's not like we're late 20's hedge fund workers making $500K and moaning about low pay and poor in-house massage therapy.
I think you're still taking the top guys in the field and comparing them to the average doctor. This is a common method used to make medicine look worse than it really is.

I personally know family doctors making ~350k before turning 30 and other generalists clearing mid to high 400s in their early 30s. It genuinely is not rare. If we get into the "rare" in medicine, there are doctors into the 7 figure income range. But we can ignore them and focus on the ones making 300-500k at a relatively young age. If you compare those to the 150-200k tech guys, the doctor is still coming out ahead financially.

I agree with you though that banking on the future isn't always wise and it's ideal to live in the present. But I still think you're focusing on the less common cases/exceptions and making it out to be the norm.

The reality is that medicine has lots its prestige/status to a major degree, but financially it still leads all mainstream careers.
I think it's fair to compare semi-top tech guys and the average doctor. I'm not talking about execs. Think about all the companies that hire devs and other rank-and-file engineers at physician-level compensation. We're talking FAANGMULA plus a ton of others. There are so many you couldn't list them all out (Coinbase, Snap, Twitter, Databricks, Roblox, Stripe, Square, etc...). A quick search on levels.fyi shows you that.

There are 4.4 million software engineers and about 1 million doctors. Then on top of that there are more data scientists, product managers, etc... The top 15-20% of these workers are making physician income if you apply the 40% pay cut of opportunity cost to physician income. While I definitely don't think every doctor would become an L7 at Google, I do think that it's fair to compare doctors to the top 15-20% of skilled tech workers.

I'd also challenge your claim that financially it leads all mainstream careers. You really have to apply the opportunity cost subtraction (35-45%). Being a physician is equivalent to another career making $140K-$300K. It's not bad money at all, but you definitely work for every penny.
If medical school is a bad choice financially, MD/PhD is arguably even worse.

Anyway, things are not all that bad as a physician. This is my second career and I started medical school at 26. I’m now 38, roughly 3 years into practice, paid off my student loans of $425k in 1.5 years, and savings now approaching nearly 7 figures. I am ahead of all of my friends my age, tech, law, and finance. i expect that to grow significantly in 40s and 50s, as long I am healthy enough to work. Also, I get to nail femurs and Tibias and then see my patients walk. Doubt any excel jockey or tech types can have that kind of gratification.

TLDR; it’s not that bad.
MD/PhD is definitely not a financially sound decision. I like everything about it except the money, but the money aspect is getting old.

However, if MD/PhD is a bad financial comparison to the rest of medicine, then ortho is the same, just in the other direction. Neither of us represents the average doctor.
Intellectually curious pragmatists exist. There's a lot of fascinating things to learn in every field. If all jobs paid the same, I'd probably be a mechanic. I don't even particularly like cars, I just think big machines are cool.
Agreed. Fields are overrated. Most people just like the right type of problem to chew on/the right workflow. I work on molecular biology in a wet lab. I have a lot more in common with synthetic chemists than I do with bioinformaticists in terms of workflow/enjoyment, but the subject of my work overlaps a lot more with the latter.

That's actually a major plus to medicine. You have a full spectrum of working environments/styles to choose from, from radiology to ortho. Even if you hate medicine as a subject, at least one specialty will probably appeal to you.
 
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Unless you come from a wealthy family, this really isn't 1st world bitching.
Bitching about the pros and cons of three different careers in which you make hundreds of thousands of dollars per year using just your brain (keep in mind the median household income across the world is about 10k dollars, and billions of people put their physical bodies on the line to put food on the table) is the most first world problem I can think of (doesn't mean its not valid, just easier to have eyes rolled at).

I agree with the rest of your quote.
 
Bitching about the pros and cons of three different careers in which you make hundreds of thousands of dollars per year using just your brain (keep in mind the median household income across the world is about 10k dollars, and billions of people put their physical bodies on the line to put food on the table) is the most first world problem I can think of (doesn't mean its not valid, just easier to have eyes rolled at).

I agree with the rest of your quote.
I can't figure out where you're coming from with all these strange claims. What seems obvious to me seems esoteric to you, and I just think it's very strange.

From my perspective, as someone who was not as privileged as half of my med school classmates (50%+ of whom had at least one physician parent), things are much easier when you have money. You are still giving up your 20s to medicine, but you aren't giving up nearly as much. You have a nice apartment and can afford to go out regularly. You can vacation once or even multiple times a year, which definitely helps with wellness. You can hire a housekeeper. And much more that I'm no doubt missing.

Overall, you have a lot less to be bitter about because you just aren't sacrificing as much.
 
I can't figure out where you're coming from with all these strange claims. What seems obvious to me seems esoteric to you, and I just think it's very strange.

From my perspective, as someone who was not as privileged as half of my med school classmates (50%+ of whom had at least one physician parent), things are much easier when you have money. You are still giving up your 20s to medicine, but you aren't giving up nearly as much. You have a nice apartment and can afford to go out regularly. You can vacation once or even multiple times a year, which definitely helps with wellness. You can hire a housekeeper. And much more that I'm no doubt missing.

Overall, you have a lot less to be bitter about because you just aren't sacrificing as much.
I'm not sure how any of that relates to my post. Did you misquote me?
 
In 2021, we had 17,881 applications. We were up 24% and applications were up nationally 18%. In this current cycle, we have 15,993 applicants, so we’re down 11%, nationally they’re down 12%.
Back on topic...up 24%/down 12%...these data points are outliers.

1649039164433.png


If anyone has a more updated, longitudinal graph I would love to see it.
 
Back on topic...up 24%/down 12%...these data points are outliers.

View attachment 352836

If anyone has a more updated, longitudinal graph I would love to see it.
This is a really interesting chart, bc it suggests that the idea of more folks applying during economic recessions might not be true lol
 
Bitching about the pros and cons of three different careers in which you make hundreds of thousands of dollars per year using just your brain (keep in mind the median household income across the world is about 10k dollars, and billions of people put their physical bodies on the line to put food on the table) is the most first world problem I can think of (doesn't mean its not valid, just easier to have eyes rolled at).

I agree with the rest of your quote.
Every conversation had on a forum like this exists on the backdrop of "it's very good to be an American, especially an educated one." You could take literally any gripe from any American, European, and many others and say, "well at least you're not a cacao farmer in Ghana."

I'm incredibly grateful to be not only an American but also one who was gifted intelligence and a culture of good work ethic from my parents, who struggled immensely to give me the life I have. However, "be grateful for what you have" is a phrase too often uttered to justify a bad deal between two parties. We should still carefully consider pros and cons of careers, because the money and time you miss out on when you settle for less than you can get never travels down, always up to an administrator, investor, owner, manager, etc... It's not like if I stop being picky and let the med school deans and hospital admins have their way with my time and money that any of it is going to fund the cacao farmers in Ghana.

Be demanding for your work and time when pulling from those who have more than you. Be generous with your assets and talents when dealing with those who have less.
 
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