Attending physician told me I am too old

[greentea101]

In defense of the surgery lifestyle, something I tell students of all genders is this:

If you want to be a surgeon and also have a great family life, you have to become a very good surgeon. If you take til 10pm to do cases that other surgeons finish by 4pm, then you’re going to have a hard time being at home very much. If you can bang those cases out even faster then you have even more time. I’ve seen big time free flap recon surgeons who typically finish cases between 9-11pm and others who finish those cases between 2-4pm. Want to guess which one is picking up their kids from school each day?

If you have a higher takeback rate for complications, you’re going to be home less than others.

The skill aspect is something not talked about much but is something I’ve seen make a massive difference. Of course there’s also specialty selection and practice design that impact QOL, but the basic skill issue is a major determinant that’s just hard to quantify or predict. Applies in clinic too - I had attendings in residency whose clinics always ran until 8-9pm and others who finished on time at 5pm after seeing 50-60 patients and had all their notes done too. Want to guess which one saw their family more?

So, if maximizing family time is important, seek out good training that prioritizes efficiency and has faculty who are modeling it. This is easy to ask about in interviews when the time comes.

For me developing my clinical skills by working more (ie having more practice) made me a very efficient clinician. I regularly would see the most patients in clinic and I would be the one taking on extra patients because those with supposedly more experience than me were slower and falling behind.

Is this the same for surgery and medicine ie the more you work in training (residency), the more efficient you become?

---

Members don't see this ad.

 

[operaman]

For me developing my clinical skills by working more (ie having more practice) made me a very efficient clinician. I regularly would see the most patients in clinic and I would be the one taking on extra patients because those with supposedly more experience than me were slower and falling behind.

Is this the same for surgery and medicine ie the more you work in training (residency), the more efficient you become?

Generally speaking yes. I would only add that you will also need attendings with a similar focus since in training they can be the limiting factor. It’s also good to learn how the most efficient ones manage their workflow. If your staff are slower then it may be challenging to learn how to run a busy efficient clinic yourself. You can learn after training too, but it just takes a bit longer than if you have mentors demonstrating how it’s done.

Sounds like youve got a knack for efficiency already so this can easily be something you prioritize in training and practice. The most efficient docs get very obsessive about it but that obsession pays off. Patients also like it more too - having an appointment for 11am and the surgeon enters the room at 11:01 and you’re out the door by 11:10 with all your questions answered. I used to think patients would hate that but the satisfaction scores say otherwise, not to mention improved access times.

So yes your existing efficiency bodes well for future practice!

 

[esob]

To chime in on beating this dead horse that has literally been beaten for decades, you can pretty much go to med school at any age if they will accept you, lol. My two cents, if anyone happens to be short two cents

- at the end of the day, yes, the PA/NP track is faster and for SOME people in SOME scenarios, might make more sense, but there is not any truth in the broad statement that this pathway is better in general for older students

- at the end of the day, yes, there will be family tradeoffs regardless of whether you are male or female if you have kids. I miss mine terribly and I question on a regular basis if pursuing this goal is selfish.

Lastly, thank you to @Meridian32 for demonstrating how to expertly and efficiently counter an argument. Using reason and studies to demonstrate something should be the gold standard that we all strive for, and linking the literature propagates a chain reaction of education for everyone who encounters the thread.

 

[Mass Effect]

Well how old are you? At some point you will objectively be too old. I think all people would agree that 95 is too old and almost all people would agree that 50 is too old. Under that it is a grey area and everyone will have their own opinion.

I personally think that starting after the age of 33 is too old because if you start after that you will be in your 40's and still be a resident.

My co-resident started residency at 43. He managed to do just fine.

 

[Goro]

I was told my a attending physician that I am too old to become a physician and that I will struggle in medical school because I am older.

I was told that since I am older, I should choose something easier like PA, NP or pharmacy. And that financially its not a good choice.

Basically was told that since I am older (and possibly because I am a female) that med school is not feasible/attainable or practical.

Tea, I noticed that you didn't answer the question about your age. No matter.

My own personal cutoff line in giving advice on this is age 50.

Some of my all time best students have been in their 30s and 40s. I graduated a stellar woman a few years ago at age 50, and she's now an attending somewhere in So Cal.

 

[deleted1005514]

Tea, I noticed that you didn't answer the question about your age. No matter.

My own personal cutoff line in giving advice on this is age 50.

Some of my all time best students have been in their 30s and 40s. I graduated a stellar woman a few years ago at age 50, and she's now an attending somewhere in So Cal.

She did, she’s 31...OP, I’m an OMS-1 at 40, with a family. Do what you want and don’t listen to the naysayers.

 

[Goro]

31? Just a baby!

 

[Goro]

The physician shortage is a result of Congress's failure to increase residency spots. This has resulted in physicians choosing to be in urban areas over rural and specialties over primary care.

There is no other profession that I know of where we place the burden of need on the employees rather than the job market. Again, if you were so committed to improving the shortage, you'd work longer hours for lower pay.

In reality, there is no physician shortage, only a maldistribution.

Nice to see the Banhammer in action. Not gloating, just giving kudos to the mods.

 

[srbm1786]

I only skimmed a lot of the replies because...wow...but OP, I’m hoping to start med school next year at 35. I have a spouse and children. I’m pretty committed to family med, which puts me finishing residency at 41/42. We’ve crunched the numbers and given that my current income potential is lower than I’ll make as a resident (granted, I’ll work a lot harder for it as a resident), and considering attending FM salaries in the rural areas we want to live in, it makes financial sense even when we factor in living on one income during medical school and paying back loans (although a lot of rural FM jobs come with loan repayment perks, so that may help).

I’m lucky in that I married and had children very young, so my relationship is pretty stable and my kids are getting older and more self-sufficient. It will still be a challenge to balance family life and medical school/residency, but we’ve made arrangements to make it easier (my recently retired mom is planning to live with us) and I think we have a pretty clear idea of what we’re getting into and how we’ll make it work (as much of an idea as we can have from the outside looking in, anyway).

I think when you’re getting a “late start” you really need to have a clear picture of your goals, your financial situation, and what you want your life to look like. It sounds like you have that. As long as you’re going into it with a clear understanding of the financial risk, the time commitment, and the potential downsides of starting later in life and the things you may be giving up for medicine, I say go for it. You only get one life, might as well spend it doing what you love.

 

[readmypostsMD]

I’m a 27 year old m1 and chillin like a villain

 

[journalisttomed]

1) i am 34 (started medical school at 33), now starting M2. So i know EXACTLY what you are talking about.

2) i was told the same thing by random ppl. Then i read somewhere: "you are gonna be 40 years old anyway. Would you rather be a 40 year old doctor, or 40 year old something else?". Read it several times for it to sink it. It is so true, you know? I am single, no kids. Live alone with my cat and my dog. So i was thinking: "i need to focus on ME. what do i want? I want to be a doctor. so, forget what everyone else says. it is MY life, and it is up to me to decide what to do with it.".

3) i calculated a spread sheet with potential income, and debt, it is STILL worth it becoming a doctor, even if you dont become attending till 42 (which is my timeline).

4) i looked into egg freezing, - relatively inexpensive, and gives options for later.

5) as far as studying, - it will be hard regardless of how old you are, or how long you would have been out of school. But step will be pass/fail when you start, classes are all pass/fail. The only thing you have to worry about is step 2. That's it. and you just have to trust that if you are accepted, it means you are smart enough to be in medical school. I know how stressful it is to compare yourself to those who are younger, and think that you are, somehow, less worthy or less capable because of the age. but it is not true.

6) so i realized recently that actually while you are in medical school, age is sort of an advantage. I noticed that patients trust me more, for example, because i look a bit older i think, and overall, i dont sweat some things that stress out some of my younger classmates. So, before i started medical school, i felt like age was a negative factor. Now i see it as a positive actually. So, once you get in, i think this will go away.

btw... i am by far not the oldest person in my class.

I am starting my undergrad at 29. I will be 33 or 34 when I start med school. Are you doing MD program or DO?

 

[M&L]

I am starting my undergrad at 29. I will be 33 or 34 when I start med school. Are you doing MD program or DO?

MD. Feel free to PM me if you want more info

 

[rugbyfan23]

Even though I’m not the OP thank you for sharing as this would be almost identically my timeline! If I’m successful this cycle, I’d matriculate at 32. I too would rather be an attending in my 40’s rather than something else

 

[Mad Jack]

1) i am 34 (started medical school at 33), now starting M2. So i know EXACTLY what you are talking about.

2) i was told the same thing by random ppl. Then i read somewhere: "you are gonna be 40 years old anyway. Would you rather be a 40 year old doctor, or 40 year old something else?". Read it several times for it to sink it. It is so true, you know? I am single, no kids. Live alone with my cat and my dog. So i was thinking: "i need to focus on ME. what do i want? I want to be a doctor. so, forget what everyone else says. it is MY life, and it is up to me to decide what to do with it.".

3) i calculated a spread sheet with potential income, and debt, it is STILL worth it becoming a doctor, even if you dont become attending till 42 (which is my timeline).

4) i looked into egg freezing, - relatively inexpensive, and gives options for later.

5) as far as studying, - it will be hard regardless of how old you are, or how long you would have been out of school. But step will be pass/fail when you start, classes are all pass/fail. The only thing you have to worry about is step 2. That's it. and you just have to trust that if you are accepted, it means you are smart enough to be in medical school. I know how stressful it is to compare yourself to those who are younger, and think that you are, somehow, less worthy or less capable because of the age. but it is not true.

6) so i realized recently that actually while you are in medical school, age is sort of an advantage. I noticed that patients trust me more, for example, because i look a bit older i think, and overall, i dont sweat some things that stress out some of my younger classmates. So, before i started medical school, i felt like age was a negative factor. Now i see it as a positive actually. So, once you get in, i think this will go away.

btw... i am by far not the oldest person in my class.

I think that 40 year old quote was me talking about my struggle to decide. It was a very kind ER attending at Big Ivy that set me straight with those words. I'm a ways from the end, but I'll say it (so far) seems worth it. After all, what else would I be doing with my life?

 

[deleted1085158]

As you get older you will realize that nobody really knows anything. People just do what they know.

 

[Mad Jack]

As someone who is slightly over the 30 hump, and a resident, let me just say residency is significantly (and I mean SIGNIFICANTLY) more draining and time intensive than med school. And I wasn’t exactly someone who thought med school was cake (hardly ever took days off because I needed to study constantly to get decent grades). I’m not exactly in a grueling field either (probably above average in work hours?)

just something to consider for all the non-trads out there

gl

Depends on the residency. I found medical school to occupy far more of my time and energy than psychiatry residency. But I will say that it can feel quite draining at times, even with my benign 55ish hour work weeks

 

[DO2015CA]

The comments by many attending physicians on these boards (ages >40+) leave me to wonder whether medical education is working anymore, aside from being the financial scam it is. The usual metrics of premed, medschool and USMLE scores are not predicting whether they can survive in today’s medical milieu or whether trainees are being provided the necessary tools to survive the way medicine is practiced today vs. 50 years ago.

the old timers at the free clinic where I work are hard core old fashioned with patient face to face, meticulous H&P and protracted questioning sans computers. The younger physicians and residents volunteer at the free clinic because of their passion for medicine and idealism to help patients, but their story telling of physician work in the hospitals, as they articulate, has been disillusioning. I just wonder whether med ed is failing trainees and hammering at tried and true metrics that have little application to how medicine is practiced today in vivo. I dont know if its a matter of whether med schools should be testing EQ, maturity, resilience or adaptability given that medicine is undergoing seismic shifts towards revenue making.

all in all, as an older non-physician clinician, i see young doctors disillusioned, burnt out and seeing medicine as a job, as contrasted to vocation.


.

As residents and young attendings, We are chewed up and spit out by a failing system that has more documenting requirements, quality measures, more production forces, less true private practice meaning more administration dictating your care, way more student loans (trapped in a bad situation feeling), etc. the list could go on and on. No wonder we are burnt out. Its not that we are less resilient but we are taken advantage of way more than previous generations. If anything we are more resilient because we still show up to work despite all these factors.

 

[Dave1980]

@greentea101 how old are you?

 

[Mad Jack]

The comments by many attending physicians on these boards (ages >40+) leave me to wonder whether medical education is working anymore, aside from being the financial scam it is. The usual metrics of premed, medschool and USMLE scores are not predicting whether they can survive in today’s medical milieu or whether trainees are being provided the necessary tools to survive the way medicine is practiced today vs. 50 years ago.

the old timers at the free clinic where I work are hard core old fashioned with patient face to face, meticulous H&P and protracted questioning sans computers. The younger physicians and residents volunteer at the free clinic because of their passion for medicine and idealism to help patients, but their story telling of physician work in the hospitals, as they articulate, has been disillusioning. I just wonder whether med ed is failing trainees and hammering at tried and true metrics that have little application to how medicine is practiced today in vivo. I dont know if its a matter of whether med schools should be testing EQ, maturity, resilience or adaptability given that medicine is undergoing seismic shifts towards revenue making.

all in all, as an older non-physician clinician, i see young doctors disillusioned, burnt out and seeing medicine as a job, as contrasted to vocation.


.

This is more a function of health care going down the tubes than anything else. Physicians used to be leaders, now they're basically treated as employees. When you go from being a manager to a cog in the machine, burnout and apathy are quite prevalent. I'm likely going to lean more toward leadership and entrepreneurial practice due to the alternatives feeling quite oppressive. Thankfully psychiatry still makes forging your own path quite possible. The field isn't the problem, the system is

 

[DO2015CA]

This is more a function of health care going down the tubes than anything else. Physicians used to be leaders, now they're basically treated as employees. When you go from being a manager to a cog in the machine, burnout and apathy are quite prevalent. I'm likely going to lean more toward leadership and entrepreneurial practice due to the alternatives feeling quite oppressive. Thankfully psychiatry still makes forging your own path quite possible. The field isn't the problem, the system is

1000%

 

[DO2015CA]

I was a Clinical Perfusionist for 10+ years, then joined industry as a Medical Liaison 15+ years. Now Im a bench top medical researcher and interface with medical students, residents and Fellows, as well as PhD researchers, Attendings / Chiefs. I often stick up for Millennials and iGen individuals, and am more critical of their parents (Baby Boomers). I am often moved with compassion for them, likening them to mice in a cage. They are victims being poked, shaved and disemboweled by greedy handlers. Every time I see the construction crew at our facility adding more floors, constructing new outpatient centers, or the hospital admins engaging in massive public relations about the new “childrens hospital, surgical center, epilepsy center”, etc, I see money. I dont think in terms of new cures or new relief for patients. I see greedy hospital admins wringing their hands with dollar signs in their eyes.

The system is indeed broken. Too many books to list written by physicians but pick a smattering of them and you will find ample support and data. However, what to do? Thats the premise of my query

medical training was never easy. Instrumentation, surgical / procedural tools and supplies, availability of hospital beds and surgical suites, need of physician specialists, having appropriate pharmacological armamentarium (e.g. cancer, pain, etc) tended to separate the wheat from the chaff as to cadre of physicians. Ive seen many physicians break down and sob in hospital hallways, ive seem many more have marriages and children gone belly up, then there is suicide, addiction, criminal behaviors ala fraudulent billing, fraudulent prescriptions, etc. The stressors due to scarcity that existed 30-40 years ago dont exist today. Something more pernicious has taken their place.

Are things far worse today than 30-40 years ago? I dont think so. Walking through the university hospital where my lab is located across the street often makes me disgusted at how plush hospitals look today compared to the 1980s. Hospital beds, BP cuffs, thermometers, patient scales, patient consult rooms, etc are all stuff of luxury. When I was a teen working as an orderly at a community hospital of 3 floors, beds were foam encased in vinyl, thrown on metal springs with a manual crank to raise or lower the bed. There was nothing electric about them. Yet we functioned. Physicians were leaders, as @madjack notes below, but junior physicians and trainees were not spoon fed like today. Nurses were tough, aggressive and dealt with insecure physicians swiftly. Physicians learned by trial and error with little mentoring or less senior supervision. If you think the environment is coarse today for Residents, your predecessors dealt with outright physical and/or mental abuse. Ive seen surgical residents pushed against walls, thrown into doors, surgical instruments used as weapons by Attendings, and yes, some rightly dressed down by Chiefs because they thought they were above Black female surgical techs. Those same surgical techs taught Attendings and Chiefs how to operate. They could do surgical procedures blindfolded.

it was harsh but it worked. I cant imagine what it was like in the early to mid 1900s.



its the only way to practice medicine today, as far as I am concerned, for me. Todays hospital and physician groups are focused on revenue first, physician-patient relationship dead last. If you join such an organization, you either become part of the problem or you lose your mojo. Yet few trainees have any business background and hence see their only career option as physicians employed by the dark side. There are far better options but that is up to each trainee to discover what is best for them.

I still believe that med ed is deceiving trainees as to what awaits them precisely because of revenue for med ed. They talk about health care disparities, diversity and inclusivity, but they are part of the revenue chain as well.

'UVA Has Ruined Us': Health System Sues Thousands Of Patients, Seizing Paychecks And Claiming Homes - KFF Health News

Over six years, the state institution filed 36,000 lawsuits against patients seeking a total of more than $106 million in unpaid bills, a KHN analysis finds.

khn.org

Your essay that you just wrote means nothing to me nor addresses my statement. Great the older generation were physically and verbally abused. That is not what I’m referring to. I’m not referring to the MEDICAL training aspect. It’s the cog in the wheel, bloated failing system, and apathy. There was no argument from me about training. I prefer harsh teaching compared to hand holding. That way I learn it better. That’s why I lumped residents and young attendings as one group.

 

[FluffyCat1212]

For what it's worth, one of my mom's friends started med school in her 50s! She's just now wrapping up residency. It's hard, but it can be done! If it's what you really want, then go for it.

 

[cappy1985]

I'm an M4 and I'll be 40 when I graduate. I have a wife and kids and (fingers crossed) I'll be going into radiology. There are a lot of aspects of age that help with being in med school, one being maturity and another being experience outside of school and medicine. While I'm in relatively good shape and I haven't lost much of my edge since my 20s, as the song goes, I ain't as good as I once was (maybe 95%).

I met my wife right before I started working towards med school and I'll always be thankful for that. Dating in medical school and even more so in residency is difficult due to the time constraints, stress, and commitment. We had our first in M1 and that was honestly the perfect time. Once M3 came around I was gone more than I was around, and much of the other time I had to study.


This is a ridiculous argument. While I don't entirely disagree that it's hard to be a good surgeon and a good parent because both are so demanding, the idea that someone "took a spot" from someone else is silly. Although doctors have an obligation to treat each one of us carves out the balance we feel is appropriate. You're only working 5 days a week? You could've treated more on the 6th. Office hours are only 8-4? Why not longer? It's not our job to work all the time.



I'll say this: at a certain point, a person is too old to go to med school. The demands, the finances, the value; all of them eventually tip the scales in the other direction. There are people on this board who are in their late 40s and 50s entering med school and I think it's ridiculous, but I'm not an ADCOM and it's just my opinion.

As a parent in med school you will make sacrifices that other parents don't have to make. I'm lucky enough that I have family whom I can rely on to raise my kids in the way I would but many people don't have that. Personally, if I had to have daycare to raise my children then I would have difficulty justifying the choice to have kids. While there are things that only I can teach my kids, they're not yet old enough to learn those lessons.

Lastly, people are bastard coated bastards with bastard filling. If someone sounds like an idiot then they probably are. Ignore them and make the best decision for yourself and if you screw that up then you have the confidence of knowing that it was your own choice.

yikes, hope I don't cross this person's path.
"people are bastard coated bastards with bastard filling"
Tell me how you really feel about people? Patients too?

 

[newdoctobe]

yikes, hope I don't cross this person's path.
"people are bastard coated bastards with bastard filling"
Tell me how you really feel about people? Patients too?

Did you catch that he was going into rads?!

 

[petomed]

I was told my a attending physician that I am too old to become a physician and that I will struggle in medical school because I am older.

I was told that since I am older, I should choose something easier like PA, NP or pharmacy. And that financially its not a good choice.

Basically was told that since I am older (and possibly because I am a female) that med school is not feasible/attainable or practical.

When considering medical school as an older non-trad, we have a few things to square up with when compared to our straight-through peers.

1) Finances. How will you pay for medical school? If taking loans, are you ok with what may be taken from you (job preference, location, hours) in order to pay them back? If not, are you ok with potentially working beyond your preconceived notion of retirement age?

2) Being out of step with others your age. If your like me, folks are starting to buy their second home, make additions to their first, have their second or third kid. Perhaps these are poor examples but it is unlikely you will be able to do the same things in the same quantity as your similarly-aged friends for several years to come if you pursue medicine. Yes, straight-through med students are out of step similarly to this but we're doing it at a much more unconventional age.

3) Biology. Research has shown that both the man and the woman's age contribute to the child's health in manners that have been conventionally only associated with the woman's age. Increased age of the man and woman seem to compound the poor outcomes.

I was able to quickly work through (1) and (2) when I first stepped on the path to medicine. But (3) I struggled with. I've always wanted to have a family but I knew how hard that might become once I begin medical school, and beyond. At the end of the day, I chose medicine over family and came to terms with that reality. Then, like so many others, I met my wife along the way and here we are with our first kiddo. We would like to have another and another and another, but biology may have already put the breaks on that for us. Adoption has never been off the table so who knows how our family will grow as time goes on.

Being pregnant during medical school and going into labor when you're supposed to be sitting at a desk taking your exam would suck, no doubt about it. The schedule of a med student really doesn't accommodate any events to occur during the school year, planned or unplanned. There are of course policies for health events like childbirth but there is no way it's convenient. With that being said, many women have children during medical school. I've focused here on women specifically because while men are in the same boat if they have kids, they aren't physically being pregnant, pushing out a baby, getting a third degree tear, learning to poop again, etc. Women just have it worse, there's no comparison.

Look, there's no perfect time to have a kid. There's no perfect time to date. There's no perfect time to go to medical school. Time is always against all of us. You can do medical school at 31, 51, or 71 for that matter. All you have to work out for yourself is if the juice is worth the squeeze.

 

[Nugester]

Late to the game but throwing in my age in case you read this. You are never too old (unless you are dead).

Finishing up year 1, 35. There are maybe a couple of older classmates that I can think of (one is in her 40s with two kids).

And no, I'm not struggling and doing quite well academically. If you want children/family, there are options and you can have both though you may have to be a little more selective about the specialty you choose.