CRNA to MD

[OpenMind10]

I'll try and keep this brief.

I'm a CRNA that works in very autonomous positions. I see the vast majority of my patients alone, and do any procedures I like (ISBs, Epidurals, CVLs). Anesthesiologists are essentially consultants in our practice. We have a good relationship with open communication. They don't limit me, and I don't disregard their knowledge and expertise. It's a good gig.

I've enjoyed being a nurse, and a CRNA. I get paid about average, live in a decent area.

However, I'm thinking about medical school.

As for why - it boils down to limitations. I've grown tired of the limitations of my profession, in many ways - general medical knowledge, education and training, not to mention career possibilities (ex: if I want to work in a desirable area, I have to trade compensation and/or autonomy - usually both).

I sense these limitations on an every-day basis - when I see critical patients and seek consultation, when I speak with my colleagues whom I observe don't have the same basic desire for in-depth knowledge of the field, and when I look at job opportunities across the country.

In regards to clinically-related personal characteristics, I often have more in common with the physicians in my group than members of my own profession. This leads me to think that perhaps it's worth a investigating a change of profession.

This post was prompted by a few physician friends encouraging me to investigate this possibility.

I suppose I'm a late bloomer.

So here's my question for those who feel they have an answer to share, and are willing -

Attending medical school and residency would come at great cost personal and financial cost. Given the current situation in healthcare -

Is this itch worth scratching? Or I am being foolish for inquiring about this goal? Has medicine change so much (future changes not withstanding) that it would be wiser, on the whole, to be satisfied with where I am, live my life, accept my limitations and do as much good as I can in my current profession?

Thanks for your insight,

OM10.

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[deleted307836]

I lurk on the anesthesia forum here as I'm interested in the specialty. You may get better advice there though they can be hostile to CRNA's posting. There is one poster there who made the transition from CRNA->MD, though decades ago when the climate was different (I think his username is Dejavu?).

Anyway, some questions:

-How old are you? Do you have a family? Do you want one?

- Do you have any of the medical school prerequisites completed? How competitive are your stats so far (GPA, etc.)?

- Are you open to moving across the country for medical school? For residency?

- Are you considering pursuing other specialties besides anesthesia, or are you only interested in becoming an anesthesiologist?

As a CRNA, I would guess that you have some of the pre-requisites completed. But if not, that could add another two years before you can apply. Add that to four years of medical school, 4-5 years of residency (if you pursue a fellowship), and you could be looking at just over a decade before practicing as an anesthesiologist. Depending on many factors such as your age, current ability to pay for school, and the practice environment in ten years... financially speaking, this is likely to be a "wash" at best and likely something you won't ever benefit from (financially). However, it's hard to put a price on career satisfaction, and if this is something you really want to do, then it's better to do it sooner rather than later.

If you're curious about how this would affect you financially, I would suggest creating an excel spreadsheet with two scenarios -- one if you continue as a CRNA, and one if you choose to pursue medicine. This will better help you visualize the opportunity cost of pursuing medicine (or potentially, the long-term opportunity cost of remaining as is).

 

[Dejavu]

I lurk on the anesthesia forum here as I'm interested in the specialty. You may get better advice there though they can be hostile to CRNA's posting. There is one poster there who made the transition from CRNA->MD, though decades ago when the climate was different (I think his username is Dejavu?).

Anyway, some questions:

-How old are you? Do you have a family? Do you want one?

- Do you have any of the medical school prerequisites completed? How competitive are your stats so far (GPA, etc.)?

- Are you open to moving across the country for medical school? For residency?

- Are you considering pursuing other specialties besides anesthesia, or are you only interested in becoming an anesthesiologist?

As a CRNA, I would guess that you have some of the pre-requisites completed. But if not, that could add another two years before you can apply. Add that to four years of medical school, 4-5 years of residency (if you pursue a fellowship), and you could be looking at just over a decade before practicing as an anesthesiologist. Depending on many factors such as your age, current ability to pay for school, and the practice environment in ten years... financially speaking, this is likely to be a "wash" at best and likely something you won't ever benefit from (financially). However, it's hard to put a price on career satisfaction, and if this is something you really want to do, then it's better to do it sooner rather than later.

If you're curious about how this would affect you financially, I would suggest creating an excel spreadsheet with two scenarios -- one if you continue as a CRNA, and one if you choose to pursue medicine. This will better help you visualize the opportunity cost of pursuing medicine (or potentially, the long-term opportunity cost of remaining as is).

This is all very true.

I am that guy mentioned earlier who did what you are thinking about doing, CRNA to MD (not, by the way, MDA).

But to add, I was unprepared for the amount of work that Med school and residency were. The first two years of med school are about 27 credit hours each semester of hard core science, not music history. I studied from 0800 to supper time, ate with my family then studied till 2200, each night and weekends for two years. There is no comparison of work involved between CRNA school and Med school. None.

Then you are a peon med student on the wards for the last two years. So low on the totem pole that nurses consider it okay to just grab a chart out of your hands without asking, since you are a non-entity. And every day you submit to grilling from every doctor you meet. Believe me, you get no credit for all the experience you gained as an RN and CRNA. They don't care.

You will gain no retirement benefits for those years, and no salary, since you are a student, not an employee.

Then you get out and into internship year. I was in the Marine Corps for 4 years and I would rather do those 4 years over again than my internship year.

And, depending on the specialty, the 3-6 more years of residency aren't much better. Again, you gain no retirement benefits, work long hours for little pay.

You better really want to be a physician. I wasn't prepared for all the work and BS involved.

Am I glad, now, that I did it? I would answer with a qualified "yes". But not without regret and second thoughts. My family and I were clinically depressed as we all went through it. If you have kids, my biggest regret of doing this was having moved my son in the middle of high school. That was 20 yrs ago and I think he is still angry about the upheaval in his life, just to follow my dream.

If you want this, do it and do it now. It will take 10 yrs, but you will be 10yrs older whether you do it or not.

Being a physician is pretty nice, but a hard road to get there. I don't care what schooling you have had in the past, this pathway is harder by many multipliers. At least go into it with your eyes open, and, if you are married, with your family fully prepared.

 

[OpenMind10]

I lurk on the anesthesia forum here as I'm interested in the specialty. You may get better advice there though they can be hostile to CRNA's posting. There is one poster there who made the transition from CRNA->MD, though decades ago when the climate was different (I think his username is Dejavu?).

Anyway, some questions:

-How old are you? Do you have a family? Do you want one?

- Do you have any of the medical school prerequisites completed? How competitive are your stats so far (GPA, etc.)?

- Are you open to moving across the country for medical school? For residency?

- Are you considering pursuing other specialties besides anesthesia, or are you only interested in becoming an anesthesiologist?

As a CRNA, I would guess that you have some of the pre-requisites completed. But if not, that could add another two years before you can apply. Add that to four years of medical school, 4-5 years of residency (if you pursue a fellowship), and you could be looking at just over a decade before practicing as an anesthesiologist. Depending on many factors such as your age, current ability to pay for school, and the practice environment in ten years... financially speaking, this is likely to be a "wash" at best and likely something you won't ever benefit from (financially). However, it's hard to put a price on career satisfaction, and if this is something you really want to do, then it's better to do it sooner rather than later.

If you're curious about how this would affect you financially, I would suggest creating an excel spreadsheet with two scenarios -- one if you continue as a CRNA, and one if you choose to pursue medicine. This will better help you visualize the opportunity cost of pursuing medicine (or potentially, the long-term opportunity cost of remaining as is).

This is all very true.

I am that guy mentioned earlier who did what you are thinking about doing, CRNA to MD (not, by the way, MDA).

But to add, I was unprepared for the amount of work that Med school and residency were. The first two years of med school are about 27 credit hours each semester of hard core science, not music history. I studied from 0800 to supper time, ate with my family then studied till 2200, each night and weekends for two years. There is no comparison of work involved between CRNA school and Med school. None.

Then you are a peon med student on the wards for the last two years. So low on the totem pole that nurses consider it okay to just grab a chart out of your hands without asking, since you are a non-entity. And every day you submit to grilling from every doctor you meet. Believe me, you get no credit for all the experience you gained as an RN and CRNA. They don't care.

You will gain no retirement benefits for those years, and no salary, since you are a student, not an employee.

Then you get out and into internship year. I was in the Marine Corps for 4 years and I would rather do those 4 years over again than my internship year.

And, depending on the specialty, the 3-6 more years of residency aren't much better. Again, you gain no retirement benefits, work long hours for little pay.

You better really want to be a physician. I wasn't prepared for all the work and BS involved.

Am I glad, now, that I did it? I would answer with a qualified "yes". But not without regret and second thoughts. My family and I were clinically depressed as we all went through it. If you have kids, my biggest regret of doing this was having moved my son in the middle of high school. That was 20 yrs ago and I think he is still angry about the upheaval in his life, just to follow my dream.

If you want this, do it and do it now. It will take 10 yrs, but you will be 10yrs older whether you do it or not.

Being a physician is pretty nice, but a hard road to get there. I don't care what schooling you have had in the past, this pathway is harder by many multipliers. At least go into it with your eyes open, and, if you are married, with your family fully prepared.

Thank you both for the thoughtful replies. I spent the day and evening thinking about this thread.

Citylights - to answer you, I'm almost 30, no family but open to that possibility, GPA > 3.5, have some (not most) of pre-reqs done, and would be somewhat willing to move*, and would consider other specialties. (*> I'm willing, my wife has some health issues, which complicates the matter).

Financially, it is a wash, probably even a loss.

CRNA: $150k x 30yrs = 4.5 million.
MD (not MDA 😉 - $300k x 20 years = 6million

The $1.5 million difference is erased with lost income, debt, interest, and opportunity cost.

Med school (150k x 4) + Residency (100 x 5) + (150k of student debt + interest) + Med School cost (200k) = 1.5m - ish.

Dejavu, thank you for your honest answer and for your description of the rigor of medical education. There is a part of me that says, "Challenge!! Oooo fun! Do it!" ... but looking at the financial cost, and the personal cost, especially - the decision becomes very clear. Looking at those years of stress you've described - for me, the cost outweighs the benefit.

I have obligation not just to myself, but also to my wife, who has already been waiting for 3 years for me to be out of full-time education. Not to mention the high probability of moving, spending time apart, and the only reward being my heightened personal satisfaction, since the financial benefit is nil.

Perhaps if my current career wasn't a solid one, the choice would be different. Or if this was a 'calling.' But it's not, just an interest and investigation. I'm thankful to have a career where I can do a great deal of good for others, and be well-compensated to boot.

Thinking about your replies helps to bring clarity to the matter. Thank you both.