What do you think a helpful response to the question "why shouldn't we (medical students) get paid along the way?" should look like?
I'll leave it to you to start the discussion. The reason YOU, MrCheetah, don't get paid, is because you took a job that doesn't pay for the period during which you are a trainee. Did you not know that on your first day of orientation as an MS1? Was that a surprise? Were any of your classmates surprised that they weren't going to be pulling down a paycheck? Were you surprised that medical school would be the hardest thing you've ever done? You can continue to feel like you *deserve* to get paid, and that not getting paid is a great reason to be so sadly bitter. Let me know how that works out. I feel sorry for you.
Of course, you make the obvious point.
However, my suggestion was a little less superficial than that.
And I'll remind you that you still did initially try to make your point by pulling some **** out of your ass.
I think that there is a very strong argument to be made that medical students should have their training paid for by the government and given a small stipend to live off of. Just take a look at the way medical education works in Western European countries. Its essentially free compared to how we have it here.
I don't feel as if I deserve to get "paid" per say, but I feel that I do deserve to become educated without having to pay off $400k + in loans to do so, especially if I'm passing up more financially lucrative career opportunities to do so. Its an appalling amount of punishment to take to get into a career in which your sole purpose is to "serve others".
I'm not aganist "paying your dues" when it comes to most professions, except medicine.
If a kid wants to get to the top of a Wall Street investment firm and needs to pay his dues - thats fine. Banking is a, relatively speaking, selfish profession, he is getting paid a good wage while he is "paying dues", and he has the potential to make millions per year in a senior position. He knows that he is being exploited by his superiors, but its not a big deal for all of the reasons above.
In medicine there is a similar concept of "paying your dues", however none of the above applies to this profession. Not only are you not getting paid while you are "paying them", but you are going several hundred thousand dollars into debt if you're in school, and are making a low wage while a resident, not to mention the fact that you, at this point, are getting absolutely no assistance with that 200-300k+ debt. You're not even on track to make half of what an equally intelligent person who goes into finance or business and spends equal time rising the ranks or growing will pull in.
However, most of us see medicine as something that is "safe", and "secure", and most people, the scared bunch that we all are, will pay quite a high price for security. Yes, even if it is over 1 million dollars when we calculate our opportunity cost and account for it. Yes, even if we are stressed, overworked, and take on a shorter life expectancy because of it.
Some of us, though, do have a genuine desire to help others, and have a passion for medicine and science. Some of us are extremely and rational as well, and realize that despite this passion we might not lead a happy life due to the reasons above. We have "altrustic" merit, but realize our first priority must be to take care of ourselves, even if it ultimately leaves others worse off.
This is one of the problems with the current system: It punishes those types of people who are the most responsible.
There are two broad factors which compel most people to enter medical school: The money and prestige associated with being a doctor, and a sheer interest in medicine and serving others.
I don't know about you, but I'm undoubtedly one of those idealistic few who could care less about the money and prestige factor. Its for the medicine and ultimately for the service to humanity that I'm in this for, however my top priority is, and always will be, to take care of myself first.
And to pre-empt a retort I'm sure someone will make in which they say "Bullocks, you're given money to take care of yourself," I'll tell you exactly what I mean; I have a simultaneously liberal and very modest definition of what taking care of myself means. It means being able to have a roof over my head, healthy food to eat, and time to exercise and form meaningful relationships with people (having the capacity to be both mentally and physically healthy, in other words). It means having the freedom to perform all of my life's actions by choice, not by force, and to have no restrictions on my ability to achieve any of these extremely modest ends.
One of the things which you've hammered upon several times is that its not a "huge loss" if someone decides not to go to medical school, or to drop out, because "someone else will gladly step up". And I agree with you to the extent that if someone who was casually looking for a vocation who happened to be considering medicine were to decide upon another that it wouldn't be a huge deal. But when there arises even a slight proclivity among those with more noble merits to be forced away from medicine because of the cost, the time, stress, or any of those other reasons which would make it a "bad" profession to go into, its a greater injustice that the patients are the ones who ultimately lose, not necessarily the non-matriculants who I feel you so desperately want it to be.
Most of us medical students are not taken care of in any way in the standard I mention above. Sure, we can choose to go into the profession or not, however after a year or so into training we are more-or-less slaves to our debts and are reasonably, financially forced to go through with it whether happy and mentally healthy or not. We will be stressed and work vigiriously and work long hours at various times throughout our training.
This would be acceptable if, by the end, there was some big payoff that we were fervently working toward. For many of us there is a payoff; we get a job that pays above the average wage that seems to be reasonably secure for the forseeable future, and of course we get to wear that white coat too. Though, For those of us who go into the field because of those more "noble" factors I mention above there isn't a similar payoff. The closest we get to one is that which we gain from that which is not money, nor prestige or status. Its some form of satisfaction at our deeds which comes from within. Its a nice feeling, but we are quick to forget everything that we both give and give up to attain it. Perhaps we shouldn't.
