DPT considering pursuing OP PM&R. Looking for guidance

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Undecided_DPT

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Hi,

First off, my background: I am an attending in my second full-time employment after completing a Sports Medicine fellowship.

I have no doubt you will be successful no matter what decision you make. However, my advice is to stay your current course.

The financial hit is simply not worth it. You seem to have a high business acumen, so I would focus on building your brand. I don't know if 100K is good for a travel PT, but from what I know, salaried PTs should be clearing 100K easily. If you fulfill your other business plans, you can be competitive with a lot of physicians.

If knowledge is what you seek, you can always do research and get involved with a PM&R training program.

Other things to consider - what would be your career goals as an MD/DO? Have your own practice? Be employed at a university? Be 100% clinical? As physicians move up the ladder, in general, there is less clinical time and more administrative time, which kind of negates your other reasons for considering this path.

Happy to answer any more questions. Good luck!
 
Lets say you start med school at 28. Finish med school+residency+fellowship by 37. Also lets assume you will practice for 25 years after that. A business minded person like you with multiple skills should be able to make 500k+ a year(10 years from now). Your net earning would be 12 million+ before taxes. Off course if you limit your self and are just an employee at a academic hospital the number is going to be lower. Maybe close to 300k+ by than.
If you continue doing what you are doing now and make 100k/year, grow a little bit every year, save, invest and don't make any significant financial mistakes you will probably still only have 1/2-1/3rd of what you can make as an attending in 25 years. The only way financially you can do better than a physician would be if you start your own PT practice, have multiple therapists/locations and sell to a bigger group or private equity. Money is a secondary goal. Personal satisfaction is what you should be striving for.
If I was in your position I would take the MCAT and apply to med school. If you don't get in at least you will know that you tried. In the end I would rather spend 25 years practicing at the top of my ability versus 36 years regretting not pushing myself harder. My med school room mate was 42 when he started with me. It has been 12 years since we completed med school and even today he tells me the worst day as a physician is better than the best day at his previous job.
 
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dont do it.

maybe its b/c its a monday, or maybe its because i am semi-burned out, but id recommend against it.

too many ins and out to go point by point, but with the given info, and if i were you..... i wouldnt do it.
 
Undecided_DPT said:
Hey! Thank you for the response.

On your first point - the potential for creating income beyond the standard staff salary is something I have wondered about. I had seen some unique ways I could blend what I’m doing now with that to try to generate some extra revenue on the side.

My big Q there though is how realistic is it to generate income at that level/make it as an OP private practice? From what I’ve seen of salary (which is limited) I would anticipate making ~200-250k as a staff physician. & I’ve heard a lot of doom & gloom about PM&Rs future in OP private practice (though everyone in healthcare always seems to be doom and gloom these days)

I think you make a really good point about the future and potential regret. I agree that it’s probably best to take the class & MCAT with intent to apply this upcoming cycle if even just to satisfy the desire

Thank you again,
-Adam
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Generating that income is very possible. The number you are quoting is a hospital employee in a saturated market at the current time. 10 years down the road expect to make more. If you do procedures and are business savvy 500k is not difficult. As long as patients have pain and disability PM&R will survive. Take the MCAT. Don't worry about getting a PhD. You will have plenty of people tell you not to do this but if I was in your position I would try my best and try to get into med school.
My room mate is 54 now and probably will work until he is 65. But most importantly he is happy.
 
I think you answered your own question when you wrote: “frankly I imagine I’ll regret not going not going back to medical school if I don’t do so.”

I didn’t start medical school until I was 26. I had a gap year between internship and residency and am currently in a sports medicine fellowship. I will be 36 when I finish. I never would have been happy doing anything else. Life is too short to not do what you are passionate about.
 
Kissmyabjj said:
I think you answered your own question when you wrote: “frankly I imagine I’ll regret not going not going back to medical school if I don’t do so.”

I didn’t start medical school until I was 26. I had a gap year between internship and residency and am currently in a sports medicine fellowship. I will be 36 when I finish. I never would have been happy doing anything else. Life is too short to not do what you are passionate about.
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That’s not true at all. There are a great number of reasons to not pursue a passion. Particularly as it becomes more and more detrimental to your personal, familial, spiritual and financial well-being.

I don’t know how detrimental this would be the the OP but “passion” is not a blank check to do something.
 
Thank you all to those of you who have responded and/or DMed or messaged me. I truly appreciate it & have found it all very helpful.

For those of you who have replies but not said this part — my big Q is would you do it again? Why/why not?
 
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Absolutely. Sure things are not as ideal as the 'golden age of medicine' but I still love going to work every day. Being able to help patients regardless of the all the barriers is what makes this worth it.
 
Undecided_DPT said:
Hey everyone!

Background: I’m a 26 year old physical therapist who has been practicing for about 1.5 years in the outpatient setting & am currently doing travel PT. I’m looking for guidance from those currently in the field (whether attendings or residents)

As early as second year of my DPT I found myself tempted by the idea of medical school and wrote it off (I initially had the thought in undergrad but immediately shut it down due to the long path & lifestyle.) However I keep finding myself coming back to the idea - with the goal of pursuing OP PM&R (sports or spine fellowship most likely.)

What drives me toward it is 1) More knowledge than what I have currently, 2) The ability to manage more of a patients care & so help more than I can currently, 3) The ability for more diagnostics (nerve conduction, ultrasound, etc.)

What makes me hesitant (/how I’ve tried to unsuccessfully talk myself out of this) is 1) The greater student loan debt (I would only pursue a state program and still anticipate taking on 200k more debt minimum) paired with lost income & investments as I currently make ~100k+ as a travel PT (would expect to currently hit ~80k if I went fulltime) Also having gone to the fancy #1 DPT program I already have 170k in grad student loan debt 2) The lifestyle cost as I woudn’t exit residency until 37/38 & what that may mean for friends & family and....

.3) In the last 1.3ish years I have built a large online presence and social media following (you can see my Instagram at this link if you’re curious Adam Fehr, PT, DPT, CSCS (@dr.afehr.dpt) • Instagram photos and videos ). From this I’m beginning to sell online services/products/programs/etc. with plans to build it into much more (a cash based clinic, likely courses down the road, etc.) Returning back to medical school would likely mean giving up or at least dramatically reducing the time I spend on growing my business

Overall I love being a PT, but I can’t see myself spending 2/3 my day walking someone through the mind numbingly simple TKA rehab 20 years in the future. In my eyes the solution to this is either to try and find intellectual fulfillment on the business/entrepreneurial side or to just satisfy my desire & return back to med school.

Frankly I imagine I’ll regret not going back to medical school if I don’t do so. But I also wonder if I would regret having done it even if I do (grass is always greener & all that.)

I apologize for making the post so long - but I wanted to give as much insight as I could. What I’m hoping is for advice or thoughts from those of you in the field - would you do it if you were in my shoes? What’re your thoughts on the idea? Etc.

Also: If you want to know stats for likelihood of admission: I have a ~3.8 math/science or pre-req GPA (like a 3.95 if you take out Bio2 that I blew off in my last semester of UG.) Cumulative UG is a 3.49 (lot of dumb reasons for the discrepancy) while my DPT GPA is a 3.4. Only pre-req I need for my state med school is Ochem I & to take the MCAT. MCAT might be a pain having been ~5 years out of the hard sciences but generally I have traditionally done quite well on standardized tests (85-98th percentiles on the GRE albeit it a much different test)

Thank you for any guidance, I really appreciate it!

-Adam
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I wouldn't to that myself. I would go with the course. You are looking at years of training with lots of lost income. Lots of possibilities for failure in the medical journey - you don't know if you'll do well on MCAT, if you'll get into med school, how you'd do in med school, if/which residency you'd get into, etc.
Don't do it
 
fwiw - you'll match at a dope place for residency with your existing credentials which will open plenty of doors throughout your career. Also, you should expect to make more than 200k/yr as an attending unless you go into academics. Median salary for private practice is ~275k/yr.
 
Plenty of med students are older than you.

The debt is a concern. I wish we didn’t borrow so much. But it’ll get paid off and we can afford a decent home in a very high COL area, so we still have it pretty good.

You get one life. Do what will make you happy-granted what will make us happy is hard to figure out and often changes.
 
RangerBob said:
Plenty of med students are older than you.

The debt is a concern. I wish we didn’t borrow so much. But it’ll get paid off and we can afford a decent home in a very high COL area, so we still have it pretty good.

You get one life. Do what will make you happy-granted what will make us happy is hard to figure out and often changes.
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Correct - your statement at the end couldn't be truer - what will make us happy is hard to figure out and often changes. Being a PT is a perfectly reasonable and good career choice, and with a salary of 80-100k as the OP mentioned at 26, he/she can certainly continue to improve his business, own therapy practices, etc.
Doing well on the MCAT is a +/- let's say you take it, get into 2021/2022 class of medicine - then you have at least 4 years of med school. then you have all the steps, then 4 years of residency. You will loose all that income for 8 years plus - you will likely get another 200k or so of debt - so yousaid you had 170k already - so you are looking at close to 400k by the time you graduate residency. Sure you may make long term another 150k plus yearly but you can probably also do that if you open PT practices, offer concierge services, etc.

It's a lot of "life" lost. I wouldn't do it if I were you. But that's just my perspective.
I also acn't believe you can now dislike comments! That's kind of cool.

Lastly I am not sure if you mentioend whether you have already done your pre reqs?
 
Piebaldi said:
I also acn't believe you can now dislike comments! That's kind of cool.
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nothing personal @Piebaldi lol.
'life lost'. Why would you say that. Do you not live during med school, residency etc. I had a great time and made some life long friends. I had to sacrafice a few things no doubt. Being a PT is fantastic for those who love it. But as the OP mentioned he feels that he is limited.
As he said earlier ''What drives me toward it is 1) More knowledge than what I have currently, 2) The ability to manage more of a patients care & so help more than I can currently, 3) The ability for more diagnostics (nerve conduction, ultrasound, etc.) '
For that he has to go to medical school. 400k in debt is daunting and so is the 800k is lost income. But as I had mentoned earlier if you look at it purely in the financial point of view he will catch up within 5-10 years of practicing medicine. Regardless @Undecided_DPT you have some tough choices to make.
@DOctorJay give him your prospecticve as a former PT. Quick intro about him. He is a MSPT who ended up going to DO school, trained at the top PM&R program for residency and fellowship.
Another example is
Allan Vrable DO, PT, DABPMR. I don't know him personally
www.globalneuroandspine.com

Pain Clinic Near Me | Global Neuro & Spine Institute

Welcome to Global Neuro & Spine Institute in Orlando, Jensen Beach, Palm Bay, Atlantis, Fort Pierce, Winter Park and Plantation, FL.
www.globalneuroandspine.com www.globalneuroandspine.com
 
PMR2008 said:
nothing personal @Piebaldi lol.
'life lost'. Why would you say that. Do you not live during med school, residency etc. I had a great time and made some life long friends. I had to sacrafice a few things no doubt. Being a PT is fantastic for those who love it. But as the OP mentioned he feels that he is limited.
As he said earlier ''What drives me toward it is 1) More knowledge than what I have currently, 2) The ability to manage more of a patients care & so help more than I can currently, 3) The ability for more diagnostics (nerve conduction, ultrasound, etc.) '
For that he has to go to medical school. 400k in debt is daunting and so is the 800k is lost income. But as I had mentoned earlier if you look at it purely in the financial point of view he will catch up within 5-10 years of practicing medicine. Regardless @Undecided_DPT you have some tough choices to make.
@DOctorJay give him your prospecticve as a former PT. Quick intro about him. He is a MSPT who ended up going to DO school, trained at the top PM&R program for residency and fellowship.
Another example is
Allan Vrable DO, PT, DABPMR. I don't know him personally
www.globalneuroandspine.com

Pain Clinic Near Me | Global Neuro & Spine Institute

Welcome to Global Neuro & Spine Institute in Orlando, Jensen Beach, Palm Bay, Atlantis, Fort Pierce, Winter Park and Plantation, FL.
www.globalneuroandspine.com www.globalneuroandspine.com
Click to expand...

No hard feelings man 🙂
The above were just my feelings and advice. The OP should decide what's best for him based on all perspectives. If he ultimately decides to go to med school, cool. But I think it's important to look at all perspectives.

Best of luck OP!
 
I work with a lot of excellent therapists. The ones that are my favorite are those who are confident enough to acknowledge their gaps in knowledge and know their limitation. Same goes for physicians. Always stay humble, ask for help and enjoy the lifetime of learning.
 
Not PMR but my take is don’t do it. You have so much more career flexibility in your current path, ability to work for yourself, etc. Plus you actually get to do the rewarding stuff, work with the patients to get better. Medicine is a whole lot of not that. Charting, insurance, consultants, etc. All in a generally toxic atmosphere and a broken system. There’s a reason 50% of medicine is burned out, high suicide rates, etc. More than half wouldn’t recommend it to others. The knowledge is all out there online, learn it for fun, save yourself the debt and the time. Med school isn’t bad but residency your time is not remotely your own. You have a career and a job you enjoy and you are successful at it, I wouldn’t give that up. I wish I had done PT to be honest.
 
DOctorJay said:
I’m glad I did it as well, as is my best friend from PT school. We’re both PM&R docs (me pain, him peds).


Sent from my iPhone using SDN
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Hey Jay! Thanks for your input. Would you be willing to share the a) age you did it? b) what you feel made it worth it for you? & c) If you would do it again if looking at 300-400k of loans?

I ask largely for any other PTs that find this thread. As I know a rather large group of DPTs that find themselves with the same desire but are dissuaded by the loan burden (myself included - if I could do an MD with no debt I doubt I would stress about doing so)

Thank you either way!
 
Undecided_DPT said:
Hey Jay! Thanks for your input. Would you be willing to share the a) age you did it? b) what you feel made it worth it for you? & c) If you would do it again if looking at 300-400k of loans?

I ask largely for any other PTs that find this thread. As I know a rather large group of DPTs that find themselves with the same desire but are dissuaded by the loan burden (myself included - if I could do an MD with no debt I doubt I would stress about doing so)

Thank you either way!
Click to expand...

so the emotional answer is to do what is going to make you happy. I knew I would always wonder if I could have gone on to become a physician if I remained a PT and likely would have been unfulfilled. I knew during PT school I wanted to pursue medicine. some of my advisors at the time recommended I drop out of PT school to pursue medicine. I'm glad I didn't. PT school gave me such a great understanding of the musculoskeletal system and my clinical experiences were all helpful to me in medical school. I also was able to work on weekends after block exams which provided some income and was familiar with the hospital prior to years 3 and 4 since I worked in the hospital where I was doing my rotations. my PT program graduated us in January so I worked for 6 months before starting medical school.

the rational return on investment answer is that you really need to consider the things @whatisthisstuff mentioned above. going into debt 300-400k is a tough pill to swallow when you're already in a successful career. I went to a state school and just paid off my student loans about 6.5 years into my practice. I'm doing well and happy with my decision. however, things are rapidly changing and there are no guarantees in the future. you could end up not matching into your desired field and that can be devastating on multiple fronts.

if you feel like you have to do something in medicine I'd say check out a PA program. if you're dead set on becoming a physician then by all means make it happen but with full understanding of the debt load and responsibility you're taking on.

to be very honest I do not recommend medicine as a career to friends and family at this point.
 
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Might want to consider this as well:

"Many doctors are being replaced with people with far less training. Procedural fields, such as my field of electrophysiology, may be protected—for now. But think about it: the procedural part of medicine is the easiest part. The two letters after my name have little to do with my ability to move a catheter or tie good knots. Groupthink among doctors holds that our replacement by people with less training will lead to Armageddon. That's because doctors make causal connections from our years of training/suffering to our ability to help people. We think the same way because we endured the same training.I see it nearly every day: many patients get better on their own, despite us. Many patients fall into an easy protocol—say, chest pain, dyspnea, or atrial fibrillation. With basic training, a motivated person quickly gains skill in recognizing and treating everyday problems."

www.medscape.com

Independent NPs and PAs: A Doc's View

Nurse practitioners and physician assistants increasingly manage patient care independently. While professional physician organizations cry foul, this doctor is not alarmed.
www.medscape.com www.medscape.com
 
Thank you both for your answers and for taking the time to help when you get no benefit from it. I really, really do appreciate it.
 
You are looking at a minimum of 500k debt (probably more like 700k) and starting your medical career in your late 30s. That is not even counting the close to 400k of lost income during your medical school years combined with probably another 200k lost income with residency pay. The burden that would place on your life is staggering to me. I'm not saying being a physician can't be a very good job, it can be. It can be rewarding and intellectually satisfying in the right situation for the right person. That said, there are alot of ways to do rewarding and intellectually satisfying things in this world that don't come at an opportunity cost of 1 mil+ as well as the total life commitment that medicine is (for at least some period of time). Do random acts of kindness, volunteer, learn a language, learn something totally new for fun, etc. There is alot of ways to do good for humanity that don't involve being a physician. Sounds like you have an amazing opportunity to build your own thing and be your own boss. Thats not even touching the utter disaster that is the American health care system at every level.
 
Been about 3.5 years since this post and wanted to toss out an update. Original post was edited out so I doubt those of you in the thread would recall but was I was a DPT debating going back to med school for PM&R and had just started preparing for MCAT studying at time of this post (was 3 years out, had an online business, working on PT phone app at the time and all that)

I ended up going back! Got a solid score on the MCAT and ended up at my #1 choice (state MD school with "cheap" tuition which helped control my debt load.) Am currently an M3, just finished my first clerkship, and have been doing well academically (top 10% my class a large chunk of pre-clinical, top quartile most the rest)

So things have been going well and I'm very happy with my choice so far! Still very much intending to apply to PM&R here in a year or so and that has generally just solidified the more I progress through my training.

Thanks again to everyone who helped give me advice/guidance a few years back. Hope you all are doing well!
 
Undecided_DPT said:
Been about 3.5 years since this post and wanted to toss out an update. Original post was edited out so I doubt those of you in the thread would recall but was I was a DPT debating going back to med school for PM&R and had just started preparing for MCAT studying at time of this post (was 3 years out, had an online business, working on PT phone app at the time and all that)

I ended up going back! Got a solid score on the MCAT and ended up at my #1 choice (state MD school with "cheap" tuition which helped control my debt load.) Am currently an M3, just finished my first clerkship, and have been doing well academically (top 10% my class a large chunk of pre-clinical, top quartile most the rest)

So things have been going well and I'm very happy with my choice so far! Still very much intending to apply to PM&R here in a year or so and that has generally just solidified the more I progress through my training.

Thanks again to everyone who helped give me advice/guidance a few years back. Hope you all are doing well!
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Congratulations!!!
 
Hey all,

Wanted to give a final update as a thank you for taking time to advise years ago

(This is me for reference - have met or interacted w a few of you over time https://www.instagram.com/dr.afehr.dpt/ )

Ended up matching back at WashU in STL (I went there for my DPT) which works quite well for my career & life goals.
  • My large college friend group all lives in STL & it’s only a few hours from my future-wife + my family in KC.
  • And I intend to pursue something in the MSK space (whether general /w heavy OP/MSK lean or Pain. TBD. I like most everything. But sunk cost at play for sure given PT background)
Had a wild interview cycle. Had the privilege of interviewing at literally every fancy place around the country. Given the environment I grew up in and the SES/class I came from I never expected to be able to say that. So that was honestly super neat (although didn’t quite craft my rank list accordingly.)

Looking forward to being colleagues. Thanks again for the advice!
  • Adam
 
Undecided_DPT said:
Hey all,

Wanted to give a final update as a thank you for taking time to advise years ago

(This is me for reference - have met or interacted w a few of you over time https://www.instagram.com/dr.afehr.dpt/ )

Ended up matching back at WashU in STL (I went there for my DPT) which works quite well for my career & life goals.
  • My large college friend group all lives in STL & it’s only a few hours from my future-wife + my family in KC.
  • And I intend to pursue something in the MSK space (whether general /w heavy OP/MSK lean or Pain. TBD. I like most everything. But sunk cost at play for sure given PT background)
Had a wild interview cycle. Had the privilege of interviewing at literally every fancy place around the country. Given the environment I grew up in and the SES/class I came from I never expected to be able to say that. So that was honestly super neat (although didn’t quite craft my rank list accordingly.)

Looking forward to being colleagues. Thanks again for the advice!
  • Adam
Click to expand...
Thank you for the update! So stoked for you!
 
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