Having serious doubts...

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Onebyone

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I know there are a lot of "is medicine worth it?" threads, but I think my situation is different than the other threads I have read on this topic because 1) I have already been accepted to medical school, 2) I am not doubting my own abilities; I know I can make it through medical school, and 3) I am a non-trad who has held a "real" job, so I have had experiences outside of being a pre-med. I am not trying to start an "is medicine worth it?" debate - only if medicine is worth it FOR ME.

I have been having these doubts for about a year now, but I have been too afraid to seriously address them. I have never been a gunner - I am more of a laid back person who is serious about schoolwork and knows how to jump through the required hoops without getting lost in the process. More and more often I have found myself feeling that entering medicine is like walking off a cliff. Willingly.

My parents are not going to pay for school. I am probably looking at 160k-200k in loans for tuition plus whatever for living expenses. Maybe I'll qualify for some need-based aid, but who knows; I can't count on it. The debt burden is such that if I try medicine and end up being miserable, there will be no escape. The debt keeps you locked in.

I am 25 and a female who wants to have a family. Going into medicine means I wouldn't be able to have a family until my early to mid 30s (I am not willing to try during school or residency). I would like to be actively involved in the life of my children. For example, I love to cook - I would love to be able to cook my children dinner every day and sit together as a family. I don't think that my fiance truly understands the rigors of medical school/residency, despite my trying to explain it. I am worried that I would lose him (what are the current MD divorce rates? Terrible I'm sure...). He would also have to leave his current job to follow me to medical school.

A big motivating factor for pursuing medicine for me is that I've already done the legwork. What else would I do? I think about that a lot. But I finally took the time to look at PA programs and here is what I discovered. PA programs are two years long, and an expensive program costs about 50k total. After those two years, you have a couple years additional training, but fresh out of PA school you're looking at 70k/year starting salary during said training. From there, depending on the state, you can work yourself up to a 6 figure salary. The median salary is around 90k. Even compared to medicine, this is excellent. With medicine, my initial investment is so much greater in both money and time. Think of the years I would be paying off debt as a doctor. That, in my mind, equalizes a lot of the salary bump MDs get. And as a PA you start making money after only two years.

Sure, as a PA you don't have the respect, the autonomy, etc that MDs have. But I am feeling that this isn't as big a sacrifice as I have forced myself to believe for so long. Do I want to devote my life to my career? I don't know. PA would give me both a career in medicine and the freedom to have a great family life as well. I have researched the programs and it looks like I would have to take another year off to take some pre-reqs that I didn't take in undergrad and maybe do some more volunteering (I am light on direct patient contact). Fine.

Are these doubts normal? I should have done this research before applying to medical school I know, but the time/debt burden doesn't seem so bad until you're a few months away from signing onto it. I just feel like I'm (potentially) setting myself up for inescapable misery. Does anyone else feel this way?! I constantly feel like I'm justifying to myself reasons that becoming a doctor WON'T be miserable, and that seems like no way to start my future career!

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Going into a PA program with no paid clinical experience produces a weak clinician, according to a lot of seasoned PAs.

You're 25, right in line with most entering med school, give or take a year or 2. The autonomy thing is really based on personal preference, but it really does matter. There are many examples of PAs becoming frustrated by disrespect from clinicians, hospital staff, and patients that don't know their capabilities and mentally subjugate them to "minor" tasks even though a good PA can be very skilled and an outstanding colleague to physicians in practice.

Check out http://www.physicianassistantforum.com/forums/forum.php for advice from PAs. They're going to give you much better advice on their profession than any pre-med (who hasn't been a PA, like myself) ever could. And many seasoned ones will probably tell you that if you're in your 20s, you should pursue medical school, because the profession of PA is designed as a second career for medically experienced individuals.

You need to ask yourself why you are pursuing medicine. If it's for financial stability, you can get that in a variety of professions, and med school is the path of most resistance to that. You need to pursue medicine because you are interested in the medicine and the assistance of those who require that vast knowledge. If you truly want that, nothing else will suffice.

Everyone is going to doubt a choice as massive as this. It's outstanding to be introspective and realistic about your goals. But at the end of the day, you only live once. Many doctors pay off their debt and raise families. It simply comes down to smart decisions in terms of where you decide to practice and what specialty you choose.

But you won't get to work that out if you don't put your foot in the door ;).

Good luck.
 
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Are you ovulating? :)

Only you know whether you will be adequately fulfilled and challenged as a PA or in another career. Personally I don't think the salary difference between PA and MD is big enough to warrant the toll of becoming an MD. I am applying to medical school only because I know for certain I would not be happy as an RT, RN, PA, NP, etc. If you would be happy in any of those roles, my advice is to run away, raise your kids, and never look back.

Medical school will be difficult but doable. Residency will suck for you and your husband. You will plan and prepare yourself for it, but it will be more lonely and challenging than either of you expected. Read "Intern" and "The House of God" if you haven't. Depending on your specialty it will suck to varying degrees and for varying lengths of time. An example: I will not sleep in the same bed as my wife for the next 6 nights because she is working nights. Stuff like that matters and starts to take a toll, even if your spouse is incredibly independent and you promise yourselves that you will "make time for each other" and go on regular "date nights."

It's certainly doable, but you will make sacrifices to get through. It's up to you to decide whether or not those sacrifices outweigh the laudable reasons that led you to medicine in the first place.
 
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I've thought about this as a "trad" extensively. I'm also a male so the whole family thing I obviously can't provide proper perspective on. BUT I do know that my strongest motivation is applying medical science/knowledge (probably one of the neuro fields btw), and that's what keeps me motivated. You just have to find that motivation that keeps you going everyday. It could be serving your community or the US and removing those socioeconomic barriers in healthcare, or maybe you want to do gastro so that people can eat pizza without the fear of heartburn.

I know it is "unorthodox" to say that "I want to be a doc because of my own interests, (I'm not talking about money)" and yes helping people is a good thing, but you have to find a reason that keeps you happy or else every patient will be a puzzle piece in an unfortunate cynical view of life and medicine.
 
I've thought about this as a "trad" extensively. I'm also a male so the whole family thing I obviously can't provide proper perspective on. BUT I do know that my strongest motivation is applying medical science/knowledge (probably one of the neuro fields btw), and that's what keeps me motivated. You just have to find that motivation that keeps you going everyday. It could be serving your community or the US and removing those socioeconomic barriers in healthcare, or maybe you want to do gastro so that people can eat pizza without the fear of heartburn.

I know it is "unorthodox" to say that "I want to be a doc because of my own interests, (I'm not talking about money)" and yes helping people is a good thing, but you have to find a reason that keeps you happy or else every patient will be a puzzle piece in an unfortunate cynical view of life and medicine.

I really respect this response. You definitely have to be intrinsically motivated like this response states. Having extrinsic factors (I.e. money) play too much of a part in a decision is detrimental and ineffective in the long run. Extrinsic factors will not give you the motivation to work as hard as you need to as a person striving to become an MD. Just from reading your post, OP, you really sound like someone who wants to be a PA. You only hastily cite the positive aspects of being an MD and cite several negative aspects which honestly vary case by case. I know women doctors with huge families who are extremely successful in surgical specialties and are doing amazingly with their families. However, you do emphasize all of the aspects which you believe to be good about PAs.

You asked if such doubts were normal presumably from someone in the same position of recently being accepted, and I can easily say that since my first acceptance in October, I have never had any of those doubts or any other doubts in fact except for a little fear of the change in workload (that, I believe, is actually normal). Of course, everyone is different from you. I do not sacrifice education for my future family or my current significant other, but our values clearly differ there. All about that intrinsic motivation though.
 
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