If you could do it all over, would you do medicine again?

[Zyra]

Any reasons? What specialty are you in?

Also curious. Meister, what would you be doing instead?

---

Members don't see this ad.

 

[meister]

I'm in radiology residency. High debt, high stress, comically delayed gratification, way less time with my wife and kids than in almost any other career, omnipresent medical malpractice concerns, etc. And I'm not even in a surgical field. I'm glad some of you would do it again and would do it even under worse conditions, but personally, no thanks. I would have continued in engineering, probably would have bought a home ten years ago, and likely would be working half as many hours for a fifth of the debt and a tenth of the stress.

Probably the best time to really ask this question is at least a few years out of training.

 

[Zyra]

I'm in radiology residency. High debt, high stress, comically delayed gratification, way less time with my wife and kids than in almost any other career, omnipresent medical malpractice concerns, etc. And I'm not even in a surgical field. I'm glad some of you would do it again and would do it even under worse conditions, but personally, no thanks. I would have continued in engineering, probably would have bought a home ten years ago, and likely would be working half as many hours for a fifth of the debt and a tenth of the stress.

Probably the best time to really ask this question is at least a few years out of training.

Won't it get better post-residency or do you still think medicine is not worth it given the time, debt and stress? Also do you think other non-surgical fields are less stressful or similarly stressful?

 

[meister]

Radiology is probably middle of the road in terms of stress if you compare it to all non-surgical fields, interventional cards versus FM versus GI, etc.

I really hope it gets better after residency. Hard to imagine that money alone will turn the tide but perhaps the increased autonomy you gain after completing residency will help. I don't know.

 

[illinichief89]

I think I would only do it again if they let me start med school after high school rather than waste some years of my youth in undergrad. And the tuition would have to be half of what is now. Otherwise, this is a very long and stressful road and all the 6 figure income and great patient outcomes in the future don't seem like they can make up for the journey I'm on now. But maybe my tune will change after I'm done with all the training.

 

[DetectiveAlonzo]

Would it be safe to say if y'all had no debt at all coming out of med school... you would do it over again?

 

[MYRIAD909]

"Buyer's remorse" in the medical community is a common and well-documented phenomenon. For those interested in a more detailed commentary, I'd suggest this: http://www.wsj.com/articles/the-u-s-s-ailing-medical-system-a-doctors-perspective-1409325361

 

[Phloston]

I'm in radiology residency. High debt, high stress, comically delayed gratification, way less time with my wife and kids than in almost any other career, omnipresent medical malpractice concerns, etc. And I'm not even in a surgical field. I'm glad some of you would do it again and would do it even under worse conditions, but personally, no thanks. I would have continued in engineering, probably would have bought a home ten years ago, and likely would be working half as many hours for a fifth of the debt and a tenth of the stress.

Probably the best time to really ask this question is at least a few years out of training.

Posts like this have extremely high value because of how candid they are. It also seems like he's someone who realizes there's fulfillment outside medicine (e.g., family).

 

[Zyra]

"Buyer's remorse" in the medical community is a common and well-documented phenomenon. For those interested in a more detailed commentary, I'd suggest this: http://www.wsj.com/articles/the-u-s-s-ailing-medical-system-a-doctors-perspective-1409325361

Thanks. Can't see it without a login. Can you repost or is there any other way to read without a login?

 

[Zyra]

Posts like this have extremely high value because of how candid they are. It also seems like he's someone who realizes there's fulfillment outside medicine (e.g., family).

I think that's how most people find fulfillment...when we're young, we tend to have the wrong impression that a career can be truly fulfilling. For most people, a job is just a job. Unless you're literally living your dream of being a rock star or whatever (or truly unicorn jobs that people would do for little money), most people will find more fulfillment outside of work/career/jobs.

 

[MYRIAD909]

Thanks. Can't see it without a login. Can you repost or is there any other way to read without a login?

Why Doctors Are Sick of Their Profession
By SANDEEP JAUHAR
Aug. 29, 2014 11:16 a.m. ET

All too often these days, I find myself fidgeting by the doorway to my exam room, trying to conclude an office visit with one of my patients. When I look at my career at midlife, I realize that in many ways I have become the kind of doctor I never thought I'd be: impatient, occasionally indifferent, at times dismissive or paternalistic. Many of my colleagues are similarly struggling with the loss of their professional ideals.

It could be just a midlife crisis, but it occurs to me that my profession is in a sort of midlife crisis of its own. In the past four decades, American doctors have lost the status they used to enjoy. In the mid-20th century, physicians were the pillars of any community. If you were smart and sincere and ambitious, at the top of your class, there was nothing nobler or more rewarding that you could aspire to become.

Today medicine is just another profession, and doctors have become like everybody else: insecure, discontented and anxious about the future. In surveys, a majority of doctors express diminished enthusiasm for medicine and say they would discourage a friend or family member from entering the profession. In a 2008 survey of 12,000 physicians, only 6% described their morale as positive. Eighty-four percent said that their incomes were constant or decreasing. Most said they didn't have enough time to spend with patients because of paperwork, and nearly half said they planned to reduce the number of patients they would see in the next three years or stop practicing altogether.

American doctors are suffering from a collective malaise. We strove, made sacrifices—and for what? For many of us, the job has become only that—a job.

That attitude isn't just a problem for doctors. It hurts patients too.

Consider what one doctor had to say on Sermo, the online community of more than 270,000 physicians:

"I wouldn't do it again, and it has nothing to do with the money. I get too little respect from patients, physician colleagues, and administrators, despite good clinical judgment, hard work, and compassion for my patients. Working up patients in the ER these days involves shotguning multiple unnecessary tests (everybody gets a CT!) despite the fact that we know they don't need them, and being aware of the wastefulness of it all really sucks the love out of what you do. I feel like a pawn in a moneymaking game for hospital administrators. There are so many other ways I could have made my living and been more fulfilled. The sad part is we chose medicine because we thought it was worthwhile and noble, but from what I have seen in my short career, it is a charade."

The discontent is alarming, but how did we get to this point? To some degree, doctors themselves are at fault.

In the halcyon days of the mid-20th century, American medicine was also in a golden age. Life expectancy increased sharply (from 65 years in 1940 to 71 years in 1970), aided by such triumphs of medical science as polio vaccination and heart-lung bypass. Doctors largely set their own hours and determined their own fees. Popular depictions of physicians ("Marcus Welby," "General Hospital") were overwhelmingly positive, almost heroic.

American doctors at midcentury were generally content with their circumstances. They were prospering under the private fee-for-service model, in which patients were covering costs out of pocket or through fledgling private insurance programs such as Blue Cross/Blue Shield. They could regulate fees based on a patient's ability to pay and look like benefactors. They weren't subordinated to bureaucratic hierarchy.

After Medicare was introduced in 1965 as a social safety net for the elderly, doctors' salaries actually increased as more people sought medical care. In 1940, in inflation-adjusted 2010 dollars, the mean income for U.S. physicians was about $50,000. By 1970, it was close to $250,000—nearly six times the median household income.

But as doctors profited, they were increasingly perceived as bilking the system. Year after year, health-care spending grew faster than the U.S. economy as a whole. Meanwhile, reports of waste and fraud were rampant. A congressional investigation found that in 1974, surgeons performed 2.4 million unnecessary operations, costing nearly $4 billion and resulting in nearly 12,000 deaths. In 1969, the president of the New Haven County Medical Society warned his colleagues "to quit strangling the goose that can lay those golden eggs."

If doctors were mismanaging their patients' care, someone else would have to manage that care for them. Beginning in 1970, health maintenance organizations, or HMOs, were championed to promote a new kind of health-care delivery built around price controls and fixed payments. Unlike with Medicare or private insurance, doctors themselves would be held responsible for excess spending. Other novel mechanisms were introduced to curtail health outlays, including greater cost-sharing by patients and insurer reviews of the necessity of medical services. That ushered in the era of HMOs.

In 1973, fewer than 15% of physicians reported any doubts that they had made the right career choice. By 1981, half said they would not recommend the practice of medicine as highly as they would have a decade earlier.

Public opinion of doctors shifted distinctly downward too. Doctors were no longer unquestioningly exalted. On television, physicians were portrayed as more human—flawed or vulnerable ("M*A*S*H*," "St. Elsewhere") or professionally and personally fallible ("ER").

As managed care grew (by the early 2000s, 95% of insured workers were in some sort of managed-care plan), physicians' confidence plummeted. In 2001, 58% of about 2,000 physicians questioned said that their enthusiasm for medicine had gone down in the previous five years, and 87% said that their overall morale had declined during that time. More recent surveys have shown that 30% to 40% of practicing physicians wouldn't choose to enter the medical profession if they were deciding on a career again—and an even higher percentage wouldn't encourage their children to pursue a medical career.

There are many reasons for this disillusionment besides managed care. One unintended consequence of progress is that physicians increasingly say they don't have enough time to spend with patients. Medical advances have transformed once-terminal diseases—cancer, AIDS, congestive heart failure—into complex chronic conditions that must be managed over the long term. Physicians also have more diagnostic and treatment options and must provide a growing array of screenings and other preventative services.

At the same time, salaries haven't kept pace with doctors' expectations. In 1970, the average inflation-adjusted income of general practitioners was $185,000. In 2010, it was $161,000, despite a near doubling of the number of patients that doctors see a day.

While patients today are undoubtedly paying more for medical care, less of that money is actually going to the people who provide the care. According to a 2002 article in the journal Academic Medicine, the return on educational investment for primary-care physicians, adjusted for differences in number of hours worked, is just under $6 per hour, as compared with $11 for lawyers. Some doctors are limiting their practices to patients who can pay out of pocket without insurance company discounting.

Other factors in our profession's woes include a labyrinthine payer bureaucracy. U.S. doctors spend almost an hour on average each day, and $83,000 a year—four times their Canadian counterparts—dealing with the paperwork of insurance companies. Their office staffs spend more than seven hours a day. And don't forget the fear of lawsuits; runaway malpractice-liability premiums; and finally the loss of professional autonomy that has led many physicians to view themselves as pawns in a battle between insurers and the government.

The growing discontent has serious consequences for patients. One is a looming shortage of doctors, especially in primary care, which has the lowest reimbursement of all the medical specialties and probably has the most dissatisfied practitioners. Try getting a timely appointment with your family doctor; in some parts of the country, it is next to impossible. Aging baby boomers are starting to require more care just as aging baby boomer physicians are getting ready to retire. The country is going to need new doctors, especially geriatricians and other primary care physicians, to care for these patients. But interest in primary care is at an all-time low.

Perhaps the most serious downside, however, is that unhappy doctors make for unhappy patients. Patients today are increasingly disenchanted with a medical system that is often indifferent to their needs. People used to talk about "my doctor." Now, in a given year, Medicare patients see on average two different primary care physicians and five specialists working in four separate practices. For many of us, it is rare to find a primary physician who can remember us from visit to visit, let alone come to know us in depth or with any meaning or relevancy.

Insensitivity in patient-doctor interactions has become almost normal. I once took care of a patient who developed kidney failure after receiving contrast dye for a CT scan. On rounds, he recalled for me a conversation he'd had with his nephrologist about whether his kidney function was going to get better. "The doctor said, 'What do you mean?' " my patient told me. "I said, 'Are my kidneys going to come back?' He said, 'How long have you been on dialysis?' I said, 'A few days.' And then he thought for a moment and said, 'Nah, I don't think they're going to come back.' "

My patient broke into sobs. " 'Nah, I don't think they're going to come back.' That's what he said to me. Just like that."

Of course, doctors aren't the only professionals who are unhappy today. Many professions, including law and teaching, have become constrained by corporate structures, resulting in loss of autonomy, status, and respect. But as the Princeton sociologist Paul Starr writes, for most of the 20th century, medicine was "the heroic exception that sustained the waning tradition of independent professionalism." It is an exception whose time has expired.

How can we reverse the disillusionment that is so widespread in the medical profession? There are many measures of success in medicine: income, of course, but also creating attachments with patients, making a difference in their lives and providing good care while responsibly managing limited resources.

The challenge in dealing with physician burnout on a practical level is to create new incentive schemes to foster that meaning: publicizing clinical excellence, for example (public reporting of surgeons' mortality rates or physicians' readmission rates is a good first step), or giving rewards for patient satisfaction (physicians at my hospital now receive quarterly reports that tell us how our patients rate us on measures such as communication skills and the amount of time we spend with them).

We also need to replace the current fee-for-service system with payment methods such as bundled payment, in which doctors on a case are paid a lump sum to divide among themselves, or pay for performance, which offers incentives for good health outcomes. We need systems that don't simply reward high-volume care but also help restore the humanism in doctor-patient relationships that have been weakened by business considerations, corporate directives and third-party intrusions.

I believe most doctors continue to want to be like the physician knights of the golden age of medicine. Most of us went into medicine to help people. We want to practice medicine the right way, but too many forces today are propelling us away from the bench or the bedside. No one ever goes into medicine to do unnecessary testing, but this sort of behavior is rampant. The American system too often seems to promote knavery over knighthood.

Fulfillment in medicine, as with any endeavor, is about managing hopes. Probably the group best equipped to deal with the changes wracking the profession today is medical students, who are not so weighed down by great expectations. Doctors ensconced in professional midlife are having the hardest time.

In the end, the problem is one of resilience. American doctors need an internal compass to navigate the changing landscape of our profession. For most doctors, this compass begins and ends with their patients. In surveys, most physicians—even the dissatisfied ones—say the best part of their jobs is taking care of people. I believe this is the key to coping with the stresses of contemporary medicine: identifying what is important to you, what you believe in and what you will fight for. Medical schools and residency programs can help by instilling professionalism early on and assessing it frequently throughout the many years of training. Introducing students to virtuous mentors and alternative career options, such as part-time work, may also help stem some of the burnout.

What's most important to me as a doctor, I've learned, are the human moments. Medicine is about taking care of people in their most vulnerable states and making yourself somewhat vulnerable in the process. Those human moments are what others—the lawyers, the bankers—envy about our profession, and no company, no agency, no entity can take those away. Ultimately, this is the best hope for our professional salvation.

Dr. Jauhar is director of the Heart Failure Program at the Long Island Jewish Medical Center. This essay is adapted from his new book, "Doctored: The Disillusionment of an American Physician," published by Farrar, Straus and Giroux.

 

[VA Hopeful Dr]

Yeah, I definitely would. For context, I'm a family doctor 3 years out of residency.

1) Being a doctor does suck some days, but some days its pretty awesome. I had a patient stop by today for a routine injection and we got to talking. I was seeing him every week for like 3 months while he was going through a divorce - no real medical advice, he just needed someone to talk to more than anything. He's got his life back on track and told me how much he appreciated all the time I'd spent with him helping him through that rough patch.

2) The money is actually pretty good. There aren't many careers where you are pretty much guaranteed mid-6 figures by early 30s that have as many open positions as we do. For every partner in a large law firm there are 20 as junior associates maybe breaking 100k, same with finance or whatever other career.

3) Even if patients are grateful, there's a lot to be said for knowing that you made a difference. I have a good friend in insurance, makes about what I did when I was still employed. He has a good life, doesn't work too crazy of hours, but still often complains that he doesn't really feel like his work matters that much. My last patient yesterday went from limping around to walking 2 miles per day after a single steroid shot in his right knee.

Now that all said, I don't have to deal with hospital call, administrators breathing down my neck, or many of the things that make medicine miserable for so many. I will also never make the kind of money that your higher stress specialties do - but lower stress, no weekends, and 9-5 is worth making less to my mind.

 

[smq123]

Now that all said, I don't have to deal with hospital call, administrators breathing down my neck, or many of the things that make medicine miserable for so many. I will also never make the kind of money that your higher stress specialties do - but lower stress, no weekends, and 9-5 is worth making less to my mind.

Out of curiosity, do you use scribes? Or do you not need to see that many patients a day....you're doing DPC, correct?

 

[Psai]

At the same time, salaries haven't kept pace with doctors' expectations. In 1970, the average inflation-adjusted income of general practitioners was $185,000. In 2010, it was $161,000, despite a near doubling of the number of patients that doctors see a day.

Other factors in our profession's woes include a labyrinthine payer bureaucracy. U.S. doctors spend almost an hour on average each day, and $83,000 a year—four times their Canadian counterparts—dealing with the paperwork of insurance companies. Their office staffs spend more than seven hours a day. And don't forget the fear of lawsuits; runaway malpractice-liability premiums; and finally the loss of professional autonomy that has led many physicians to view themselves as pawns in a battle between insurers and the government.

The challenge in dealing with physician burnout on a practical level is to create new incentive schemes to foster that meaning: publicizing clinical excellence, for example (public reporting of surgeons' mortality rates or physicians' readmission rates is a good first step), or giving rewards for patient satisfaction (physicians at my hospital now receive quarterly reports that tell us how our patients rate us on measures such as communication skills and the amount of time we spend with them).

We also need to replace the current fee-for-service system with payment methods such as bundled payment, in which doctors on a case are paid a lump sum to divide among themselves, or pay for performance, which offers incentives for good health outcomes. We need systems that don't simply reward high-volume care but also help restore the humanism in doctor-patient relationships that have been weakened by business considerations, corporate directives and third-party intrusions.

So this guy thinks that one of the bad things about medicine is that doctors are getting paid less and spend a ton of time on paperwork. His solution is even more paperwork and even more government/insurance company oversight so that these entities can steal more money from our pockets under the guise of "performance" and "humanism". They aren't working against each other. They're both working their hardest to keep as much money from physicians as possible. Does any physician think that Press-Ganey scores are a good idea? Does any physician like being bothered by some ******* administrator that doesn't know **** about patient care because they just graduated with a bull**** mha degree about these nonsense surveys? We even have data that shows that higher patient satisfaction is associated with worse outcomes. Patients are the worst people to judge physician "performance".

Mortality rates or physician readmission rates? Lmao, a ton of our readmissions are from people not taking our advice, still smoking too much, eating too much, drinking too much and not taking the medications that were prescribed. Hey Dr. general surgeon, you will now be paid nothing because your 100 py, obese, noncompliant diabetic got an infection that's completely your fault and has nothing to do with patient characteristics.

Thank you sir, may I have more?

 

[VA Hopeful Dr]

Out of curiosity, do you use scribes? Or do you not need to see that many patients a day....you're doing DPC, correct?

DPC, but even when I did regular employed FM and urgent care I never had a scribe.

 

[zeppelinpage4]

Yeah, I definitely would. For context, I'm a family doctor 3 years out of residency.

1) Being a doctor does suck some days, but some days its pretty awesome. I had a patient stop by today for a routine injection and we got to talking. I was seeing him every week for like 3 months while he was going through a divorce - no real medical advice, he just needed someone to talk to more than anything. He's got his life back on track and told me how much he appreciated all the time I'd spent with him helping him through that rough patch.

2) The money is actually pretty good. There aren't many careers where you are pretty much guaranteed mid-6 figures by early 30s that have as many open positions as we do. For every partner in a large law firm there are 20 as junior associates maybe breaking 100k, same with finance or whatever other career.

3) Even if patients are grateful, there's a lot to be said for knowing that you made a difference. I have a good friend in insurance, makes about what I did when I was still employed. He has a good life, doesn't work too crazy of hours, but still often complains that he doesn't really feel like his work matters that much. My last patient yesterday went from limping around to walking 2 miles per day after a single steroid shot in his right knee.

Now that all said, I don't have to deal with hospital call, administrators breathing down my neck, or many of the things that make medicine miserable for so many. I will also never make the kind of money that your higher stress specialties do - but lower stress, no weekends, and 9-5 is worth making less to my mind.

I'm applying family medicine and would happily take any cut in salary for a relatively low stress work environment.
If you don't mind me asking, what kind of practice setting are you in? And is it difficult to find that type of setting coming out of residency? You're exactly where I hope to be in a few years. I didn't think a regular 9-5 job without hospital call and excess administrative work existed anymore.

 

[VA Hopeful Dr]

I'm applying family medicine and would happily take any cut in salary for a relatively low stress work environment.
If you don't mind me asking, what kind of practice setting are you in? And is it difficult to find that type of setting coming out of residency? You're exactly where I hope to be in a few years. I didn't think a regular 9-5 job without hospital call and excess administrative work existed anymore.

http://www.aafp.org/practice-management/payment/dpc.html

If you can find someone whose hiring, great. Much more likely to have to start your own. The only obstacle straight from residency is that unless you find someone hiring, you won't make much money at first so heavy moonlighting is kinda the standard.

 

[psychMDhopefully]

No too much sacrifice, too much crap to put up with, too many wasted years, if I were my 19 year old self again no way I would do this.

 

[Goro]

At graduation, when there's no need to lie, self-stroke one's ego or impress others, our grads tell us via anonymous polling that 90% of them would still make the same choice.

Going into Medicine for the money is a baseline reason.

If my own children had $2 million in the bank, I'd tell them to take the money and run. I'd advise you to do the same. Med school is hard. We throw the kitchen sink at you. Hell, we throw the entire house at you! There are easier ways to help people.

I'd say the same thing on the PhD route. Get an MS and a job as a lab mgr. One could do just as much research, get publications (with the right PI) and not have to worry about tenure, publish or perish and the grants rat race.

Also, are most of you doing medicine for the money?

Assume that you will inherit at least 2 million - would you medicine again?

 

[cs24]

I would definitely do it again. Having 2 million in the bank would just mean no loans. Other than that I would have done it exactly the same up to this point. The only thing the money would change right now is make it more likely that I would consider fields with even longer training pathways (super fellowships) because I would be less concerned with making money right away.

 

[0ncogene]

At graduation, when there's no need to lie, self-stroke one's ego or impress others, our grads tell us via anonymous polling that 90% of them would still make the same choice.

Going into Medicine for the money is a baseline reason.

You guys should send the same poll to your class after 1-2 years of residency, I am sure the % will significantly decrease. Residency is a totally different animal. Much worse in my opinion.

I matched Ortho, 3 months into my intern year. I am doing well, but no way in hell would I do this again. I am sacrificing a decade of my life working 2-3x the average population with over 300K in debt (without counting interest yet). I work 80hrs a week at the hospital, and I spend about 3 additional hours during the weekdays after or before work to study and check up on my patients. And during the weekend, I study another 10 hours if I have an off day. I am sacrificing time with my family. And when they are sick or hospitalized, I don't have have time to fly back to see them. What's the point of being a doctor if you don't have time to even care for your own family member?

So the answer is no, with or without 2 mil. I feel like I am smart enough and physically capable; I can invest a decade into another field that would help people and still be equally successful.

 

[nlax30]

I've actually thought about this question lately, mainly because I'm close to finishing up fellowship and potentially looking at another sub-fellowship...

Honestly, I don't know. IF I had some other useful, professional career background/training or interest then no, I'm not sure medicine would have been worth. For me personally though there was really no other field that really interested me (ie: business, medicine, law, basic sciences, etc...).

It's a HUGE sacrifice, financially, emotionally/mentally and flat out the time required. I have a family/kids, nearing the end of fellowship and this is probably the most stressed I have ever been in my life in trying to balance Chief duties, my own studying, work stuff, gearing up for job search, worried about finances all while trying not to short change my family. It's just constant.

So take that for what it's worth. I wouldn't consider myself depressed and I think I handle stress pretty well and am not a typical Type A personality but there are times when the stress gets overwhelming. I'm not sure what I'd tell my kids years down the road if they develop an interest in medicine..... though that they depend somewhat on what the legal/bureaucratic landscape looks like.

 

[Psai]

I've actually thought about this question lately, mainly because I'm close to finishing up fellowship and potentially looking at another sub-fellowship...

Why?

 

[Zyra]

At graduation, when there's no need to lie, self-stroke one's ego or impress others, our grads tell us via anonymous polling that 90% of them would still make the same choice.

Going into Medicine for the money is a baseline reason.

If my own children had $2 million in the bank, I'd tell them to take the money and run. I'd advise you to do the same. Med school is hard. We throw the kitchen sink at you. Hell, we throw the entire house at you! There are easier ways to help people.

I'd say the same thing on the PhD route. Get an MS and a job as a lab mgr. One could do just as much research, get publications (with the right PI) and not have to worry about tenure, publish or perish and the grants rat race.

Thanks for the advice.

It seems like most doctors and attorneys with kids that I speak to wouldn't want their kids to go into the same field. I had an attorney who makes $4 million a year (yeah, $4 million a year) tell me he wouldn't want his kids to go into law, at least at a large firm.

I guess the takeaway is that life is too short to spend most of it working and stressed out? lol

 

[Zyra]

You guys should send the same poll to your class after 1-2 years of residency, I am sure the % will significantly decrease. Residency is a totally different animal. Much worse in my opinion..

I've heard that. I know someone who dropped out in their first year of residency....Aside from the hours, I think it's also because going to school doesn't really resemble working. School is awesome IMO - there's more structure and well-defined goals to work towards and it's more familiar to people who have always liked school. Working, at least IME, is not nearly as awesome.

 

[nlax30]

Why?

Why another fellowship? Looking at a sub-specialty in cardiology.

 

[Andeve33]

With a 2 million inheritance, I would probably just invest most of it, then pursue a PhD in something that really interest me and move along at my own pace. I love learning, I love science, I don't love all the BS and misery that comes with medicine.

exactly the thing I would do. with 2 million you could make much more. but unfortunately people are simply spending if they get this money out of nowhere.

 

[Goro]

Plus, for a lot of Millennial students, residency is the very first job they've ever had.

I've heard that. I know someone who dropped out in their first year of residency....Aside from the hours, I think it's also because going to school doesn't really resemble working. School is awesome IMO - there's more structure and well-defined goals to work towards and it's more familiar to people who have always liked school. Working, at least IME, is not nearly as awesome.

 

[smq123]

I've heard that. I know someone who dropped out in their first year of residency....Aside from the hours, I think it's also because going to school doesn't really resemble working. School is awesome IMO - there's more structure and well-defined goals to work towards and it's more familiar to people who have always liked school. Working, at least IME, is not nearly as awesome.

I actually had liked school in high school and college. I am a creature of habit and need structure, a schedule, predictability, and clearly defined goals.

I really hated medical school, particularly the first 2 years. I actually liked the clinical rotation years much better.

I hated being told what it was like to be a doctor by non-MDs. We had a lot of classes on "cultural competency" and "how to relate to patients!" which were led by humanities professors - i.e. people who have never touched a patient in their lives. I didn't have much clinical experience then, but I could still sense that they were full of BS. Don't tell me about how it's important to "relate to difficult patients" when you don't truly know what a difficult patient is. Sit in a closed room with an angry, 300 lb. ex-convict who is actively in heroin withdrawal, THEN come back and talk to me about "difficult patients." And that's what it's kind of like now - you get a lot of BS about how to practice medicine from people who aren't clinicians, or who haven't seen a patient in 15 years.

I hated being broke. I hated the way that loans were constantly hanging over my head. I come from a very debt-averse family, and I felt guilty every time I went out to eat with friends or went to the movies. Having a job? With a PAYCHECK? Is so much better than being a student.

I really hated some of my holier-than-thou classmates. The ones who were convinced that, because we were doctors in training, that we couldn't complain about anything. That we had to act like saints in public because "patients are watching you!" That we couldn't complain about medical school because "DO YOU KNOW HOW MANY PEOPLE WOULD LOVE TO HAVE YOUR SEAT?!?" That we couldn't complain about being students because "OMG WHEN I WAS WORKING I HATED MY JOB AND THIS IS SO MUCH BETTER HOW CAN YOU COMPLAIN?" Well, guess what. Some of us are miserable, depressed, and barely hanging together, so shut it.

That being said, I'm not convinced that I would do it all again, even if I had $2 million. I would have a hard time willingly going back to the first two years of medical school, which were genuinely pretty bad. I don't know if I could go back to being a 3rd year medical student again - even though I loved it when I did it, I was ok with being treated like ignorant pond scum back then (cause I really didn't know anything back then). To have to go from attending to MS3 and be everyone's bit** AGAIN....I dunno.

I actually loved residency, and even intern year, but I'm not convinced that I could do those again either - part of te reason why I loved those years was because I felt like I was learning so much and growing as a professional. That feeling wouldn't be there again this time, so I don't think it would be nearly as fun - all the drudgery without the learning.

If you gave me $2 million today and asked if I'd still be a doctor....probably? As long as I could choose where I could practice, and I definitely wouldn't be full time - I would cut back to 2-3 days a week, for sure.

 

[Frazier]

When do I inherit the 2M? Assuming immediately and that figure is after taxes, no, I would absolutely not do medicine (if I was a premed 6-8 years ago).
Invest it, reap a modest estimate of 120k/year via interest alone.

At this point, there has been a lot of sacrifices made and years already spent. Fortunately resulting in a specialty I enjoy.
So if the inheritance was obtained now, I'd complete EM residency -- but only work 2 shifts/week as an attending.

 

[Zyra]

Plus, for a lot of Millennial students, residency is the very first job they've ever had.

Yep, I think that's another problem. Honestly, I think most people should work a full time job for a couple of years before going to any kind of graduate school. It would allow them to explore other careers and also understand what working is like. I know that it would have benefited me - maybe I would have stuck it out in another career straight out of college rather than invest time/money in a degree for a career that I didn't fully understand. And if I chose to go to grad school after working, I'd be more sure that it's what I really want.

 

[Goro]

It wouldn't surprise me if med schools started favoring applicants with actual work experience.

Yep, I think that's another problem. Honestly, I think most people should work a full time job for a couple of years before going to any kind of graduate school. It would allow them to explore other careers and also understand what working is like. I know that it would have benefited me - maybe I would have stuck it out in another career straight out of college rather than invest time/money in a degree for a career that I didn't fully understand. And if I chose to go to grad school after working, I'd be more sure that it's what I really want.

 

[zeppelinpage4]

It wouldn't surprise me if med schools started favoring applicants with actual work experience.

Don't they already favor work experience quite a bit? I absolutely agree though.
If you're not in the rush to finish the degree, working a couple years and seeing what it's like on the outside can offer some much needed perspective. A non-trad on these forums said something along the lines of, you don't wonder if the grass is greener, cause you've been on both sides of the fence.
Still, it's nice going straight through too and just getting all this drudgery done early while you're young and have the energy to do it.

 

[exsanguination]

I posted this in another thread here and I believe it holds weight here too. To add some relevance to the thread, no I would never do this all over again. It's simply not worth it.

Not a day goes by that I wonder if I should have picked a different specialty or field altogether. The "high salary" (250k/year) isn't really that large when you consider the behemoth effort required to get to this point and the liability one assumes. And what are the perks? A life time of dealing with nonsense, answering to hospital administration, and boat-loads of charting (I have 16 charts from my shift that ended a few hours ago to finish!).

The most important part of this post is that the OP is her own boss. Controlling your work environment is such a critical aspect to happiness if you are relegated to being a wage-slave like most of the US populace. EM docs (and a lot of other specialties) are no longer in charge of their practices. Metrics, patient satisfaction, protocols, and "standard of care" pigeon hole me and my colleagues routinely. "No doctor, you cannot give that medication because it is against hospital policy to use it without getting x,y, z test and you can only run it at this rate" "No doctor, ketamine is a dangerous drug and cannot be used for that without monitoring, an RN/RT/Tech in the room, aid airway equipment close by. "No doctor, you have to properly document this diagnosis (read: bend the truth) in order to bill for a level 5 chart, otherwise the hospital loses money." My attendings answer to the medical director, who answers to the C-suite who answers to the hospital board and so on. You are a cog, utterly replaceable.

The only physicians that have similar autonomy as the OP are doctors that can still open a cash-based practice (dermatology, plastic surgery, and choices such as those) and a select few elective surgeons who bring actual profit to hospitals that lose money on other acute care services, which seem to be predominantly medicaid patients.

The problem is that as pre-meds, and even medical students, there is no conceivable way for you to understand the rigors of being a doctor, let alone what each specialty entails as an attending. I don't understand it yet to the full extent because I'm not an attending (though moonlighting has matured me considerably).

If you have rich parents like the OP, and not a mountain of debt like I do, I would consider the option of leaving or at least finishing school to get the MD and moving on to something else. I will practicing until I can pay off the debt and then ideally stumble upon some other profession. The pay cut will be welcomed because I will gain so much in other aspects of my life.

Remember this as you move on to the next post: I was just as eager as some of you during my MS4 EM audition rotation. I thought EM was the best! I even was an EMT for a while and thought that this is what I wanted. Nothing cooler than "saving a life" right? I hate to break your bubble, but I can count the amount of "true saves" I've had on one finger and my colleagues would corroborate their similar experiences too.

Medicine eats your soul one day at a time and one day you will look at yourself and wonder how the heck you got here!

 

[giantswing]

I think a big problem is going w the mind set that it's puppies and rainbows and helping people. It's not. It never has been.

 

[Stagg737]

I think a big problem is going w the mind set that it's puppies and rainbows and helping people. It's not. It never has been.

But my peds rotation promised there'd be puppies...