If you could do it over would you?

[DD214_DOC]

Allergy and Sleep Med are fellowships so I wouldn't count them. I did forget about EM and PM&R though (although I'd consider EM high-stress despite the shift work). Might include Rad Onc too.

Eh, EM is sucky. Shift work means less hours but constantly switching from nights to days is terrible.

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[alwaysaangel]

Absolutely. I make almost $8000 a month as a resident. I live in an awesome place.

Either that's a typo or I call BS. Your residency pays $96,000/year for pgy1???

 

[476515678234896]

Right now? Hell not. But I don't know if I still think the same tomorrow.

Aren't you a dentist?

 

[476515678234896]

Eh, EM is sucky. Shift work means less hours but constantly switching from nights to days is terrible.

With the kind of hrs and $ you said, I would guess that getting into psych would be competitive...why is it not?

(not belittling your field, just curious)

 

[JaggerPlate]

Either that's a typo or I call BS. Your residency pays $96,000/year for pgy1???

Probably has the ability (and time) to moonlight.

With the kind of hrs and $ you said, I would guess that getting into psych would be competitive...why is it not?

(not belittling your field, just curious)

I've said for the last few years that psych will probably get competitive when people start catching on. However, I think a lot of people are concerned with the lack of 'clinical medicine' applied in psych (you'll see a lot more of this from med students who haven't practice clinical medicine for 30 years and now can't stand seeing patients - hahaha), or get turned off by experiences with psych patients during rotations.

Just my guess though.

 

[ShyRem]

I just have to throw in here that I'm an intern. A medicine intern.

I would absolutely do this again. In a heartbeat.

 

[muhali3]

I just have to throw in here that I'm an intern. A medicine intern.

I would absolutely do this again. In a heartbeat.

Why? Do you still find it rewarding despite all the paperwork and patients that could care less about their health?

 

[Slack3r]

Absolutely. I make almost $8000 a month as a resident. I live in an awesome place. My PGY2-4 call is q20. I rarely stay past 4pm. When I'm not relaxing at home on the weekends, I'm snorkeling over reefs through schools of fish or hiking up one of the mountain ranges here. My life is pretty damn good right now.

Now, had I been stupid enough to choose any other specialty ...

I'm assuming a substantial amount of moonlighting?

I've said for the last few years that psych will probably get competitive when people start catching on. However, I think a lot of people are concerned with the lack of 'clinical medicine' applied in psych (you'll see a lot more of this from med students who haven't practice clinical medicine for 30 years and now can't stand seeing patients - hahaha), or get turned off by experiences with psych patients during rotations.

Just my guess though.

I think the patient population turns a lot of people off, so I doubt it will ever be more than just mildly competitive. And while the pay can be highly variable, most averages I've seen put it just under $200k. That fact alone would turn a lot of potential candidates off as well.

 

[muhali3]

I'm assuming a substantial amount of moonlighting?


I think the patient population turns a lot of people off, so I doubt it will ever be more than just mildly competitive. And while the pay can be highly variable, most averages I've seen put it just under $200k. That fact alone would turn a lot of potential candidates off as well.

Psych is a lot like Path in the sense that even though they both have great hours during and after residency, the nature of the work turns many students away.

 

[DD214_DOC]

For those who asked, I'm active-duty military stationed in an area with a really high amount for cost of living and housing allowances. I get $3660/mo for my base pay, $2950/mo for housing, $800/mo for cost of living, and about $500/mo for "other stuff". My income is public information so no point in hiding it. It also increases my PGY3 year.

The military prohibits moonlighting so I'm not doing any.


Psych actually has a really great lifestyle, but as others have said, the nature of the work turns many away. Also, if you're not comfortable with basically everyone on earth thinking you're not a physician and never went to medical school, you probably shouldn't do it.

It's not considered to be one of the more competitive areas, but this is changing. At least in the military match, psych this past cycle was more competitive than FM, IM, Peds, and a couple other things. I don't pay attention to the civilian match so I cannot comment, although I have read that medical students are starting to realize this hidden gem of a specialty. Also, there is a LOT of neurology in psychiatry, which may further turn people away, as most medical students seem to dislike or struggle with neuro. At least, a good psychiatrist should also have a firm grasp of neurology anyway.

Outside of residency, psych still does pretty well. Outpatient only practices without call and less than 50 hours per week can still net $160k-$170k yearly. It pays better than the primary care specialties. Depending upon how one structures his practice and fellowships, it's possible to barely break $200k. Some shrinks do addictions fellowships and open up their own treatment facilities and make millions depending upon the area (google Talbot recovery for an example, though the original founder and current medical director were both IM-fed Addictions Medicine guys). The less scrupulous will open up methadone mills and rack up $300,000 plus. As with the primary care fields, psychiatrists are in pretty high demand and can see really good offers in certain areas. Some guys also open up cash-only practices in upscale areas treating the scorned wives of business executives and do well. It's pretty wide open.

The field itself is awesome. It's wide open to research. We learn more and more about these disorders every day. We just had a grand rounds on the neural pathways implicated in PTSD and what changes take place within the neurotransmitters, receptors, and pathways. It's also challenging, because everything relies on the history and what you *think* is going on based upon your understanding of how things work and interact. You could be completely wrong, which is ok because nobody knows **** at this point.

I have to say, though, after doing a few months of psych then having to do my medicine wards month, I honestly have no idea how you IM guys do 3 years of that crap. I thought I was, "missing out" on clinical medicine until I had to start doing it again. I was happy for that rotation to end. Now that I'm done with boards and almost done with internship, it feels great to realize that I don't have to know or care what glomerulopathy an IVDA might have (although I still remember up to this point)

 

[JaggerPlate]

I think the patient population turns a lot of people off, so I doubt it will ever be more than just mildly competitive. And while the pay can be highly variable, most averages I've seen put it just under $200k. That fact alone would turn a lot of potential candidates off as well.

People with 0 interest in skin kill themselves to get into derm residencies every year ... if there was some sort of shift in perception that put Psych up there with the horrendously outdated ROAD specialties ... you'd start seeing the 'Chances for Psyche?' threads pop up on SDN.

Personally, I think the biggest thing that turns people off is the conception that they may not be viewed as a 'real doctor,' or the fact that they aren't interacting, in a sense, in the traditional 'medical' type doctor patient interaction. However, 9-5, private practice, pulling in 200k, without a lot of the headaches associated with traditional patients ... not a bad thing in my book.

However, like everything else in life, I'm sure it has it's own set of issues, and I'm definitely not trying to build it up for more than it's worth, but seems like a 'smart' field to get into money and lifestyle wise. Additionally, I was under the impression that a lot of the issues with the crazy psych patients occurred in inpatient psyche, and that the hefty majority of DO/MDs psyches do private, outpatient work???

Who knows? Obviously these are my anecdotal thoughts, but it's one of those fields that I feel would become more popular with better exposure, if people focused on what it really offered, etc.

 

[Mattchiavelli]

I'm an MS4 waiting to see where I'll be a neurology resident [thursday...] and I would do it again. I took a year off to work a 9-5 leave work at work job and it was wonderful for ~5 or 6 months, and then I started really hating it because really when you get down to it editing spreadsheets sucks pretty hard. I appreciate doing something where I'm using the most of my abilities and most importantly I feel like I'm in a group of my intellectual peers that are interested in the same kind of nerdy things I am [as in WOAH check out how huge that abscess is!!!].

I decided that helping people was something that would make me happy with my life when it's all said and done, and medicine has so far allowed me to do that and I anticipate the same in the future. It's not perfect and definitely not easy but please show me a rewarding career that pays well and takes no training and no blood/sweat/tears/plasma/etc and I will consider saying no. It's not for everyone and unfortunately it's not hard to play the game and get into med school and only figure out too late that it isn't for you. A lot of people think they are going to work really hard through premed/med school/whenever and then it will all get really cush and you can just reap some rewards. I think that attitude will work poorly in any field, medicine or not.

Am I going to have debt when I graduate? Yeah. But they can't castrate me or put me into debtor's prison or anything, and I don't need to be rolling in a bath of semiprecious stones because I'm doing something I like.

 

[odieoh]

I'm an MS4 waiting to see where I'll be a neurology resident [thursday...] and I would do it again. I took a year off to work a 9-5 leave work at work job and it was wonderful for ~5 or 6 months, and then I started really hating it because really when you get down to it editing spreadsheets sucks pretty hard. I appreciate doing something where I'm using the most of my abilities and most importantly I feel like I'm in a group of my intellectual peers that are interested in the same kind of nerdy things I am [as in WOAH check out how huge that abscess is!!!].

Eh, just like spreadsheets, once you've seen a few dozen abscesses they will become routine and less exciting. Everything and anything can become routine if its your job and you have to do it. Being a skydiving instructor or an alligator wrestler has the potential to become dull once you've done it long enough.

 

[Silent Cool]

Dentistry is easy, but dental school tuition is entirely ridiculous. I seriously think most regular dentists are paying off their debt all their lives.

This, x 1000. People don't realize that dental school tuition is probably 40-50% more than medical school tuition, and to make the coveted >200K per year, you will need to BUY a practice--that means more debt. So before you even make a buck, you are looking at 350K loans from school and another 400k+ to buy a practice. It's not the golden goose doctors think it is. The dentists who make bucks now went to school when it was cheap and easy/cheap to open a practice. Now, if you want to specialize, you have to pay tuition! Imagine if you residency program make you pay tuition for more training--that's what many (not all) dental specialists have to do!

 

[cln6435]

So here's my situation. I am currently a pharmacist working in a hospital as staff. I graduated pharmacy school in 2010 and worked a year of retail pharmacy and hated it so now i've been working at a large teaching hospital for a year now. I make a good salary and it is sufficient for my lifestyle, but the work I do...it is just mind numbing! I barely need to use any of the knowledge I spent 6 years learning. I work on cruise control day in and day out and the work I do isn't fulfilling at all. I want to be doing clincial work, but that would require 2 years in a pharmacy residency and I considered that after grauation, but decided that those 2 years would be better spent pursuing a medical education. But now after two cycles of not being accepted to an MD progrpgram have now been trying to get into a DO program. now halfway through this application cycle for DO prorgams I am questioning if this time comitment will be worth it. I genuinely want to help people, but also want to be using my clinical knowledge and be required to think and exercise my brain at work, but from the sounds of the replies to this thread it sounds like I might be better off not pursuing a medical education. any insight people might have would be greatly appreciated!

 

[cln6435]

So here's my situation. I am currently a pharmacist working in a hospital as staff. I graduated pharmacy school in 2010 and worked a year of retail pharmacy and hated it so now i've been working at a large teaching hospital for a year now. I make a good salary and it is sufficient for my lifestyle, but the work I do...it is just mind numbing! I barely need to use any of the knowledge I spent 6 years learning. I work on cruise control day in and day out and the work I do isn't fulfilling at all. I want to be doing clincial work, but that would require 2 years in a pharmacy residency and I considered that after grauation, but decided that those 2 years would be better spent pursuing a medical education. But now after two cycles of not being accepted to an MD progrpgram have now been trying to get into a DO program. now halfway through this application cycle for DO prorgams I am questioning if this time comitment will be worth it. I genuinely want to help people, but also want to be using my clinical knowledge and be required to think and exercise my brain at work, but from the sounds of the replies to this thread it sounds like I might be better off not pursuing a medical education. any insight people might have would be greatly appreciated!

I should also add that my hours are probably just as crappy as some of the residents here. Being bottom of the totem pole I have to work weekends and mostly evening and night shifts. Maybe one day shift a week only. And they only require to give us 8 hours off before the start of our next shift so currently there are times where I work the evening shift and get out at midnight and have to be at work again at 8am the next day. This coupled with a mix of day, evening and overnight shifts all in the same work week makes for incredibly irratic sleep schedule

 

[gutonc]

I should also add that my hours are probably just as crappy as some of the residents here. Being bottom of the totem pole I have to work weekends and mostly evening and night shifts. Maybe one day shift a week only. And they only require to give us 8 hours off before the start of our next shift so currently there are times where I work the evening shift and get out at midnight and have to be at work again at 8am the next day. This coupled with a mix of day, evening and overnight shifts all in the same work week makes for incredibly irratic sleep schedule

First...the hours:

When you say they're just as crappy as some residents, do you mean the total number of hours you work each week are in the 70-90 range with one day off? Or do you mean you have a lot of alternating shifts (which sucks...no doubt)? Because those are two very different things.

Now to your initial question...is it worth it? That's something that only you can decide of course, but let's lay out some practical realities. You're currently on your 3rd year of applying to med school so you've "wasted" 3 years doing that (when you could have completed any Pharm residency you wanted and been doing something more intellectually challenging at this point). If you get in this year (and I wish you luck), you will have a minimum of 7 years ahead of you until you can practice medicine (and as many as 12-14 depending on your eventual desired specialty)...are you down with that?

You're also looking at roughly $250K in debt unless you've been saving your pennies (or are independently wealthy) once your done. ? Tack on the lost income from not doing what you're doing now and, let's just round it up to $1M that going to med school and doing a residency will cost you. Are you down with that

Honestly, if I were in your shoes and just wanted to be a clinician of some sort, I'd either do a year or two of pharm residency to get into the area of practice you want, or I'd go to PA school. It's ~2 years of school (master's level), doesn't require a residency (although they are available), pays in the same range (although overall a little lower) as Pharm and is 100% clinical. I seriously think that, at this point, unless you have a super compelling reason to do it (and I wouldn't consider "being a pharmacist is boring" even remotely compelling enough), med school is probably a waste of your time.

 

[notinkansas]

That would be a big fat HELL NO! and every expletive you can think of NO

I enjoyed medical school very much.

But....dealing with patients sucks *****. Big time. Some are great. The entitled, demanding, "I expect you to say how high when I say jump" patients who cop a major attitude and argue with you every step of the way are prevalent enough to suck the very life out of you every single day.

Then add the nurses, enough of whom have been through "empowerment" training (read: training to feel entitled to question everything you do and file anonymous complaints against you when you don't do what they say, using the vauge "I don't feel 'comfortable' with Dr X). Those who are actively trying to sabotage you are lazy and incompetent.

And all the bogus "CYA" consults that have to occur so that your colleagues in other specialties can be protected from lawsuits.

And the fact than nobody cares if you eat, sleep, pee... you must respond to everyone's demands IMMEDIATELY. Complaints can be filed against you for not answering a page fast enough.

I deeply, deeply regret my choice. I feel like a total slave. The debt is enslaving. Having MD degree makes it damn hard to get hired to do anything else (Oh, we can't hire a doctor to do this job- we can't afford to pay and this work is beneath a doctor) Not to mention that for single women having MD causes otherwise eligible and interested men to run as fast as possible in the other direction- because we still live in a society were men don't want to be in a relationship with a women who might have more education.

I'd be happier if I didn't have the MD degree and the associated debt as was working as a barista.

 

[deleted307836]

That would be a big fat HELL NO! and every expletive you can think of NO

I enjoyed medical school very much.

But....dealing with patients sucks *****. Big time. Some are great. The entitled, demanding, "I expect you to say how high when I say jump" patients who cop a major attitude and argue with you every step of the way are prevalent enough to suck the very life out of you every single day.

Then add the nurses, enough of whom have been through "empowerment" training (read: training to feel entitled to question everything you do and file anonymous complaints against you when you don't do what they say, using the vauge "I don't feel 'comfortable' with Dr X). Those who are actively trying to sabotage you are lazy and incompetent.

And all the bogus "CYA" consults that have to occur so that your colleagues in other specialties can be protected from lawsuits.

And the fact than nobody cares if you eat, sleep, pee... you must respond to everyone's demands IMMEDIATELY. Complaints can be filed against you for not answering a page fast enough.

I deeply, deeply regret my choice. I feel like a total slave. The debt is enslaving. Having MD degree makes it damn hard to get hired to do anything else (Oh, we can't hire a doctor to do this job- we can't afford to pay and this work is beneath a doctor) Not to mention that for single women having MD causes otherwise eligible and interested men to run as fast as possible in the other direction- because we still live in a society were men don't want to be in a relationship with a women who might have more education.

I'd be happier if I didn't have the MD degree and the associated debt as was working as a barista.

Good points. Aren't there specialties that largely avoid some of the things you mention though? Anesthesiology for example doesn't really have to deal with BS consults and overly lengthy patient encounters.

 

[medicinesux]

Notinkansas, I remember your posts well. Sorry to hear that things haven't improved much. Yet, I am not suprised that the practice of medicine hasn't miraculously gotten better. As for myself, I don't post here much anymore. I've pretty much said what I needed to say. As time goes on, I think about medicine less and less. You never forget, but time does heal. Every now and then, I catch myself waking up from the middle of a nightmare where I am on call in the hospital at 2AM with patients crashing all around me or sitting in the dictation room. I have been out of medicine for over 2 years and life couldn't be any better, especially when every weekend is a golden weekend! Having weekends and nights off for life is priceless. I have switched into another field of work entirely and bring in more money every month than goes out. Going from a 70 hr work week to a 35 hr work week has payed dividends to both my physical and mental health. I quickly came to the realization that as a physician in the US, what you put in was not worth what you got back. I have peace and contentment in my life now and most of all I have my valuable time back. Recently came back from a 3 month overseas trip in Asia. The sense of freedom with nothing but a backpack and passport can't be described. The beeps of the ICU machines seemed a world away when I was laying in a hammock outside my wooden hut in front of a river in the hills of northern Thailand. I remember saying to myself, now this is IT. I would never have been able to do such a thing if I stayed chained to the hospital. Nothing could entice me to go back to medicine, not even a million dollars. And that is the God honest truth. Getting out of medicine on your own terms is infinitely more difficult than getting in. I wish you the best in finding happiness...few seem to really find it in medicine nowadays. I know I couldn't so I had to get out and luckily found it in something else.

 

[SadieDoc]

M

 

[Grave]

I've skimmed this thread a couple of times. It seems as though the biggest problems that residents and attendings have described here are related to the debts they took on as med students.

As a pre-med student, would it seem naive of me to suggest that the military might have a program or two which might go a long way toward eliminating the cost of medical student debt? The US Navy in particular offers some attractive packages for med students, such as paid tuition and monthly stipends in exchange for x years of service. I believe you can even finish a civilian residency before beginning your tour of duty. I have a friend who is a naval physician, who tells me that his experiences as a military doctor have been rewarding in every way and that his financial health has never been less than very comfortable.

Are there any military doctors here who can confirm or contest this?

 

[DrAwsome]

Y

I've skimmed this thread a couple of times. It seems as though the biggest problems that residents and attendings have described here are related to the debts they took on as med students.

As a pre-med student, would it seem naive of me to suggest that the military might have a program or two which might go a long way toward eliminating the cost of medical student debt? The US Navy in particular offers some attractive packages for med students, such as paid tuition and monthly stipends in exchange for x years of service. I believe you can even finish a civilian residency before beginning your tour of duty. I have a friend who is a naval physician, who tells me that his experiences as a military doctor have been rewarding in every way and that his financial health has never been less than very comfortable.

Are there any military doctors here who can confirm or contest this?

I had a classmate who did one of these programs. She went through the navy and matched in OB. They paid for her schooling, and gave her a stipend which I believe was about 1200$/mo while in med school. However, she had to do a year of service per year she was supported by the Navy post residency. I don't think that makes sense, that's another 4 years of your life you kinda crap away. But for some people I guess it makes sense. It's really a personal decision.

 

[CambieMD]

Y


I had a classmate who did one of these programs. She went through the navy and matched in OB. They paid for her schooling, and gave her a stipend which I believe was about 1200$/mo while in med school. However, she had to do a year of service per year she was supported by the Navy post residency. I don't think that makes sense, that's another 4 years of your life you kinda crap away. But for some people I guess it makes sense. It's really a personal decision.

It completely makes sense to have the military pay your way through med school. The time that you have to return to them is negligible. Look at the debt load that new med school grads are coming out with. how long do you think it takes to pay off 300k.

Cambie

 

[gutonc]

I think for the right person, HPSP can be a good way to go. It is definitely not for everyone though, especially as there can be issues with specialty matching if you don't get a waiver to enter the NRMP match (and have to go through the military match). A visit to the Mil Med forum might be useful if you want more information.

 

[DrAwsome]

It completely makes sense to have the military pay your way through med school. The time that you have to return to them is negligible. Look at the debt load that new med school grads are coming out with. how long do you think it takes to pay off 300k.

Cambie

I personally disagree. Sure tuition is $$ at some schools but not all. Where I went to undergrad, tuition was less than 30k a year for in state grads. At the school I went to, I graduated with a bit more than 100k of debt, and paid it off within a few years. I did side work during my early part of residency, had some investments, started a business, etc. Giving the military 1 year of your life per year that they supported you does not seem like a good deal to me. 300k is payable in a short amount of time if you live moderately and are in a decent paying specialty.

Probably not with something like peds or primary care, but if you are making 300k+ as an attending you should be able to pay it off in a few years. Or you can do what some of my attendings did during my internship and only pay the mininum each month since the debt is forgiven after 15/20 years or so. But like gutonc said, it works for some people. I certainly would not do it.

 

[doctorjunior]

I've skimmed this thread a couple of times. It seems as though the biggest problems that residents and attendings have described here are related to the debts they took on as med students.

As a pre-med student, would it seem naive of me to suggest that the military might have a program or two which might go a long way toward eliminating the cost of medical student debt? The US Navy in particular offers some attractive packages for med students, such as paid tuition and monthly stipends in exchange for x years of service. I believe you can even finish a civilian residency before beginning your tour of duty. I have a friend who is a naval physician, who tells me that his experiences as a military doctor have been rewarding in every way and that his financial health has never been less than very comfortable.

Are there any military doctors here who can confirm or contest this?

My dad did that, ~30 years ago. He did an internship in FM in North Carolina and his residency in Jacksonville, then spent 3 years in Japan before leaving to work at a private practice with a large health network. Plus, being a PCP in the Navy means you're guaranteed on- base housing (at least 25 years ago he was) and he never spent a night at see (6 years in the Navy).

While the benefits are nice (Living in Japan meant traveling east Asia for cheap! And the match is smaller, so you know where you're going sooner) and it's wonderful to graduate without any loans, he said no one should do it unless you really are interested in joining the military. In fact, right after I told him I wanted to go to med school, he said not to do a military program. It's not worth it if you hate being in the military.