Impact of Med school (and beyond) on family life

[slee416]

OK, so first a little background about me. I have a BA in economics and an MS in finance. My background is in consulting and banking, and after having been overseas for the past 9 years working in various countries across Asia, I am career switching at the ripe old age of 39.

I want to work in healthcare and be in a position of diagnosing conditions and treating patients. Coming from the world of business, I originally thought chiropractic was the only viable option available to me. The financial rewards were a real concern but yet the idea seemed appealing to me at the time. But as quickly as I starting taking pre-requisite courses and talking to peers, I soon realized that many other options could be within my reach.

Without getting into long-winded detail about my decision making process, let me just suffice it to say that I gave up the idea of chiro within weeks to pursue a future in optometry. I never considered a career in medicine because I never thought it could be a reality, however with more and more talk amongst fellow students, and given how well I am doing in my classes, I am gaining more and more confidence that medicine could be in my future. Of course I have the MCATs to tackle but here's my question (sorry for the long delay):

I have a wife of 8 years and two kids 4 and 6 -- 1) what will life be like during the 4 years of med school? My question revolves around understanding how little I will see them, and understanding the sacrifices that will be made. Any measurable insight would be genuinely appreciated. 2) It may not be fair to ask this question, because I don't know what area of medicine I'd like to get into, but further to my question about med school, I wonder what 3 years of residency/internship would be like as well. 3) I am curious to know how the answers to 1 and 2 compare to an osteopathic track or a dental track. Please accept my apologies in advance for being a bit all over the place. If I was in my 20's and single, the driving forces in my decision would be much more streamlined.

Btw this information if not so much for me as it is for my family. I want to be able to paint an accurate picture of what life will be like and know in advance what I could potentially be putting my family thru.

I'm almost certain this question has been posed before so any thread links are appreciated as well. Thanks for reading.

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[pingouin]

Moving this to our Non-Traditional forum for discussion. Welcome to SDN!

 

[phrygian]

Hello, 37 year old 4th year med student here with a wife and 2 kids. First of all, I need to ask for clarification about your plans of going into optometry and taking the MCAT. Did you mean ophthalmology? Because that is the medical school route which would require the MCAT and getting in an ophtho residency (which is one of the hardest to land). Optometry requires taking the OAT and no medical school but optometry school. I just needed to ask that first.

Either way, I can only tell you about my personal experience during almost 4 years of medical school. I am going to a school where lecture is not mandatory so I was able to stay home for the majority of 1st and 2nd years. Anatomy lab had the largest demand on my time since you can not skip out on that! Second year was the easiest for me since there was no biochem, anatomy, etc, but more clinical based education and I only went to campus once a week. Studying for step 1 was not bad either if you have a schedule that fits to your life and you stick to it, but if you want/need a higher score, you will need to devote more time to it. I did have to sacrifice my personal interests a bit such as music in order to have more quality family/study time, but it is worth it since time with the kids can not be made back up.

3rd and 4th years are not too bad but they depend on your school, rotation sites, and the rotation you are on. Some are harder than others such as surgery and internal medicine while psych rotations are lighter. When it comes to taking step 2, if you study well during your rotations, you will not have to study too hard for step 2. Like with step 1, that does depend on what you are going to specialize in though since you need better scores for things like derm, ortho, etc.

Your second question is unclear since you say you do not know what you want to specialize in, but earlier you mention optometry/ophtho. I can not answer your question about residency, but the impression I get is that it is harder on family life, but if your spouse is supportive and understanding, you can make it worth as long as you sacrifice too.

Your last question, the osteopathic route is not easier since it nearly mirrors the allopathic track, except you take the COMLEX exams instead of USMLE, but many osteopath students take both. I have no idea about dental, but from what I heard, it is rather tough too.

You do have other options such as PA school if you do not want the longer physician road, but do not short change yourself. If you really want to become a physician, do it, but make sure you know what you are getting in to since it is a tough road and its even harder if you have a family. I would not change a thing. Good luck!

 

[WellWornLad]

I have a wife of 8 years and two kids 4 and 6 -- 1) what will life be like during the 4 years of med school? My question revolves around understanding how little I will see them, and understanding the sacrifices that will be made. Any measurable insight would be genuinely appreciated.

Before generalizing the med school experience, I'll preface by saying that much depends on how smart you are and how ambitious you are. Less of the former and more of the latter will make for a less flexible, more grueling med school experience.

Med school is roughly divided into the pre-clinical (1st & 2nd) and clinical (3rd & 4th) years, with rare variations among some schools (e.g., Duke squeezes all of pre-clinical into one year). Unless your school has a mandatory attendance policy or doesn't record lectures, the pre-clinical years could be the most flexible time you've had for a while. I did most of my studying from home during this time. I slept in until I was well-rested, had some coffee, read the news, exercised, then sat down for a solid study session.

3rd year is when you go into the hospital for your core rotations, and is probably the most time-consuming. Not only will you have an unpaid full-time job working 50-100 hours a week (depending on the rotation), you're expected to study on top of this time for shelf exams at the end of rotations. It's also possible to have long shifts (24+ hours) that are now technically verboten for residents, although that is becoming rarer.

4th year is much like 3rd year, except that you choose the rotations you get to do, there are less/no shelf exams for non-core rotations, and your evaluations tend to mean less as your residency application will be submitted early in your 4th year. On that point, you'll also be traveling during 4th year for residency interviews. Although opinions differ, 4th year is often considered to be the easiest, although you'll still have pretty regular hours.

2) It may not be fair to ask this question, because I don't know what area of medicine I'd like to get into, but further to my question about med school, I wonder what 3 years of residency/internship would be like as well.

You're right, it's not really fair. But it's going to be rough on both you and your family. I've met a few residents who can count on one hand the number of hours per week they've spent awake with their spouse, let alone children. Intern (1st year of residency) is the worst, the following years are better but still rough. There are currently new rules being proposed to limit the number of consecutive hours worked, establish more days off, etc., but that's a whole other level of detail I can't get into here, and it's not likely to drastically improve the amount of free time you have anyway (if anything, it may lead to increased years of residency).

3) I am curious to know how the answers to 1 and 2 compare to an osteopathic track or a dental track.

Osteopathic is essentially identical, especially in residency. The first two years of dental school are much less flexible than medical school because they learn all their procedural/technical stuff from the first year, so they're often shackled to the school and the equipment in it and have a lot of project deadlines in addition to studying for class. On the plus side, there's no residency for dentists unless they want to pursue some specialization, and even then it's only a year or two (I think?).

You seem open to a variety of paths, so I would definitely look into physician/surgical assistant and nursing/NP as well. Medicine is of course open to you, but if "financial rewards are a real concern" then medicine might not be a good fit at your age. The cost of medical school + opportunity cost of not working/low pay during residency might be hard to justify, especially since it sounds like you're thinking about primary care with that 3-year residency. More lucrative specialties tend to be 5+ years of residency and are competitive to match into.

 

[MaryGoRound]

From what you've said about your previous education, it sounds like you are going to need to complete your pre-reqs before you take the MCAT. If this is the case, I would suggest signing up for a couple classes this coming semester. Also start volunteering at a local hospital. If you are working full time, studying for classes and volunteering, you're going to have a better idea of the time commitment medical school requires. I would stick with that through the semester, and reassess my plans after finals are over.

 

[slee416]

Hello, 37 year old 4th year med student here with a wife and 2 kids. First of all, I need to ask for clarification about your plans of going into optometry and taking the MCAT. Did you mean ophthalmology? Because that is the medical school route which would require the MCAT and getting in an ophtho residency (which is one of the hardest to land). Optometry requires taking the OAT and no medical school but optometry school. I just needed to ask that first.

[No I actually meant optometry. I am open to most anything and everything and it comes down to things like, what's the commitment, what's the payoff, what's the lifestyle, and then on the back of all that, what's my interest. Many people say the answer to one's question, lies within answering the question "what do you want to do?" but at my age and with my personal and financial considerations, it's just not feasible to answer that because my life is not my own. I chose optometry because the chances of earning a decent pay are much better than chiro, it's not a business where you have to market and 'pull' patients in, and the lifestyle is family/personal life friendly. That having been said, I'm not all that inspired by the profession, with the caveat that I have not done any shadowing so admittedly I am forming opinions without full information. But really I don't have the luxury of putting in a lot of time to exploring a handful of different paths. The reason I am thinking med school is because 1) optometry pre-reqs cover all med school reqs including recommended but not required courses, 2) I am acing all my pre-reqs and I'm getting commentary from my peers that someone of my caliber should be going to med school and, 3) I figured that since the subject material of the OAT is similar to MCATs I would take the MCATs and see if I might be competitive. This all goes along with a real desire/interest to be a doctor working in a hospital setting, earning the respect and money that goes along with it.]

Either way, I can only tell you about my personal experience during almost 4 years of medical school. I am going to a school where lecture is not mandatory so I was able to stay home for the majority of 1st and 2nd years. Anatomy lab had the largest demand on my time since you can not skip out on that! Second year was the easiest for me since there was no biochem, anatomy, etc, but more clinical based education and I only went to campus once a week. Studying for step 1 was not bad either if you have a schedule that fits to your life and you stick to it, but if you want/need a higher score, you will need to devote more time to it. I did have to sacrifice my personal interests a bit such as music in order to have more quality family/study time, but it is worth it since time with the kids can not be made back up.

3rd and 4th years are not too bad but they depend on your school, rotation sites, and the rotation you are on. Some are harder than others such as surgery and internal medicine while psych rotations are lighter. When it comes to taking step 2, if you study well during your rotations, you will not have to study too hard for step 2. Like with step 1, that does depend on what you are going to specialize in though since you need better scores for things like derm, ortho, etc.

Your second question is unclear since you say you do not know what you want to specialize in, but earlier you mention optometry/ophtho. I can not answer your question about residency, but the impression I get is that it is harder on family life, but if your spouse is supportive and understanding, you can make it worth as long as you sacrifice too.

[If I'm being completely honest here, any choice of specialty would be based in financial reward and lifestyle. The decision would be based more in practicality than in personal interest. I only know I could rule out certain areas as opposed to specifically choosing one.]

Your last question, the osteopathic route is not easier since it nearly mirrors the allopathic track, except you take the COMLEX exams instead of USMLE, but many osteopath students take both. I have no idea about dental, but from what I heard, it is rather tough too.

[Thanks for clearing up the osteopath part]

You do have other options such as PA school if you do not want the longer physician road, but do not short change yourself.

[Not enough money, I'd rather go CRNA which also something I'm looking into.]

If you really want to become a physician, do it, but make sure you know what you are getting in to since it is a tough road and its even harder if you have a family. I would not change a thing. Good luck!

please see above in blue

 

[slee416]

Before generalizing the med school experience, I'll preface by saying that much depends on how smart you are and how ambitious you are. Less of the former and more of the latter will make for a less flexible, more grueling med school experience.

Med school is roughly divided into the pre-clinical (1st & 2nd) and clinical (3rd & 4th) years, with rare variations among some schools (e.g., Duke squeezes all of pre-clinical into one year). Unless your school has a mandatory attendance policy or doesn't record lectures, the pre-clinical years could be the most flexible time you've had for a while. I did most of my studying from home during this time. I slept in until I was well-rested, had some coffee, read the news, exercised, then sat down for a solid study session.

3rd year is when you go into the hospital for your core rotations, and is probably the most time-consuming. Not only will you have an unpaid full-time job working 50-100 hours a week (depending on the rotation), you're expected to study on top of this time for shelf exams at the end of rotations. It's also possible to have long shifts (24+ hours) that are now technically verboten for residents, although that is becoming rarer.

4th year is much like 3rd year, except that you choose the rotations you get to do, there are less/no shelf exams for non-core rotations, and your evaluations tend to mean less as your residency application will be submitted early in your 4th year. On that point, you'll also be traveling during 4th year for residency interviews. Although opinions differ, 4th year is often considered to be the easiest, although you'll still have pretty regular hours.



You're right, it's not really fair. But it's going to be rough on both you and your family. I've met a few residents who can count on one hand the number of hours per week they've spent awake with their spouse, let alone children. Intern (1st year of residency) is the worst, the following years are better but still rough. There are currently new rules being proposed to limit the number of consecutive hours worked, establish more days off, etc., but that's a whole other level of detail I can't get into here, and it's not likely to drastically improve the amount of free time you have anyway (if anything, it may lead to increased years of residency).



Osteopathic is essentially identical, especially in residency. The first two years of dental school are much less flexible than medical school because they learn all their procedural/technical stuff from the first year, so they're often shackled to the school and the equipment in it and have a lot of project deadlines in addition to studying for class. On the plus side, there's no residency for dentists unless they want to pursue some specialization, and even then it's only a year or two (I think?).

You seem open to a variety of paths, so I would definitely look into physician/surgical assistant and nursing/NP as well. Medicine is of course open to you, but if "financial rewards are a real concern" then medicine might not be a good fit at your age. The cost of medical school + opportunity cost of not working/low pay during residency might be hard to justify, especially since it sounds like you're thinking about primary care with that 3-year residency. More lucrative specialties tend to be 5+ years of residency and are competitive to match into.

[I presume specialties like anesthesiology and radiology fall into this lucrative area, but wow, I didn't know residency would be 5+. Ignorant me thought everything was 3years]

please see above in blue

 

[slee416]

From what you've said about your previous education, it sounds like you are going to need to complete your pre-reqs before you take the MCAT.

[Already underway with optometry pre-reqs which covers way more than med school requires. A's across the board in Microbio, A&P, GenChem and OChem. Physics, Psychology, Bio and BioChem left to go]

If this is the case, I would suggest signing up for a couple classes this coming semester. Also start volunteering at a local hospital. If you are working full time, studying for classes and volunteering, you're going to have a better idea of the time commitment medical school requires. I would stick with that through the semester, and reassess my plans after finals are over.

please see above in blue

 

[DrMidlife]

Whoa, easy there on prereq pronouncements. Optometry prereqs look like the nursing prereqs plus calculus. It's fairly common to have one "track" in science coursework that is for nursing/etc and one "track" that is for med/dental/research. If you do the wrong track you won't know the MCAT material.

You'll want to look at a MSAR, or the admissions web pages for some med schools. Prereqs are one year each, with lab, of genchem/ochem/physics/bio, plus/minus whatever a med school wants to require (typically biochem, English, calculus). Physics doesn't have to be calculus-based. The chem & bio should be the classes that the chem & bio majors take.

Best of luck to you.