Introduction and Questions

[ITorMD]

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Hi Everyone,

I know that I am about to ramble, but please bear with me and read it through. You will be able to tell at the end of it that I am confused and I am at a crossroad. What I am about to type are my uncensored thoughts as I am thinking them (and have been thinking about for the past week), so please read on and then please share your thoughts as some of you might have been in my shoes sometime back.

I am 34 years old. As you can guess from my username, I am in the IT field. I have recently been contemplating where my life has been heading and am taking a step back to evaluate what is important to me and if a job in IT is going to provide that for me or if switching careers might be a better option.

Being in IT, I have been traveling a lot. Sometimes, it's Mon-Thurs or Mon-Fri. Sometimes, it's for a few weeks and then I'm home for a few weeks. The pay is good (mid to high 100's), but the job security and stability is never really there in a good economy, talk less of the economy that we are in. Living in Michigan makes it harder since the economy here is worse than some other parts of the States, so if I want a well paid job that takes care of my and my family, then the travel becomes a necessity. I have been dealing with this kind of instability (travel and/or a new job every 2-3 years for different reasons) for about 6-7 years now and I am getting tired of it. We could move out of MI and maybe go live in San Fran (IT mecca), but we have family in MI and we are planning for our 1st baby soon, so being around family is really helpful in these times. Still, if we HAVE to move, we would move and figure out the rest as it plays out.

My wife and I are planning for our 1st child and I want stability in our lives. I want to wake up and know that I have a job that is stable and pays well and one that I enjoy. I have been thinking of an MBA to maybe pursue a management track, but even spending 2 years on an MBA might not guarantee me a management job unless I attend an A grade school (given that in the current times, every Tom Dick and Harry is doing an MBA, which means I need to attend an A grade school to differentiate myself) and even then, I might lose that job for whatever reason and go back to finding another job in another few years. I have thought about maybe switching to sales, but that is not stable either and involves a fair amount of travel. I have thought about going in to business for myself (opening a franchise, etc), but without a stable income/secure job, it is hard to think about opening a franchise, not to mention that these economic times don't make it easy to think of a franchise, especially in Michigan where times are tough and getting customers with discretionary spending is not easy.

I look around and even in these worst of times, I see my medical friends somewhat still unaffected by it. Now, having talked to them, I know that since a lot of people are losing jobs, they are also losing their health benefits and as a result, are not showing up to hospitals, dentists, etc and that does affect my friends, but overall, they are not huring - they have stable jobs, some have 10-12 days off a month (ER) and enjoy a decent salary and live a good life. Yes, they paid their dues going through 10-12 years of schooling/residency, they are paying off their debt, they work their butt off, but at the end of the day, they call Michigan home, they can plant their roots in Michigan without worry and have no fear of finding another job in another state if tomorrow they decide to relocate.

So instead of jumping from one IT job to another in these hard times, I am taking the time to assess my life, what is important and what I want to do to achieve those goals (stability, decent pay, a job that gives me new challenges and allows me to grow personally and professionally and at the end of the day, a job where I feel I am doing something of value and making a difference rather than just making IT execs rich).

So all this brings me to this question - SHOULD I PURSUE A CAREER IN MEDICINE?

Now, before you all jump on me and say that "there is so much more to it than this" and that "medicine is really tough", let me tell you some of of the things I have done to look in to this seriously:

- I have been looking in to pre-med classes, how tough are, etc
- I have downloaded MCAT coursework and gone through some of the material to see what I have to go through to prepare for the MCATs
- I have set up an appointment with a local university medical advisor to ask questions and get a better idea of the process and what it entails
- I have talked to a lot of my friends who are in medicine to get their opinions
- I will shadow some of my friends in different fields (radiology, anasthesia, oncology, etc) in a few weeks to see what they do and what that feels like
- I have had serious discussions with my wife on what this would mean for us, the lost income, the debt we would take on, the child that we are planning for, etc and how we can cope with the 4 years of no pay.
- I have read KevinMD.com and Panda Bear MD blogs to really understand how brutal med school can be

I consider myself to be intelligent. I have my Bachelors and Masters in Computer Science. I am highly focused and when I set my mind to something I see it through.

Here are a few reasons that DO NO contribute to me thinking about going in to medicine:

- the pay - there are other ways to make more money - sales people make more money in some cases than most doctors. CEOs make millions. Doctors will make decent money and that is enough for me.

- the prestige - I am not one that wants to be in the limelight or feels a sense of entitlement, so I am not going in to this because having a business card that says "brain surgeon" is "so cool" (besides, I don't even know if I would end up being a surgeon or a radiologist or whatever at this point).


I guess my question to you all is this:

- how do I know if I will really like medicine? People tell me "you have to like it". How do I find this out? And is this really true? Does everyone that goes in to medicine have to like it? Or can you "learn to like it" along the way?

- I hear people saying that the pay is not what it used to be and that insurance, etc are sucking the life our of the profession. As stated before, pay is not the reason I am thinking about this. But it is definitely important. I am in IT today and after working for 10 years since I came out with my Masters, I can make a decent salary (mid to high 100s). Do I really want to go through 10 years of med schooling and come out and make $150k as an Internist? No I don't. Nothing against that field, but it just does not make rational sense to me. So I would strive for a different specialty like Radiology or Anasthesia or Oncology or General Surgery or maybe ER where I can maybe make $250k-$300k and have a decent lifestyle (different topic as to whether I will actually get in to those residencies, but let's assume that I can for now). But can someone tell me what people are talking about when they say "shrinking physicial salaries"?

- With Obama working on his health care policies, what are your thoughts on the health care picture 10 years from now. Will it ever come down to me spending all this time and energy and blood sweat and tears and then coming out as a Radiologist or Neurologist or ER doctor and making $150k/year? Can that happen in the States?

- I read in a lot of blogs that many doctors would not go back and do it again. Why did you go in to medicine (honestly)? What is your driving force and can you go through med school without being passionate about saving the world? You have to like the sciences, but is that enough?

Wow, this is a long post. But these are all things going through my head. I am at a crossroad and really trying to give this some serious thought to see if I want to do this so that I build a decent life for me in the future - one that is stable, secure, pays decently and challenges me and one where no one can fire me or where I have to go work for someone else.

If any of you can please take the time to answer my questions above, I would truly appreciate it.

Thanks!

 

[LaTortuga]

Just a quick thought about one of your questions. Others will be able to write better responses to your questions about pay, security, Obama's health plan, etc.

- how do I know if I will really like medicine? People tell me "you have to like it". How do I find this out? And is this really true? Does everyone that goes in to medicine have to like it? Or can you "learn to like it" along the way?

The only way to find it out is by immersing yourself in it. While you do the prereqs/prep for the MCAT, volunteer and shadow as much as possible; try working in different settings like clinics, inpatient, outpatient, etc. You can talk to docs for hours, and read blogs until you are blue in the face ... and that's great for convincing your intellectual side that hey medicine might be the right fit for you ... but you gotta jump in, experience it day in and day out, get close enough to smell the patients, see the pus/blood/vomit/diarrhea, get accustomed to the constant smell of bleach/urine while on the floor, the paperwork, the politics of the clinic, the absurdities of insurance and all of nonsense that comes along with the claim forms and red tape.

It may sound corny, but a fellow that I shadowed extensively told me the best way to decide if medicine is right for you ... is to ask yourself, could you live without it?

One question that I have to build on your "should i pursue a career in medicine" ... is why MD? Nurses are very much in demand ... so are PA's, etc. I'm not asking you this question to give you a hard time. As a student preparing to matriculate into an MD program in the fall, I am acutely aware of the odds/sacrifices facing me ... 4 years of extremely hard work in medical school, more years in residency, $150k+ student loan debt, less time with family/friends. There are faster ways to feeling like I am doing something constructive with my life, and doing more than just making my boss rich ... why do you want to walk this particular path that ends with an MD behind your name?

Beyond the financial sacrifices, there are other important things that you will have to balance with your education ... i.e. family life with your wife and 1st born baby, sitting alone for hours on end memorizing facts while people around you go on with their lives ...

Do you want medicine enough to make all of these sacrifices?

Would you still want to go into medicine if you knew in 10 years the days of making $250-350,000 as a specialist would go away and you would have to accept $120,000 or less/year?

The scenario you wrote a question about:
"Will it ever come down to me spending all this time and energy and blood sweat and tears and then coming out as a Radiologist or Neurologist or ER doctor and making $150k/year? Can that happen in the States?"

If this happened, would you still pick medicine?

 

[behealthy]

I can't suggest what is right, or wrong, for your life, but I can say that studying pre-med topics is way different then computer science. I went from aerospace engineering-->public health science, and 2 years later, I still feel like I'm just learning how to study topics requiring memorizing. It sounds quite trivial, but for someone who works best with problems, and using a basic set of rules to solve complex problems, this can be quite difficult.

 

[ITorMD]

Would you still want to go into medicine if you knew in 10 years the days of making $250-350,000 as a specialist would go away and you would have to accept $120,000 or less/year?

The scenario you wrote a question about:
"Will it ever come down to me spending all this time and energy and blood sweat and tears and then coming out as a Radiologist or Neurologist or ER doctor and making $150k/year? Can that happen in the States?"

If this happened, would you still pick medicine?

My answer would be no. Does that mean I am in it for the money only? No, but the pay is definitely a part of the reason why I am thinking of a medical career, in addition to job stability, working a challenging job that allows me to really help people and allow me to leverage my IT knowledge to possibly improve the technology/administrative side of health care). I have my Masters in Computer Science and I'm making a decent 6 figure salary in the $100s. Why would I put myself through 10 years of blood, sweat and tears and end up making the same money 10 years later for possibly doing even more work than I am doing now? It does not make logical sense to me. Does that mean I'm in it for the money and that I'll make a bad doctor? I really don't think so and I think there are as many of me out there as there are those who will say that they would still become a doctor because all they care about is helping people in need of medical attention.

I would like to ask this same question to everyone reading this forum - if tomorrow, you had to go through 4 yrs of med school and 5 yrs of residency and 1 year of fellowship and end up earning $120,000/year (the same salary that an IT project manager can pull with 4 years of undergrad with a few years of work experience), would you do it? Given the amount of increasing work, the talk about less pay, dealing with insurance companies, complaining patients, huge student debt, etc....would you go through what you are going through for $100k or $120k/year?

Please be honest.

 

[punkiedad]

My answer would be no. Does that mean I am in it for the money only? No, but the pay is definitely a part of the reason why I am thinking of a medical career, in addition to job stability, working a challenging job that allows me to really help people and allow me to leverage my IT knowledge to possibly improve the technology/administrative side of health care). I have my Masters in Computer Science and I'm making a decent 6 figure salary in the $100s. Why would I put myself through 10 years of blood, sweat and tears and end up making the same money 10 years later for possibly doing even more work than I am doing now? It does not make logical sense to me. Does that mean I'm in it for the money and that I'll make a bad doctor? I really don't think so and I think there are as many of me out there as there are those who will say that they would still become a doctor because all they care about is helping people in need of medical attention.

I would like to ask this same question to everyone reading this forum - if tomorrow, you had to go through 4 yrs of med school and 5 yrs of residency and 1 year of fellowship and end up earning $120,000/year (the same salary that an IT project manager can pull with 4 years of undergrad with a few years of work experience), would you do it? Given the amount of increasing work, the talk about less pay, dealing with insurance companies, complaining patients, huge student debt, etc....would you go through what you are going through for $100k or $120k/year?

Please be honest.

YES.

I am doing it, but as long as I can make a similar amount to what I am making now, I will be OK, but you cannot even predict what the average physician will make with the onset of all the changes our healthcare system will bring.

But, for the bigger question, I would take pause. Making 150+k per year puts you somewhere in the 95th percentile right? Maybe a little less, but I am not sure, all I know, especially in Michigan it is pretty good. Your "cost" to go to med school will be high.....
--600K in lost wages for 4 years
--another 400K in lost wages in residency (generous)
--at least another 100-200k for fellowship for the subspecialties you mentioned
--Med school tuition 30k per year (guess? don't know where you would be going) = 120k
--living expenses. wow. what could you get by on? 100k per year? This is 400K for med school plus another 50K per year for each year of residency and or fellowship.

So, I am just guessing med school is gonna cost you about $2,000,000. And, you will have to get your wife to agree to a lifestyle of 100k per year rather than the 150k per year you have been living on.

Also, are there med schools near you or will you have to move? Not sure where you are in relation to them but this is a big consideration as you are planning a family and having a great support network is critical.

So, I am not trying to talk you out of this cause I am doing something similar. We made adjustments. Sold the big house with the pool, got rid of about 100k worh of really cool cars, and am joining the national guard. This was the best path for me to make sure my family suffers the least.

In the end, I would ask yourself one question. If you can live with the situation listed above (for you not me) would you regret your decision when the economy comes back around and IT jobs are plentiful again and the healthcare industry gets squeezed (very likely). If you envision that and won't be thinking about jumping back into IT cause capital spending is back through the roof with all that demand has comeback, then go for it.

Either way, best of luck to you and your family............By the way, being a dad is really the best job I have come across so far!

 

[LaTortuga]

Nice response. Sorry to bringing up the monetary/salary concerns of your post, but with the current state of affairs, and having wandered over to the med student forums where many current students/residents/attendings are more than worried about what will happen to the field of medicine in the next 10-30 years ... I just wanted to make sure you'd thought about what you would do if the bottom fell out and salaries took a huge plunge, say fell below $100,000.

The honest truth is who the heck knows what's going to happen to physician salaries. They *could* dive bomb in the coming years, or they could go up. Who knows. My goal was to make sure that your other motivations for wanting to go into medicine are strong enough to outweigh the very real possibility that you may not get the return on your investment that you are expecting. If this year is any indication, the Match for competitive specialities isn't going to get any less daunting, and with more schools either being created or increasing class size, finding a seat when the music stops will be downright brutal in the coming years/decades.

To answer your question ... honestly, yes, I would still chose this path, even if that means after 4 years of school, debt, residency and all of the blood/sweat/tears, I would be making the $100,000 that an IT grad could make with an undergraduate degree and a few years experience. There are many jobs out there that would yield way more than I currently make (or will ever make as a physician ... heck, my college buddy studying accounting probably makes an easy 6 figures now, whereas me ... I live off top ramen with my teeny tiny research tech salary.)

I'm picking this career because I love the science, the problem solving, the patient interactions and feeling like at the end of the day, I've actually accomplished something beyond simply selling a product or making a load of cash for my boss. I could care less if I make $150,000, $100,000 or $300,000 when I graduate. All I want is to have some sort of financial security (limping along with my puny academic research tech salary just stinks), the ability to participate in clinical research and see patients. Sure, I'm not excited about insurance company BS, increased workloads, rising malpractice insurance, and all of the red tape ... but I'll cope with it.

The people whom I look up to most in medicine are the physicians/nurses that I work with in a free weekend clinic for the urban underserved. I like being able to provide a basic service to those who are most in need. Sure our paycheck for all of this work is $0.00 ... but who cares about our pay anyway? At least I've been able to payback a valuable service to the people in my community. $120,000 per year for providing the same services when I graduate with my MD is just icing on the cake.

 

[ITorMD]

Nice response. Sorry to bringing up the monetary/salary concerns of your post, but with the current state of affairs, and having wandered over to the med student forums where many current students/residents/attendings are more than worried about what will happen to the field of medicine in the next 10-30 years ... I just wanted to make sure you'd thought about what you would do if the bottom fell out and salaries took a huge plunge, say fell below $100,000.

The honest truth is who the heck knows what's going to happen to physician salaries. They *could* dive bomb in the coming years, or they could go up. Who knows. My goal was to make sure that your other motivations for wanting to go into medicine are strong enough to outweigh the very real possibility that you may not get the return on your investment that you are expecting. If this year is any indication, the Match for competitive specialities isn't going to get any less daunting, and with more schools either being created or increasing class size, finding a seat when the music stops will be downright brutal in the coming years/decades.

To answer your question ... honestly, yes, I would still chose this path, even if that means after 4 years of school, debt, residency and all of the blood/sweat/tears, I would be making the $100,000 that an IT grad could make with an undergraduate degree and a few years experience. There are many jobs out there that would yield way more than I currently make (or will ever make as a physician ... heck, my college buddy studying accounting probably makes an easy 6 figures now, whereas me ... I live off top ramen with my teeny tiny research tech salary.)

I'm picking this career because I love the science, the problem solving, the patient interactions and feeling like at the end of the day, I've actually accomplished something beyond simply selling a product or making a load of cash for my boss. I could care less if I make $150,000, $100,000 or $300,000 when I graduate. All I want is to have some sort of financial security (limping along with my puny academic research tech salary just stinks), the ability to participate in clinical research and see patients. Sure, I'm not excited about insurance company BS, increased workloads, rising malpractice insurance, and all of the red tape ... but I'll cope with it.

The people whom I look up to most in medicine are the physicians/nurses that I work with in a free weekend clinic for the urban underserved. I like being able to provide a basic service to those who are most in need. Sure our paycheck for all of this work is $0.00 ... but who cares about our pay anyway? At least I've been able to payback a valuable service to the people in my community. $120,000 per year for providing the same services when I graduate with my MD is just icing on the cake.

LaTortuga, I admire your selflessness. I am sure there are many others like you out there. For whatever reason, the others that are not like you choose not to leave a comment on this thread, maybe because they feel like they have a hard time voicing that side of them.

But I would think that I am not alone as evidenced by the shortage of Internists in the field, along with an ever increasing number of people shooting for Radiology or Ortho, despite the long residency programs (5+). I would imagine a lot of that has to do with how little they get paid as an Internist in return for all the work, the insurance bull****, etc. So when people coming straight out of college in to a med program are not desiring to go into Internal Medicine for pay reasons, I feel justified to say that for someone like me that has worked in the field for 10 years and now has to earn an Internist salary after 10 more years of med education does not make rational sense to me (and now I have the added honor of paying off my debt while being on the same, or even less salary).

At the end of the day, I don't know which field I might like (I might hate Ortho or Radio) or for that matter, which field I can even get in to, so I have to keep that in mind.

 

[steveo1012]

Just to add to some of the comments above: One of the things I find most troubling about a potential healthcare and physician salary squeeze is the continued rise in cost of medical education. I think it's a crime that schools continue to raise tuition year after year when salaries have become stagnant and even experienced decline. Everyone wants to blame doctors' pay for the high costs of healthcare, yet no one pointing the finger knows how expensive school and opportunity costs are.

If physcian salaries drop below $100K and medical tuition does not drop, I don't care to ponder what would happen, but the magnitude of the crisis could be huge. That system would not be sustainable to meet the healthcare challenges of this century IMO. I would hope our government would realize the large disconncect between salary and cost of education if they ever universalized our healthcare system. It's one thing to make large financial and personal sacrifices to become a physician while you're going through the process, but it's another if the monetary constraints imposed on your profession make it impossible to ever advance and leave you and your family in financial discomfort.

Ok, maybe a little dramatic at the end, but I do think there has to be a return on your investment so you can ensure you can adequately support a family. Medicine is my passion, but I would not trade a family for it and don't think many others would either. If it comes to that, our society needs to re-evaluate things.

 

[glamqueen]

Get ready to reevaluate then. The healthcare system is about to dramatically change courtesy of the new administration.

 

[thedavinator]

I will keep this brief, unlike you. No.

Here is what you should do:
1) Shut up and quit whining
2) Don't have any kids (see #1 for my reason (you whine too much))
3) Take all your money to Vegas and try to get some more that way
3a) If this doesn't work say "**** it" and go back to your emo life
4) Quit writing insanely long forum posts and do something with your life
5) You are in IT so move out of your mom's basement
6) If you really need money do one of them computer things they did in the movie Office Space, if you are not smart enough to pull this off then you are too dumb to be a doctor anyways.
7) Join the marines where they can make a man out of that little emo girl that you are now.

-Peace out

 

[ITorMD]

I will keep this brief, unlike you. No.

Here is what you should do:
1) Shut up and quit whining
2) Don't have any kids (see #1 for my reason (you whine too much))
3) Take all your money to Vegas and try to get some more that way
3a) If this doesn't work say "**** it" and go back to your emo life
4) Quit writing insanely long forum posts and do something with your life
5) You are in IT so move out of your mom's basement
6) If you really need money do one of them computer things they did in the movie Office Space, if you are not smart enough to pull this off then you are too dumb to be a doctor anyways.
7) Join the marines where they can make a man out of that little emo girl that you are now.

-Peace out

Wow...I really hope you're not on your way to becoming a doctor. If this is how you treat someone looking for some honest answers because they are at a crossroad and looking for direction, you'd never make a good doctor.

As for making a man out of me, why don't you stop hiding behind your computer and meet me in person? You can show me how manly you really are after I'm done with you.

You're pathetic.

 

[glamqueen]

ITorMD - it's obviously a troll. Just ignore them. I don't know why they like our board so much, but they do.

 

[steveo1012]

I would think that the same factors that would prompt me to re-evaluate medicine would cause most to do the same. I'm assuming the majority of people want to get married and have a family someday. I just don't foresee any radical legislation to cap salaries at $95 or $100K ever succeeding, especially with the cost of education and the years required to become a physician. Are the rest of you really ok with that or do you secretly maintain that it will never get that bad? Just curious.

 

[ITorMD]

Get ready to reevaluate then. The healthcare system is about to dramatically change courtesy of the new administration.

GlamQueen, can you share your thoughts on the new administration and its impact on the future of medicine as you see it? Just curious what people think will happen in the future with medicine.

 

[thedavinator]

Let us duel!

You are the computer loser Mr. IT.

By the way I already have a degree from a school of medicine. Good luck getting yours.

If you want to fight me so much then you are too crazy to be a doctor. My favorite activity is also pumping iron so be my guest to kick my ass.

I also want to point out you are an idiot if you think you can get into med school after being arrested for assault because I will let you punch me first. I will also let you beat me up so bad it looks like you are a total psycho.

You probably hate puppies too, jerk.

 

[ChandutheMagici]

Let us duel!

You are the computer loser Mr. IT.

By the way I already have a degree from a school of medicine. Good luck getting yours.

If you want to fight me so much then you are too crazy to be a doctor. My favorite activity is also pumping iron so be my guest to kick my ass.

I also want to point out you are an idiot if you think you can get into med school after being arrested for assault because I will let you punch me first. I will also let you beat me up so bad it looks like you are a total psycho.

You probably hate puppies too, jerk.

I'm shocked that you got banned 🙄

 

[glamqueen]

Yeah, I reported him. I'm sure others did too.

ITorMD - I think this article shows how the new administration considers physicians.

http://www.cbsnews.com/stories/2009/...n4894650.shtml

I think we are going to see reimbursements decrease and then when universal coverage in whatever form comes - we will also see specialties realign under whole new pay structures. I don't think the loans doctors are up to their ears in are considered adequately, and I also don't think the job doctors do separate from other health professionals is considered either. That's my two cents, though. I can't say I have all the answers. I've only heard the same speeches and read the same articles you have. We each can only speculate as to what will happen. I know that I am not doing this for the money. It's also a reason I am HPSP. I won't have to worry as much as others about paying my loans back if salaries change significantly.

 

[ChandutheMagici]

It's also a reason I am HPSP.

Run my friend, RUN! While you still can 😉

 

[glamqueen]

I get what is implied....I know the opinion of HPSP on these boards, but I have friends who are doctors currently in residency and in attending status in the AF, and they are very happy. To each his own...I don't need to hear your reasons you are against it, but I thank you for your post back on it. I do think everyone should do considerable research to make sure they are committed to the military AND medicine, which I am.

 

[glamqueen]

Let's stay on the OP's topic, though.

 

[ITorMD]

Yeah, I reported him. I'm sure others did too.

ITorMD - I think this article shows how the new administration considers physicians.

http://www.cbsnews.com/stories/2009/...n4894650.shtml

I think we are going to see reimbursements decrease and then when universal coverage in whatever form comes - we will also see specialties realign under whole new pay structures. I don't think the loans doctors are up to their ears in are considered adequately, and I also don't think the job doctors do separate from other health professionals is considered either. That's my two cents, though. I can't say I have all the answers. I've only heard the same speeches and read the same articles you have. We each can only speculate as to what will happen. I know that I am not doing this for the money. It's also a reason I am HPSP. I won't have to worry as much as others about paying my loans back if salaries change significantly.

GlamQueen, your link did not come through properly - the page does not load. Would you mind re-posting it?

 

[glamqueen]

http://www.cbsnews.com/stories/2009/03/26/ap/politics/main4894650.shtml

 

[glamqueen]

Double checked, and that opens for me - let me know if it won't for you.