2+ Year Member
- Oct 5, 2016
I haven't read all the replies, but here are my thoughts:Hi All i was hoping to talk with a few current Med students and/or current residents. Long story short I’m an older non trad student. I would be 38 when I would potentially start med school. I’m married with three kids. We would have to move for school so we would not have any family help. I’m looking at prob 500k in debt before interest or so. Since I’m older I’m thinking of doing IM or family practice. Would this be a terrible idea? I’m starting to think the debt isn’t worth it. I have shadowed several docs and a few have mentioned the crna and PA route. One mentioned Dental but cautioned of similar debt. However, my passion lies more with being a physician. Any real world insight I would greatly appreciate. Thanks!
Ask. Don't just ask med students, but ask residents and especially attendings too (though residents might be the ones who are most likely to say it's not worth it since they're working crazy hours, not making much money, sometimes getting yelled at, often feeling underappreciated, etc.). Also ask new attendings and mid-career attendings. And ask attendings in different specialties. This will give you a fuller picture.
Family. This is the most important factor. If your family is on board, then med school and residency are do-able. If they are not on board, then it's not worth potentially breaking up your family just to become a doctor. No career is worth potentially destroying your family.
Age. I'm not near your age, but I did work a couple of years after undergrad, and I have friends near your age, and 38 isn't that old. You'll be 42 when you finish med school and 45 if you do a 3 year residency. That gives you 20+ years as a practicing physician. I have met med students who are 50+. At worst, maaaaybe specialties that are heavily procedural or physically demanding aren't worth it (since they require things like good manual dexterity and stamina), but there are many other specialties to choose from.
Health. I have seen 40+ year olds who run marathons and do triathlons and I have seen 40+ year olds who are morbidly obese. If you stay fit and healthy, then that can only help you get through med school and residency.
Locale. Where do you live? Where do you want to end up practicing? It might be a harder sell to do medicine if you want to live in an expensive state like California or New York. But if you are willing to live in a more affordable state like in the Midwest or South, then even if you have $500k in debt, and you end up in a lower compensated specialty like FM, you could pay it back in a few years.
Money. MGMA is the gold standard (or at least it is considered one of the most reliable) for physician compensation. Here is MGMA 2019 (but based on 2018 data). It is "median" salaries. Anecdotally, I've had several attendings in different specialties tell me that they think MGMA median salaries are actually much lower than they make.
However, even going with median salaries, you can make about $250k as a primary care physician, which is a 3 year residency (usually FM but sometimes general IM or IM with a primary care track). From what I've seen on the FM forum, the standard expectation is 36 hours per week (so 4-4.5 days per week), no nights, no weekends, no holidays, minimal call. That's a great lifestyle. And I mention PCP because it's one of the easiest specialties to match into. And many PCP groups will offer you loan repayment, a sign-on bonus, and other things that can help you repay your loans. Search or ask the FM forum for more information.
According to MGMA, PAs make from around low $100k to $150k per year. CRNAs make around $175k per year.
Again, remember that these are all median salaries that are reported in MGMA, so potentially you could make more as a physician if you work more, get better RVUs, work in a community with good payor mix, pick up side gigs (e.g. telemedicine, pick up extra locums shifts), etc. I don't know if PAs and CRNAs can make more too, like doctors, but I assume they can if they work more hours. But my point is doctors can make more money not only by just working more hours.
Conclusion. If your family is not on board, then something else like PA or CRNA might be better. If your family is on board, then I would do it. Medicine is awesome. It's worth the sacrifices. If you become an anesthesiologist (which I mention only because you mentioned CRNA), then making $400k per year is very attainable and many anesthesiologists make a lot more than that. But even if you end up "only" a primary care physician, I still think that's worth it, because you can make around $300k per year for a fairly cush lifestyle, all things considered, and it's fulfilling being able to help people as well as to have the knowledge and skills of a physician. I also think people who are older have a better perspective on life and don't think they're missing out as much as people who went straight to med school. The latter seem to complain more than the former, but maybe this is just what I have seen where I am. Just my opinion, but I think it's worth it if your family is on board.