MD vs DPM -- Looking for Advice

[PreMedGuy222]

After seeing some great discussions and a mix of opinions in this thread http://forums.studentdoctor.net/showthread.php?t=953189 I've decided to post my own. Please note I have already talked with several DPM's and a few MD's, but would love to hear more opinions.

About me-- I'm in my mid 20's and have a 3.6 GPA and 32 MCAT score with a variety of extracurricular activities (everything you'd expect from a pre-MD). I'm a California resident.

While volunteering I've met some pretty awesome podiatrist who've made me strongly consider the field. They seem to enjoy what they do, get to do a great mix of clinical stuff and surgery, and enjoy being able to take care of nearly all foot and ankle related problems for their patients. They also stress how great the lifestyle is as it's very common to hear podiatrist talk about how they went on vacation for the weekend or took their kids to a theme park.

Personality wise, I know family and friends are always going to be very important to me. I'm realistic and not so passionate about anything that I believe I can do something for 70+ hours a week and it won't feel like work. I also like the idea of working a pretty normal (9-5) schedule as balance is pretty important in my life. I also like the idea that with my numbers I should hopefully get a scholarship for podiatry school, and approximately $15k/year tuition for a DPM is much cheaper than $35k to $55k per year for MD school (please note even California public schools are very expensive, and I'm very far from guaranteed to get into one).

Here is a pro and cons list I wrote that I'd like additional input on. I'm sure there are many pros and cons I've forgetten, and I'm not going to list every single detail (for example, I think I'd both enjoy being a DPM and an MD, so there's no need to list that in both). I also think I may be wrong on some of these, so please chime in if you feel anything I've stated is incorrect and please be as honest as possible.

Pros of DPM:

• Much, much less debt. As someone who is a bit older, this allows me to start the next stage of my life a bit earlier and more comfortably. This is especially true if I had to do a private MD over a DPM.

• Better lifestyle than most MD specialties. A 40 hour work week with standard hours is the norm.

• Short 3 year residency

• Less intensive medical school and residency **relative** to MD (please correct me if I'm wrong on this). For example, I won't need to take STEP 1 and STEP 2, and if the average student at my school has a 3.0 GPA and 22 MCAT then I think it's reasonable to assume classes will likely be easier than those where students have a 3.7 GPA and 31 MCAT

• Probably easier to get compete for the best residencies in the most desired locations, which will allow me more easily stay in California for residency

Cons of DPM

• Cannot wait and hope to fall in love with my specialty. I'm already committed to working on foot and ankle problems.

• Less prestigious. I'm human and humans tend to care about prestige (even if most of us wish we didn't care about it).

• The degree is less versatile. Not everyone knows what a DPM is, and since there are fewer DPM's than MD's it's harder for DPMs to effectively lobby. If salary's across the entire medical field continue to see cuts, this may become important.

• Less exciting schools. Some MD schools are absolutely amazing with most of their rotations taking place in one amazing hospital. This isn't the case for many (any?) DPM schools.

• Fewer overall residency locations. For example, there are no DPM residencies in some states.

Pros of MD

• Degree is incredibly flexible. I can't see the future, and it's possible I'll fall in love with a certain specialty, research, etc while in MD school that I didn't predict.

• Some medical schools are extremely exciting. State of the art facilities in amazing locations with access to more resources.

• Since I'll have to take the boards and my peers will probably be a bit more hard working and/or intelligent (on average), MD school will likely force me work very, very hard and reach closer to my full potential.

• MD's have lots of lobbying power in the US. I'll be part of an exclusive group that can lobby aggressively for it's own interest.

• Likely will earn more money, but not necessarily more money per hour (especially when taxes/benefits/additional years of residency are taken into account).

Cons of MD

• Again, debt. Over 4 years, I'll have to pay between $80,000 (public) to $160,000 (private) more to get an MD rather than a DPM

• While "reaching close to my full potential" sounds awesome, it will come at a high cost. Working harder means I'll learn more but miss more weddings, parties, and holidays with family and friends.

• More difficult residencies (I think?) and hard to get into the more competitive residencies. This means living a very balanced life style while in M.D. school and getting into a competitive California residency will be quite hard if not impossible.

• Even as a practicing MD, I'll likely have to work some odd hours or be on call depending on specialty. This means having a balanced lifestyle will be more difficult relative to a DPM.

My thanks to anyone who read all or most of the above post. I would love to hear your advice.

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[PreMedGuy222]

One more thing to note-- I'm sure someone will point out I made another thread with different stats asking about D.O. scholarships. I always distort my stats a bit, and as you can tell from this post debt is a pretty big concern to me so I was also considering the DO option if it provided more financial aid.

Thanks again for any insight.

 

[QofQuimica]

Based on your lists of pros and cons, I think you should do the DPM. Med school sucks. Residency sucks even harder. You aren't going to be happy living this lifestyle for the next 7+ years, and paying out the nose for it.

 

[TriagePreMed]

Go for DPM if its a field you think you can be happy. It'll be a road that's much easier to travel. I know that California at SMU would give you $20,000 scholarship. Getting a good residency after will probably be cake considering your competition.

 

[TheWeeIceMan]

Is podiatry really a 40 hr/wk job? I had no idea, to be honest.

 

[deleted6669]

Residency sucks even harder. You aren't going to be happy living this lifestyle for the next 7+ years, and paying out the nose for it.

don't DPMs have to do a mandatory residency now? something like 3 years(?)

 

[sazerac]

Much like the situation for US medical schools in another three years or so, DPM schools today produce more graduates than there are DPM residencies.

Some DPM graduates every year will literally never get a residency.

 

[PreMedGuy222]

Much like the situation for US medical schools in another three years or so, DPM schools today produce more graduates than there are DPM residencies.

Some DPM graduates every year will literally never get a residency.

From what I've heard, this is being fixed. It's of course pretty impossible for me to tell if it's legitimately being fixed or if people just think it will be, but from what I understand this likely won't be a huge issue for me in 4 years and it wasn't a big issue for graduates other than from last year.

 

[PreMedGuy222]

don't DPMs have to do a mandatory residency now? something like 3 years(?)

Yes mandatory 3 year surgical residency. But I assumed (perhaps incorrectly) that while this residency is intense, it's not as intense as most MD residencies.

 

[Law2Doc]

Is podiatry really a 40 hr/wk job? I had no idea, to be honest.

The ones I've seen who are predominantly surgeons usually work longer. The ones who spend their days filing down corns and prescribing fungicides probably could work 40 hours/week.

I think there are inherent problems with pro/con lists for career decisions and would suggest this is really a way to defend to yourself a decision rather than make one. I would point that many residencies in medicine are also 3 years long, so I wouldn't put that as an advantage of podiatry over medicine. The huge disadvantage I see with podiatry, which outweighs all the others combined, is that you will have picked a very finite specialty and body part before you even start whereas med school isn't really a decision point for that yet. If this isn't the "right" specialty for you, nothing else on your list matters.

The fact that you've (OP) highlighted which path is "easier" academically (and less "intense" residency) as a positive suggests to me that maybe you wouldn't like med school -- the people interested in learning and intellectual challenge rather than a means to a job tend to enjoy med school a lot more. It can be a grind living for that light at the end of the tunnel unless you really enjoy being in that tunnel. Sounds to me like those reasons you like podiatry are reasons you wouldn't be so happy in med school/residency, so I think you probably should run with that.

There are more than a few former podiatrists who have switched to medicine, so if you can find one of them, they might be able to shed some actual light on the issues.

 

[PreMedGuy222]

Thanks a lot for all the responses, really appreciate it.

The ones I've seen who are predominantly surgeons usually work longer. The ones who spend their days filing down corns and prescribing fungicides probably could work 40 hours/week.

From what I've been told, it's pretty normal to spend 4 days out of the week doing relatively routine stuff (fungicides, ingrown toe nail removing, etc) and then 1 day out of the week doing surgery. I've been told it's hard to try to do only surgery or do no surgery (especially since all podiatrist now have surgical residencies).

I think there are inherent problems with pro/con lists for career decisions and would suggest this is really a way to defend to yourself a decision rather than make one. I would point that many residencies in medicine are also 3 years long, so I wouldn't put that as an advantage of podiatry over medicine. The huge disadvantage I see with podiatry, which outweighs all the others combined, is that you will have picked a very finite specialty and body part before you even start whereas med school isn't really a decision point for that yet. If this isn't the "right" specialty for you, nothing else on your list matters.

Good points, though I'm honestly not trying to defend DPM or MD and simply trying to make the best decision (I hope I'm somewhat aware of how little I know right now without having actually done either).

I agree that committing myself to the foot and ankle before starting school is the biggest disadvantage of podiatry. But I'm also not completely convinced this really restricts my freedom more than an MD would since an MD comes with a silly amount of debt and most specialties

In other words, it seems like a DPM limits what I can do while I'm working, whereas an MD limits the kind of life choices I can make (since I'll be in much more debt and working a 9-5 is much more difficult).

The fact that you've (OP) highlighted which path is "easier" academically (and less "intense" residency) as a positive suggests to me that maybe you wouldn't like med school -- the people interested in learning and intellectual challenge rather than a means to a job tend to enjoy med school a lot more. It can be a grind living for that light at the end of the tunnel unless you really enjoy being in that tunnel. Sounds to me like those reasons you like podiatry are reasons you wouldn't be so happy in med school/residency, so I think you probably should run with that.

I do think I'll enjoy medical school and I hope I'll enjoy residency no matter what I decide. Honestly, both career paths look good to me, so I'm just trying to pick the better of two good options.

That said, while I don't expect podiatry school or a podiatry residency to be easy, I do think I might really enjoy studying or working 60 hours a week but be pretty miserable if I had to do it 90 hours a week. Since I haven't done either yet though, there's no real way for me to tell which is why I really appreciate all the input I'm getting.

There are more than a few former podiatrists who have switched to medicine, so if you can find one of them, they might be able to shed some actual light on the issues.

Good advice and I will look into that.

 

[PreMedGuy222]

Thanks a lot for all the responses, really appreciate it.

The ones I've seen who are predominantly surgeons usually work longer. The ones who spend their days filing down corns and prescribing fungicides probably could work 40 hours/week.

From what I've been told, it's pretty normal to spend 4 days out of the week doing relatively routine stuff (fungicides, ingrown toe nail removing, etc) and then 1 day out of the week doing surgery. I've been told it's hard to try to do only surgery or do no surgery (especially since all podiatrist now have surgical residencies).

I think there are inherent problems with pro/con lists for career decisions and would suggest this is really a way to defend to yourself a decision rather than make one. I would point that many residencies in medicine are also 3 years long, so I wouldn't put that as an advantage of podiatry over medicine. The huge disadvantage I see with podiatry, which outweighs all the others combined, is that you will have picked a very finite specialty and body part before you even start whereas med school isn't really a decision point for that yet. If this isn't the "right" specialty for you, nothing else on your list matters.

Good points, though I'm honestly not trying to defend DPM or MD and simply trying to make the best decision (I hope I'm somewhat aware of how little I know right now without having actually done either).

I agree that committing myself to the foot and ankle before starting school is the biggest disadvantage of podiatry. But I'm also not completely convinced this really restricts my freedom more than an MD would since an MD comes with a silly amount of debt and most specialties

In other words, it seems like a DPM limits what I can do while I'm working, whereas an MD limits the kind of life choices I can make (since I'll be in much more debt and working a 9-5 is much more difficult).

The fact that you've (OP) highlighted which path is "easier" academically (and less "intense" residency) as a positive suggests to me that maybe you wouldn't like med school -- the people interested in learning and intellectual challenge rather than a means to a job tend to enjoy med school a lot more. It can be a grind living for that light at the end of the tunnel unless you really enjoy being in that tunnel. Sounds to me like those reasons you like podiatry are reasons you wouldn't be so happy in med school/residency, so I think you probably should run with that.

I do think I'll enjoy medical school and I hope I enjoy residency no matter what I decide. Honestly, both career paths look good to me, so I'm just trying to pick the better of two good options.

That said, while I don't expect podiatry school or a podiatry residency to be easy, I do think I might really enjoy studying or working 60 hours a week but be pretty miserable if I had to do it 90 hours a week. Since I haven't done either yet though, there's no real way for me to tell which is why I really appreciate all the input I'm getting.

There are more than a few former podiatrists who have switched to medicine, so if you can find one of them, they might be able to shed some actual light on the issues.

Good advice and I will look into that.

 

[Law2Doc]

...

From what I've been told, it's pretty normal to spend 4 days out of the week doing relatively routine stuff (fungicides, ingrown toe nail removing, etc) and then 1 day out of the week doing surgery. I've been told it's hard to try to do only surgery or do no surgery (especially since all podiatrist now have surgical residencies).
....

the guys I know seem to either have 1 to 2 clinic days and spend the rest of their week in the OR, or are exclusively doing office practices and no OR. Im sure there are probably people with schedules in between, but not that i know. Bear in mind that from what I can see from my admittedly limited vantage point, podiatric surgery isn't exactly Grey's Anatomy caliber cases -- lots of amputations and debridements relating to the sequela of diabetes and atherosclerotic-vascular disease, bunionectomies, and removal of infected hangnails. Around here most of the trauma and sports injuries end up with ortho, and most of the vascular procedures go to vascular surgery. You might want to see if someone will let you shadow so you can see if it's something you'd like.