Grad school is fundamentally about heuristic learning, and this type of training is different from the pedagogically didactic styles that we've often become accustomed. To say that no explicit teaching is going on, and no explicit learning is going on is to narrowly define what teaching and learning look and feel like - it's no wonder that ones expectations would be bitterly dashed given these parameters. To a lesser degree, many of these issues are present on clerkships, though often unquestioned, where learning and teaching is simply understood to be encompassed within whatever medical students do, rightly or wrongly. And sure, even viewing either process in a broad sense, could be embittering given the wrong fit.
For better or worse, graduate school training is uniquely heterogeneous, as are students and PI's. One students perfect lab environment is anothers' personal hell: I've experienced both and am luckily in the former for my thesis work, and the magic formula for me, personally, was quite unexpected.
I can't say that my PI's first priority is training me explicitly in the arenas mentioned, but by leaving most everything up to me, from writing grants to designing and interpreting experiments and next steps to setting up collaborations, it is, in effect, the training I get. This could be interpreted as a PI absconding his duties, but he's happy with it, and so am I: no complaints.
Friends of mine in banking or law (the quintissential new york professions) often ask me if i've "gotten smarter", or can "think more critically" as a direct result of my graduate training - and i'll admit that it is often hard to give a definitive yes. I think this is mostly attributable to the fact that it is a slow, seeping process, one that does not lend itself to being put in high relief, whereas in medicine, a fact learned today is one more fact that you didn't know yesterday. But looking back to 1 year ago, 2, and 3, the answer is a clear yes.
As for banking, law, I can vouch for Sluox's numbers. But to hear the dominant conversations amongst friends in such fields with the connections, creativity, pedigree and intelligence to do just about anything makes one realize that the grass seems greener through green tinted shades: competition between who works more, plays less, life sucks more, makes the most money, and ranks higher in the ibanker, equity, hedge, and corp law hierarchies.
When you find your 20-something-self sitting in the midtown offices of the Blackstone Group at 1:30AM on a friday night, calling your merger and acquisitions lawyer at Skadden who picks up immediately, you might think about how much the money is worth. If it is, by all means - you're a sucker if you stay in science and medicine for a moment longer - you're wasting borrowed time that could be spent capitalizing on a steep positive discount rate.
There are definitely serious structural problems that need to be addressed in science and medicine, or other paths that seem may seem more interesting, and they may be. But one could do far worse than have the time to see Robert Pinsky speak at Psych Grand Rounds and attend a biophysics lecture on AFM in between doing some work that you planned, and then go out, all while being a paid student in NYC (for example).
As for after this, it will require some thought; unthinkingly moving down a path and track has never made sense. Science, medicine, industry, other academics, business, government, non-profit, private sector work, are all possible: and I'd have to say thus far that this time spent in an md/phd program will not have been a waste regardless.
