My mind was fully set to anesthesia before I read this forum..

[badasshairday]

I have to ask. How much did you make per year in BFE? And where was the BFE (what state, how far from major/mid size city)?

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[jetproppilot]

I have to ask. How much did you make per year in BFE? And where was the BFE (what state, how far from major/mid size city)?

ALOT.

I'm consciously ignoring (with all due respect) your other inquiries, since I've still got Homies there.

 

[chudat]

Six hundred large.

I'm consciously ignoring (with all due respect) your other inquiries, since I've still got Homies there.

mustve been the mother of all BFEs....

 

[p30doc]

I hope these BFE gigs still exist when get out of residency. I'd gladly spend some years in the very center of nowhere to to #1 pay off my ludicrous 400k worth of student loans and #2 build a nice fu account.

 

[Gern Blansten]

I hope these BFE gigs still exist when get out of residency. I'd gladly spend some years in the very center of nowhere to to #1 pay off my ludicrous 400k worth of student loans and #2 build a nice fu account.

I suspect there will still be the differential pay, just at a lower rate for both. I see pay cuts coming for all of the house of medicine. I think all advanced practice providers will feel the sting as well. They are over-training and will fall victim to supply and demand.

 

[threeds]

I am not sure where you are getting all this optimism from!
Have you checked the anesthesia job market lately?
People should know what they are getting into and then make an informed decision.
The anesthesia residencies are producing crazy numbers of new grads while the number of available jobs has dropped dramatically.
The management companies and hospitals are taking over and as a result slashing reimbursement significantly.
Independent CRNA practice is not an illusion, it's a reality and expanding daily.
We are not in the same boat with all the other specialties, we are in a sinking boat by ourselves.

You are absolutely right!!!

 

[threeds]

I am not sure where you are getting all this optimism from!
Have you checked the anesthesia job market lately?
People should know what they are getting into and then make an informed decision.
The anesthesia residencies are producing crazy numbers of new grads while the number of available jobs has dropped dramatically.
The management companies and hospitals are taking over and as a result slashing reimbursement significantly.
Independent CRNA practice is not an illusion, it's a reality and expanding daily.
We are not in the same boat with all the other specialties, we are in a sinking boat by ourselves.

This is how I feel about the specialty. My 4th year electives were done in community hospitals with attendings who only preceptored 4th year medical students going into anesthesia. They were pretty frank with their opinions, and they mirrored this, for the most part.

I can completely understand the POV from those giving the "realistic" advice, but I'm finding out that realism varies in different markets in the country.

As much as I really enjoyed certain aspects of other specialties, I can't see myself doing anything other than anesthesiologist's work, and still be happy with my career.

I also feel like anesthesiology is a field worth saving and improving for future physicians, and you can't do that by discouraging bright minds by encouraging them to go into something else (out of fear of what might be). Realism is ok, but apparently subjective. I want to be part of bringing anesthesiology around again, if that's possible. It may be fruitless, but I'm willing to give it a shot.

I see your POV. One of the major problems with anesthesia is that our skill and knowledge have been devalued by the existence of CRNA's. They're scope of practice and numbers are increasing daily. I've seen the job market significantly dry up in the past four years even for small town America. There will be jobs for Anesthesiologists but in very undesirable locations (i.e. Show Low, Arizona). While living with "what ifs" may seem unproductive its what Anesthesiologist do daily. We always have a plan A, B, C....

My recommendation to a medical student considering Anesthesiology is to examine it closely from a business perspective. We don't generate an income for the hospital unless we become their employees. Therefore, on their books we are a liability. A cost. Any business trying to be profitable might attempt to lower their cost. In our case, wages. As far as loving anesthesia, please reconsider. What exactly do you love? Lifestyle? Money? Be careful of those aspirations.

To residents in anesthesia. Do a fellowship.

To attendings. Work and enjoy your life. Keep an ear to the ground.

IMHO...

 

[r0ckaction]

As a third-year with everything all lined up to apply for an anesthesiology slot come September I have an honest pair of questions for attendings/residents who say they would not chose anesthesiology if they could do it again;

1) Why did you chose anesthesiology in the first place? (not accusatory at all, I want to know what factors motivated your original decision)

2) What other medical speciality would you pursue (of have pursued) instead? (assuming you were afforded the opportunity and the match was no obstacle)



I'm curious because I have enjoyed an overwhelmingly positive experience on my rotations here (at a major academic center - where all the brainwashing occurs ), as well as hearing generally positive things from the anesthesiologists at the private community hospital I worked at for 2 years along with those in private practice I know as family friends.
It's not simply blind optimism or blissful encouragement either. People are very frank in discussing the current and looming problems in the field (reimbursement, CRNAs, practice structure changes, etc) but nevertheless uniformly love what they do, would do it again, and genuinely recommend the speciality.

Consequently, I'm intrigued by how adamant some posters are about feeling trapped in a "sinking-ship" of a speciality. I've been exposed to such an entirely different picture than the one painted by many posters in this forum (which I very occasionally read when I'm feeling too happy and have the desire to reevaluate my career path, reason for existence, motivation to keep on breathing, and value as a person).

I appreciate, value, and take seriously the perspective of those who would advise current students to steer clear of anesthesiology and/or more closely evaluate their personal reasons in choosing the field, but have a difficult time believing doom & gloom that I only encounter in an internet forum and never see or hear echoed in real life. Again, I am not ignorant as to the difficulties facing the profession and have had numerous discussions with residents and faculty about these problems - the difference is that in real life I hear things along the lines of "stuff may really, really suck in a few years, but man I sure love what I do and wouldn't change it." Here I get the distinctly different message, "Stuff may really, really suck in a few years (or in some cases now), I'd advise everyone to avoid the speciality and wish I could get out of it."

Also, I fully understand the match data and that overall the average Step I score in anesthesiology is pretty weak. I also understand that some students may be "relegated" to anesthesiology because they couldn't cut it on Step I and didn't match into that derm residency they really wanted, and that there are many FMGs and DOs in the speciality (absolutely NOT knocking either one, but let's face it - right or wrong - it's often used as an indicator of "competitiveness").

That being said, what most impressed me about anesthesiology was the intelligence and likability of the residents at my program. The past few years the Step scores have been more than respectable for each class. Most telling perhaps is that not a single resident that I have worked with or met chose anesthesiology because they couldn't get into a radiology program (or pick your more numerically competitive speciality). Instead I hear some well-defined reasons for choosing the specialty, many of which I share and many of which I have read as reasons provided by posters in this forum.
I say this not to brag about the "home" program towards which I am obviously biased. I am merely saying that some very sharp students continue to be drawn to the field - and I assume many other good programs are drawing similar flocks of stronger and stronger applicants each year - for reasons other than them not being competitive for plastics. I think this bodes well for the speciality as a whole.
In light of this, I can't help but think (in my perhaps naively optimistic student brain) that there will continue to be a role for capable, intelligent, and well-trained anesthesiologists in the care and management of patients in the OR and throughout the hospital. I also believe the role of anesthesiologists in basic science, clinical, translational, and outcomes/quality improvement research will continue to expand. I won't enter into the raging debate about critical care, but I do get the impression that now is a particularly good time for anesthesiologists to further delve into palliative medicine and pain management.

At any rate - those are my 2 questions and my 2 cents.

 

[ThankGod]

I also am wondering about this...am currently doing an anesthesia rotation and will be applying in September.

If anesthesia is bound to doom, why are people still applying to the specialty??

It doesn't make sense to me. The graduating class at my school had about 12 students match into anesthesia...they matched at top programs like Stanford, Harvard, UCSF, Tufts...

Many of those who went into anesthesia had stellar step scores and were AOA...they could have gone into any other specialty yet they chose a specialty that is supposedly going down in the "competition" with CRNAs??

 

[Consigliere]

You'll see.....you'll see.

 

[BLADEMDA]

I also am wondering about this...am currently doing an anesthesia rotation and will be applying in September.

If anesthesia is bound to doom, why are people still applying to the specialty??

It doesn't make sense to me. The graduating class at my school had about 12 students match into anesthesia...they matched at top programs like Stanford, Harvard, UCSF, Tufts...

Many of those who went into anesthesia had stellar step scores and were AOA...they could have gone into any other specialty yet they chose a specialty that is supposedly going down in the "competition" with CRNAs??

Book Smart does not equal Street Smart. That statement applies across the board in life.

 

[Silent Cool]

That is very realistic. I came out with 275K. My wife came out with 350K+ in debt.

God forbid you are an american grad that went to a Caribbean medical school.

Then you are really behind the eight ball.... and if you match to FM... it will be @ LEAST 10-20 years before you get out of the hole if you don't have loan forgiveness behind you and have a family + house and expenses.

You feel me?

Seroiusly, 'lil G: You don't know what you are talking aobut.

Sevo, what fielid is your wife in? If people are coming out NOW with 350-400K loans, then I would expect in 6-7 years we will start seeing tons of people with 500K loans. Already, over on the dental forum, a guy posted who got into NYU dent that he would have 500K (after interest) at graduation. He ultimately decided not to go.

 

[countingdays]

Sevo, what fielid is your wife in? If people are coming out NOW with 350-400K loans, then I would expect in 6-7 years we will start seeing tons of people with 500K loans. Already, over on the dental forum, a guy posted who got into NYU dent that he would have 500K (after interest) at graduation. He ultimately decided not to go.

The thing about including interest is that you won't really take 30 years to pay the loans off so the interest can be a lot less than you think. It's still ridiculously high though. Our inability to deduct student loan interest is grossly unfair compaired to all the b s that other people can deduct. Somebody needs to bribe his congressman.

 

[herkyMD]

300-400k medical/school loans? Really?? Come on!! Be more realistic, please. Why go to an expensive private school which makes you pay out of your a**? Here's a solution. Why not choose an in-state public institution instead? There are plenty of great medical schools that are a lot less expensive than Harvard or Yale.

I see you have not posted here in awhile, probably because you realize you don't know what you're talking about, but I've gone to a state school for all of undergrad and med school (and a reasonably priced one at that) and I will owe roughly $250,000 when I get done in a year. Check your facts, chief. Going the state school route doesn't mean you're graduating with low debt that you can pay off in a few years - med school is a money suck and is only getting worse.

 

[Dwindlin]

I see you have not posted here in awhile, probably because you realize you don't know what you're talking about, but I've gone to a state school for all of undergrad and med school (and a reasonably priced one at that) and I will owe roughly $250,000 when I get done in a year. Check your facts, chief. Going the state school route doesn't mean you're graduating with low debt that you can pay off in a few years - med school is a money suck and is only getting worse.

This. Go to the cheapest school in my state and as of my exit interview a few weeks ago I'm sitting at 249 (plus some UGrad stuff but that's not what we're talking about).

 

[DannyB]

Whatever specialties you're thinking about find mentors in that field, both academic and private. Try as best you can to gather information about that field and try to see if it's something you could do every day, day in and out for many years. This is probably the hardest thing to do as a medical student. At the end of the day, taking advice that will affect the rest of your life from a couple of anonymous internet posters is pretty ridiculous in my opinion

 

[ph8]

WORD.

Word.

 

[BLADEMDA]

Whatever specialties you're thinking about find mentors in that field, both academic and private. Try as best you can to gather information about that field and try to see if it's something you could do every day, day in and out for many years. This is probably the hardest thing to do as a medical student. At the end of the day, taking advice that will affect the rest of your life from a couple of anonymous internet posters is pretty ridiculous in my opinion

Good post. It's your life and career so make the decision for yourself. But, if you think this field is ONLY about lifestyle and money then you are in for a rude awakening.

 

[Infexious]

.

 

[BLADEMDA]

You are correct that this can be extremely difficult as a student. For example, I was at a medical school that did not have an academic anesthesia department and the PP guys were few and far between. With the inability to do aways until mid-late MS4 year, you are making a big decision with limited information. I think I have made the correct choice, but sometimes the "anonymous internet poster" is better than what you have access to as a medical student.

On a larger scale I think it is fairly obvious that everyone you come in contact with in relation to a certain specialty shapes and effects your perception of that specialty. The mean resident that made you hate OB third year or the random assignment with the great peds attending that everyone wants to be like, all mold your decision for better or worse. It is hard to isolate out the objective from the subjective.

But you need to try and be objective. This is your career and financial future so choose wisely.

 

[Taurus]

I also am wondering about this...am currently doing an anesthesia rotation and will be applying in September.

If anesthesia is bound to doom, why are people still applying to the specialty??

It doesn't make sense to me. The graduating class at my school had about 12 students match into anesthesia...they matched at top programs like Stanford, Harvard, UCSF, Tufts...

Many of those who went into anesthesia had stellar step scores and were AOA...they could have gone into any other specialty yet they chose a specialty that is supposedly going down in the "competition" with CRNAs??

Because people tend to be reactionary not proactive. The herd mentality won't change until people start to see/hear about jobs disappearing and/or salaries going down. It can take years before it's evident. By then, you're deep into it and it's hard to change course.

 

[John Lannister]

Because people tend to be reactionary not proactive. The herd mentality won't change until people start to see/hear about jobs disappearing and/or salaries going down. It can take years before it's evident. By then, you're deep into it and it's hard to change course.

What are the most protected specialties outside of surgery (or derm)? Just curious

 

[GasQuestions]

What are the most protected specialties outside of surgery (or derm)? Just curious

I think the most protected subspecialties in Medicine are the ones that do not rely on insurance companies or the government (e.g. plastics).

But of course, those subspecialities are more reliant on the overall health of the economy.

Overall, anesthesia is a very rewarding field -- both professionally and financially.

 

[Yo GabbaPentin]

What are the most protected specialties outside of surgery (or derm)? Just curious

Absolutely. I strongly recommend a residency in either hospital administration or government bureaucracy. Those two specialties are at the top of the medical mountain and the only really 100% safe options.

If selling your soul isn't your thing, then just pick a field you like.

 

[Gern Blansten]

absolutely. I strongly recommend a residency in either hospital administration or government bureaucracy. Those two specialties are at the top of the medical mountain and the only really 100% safe options.

If selling your soul isn't your thing, then just pick a field you like.

qft

 

[Consigliere]

Think about this: if you are masturbating to a pornographic film basically you are a jag off, jagging off to some jag off, jagging off. Food for thought.....

 

[jetproppilot]

Come back in 13 years when you've matched his time spent in training. If you even have the will and ability to do it, that is.


Few things on this forum make me as bone-weary tired as pre-meds who pontificate about their noble willingness to sacrifice a paycheck they haven't even earned yet on the altar of taxes and the public good.

WOW.

pgg, I couldn't agree with you more.

 

[KLPM]

Think about this: if you are masturbating to a pornographic film basically you are a jag off, jagging off to some jag off, jagging off. Food for thought.....

[YOUTUBE]http://www.youtube.com/watch?v=xhNneU5shTs[/YOUTUBE]

 

[deleted126335]

No matter how bad the job market gets, the med students are going to keep coming.


http://management.fortune.cnn.com/2013/04/01/medical-students-residencies/?iid=obnetwork

 

[BLADEMDA]

Four new medical schools recently graduated their first classes, adding nearly 1,000 students to this year's residency matching pool. And medical schools are on track to increase enrollment by 30%, according to AAMC figures. But closing the doctor deficit takes time because students must spend between three and seven years training in a medical specialty, which can range from primary care to surgery.

Med school graduates who fail to find a match end up in a kind of professional no man's land. They can apply for one of the approximately 1,000 positions that are not filled in the official matching process, apply for a research grant or -- in the worst case -- abandon plans to become a doctor.

This year, nearly 17,500 graduates of U.S.-based medical schools applied to the National Resident Matching Program, which uses an algorithm that pairs student and hospital preferences with available openings at teaching hospitals around the country.

Some 1,100 U.S. graduates did not find a match this year -- and about half of those didn't land a spot in the informal period afterward. Medical groups say the disparity between students and slots will only grow in coming years and are urging Congress to make changes to assure that all applicants find training.

 

[Silent Cool]

Four new medical schools recently graduated their first classes, adding nearly 1,000 students to this year's residency matching pool. And medical schools are on track to increase enrollment by 30%, according to AAMC figures. But closing the doctor deficit takes time because students must spend between three and seven years training in a medical specialty, which can range from primary care to surgery.

Med school graduates who fail to find a match end up in a kind of professional no man's land. They can apply for one of the approximately 1,000 positions that are not filled in the official matching process, apply for a research grant or -- in the worst case -- abandon plans to become a doctor.

This year, nearly 17,500 graduates of U.S.-based medical schools applied to the National Resident Matching Program, which uses an algorithm that pairs student and hospital preferences with available openings at teaching hospitals around the country.

Some 1,100 U.S. graduates did not find a match this year -- and about half of those didn't land a spot in the informal period afterward. Medical groups say the disparity between students and slots will only grow in coming years and are urging Congress to make changes to assure that all applicants find training.

Blade,

I read the article that you posted from. This is scary. What the article says rings true for me and many of my classmates--that we may not get a spot, and it is getting worse each year.

What are your personal opinions on the issue? Do you think congress will actually authorize funding for more spots? Or will the excess be absorbed by private hospitals (and private funding) providing money for trainees? (I've heard of this already happening in a number of places).

It's just going to make matching that much harder for....everyone.

 

[gas2014]

I know there has been a lot of doom and gloom about nurses taking over medicine, but look at what the Anesthesiology Society in North Carolina has done to "safeguard" physician supervision requirements. They have convinced state lawmakers to introduce and approve legislation that explicitly requires physicians to supervise advanced care nurses.


I wish more legislation such as the one in NC is introduced in the more prominent states like Pennsylvania, New York, Georgia, Florida, Texas, Ohio, and Illinois.

 

[deleted307836]

Blade,

I read the article that you posted from. This is scary. What the article says rings true for me and many of my classmates--that we may not get a spot, and it is getting worse each year.

What are your personal opinions on the issue? Do you think congress will actually authorize funding for more spots? Or will the excess be absorbed by private hospitals (and private funding) providing money for trainees? (I've heard of this already happening in a number of places).

It's just going to make matching that much harder for....everyone.

This is something I'm also very curious about.

As more students go unmatched, I think it is highly likely that the government will provide funding for more spots.

But in that case, what specialties will receive extra funding? Any besides FM?
If specialties receive extra funding, would increased output be balanced relative to demand? There's probably a delicate balance between providing increased access to care through more physicians, and decreasing the leverage that physicians have due to increased supply/decreased demand.

 

[Silent Cool]

This is something I'm also very curious about.

As more students go unmatched, I think it is highly likely that the government will provide funding for more spots.

But in that case, what specialties will receive extra funding? Any besides FM?
If specialties receive extra funding, would increased output be balanced relative to demand? There's probably a delicate balance between providing increased access to care through more physicians, and decreasing the leverage that physicians have due to increased supply/decreased demand.

L2D and others have speculated that the legislators/AMA will use the current "residency crunch" to their advantage in order to force more students into primary care. I wouldn't put it past them.

With NP's and PA's making 150+ in some areas, I have to wonder: WTF is the point of going to medical school and paying 400K+ in loans? Only to *hope* to get a spot in...FP? Seriously?

 

[deleted126335]

L2D and others have speculated that the legislators/AMA will use the current "residency crunch" to their advantage in order to force more students into primary care. I wouldn't put it past them.

With NP's and PA's making 150+ in some areas, I have to wonder: WTF is the point of going to medical school and paying 400K+ in loans? Only to *hope* to get a spot in...FP? Seriously?

Of course they will only fund additional spots for residencies that they think there is a need for.

Seriously.

 

[bkell101]

100% agree with the below....

Originally Posted by pgg
Come back in 13 years when you've matched his time spent in training. If you even have the will and ability to do it, that is.


Few things on this forum make me as bone-weary tired as pre-meds who pontificate about their noble willingness to sacrifice a paycheck they haven't even earned yet on the altar of taxes and the public good.........


Why are so many residents/medical students like this?

Many of my classmates/fellow residents have never had a job or earned a paycheck prior to residency

 

[bkell101]

__________________
Clinical training hrs
DNP: 700 (offered online )
PA: 2400
MD/DO: >17000

50% failed simplified Step 3

Yet, DNP's want to be called 'Dr', independent everywhere (outpt, inpt, ER), be equivalent to PCP's & have full hospital privileges

DNP residencies New!

NY Times story

Future of medicine?
1) Do true NP outcome studies
2) Pass institutional policies restricting 'Dr' title
3) Hire PA's & AA's not DNP's or CRNA's



........This post caught my eye because one of my attendings was telling me about this...he must have read the article.

Then I think to myself....

Forget the fact that they pick and chose their questions

Forget the fact that half of them fail

STEP 3?????? Are you f-ing kidding me?

The test is a joke.

What's the classic 3-3-3 rule for studying? 3 days worth of studying for step 3...

Everybody knows that the money is in step1/2 ....I mean there is a thread on here about useless step3 scores are for fellowship

I have ortho jock buddies that haven't looked up from their handbook of fractures in the last year and dominated this test with ease.

And this is how the dnp wants to compare themselves?

What a joke.

Kudos to the md in the article highlighting the picking and choosing of questions....

But come on...what about shelf exams/step1 / step2 / and the certification exams that exist after residency

Whoever is in some sort of position of power/leadership in medicine needs to step up and debunk these idiots that want to portray themselves as equally trained and qualified.

 

[IlDestriero]

The USMLE rule is 2 months, 2 weeks, number 2 pencil.
In light of the fact that step 3 is now computerized and you need to understand how to interact with the program for the scenarios, I propose a new rule for the new generation.
2 months, 2 weeks, 2 hours.
The noctors will still fail, but you won't.

 

[bkell101]

Yes, my above post sounds a bit inflammatory....


But here's the thing....

I sacrificed 4 years of painstaking work. (Ok most of med school was pretty fun and I loved it)

I accumulated 250k worth of debt at ridiculous interest rates

I will sacrifice another 3 working my a'** off during residency

To learn a highly valuable noble trade. To gain a set of skills and knowledge.

This skill set / knowledge will allow me to me will help people and saves lives (for all those "bone weary pontificating pre meds")

But

From a BUSINESS perspective

It will also earn a living .

I have invested ...developed ....and expect a certain return.

This lady is a different company wanting to sell a knock off and force me to accept less in order to compete ....

Mary O'Neil Mundinger, DrPH, RN, dean of Columbia University School of Nursing in New York, was quoted as saying: "If nurses can show they can pass the same test at the same level of competency, there's no rational argument for reimbursing them at a lower rate or giving them less authority in caring for patients." Mundinger, CACC president, declined comment for this article.

If FORD spent billions of dollars developing the first car that didn't need anything but a triple A battery to run for over 300,000 miles....

Do you think their leadership would let Honda make some knock off brand that isn't made as well and doesn't really work?

Then turn around and convince the public that it works just as well and will be sold at the same price.

He** no.

Even better.....would FORD allow Honda engineers over to the FORD plant to share their technology?

Would they teach Honda how to "kinda" make a the same version?

I doubt their investors would be very happy.

I doubt ford's CEO would still have a job if he "declined to comment" or didn't act.


Please let me know if I'm way off base.

 

[chessknt]

This is something I'm also very curious about.

As more students go unmatched, I think it is highly likely that the government will provide funding for more spots.

But in that case, what specialties will receive extra funding? Any besides FM?
If specialties receive extra funding, would increased output be balanced relative to demand? There's probably a delicate balance between providing increased access to care through more physicians, and decreasing the leverage that physicians have due to increased supply/decreased demand.

Why would they fund more spots? Why should they care about a politically powerless group of people trying to 'get rich'?

 

[Silent Cool]

Why would they fund more spots? Why should they care about a politically powerless group of people trying to 'get rich'?

Yeah, see, that's what I'm worried the perception of medicine is. I think powers that be actually like the residency crunch because it is how they are going to force people into primary care. So much for having a choice.

 

[IlDestriero]

Why would they fund more spots? Why should they care about a politically powerless group of people trying to 'get rich'?

Medical students and premeds have no idea what's coming down the line at 90mph.
It's been noted on these boards several times that ideas are being floated around to reallocate training funds from specialties to primary care, and any thoughts about expanding specialty training funding (unless it's grossly undermanned) are almost certainly fantasy. Still want to do plastics or derm for no income during residency? That is a possibility.
Students line up to take ridiculously high interest loans for medical school. Graduating well over 200k in debt will be the norm. In my day the interest was 1/2 as much, a significant amount could be subsidized, and 100k of debt was a lot. Massive debt when income will almost certainly decline, good plan. They're betting on IBR to save them, all the while forgetting IBR will soon find itself a target for gov't cost savings. I wonder what group of students could be excluded? Professional students? Great idea Senator!
How about generous loan repayment bonuses? Nope. Increased competition for jobs and decreased reimbursement will eliminate them, if they haven't already. We don't offer a signing bonus anymore. We have many applicants for every opening, and the last couple years have had a 100% acceptance rate for our offers. They recognize a fair and secure job offer in a nice location doesn't come along every day anymore. No need for a signing bonus.
They're in big trouble.

 

[deleted307836]

Medical students and premeds have no idea what's coming down the line at 90mph.
It's been noted on these boards several times that ideas are being floated around to reallocate training funds from specialties to primary care, and any thoughts about expanding specialty training funding (unless it's grossly undermanned) are almost certainly fantasy. Still want to do plastics or derm for no income during residency? That is a possibility.
Students line up to take ridiculously high interest loans for medical school. Graduating well over 200k in debt will be the norm. In my day the interest was 1/2 as much, a significant amount could be subsidized, and 100k of debt was a lot. Massive debt when income will almost certainly decline, good plan. They're betting on IBR to save them, all the while forgetting IBR will soon find itself a target for gov't cost savings. I wonder what group of students could be excluded? Professional students? Great idea Senator!
How about generous loan repayment bonuses? Nope. Increased competition for jobs and decreased reimbursement will eliminate them, if they haven't already. We don't offer a signing bonus anymore. We have many applicants for every opening, and the last couple years have had a 100% acceptance rate for our offers. They recognize a fair and secure job offer in a nice location doesn't come along every day anymore. No need for a signing bonus.
They're in big trouble.

I'm just graduating college now, and looking at applying for the class of 2019. All of this scares the hell out of me.

The greatly increasing debt required of students in combination with the consistent downward pressure on reimbursements is scary. I'm graduating undergrad with no debt, but if I'm accepted at a private school, tuition and living costs will easily approach 300k with today's numbers. Will it make sense to then pursue a specialty with average income of 150-200k? (As I am interested in a handful of lower paying specialties.)

Coming out at 34 years old, 300k debt, and working for 175k a year -- what will my potential retirement options be? What standard of living will I need to save for a comfortable retirement starting in my early 60's? It's impossible to say now, but I know my options will be fewer than older physicians. Obviously, banking on loan forgiveness is extremely foolish.

I wonder at what point it no longer makes sense. There aren't many alternatives out there that offer the job security and "basement-level" compensation that medicine does. In the end I figure these are sacrifices that are necessary to do what I want to be doing, but it really is a bitter pill to swallow when I allow myself to think about it too much...

 

[thierryhenry]

I get soo sick of hearing all the complaining from student on this site. You got into medical school hopefully for the reasons. Good for you. You'll get way more money than the average American and have prestige. There are thousands of people who wish they could be doctors who will never be able to. So STOP complaining about who gets payed how much and who deserves how much and who thinks the profession is going down hill just because they think they might be making 300,000 a year instead of 320,000. In the end, even doctors die so who cares? You cant spend money when you are dead Just focus on being the best doctor you can be.

the realest statement in this thread

+1

 

[chessknt]

I wonder at what point it no longer makes sense. There aren't many alternatives out there that offer the job security and "basement-level" compensation that medicine does. In the end I figure these are sacrifices that are necessary to do what I want to be doing, but it really is a bitter pill to swallow when I allow myself to think about it too much...

Nursing does, and they are way ahead of the game politically. Become an NP and you can get to do a lot of stuff if you find the right practice. Only 2 years after college to become a full NP instead of 4. Way less debt and you get instant 6 figure salary after graduating.

 

[ssmallz]

Yeah, see, that's what I'm worried the perception of medicine is. I think powers that be actually like the residency crunch because it is how they are going to force people into primary care. So much for having a choice.

Good medical students would still be able to get those competitive subspecialty spots but it would also create pressure for the ever expanding base of medical students to enter primary care, an area of need which is good for everyone. Creating more specialists would lead to more unemployment and lower salaries of specialists b/c of the supply and demand mismatch.....just look at the anesthesia, radiology, and pathology job markets. It's good for everyone to limit the number of slots in various specialties to levels needed in the population...just imagine what would happen if there were 1500 dermatology spots, you'd have a massive glut of dermatologists and no jobs to be found b/c you just don't need that many derms in any area and there's only so many cases and pts to go around.

 

[deleted126335]

http://www.kaiserhealthnews.org/Stories/2013/April/02/Quinnipiac-medical-school-primary-care.aspx

Michael Ellison has a tough assignment.

He's the associate dean of admissions choosing the first class of a brand new medical school, the Frank H. Netter MD School of Medicine at Quinnipiac University in Connecticut. It's a school with a very specific mission: minting new doctors who want to go into primary care practice....

 

[partydoc]

http://www.kaiserhealthnews.org/Stories/2013/April/02/Quinnipiac-medical-school-primary-care.aspx

Michael Ellison has a tough assignment.

He's the associate dean of admissions choosing the first class of a brand new medical school, the Frank H. Netter MD School of Medicine at Quinnipiac University in Connecticut. It’s a school with a very specific mission: minting new doctors who want to go into primary care practice....

I found a list of new medical schools opening in the next couple of years, holy crap I didn't realize there were so many. Not to mention all the ones that have already opened since I started school 4 years ago.

 

[Silent Cool]

http://www.kaiserhealthnews.org/Stories/2013/April/02/Quinnipiac-medical-school-primary-care.aspx

Michael Ellison has a tough assignment.

He's the associate dean of admissions choosing the first class of a brand new medical school, the Frank H. Netter MD School of Medicine at Quinnipiac University in Connecticut. It’s a school with a very specific mission: minting new doctors who want to go into primary care practice....

"I remember watching Dr. Jacobs counsel a patient on an ingrown toenail. I knew then that my heart was in primary care. My application, too, shows the many extracurricular service activities that broaden me and make me well-rounded to prepare myself to serve the diverse community in which I live as a primary care physician some day." or some s h i t like that.

Or, my favorite, PandaBearMD's "application essay:"

(seen here: http://www.studentdoctor.net/pandabearmd/2006/05/26/my-personal-statement/ )

"
“Mbuto.”
My African driver springs to his feet.
“Yes, Sahib.”
“Pass me another baby, I think this one has died.” I lay the dead infant in the pile by my feet. What I’d really like him to do is pass me an ice-cold bottle of the local beer. Compassion is hot, thirsty work. There is no ice in this wretched refugee camp, mores the pity, but as I’m here to help I will suffer in silence. I stare into the eyes of the African baby who is suffering from HIV or dengue fever or something gross and look out into the hot, dusty savannah and ask, “Why? Why gender-neutral and non-judgmental Deity (or Deities) does this have to happen?”
“And Why, Mbuto, is the air-conditioning on my Land Rover broken again?”
“One thousand pardons, Sahib, but the parts have not arrived.”
I will suffer. I have lived a life of privilege and my suffering serves to link me to the suffering of mankind. I roll the window down. God it’s hot. How can people live here? Why don’t they move where it’s cool? Still, I see by the vacant stare from the walking skeletons who insist on blocking the road that they appreciate my compassion and I know that in a small way, I am making a difference in their lives.
Africa. Oh wretched continent! How long must you suffer? How long will you provide the venue to compensate for a low MCAT score? How many must die before I am accepted to a top-tier medical school?
When did I first discover that I, myself, desired to be a doctor? Some come to the decision late in life, often not until the age of five. The non-traditional applicants might not know until they are seven or even, as hard as it is to believe, until the end of ninth grade. I came, myself, to the realization that I, myself, wanted to be a doctor on the way through the birth canal when I realized that my large head was causing a partial third degree vaginal laceration. I quickly threw a couple of sutures into the fascia between contractions so strong was my desire to help people.
My dedication to service was just beginning. At five I was counseling the first-graders on their reproductive options. By twelve I was volunteering at a suicide crisis center/free needle exchange hot-line for troubled transgendered teens. I’ll never forget Jose, a young Hispanic male with HIV who had just been kicked out of his casa by his conservative Catholic parents. He had turned to black tar heroin as his only solace and he was literally at the end of his rope when he called.
“How about a condom, Hose,” I asked. The J, as you know, is pronounced like an H in Spanish.
Annoying silence on the line. Hesus, I was there to help him.
“Condoms will solve all of your problems,” I continued, “In fact, in a paper of which I was listed as the fourth author, we found that condoms prevent all kinds of diseases including HIV which I have a suspicion is the root of your depression.”
More silence. No one had ever had such a rapport with him. He was speechless and grateful and I took his sobs as evidence of my compassion.
“Hey, it was double-blinded and placebo controlled, vato.” Cultural competence is important and I value my diverse upbringing which has exposed me to peoples of many different ethnicities. I always say “What up, Homes?” to the nice young negroes who assemble my Big Mac and I think they accept me as a soul brother.
“We also have needles, amigo. Clean needles would prevent HIV too.”
My desire to be a physician has mirrored my desire to actualize my potential to serve humanity in many capacities. This may be something unheard of from medical school applicant but I have a strong desire to help people. I manifest this desire by my dedication to obtaining all kinds of exposure to all different kinds of people but mostly those from underserved and underprivileged populations. In fact, during a stint in a Doctors Without Borders spin-off chapter I learned the true meaning of underserved while staffing a mall health care pavilion in La Jolla, California.
Most of my friends are black or latino and I am a “Junior Cousin” of the Nation of Islam where I teach infidel abasement techniques to the Mohammed (PBUHN) Scouts. I also am active in the fight for women’s reproductive rights except of course for women in Afghanistan who were better off before our current racist war.
As Maya Angelou once said, “All men (and womyn) are prepared to accomplish the incredible if their ideals are threatened.” I feel this embodies my philosophy best because the prospect of grad school is too horrible to contemplate."

oh, panda, where art thou?