Need Advice - MD Considering a Career Change without doing Residency

[Captain29]

Hello everyone,
So I'm a 4th year medical student who will be graduating from a very good medical school outside of the US, but I was born and raised in the US and carry the citizenship.

Over the past couple of months, I've been seriously considering a career change. I know we all have our reasons for going into med school, but for me, it was to change the world. I don't mean to help make the world a better place by helping the patients who walk into my clinic (not criticizing that at all, I actually think it's one of the most noble things you can do - it's just not for me), I mean large-scale impact. It's my life's purpose - always has been, and always will be.

Having said that, it's one thing to know/decide what your purpose in life is, and it's a completely different thing to figure out the means with which you will achieve your purpose. Now, I won't bore you with my full story and why I chose medicine, so I'll just tell you where I'm at now:
It's been 4 years since I've started medical school and I finally realized that they way for me to be able to make a change is to target healthcare itself (delivery, organization, accessibility, equality, etc) rather than tackle a specific medical specialty/field. I don't mean for this to sound like an epiphany that just fell upon me. It's been a while coming. We each know where our own strengths lie, what way of thinking we like to equip, and the type of problems we'd like to dedicate our efforts to. The things I find most interesting about healthcare/medicine are:
- Hospitals (how they work, their structure, how they're staffed, and generally everything that has to do with getting a good hospital working well).
- Healthcare delivery and accessibility, ie making healthcare more accessible for individuals of all backgrounds + improving the quality of care.

This is what I'd like to dedicate my life and career to. I think an MBA or an MHA might be the best next step for me to pursue but I'd like your advice. Any advice, criticisms, anything. Would it be completely stupid to not do a residency? What type of job should I start with? Do you think it's at all possible to make a difference in the things I mentioned?

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[geripalgal]

Hello everyone,
So I'm a 4th year medical student who will be graduating from a very good medical school outside of the US, but I was born and raised in the US and carry the citizenship.

Over the past couple of months, I've been seriously considering a career change. I know we all have our reasons for going into med school, but for me, it was to change the world. I don't mean to help make the world a better place by helping the patients who walk into my clinic (not criticizing that at all, I actually think it's one of the most noble things you can do - it's just not for me), I mean large-scale impact. It's my life's purpose - always has been, and always will be.

Having said that, it's one thing to know/decide what your purpose in life is, and it's a completely different thing to figure out the means with which you will achieve your purpose. Now, I won't bore you with my full story and why I chose medicine, so I'll just tell you where I'm at now:
It's been 4 years since I've started medical school and I finally realized that they way for me to be able to make a change is to target healthcare itself (delivery, organization, accessibility, equality, etc) rather than tackle a specific medical specialty/field. I don't mean for this to sound like an epiphany that just fell upon me. It's been a while coming. We each know where our own strengths lie, what way of thinking we like to equip, and the type of problems we'd like to dedicate our efforts to. The things I find most interesting about healthcare/medicine are:
- Hospitals (how they work, their structure, how they're staffed, and generally everything that has to do with getting a good hospital working well).
- Healthcare delivery and accessibility, ie making healthcare more accessible for individuals of all backgrounds + improving the quality of care.

This is what I'd like to dedicate my life and career to. I think an MBA or an MHA might be the best next step for me to pursue but I'd like your advice. Any advice, criticisms, anything. Would it be completely stupid to not do a residency? What type of job should I start with? Do you think it's at all possible to make a difference in the things I mentioned?

If you want to succeed in the healthcare adminstration field you will need to do a residency then mba. A doc without a residency wont win the respect of the other physicians at the hospital. Simply put, you havent had to endure the trials of residency, so how could you possibly know about the difficulties of my job, and yet you want to tell me what to do. Its good to have leadership with a medical background, but without the residency you aren't really considered a full doctor by your fellow physicians.

Just my opinion.

 

[Captain29]

If you want to succeed in the healthcare adminstration field you will need to do a residency then mba. A doc without a residency wont win the respect of the other physicians at the hospital. Simply put, you havent had to endure the trials of residency, so how could you possibly know about the difficulties of my job, and yet you want to tell me what to do. Its good to have leadership with a medical background, but without the residency you aren't really considered a full doctor by your fellow physicians.

Just my opinion.

I understand what you're saying and I understand that without residency I won't be considered a full doctor, but my point is: what's the point of being considered a full doctor when you're going to be doing something that is mostly done by people who aren't MDs. It would be a career change like I said in the title. And I think having MD won't be a complete waste since it is was led me to get this point and I will carry some of the things I learned with me.
Is it really worth it to go through a few more years just to "gain the respect of the other physicians"? Especially if I won't be seeing patients?

 

[gutonc]

I understand what you're saying and I understand that without residency I won't be considered a full doctor, but my point is: what's the point of being considered a full doctor when you're going to be doing something that is mostly done by people who aren't MDs. It would be a career change like I said in the title. And I think having MD won't be a complete waste since it is was led me to get this point and I will carry some of the things I learned with me.
Is it really worth it to go through a few more years just to "gain the respect of the other physicians"? Especially if I won't be seeing patients?

Here's the thing about your plan. You want to change the way the healthcare system in America works. That's laudable, and we need more docs who are willing to work in that setting. But you're graduating from a med school outside the US. So you really don't have any firsthand knowledge of how the US medical system works from the inside. And an MBA/MHA won't help you with that. So a residency, or at least an internship, will give you that inside information which potential employers are going to want.

So, feel free to pursue your plan as you have outlined it. But recognize that you're going to be at a distinct disadvantage without US experience.

 

[J ROD]

Got to play in the sandbox. Before you can take a poop in it.

 

[AdmiralChz]

Had a couple medical school friends explore/enter healthcare consulting as well as policy. All of them are residency-trained and would agree with the others here - without a residency you don't have much to bring to the table than any other MBA/MHA/random masters here since you lack clinical and occupational experience. Plus since you didn't attend a US medical school and experience US problems first-hand, it's a non-starter to be honest.

 

[gutonc]

Let me give you a more personal example here.

We have a management tool in our group who graduated from a very good US med school. He also decided to "change medicine" and went to get his MBA instead of doing a residency. He's done a pretty good job of getting people to hire him, but he's managed to make exactly 0 substantive change other than making us all go to stupid meetings so we can read off buzzwords from Power Point presentations. The RNs and non-clinical staff eat his s*** up because he does it with such salesmanship. The docs smile and nod so the meeting ends sooner and we just do it the way we know it works already.

This is primarily because he has only theoretical healthcare management experience and no actual healthcare experience.

Don't be that guy. Do it right, or don't do it at all.

 

[GastriqueGraffin]

Look into a preventive medicine residency +/- masters degree. You might actually enjoy it.

 

[enalli]

In which country did you go to medical school? How similar is their healthcare system to ours?

I don't have much advice to add here, but I agree with what the others have said. Your plan of getting an MHA/MBA will certainly get you hired as a hospital administrator. If you want to make some meaningful, positive changes to a healthcare system, you should have some clinical experience--do know that some people will never be satisfied (i.e. "this guy only did an internship," "this guy only did a residency," "this guy was only an attending for 2 years," etc.).

If you want to get closer to "change the world" type of stuff, you need to become a politician and fix our healthcare system (ha!) or become filthy rich and do some philanthropy.

Do you think it's at all possible to make a difference in the things I mentioned?

I'm pretty jaded, so my answer to this is no, but that doesn't mean you shouldn't try. Somebody out there is going to make a real difference one day and surprise us all; maybe it'll be you. So go for it.

 

[Old_Mil]

Hello everyone,
So I'm a 4th year medical student who will be graduating from a very good medical school outside of the US, but I was born and raised in the US and carry the citizenship.

Over the past couple of months, I've been seriously considering a career change. I know we all have our reasons for going into med school, but for me, it was to change the world. I don't mean to help make the world a better place by helping the patients who walk into my clinic (not criticizing that at all, I actually think it's one of the most noble things you can do - it's just not for me), I mean large-scale impact. It's my life's purpose - always has been, and always will be.

Having said that, it's one thing to know/decide what your purpose in life is, and it's a completely different thing to figure out the means with which you will achieve your purpose. Now, I won't bore you with my full story and why I chose medicine, so I'll just tell you where I'm at now:
It's been 4 years since I've started medical school and I finally realized that they way for me to be able to make a change is to target healthcare itself (delivery, organization, accessibility, equality, etc) rather than tackle a specific medical specialty/field. I don't mean for this to sound like an epiphany that just fell upon me. It's been a while coming. We each know where our own strengths lie, what way of thinking we like to equip, and the type of problems we'd like to dedicate our efforts to. The things I find most interesting about healthcare/medicine are:
- Hospitals (how they work, their structure, how they're staffed, and generally everything that has to do with getting a good hospital working well).
- Healthcare delivery and accessibility, ie making healthcare more accessible for individuals of all backgrounds + improving the quality of care.

This is what I'd like to dedicate my life and career to. I think an MBA or an MHA might be the best next step for me to pursue but I'd like your advice. Any advice, criticisms, anything. Would it be completely stupid to not do a residency? What type of job should I start with? Do you think it's at all possible to make a difference in the things I mentioned?

My friend, you have fallen into the trap. The slavers have you in chains the minute you sign the student loan paperwork.

Do your residency. Get out a f pay off your student loans as expeditiously as possible... Then be free.

 

[AMEHigh]

Definitely do residency. Either IM or FM, 3 years isn't all that long in the grand scheme of things.

You will learn so many things that will be highly valuable in your future career that you never would've as a medical student.

I plan to eventually get out of clinical practice and am so glad I'm going through residency in the meantime.

 

[WingedOx]

Let me give you a more personal example here.

We have a management tool in our group who graduated from a very good US med school. He also decided to "change medicine" and went to get his MBA instead of doing a residency. He's done a pretty good job of getting people to hire him, but he's managed to make exactly 0 substantive change other than making us all go to stupid meetings so we can read off buzzwords from Power Point presentations. The RNs and non-clinical staff eat his s*** up because he does it with such salesmanship. The docs smile and nod so the meeting ends sooner and we just do it the way we know it works already.

This is primarily because he has only theoretical healthcare management experience and no actual healthcare experience.

Don't be that guy. Do it right, or don't do it at all.

to be fair, that sounds like your typical MBA regardless of experience.

 

[Captain29]

Thank you so much for all the replies! I was a little busy for the past couple of days and I honestly did not expect so many responses!

To get to the point, I'm convinced! I will apply for either IM or FM. I have a step 1 score in the low 240s and I'm hoping my low class ranking won't hurt me that much.

 

[Captain29]

Definitely do residency. Either IM or FM, 3 years isn't all that long in the grand scheme of things.

You will learn so many things that will be highly valuable in your future career that you never would've as a medical student.

I plan to eventually get out of clinical practice and am so glad I'm going through residency in the meantime.

Do you mind me asking what your residency field is?

 

[AMEHigh]

Do you mind me asking what your residency field is?

Family med

 

[rlx009]

I completely understand how you feel. I completed an MPH in healthcare management before going to med school. My reason was to understand healthcare in general before going to such a big endeavor, although most tend to do it after med school. You don't have to do a residency, but I would highly suggest a masters program, whether an MPH, MHA, MBA in order to see where in healthcare you would like to focus your attention on, whether it's policy, management, operations, finances, etc as the field is much too large and complex to be a master of all. Doing a residency will only reaffirm most of what you probably already suspect at this point, and it may jade you even further and make you feel smaller and more insignificant. On the other hand, it'll help you grow and mature given you're already on that path. What I did was continue research in quality improvement and attend admin meetings through residency to keep my feet in both worlds. Perhaps getting out early with a sense of youthful optimism may be just what the doctor ordered (pun intended). Whatever you do stay true to yourself. Good luck.

 

[Ericslv]

If you want to succeed in the healthcare adminstration field you will need to do a residency then mba. A doc without a residency wont win the respect of the other physicians at the hospital. Simply put, you havent had to endure the trials of residency, so how could you possibly know about the difficulties of my job, and yet you want to tell me what to do. Its good to have leadership with a medical background, but without the residency you aren't really considered a full doctor by your fellow physicians.

Just my opinion.

If he gets an MBA he won't need the respect of the other doctors. They will be working for him and the hospital. They will have to follow policy and what he says. Don't believe me? Just ask the attendings at any hospital USA how much they hate the admins because they dictate to them how to do everything.

 

[GastriqueGraffin]

If he gets an MBA he won't need the respect of the other doctors. They will be working for him and the hospital. They will have to follow policy and what he says. Don't believe me? Just ask the attendings at any hospital USA how much they hate the admins because they dictate to them how to do everything.

That sounds like a pretty sh***y hospital you're describing.

 

[Ericslv]

That sounds like a pretty sh***y hospital you're describing.

That's any hospital USA.

 

[LookForZebras]

I agree with many of the replies above posters that doing a residency is the best route. After that, you'll have so many more options. I wrote a post on my site recently about this topicthat you might find helpful: I know I want to have a non-clinical job. Do I need to do a residency? | Look for Zebras

I also second GastriqueGraffin's recommendation to look into preventive medicine. Since you want to have a large-scale impact, this could be a great fit for you. You'd gain experience in public health, leadership in medicine, and healthcare management. And you'd come out of it being board-eligible, and having additional patient care experience.

 

[NotAProgDirector]

If he gets an MBA he won't need the respect of the other doctors. They will be working for him and the hospital. They will have to follow policy and what he says. Don't believe me? Just ask the attendings at any hospital USA how much they hate the admins because they dictate to them how to do everything.

Somewhat disagree. Sure, if you attend a top B school you can often end up with a top leadership position. But B school is very different from Med School. Go to any US MD/DO program, and you get to be a doctor. Go to a non-top B school, and you likely end up being nothing unless you work like crazy for it.

 

[fantasty]

Look into a preventive medicine residency +/- masters degree. You might actually enjoy it.

Too tired to retype this but if it helps OP - post 7:

HELP, want to change residency

 

[Ericslv]

Somewhat disagree. Sure, if you attend a top B school you can often end up with a top leadership position. But B school is very different from Med School. Go to any US MD/DO program, and you get to be a doctor. Go to a non-top B school, and you likely end up being nothing unless you work like crazy for it.

being a doctor dosn't mean you will be in charge of anything. The direction of healthcare and medicine is corporate. NP's are increasing their roles in the primary care and specialty areas. Corporate want to save money so the value of MD has gone down while the cost of getting one is going up both in dollars and time. Physicians have one of the highest rates of suicide and burnout than any other industry. Primary care is one of the lowest paid and have mostly become data collection specialist. They get paid zero for the time spent charting, charting and collecting more useless data. They Boards in medicine have become a money collecting machine with little value to the end user (the doctor). They have become corrupt (ABIM is just one example).

Why would someone want to go through all of this if they truly grasped the concept and lack of power they will have? That along with the massive debt and years lost in their youth.

To the original post since he has already come this far it is too late to not do a residency because that will make his prospects even worse.

 

[IlDestriero]

If he gets an MBA he won't need the respect of the other doctors. They will be working for him and the hospital. They will have to follow policy and what he says. Don't believe me? Just ask the attendings at any hospital USA how much they hate the admins because they dictate to them how to do everything.

That’s not really true at all.
Our group is independent of the hospital. We have a contract with them, but they don’t own the practice. They ask for things, we may or may not be able to support them, and they may or may not have to pay us to support them. They can’t dictate the way we practice.
Want 24/7 coverage for a room elective cases, sure no problem. But you’re going to have to guarantee the pay for 2+ FTEs, one to do the work and one more because the night guy won’t be there the next day, so someone has to do the work he would have done. Still interested?


--
Il Destriero

 

[deleted877019]

Hello everyone,
So I'm a 4th year medical student who will be graduating from a very good medical school outside of the US, but I was born and raised in the US and carry the citizenship.

Over the past couple of months, I've been seriously considering a career change. I know we all have our reasons for going into med school, but for me, it was to change the world. I don't mean to help make the world a better place by helping the patients who walk into my clinic (not criticizing that at all, I actually think it's one of the most noble things you can do - it's just not for me), I mean large-scale impact. It's my life's purpose - always has been, and always will be.

Having said that, it's one thing to know/decide what your purpose in life is, and it's a completely different thing to figure out the means with which you will achieve your purpose. Now, I won't bore you with my full story and why I chose medicine, so I'll just tell you where I'm at now:
It's been 4 years since I've started medical school and I finally realized that they way for me to be able to make a change is to target healthcare itself (delivery, organization, accessibility, equality, etc) rather than tackle a specific medical specialty/field. I don't mean for this to sound like an epiphany that just fell upon me. It's been a while coming. We each know where our own strengths lie, what way of thinking we like to equip, and the type of problems we'd like to dedicate our efforts to. The things I find most interesting about healthcare/medicine are:
- Hospitals (how they work, their structure, how they're staffed, and generally everything that has to do with getting a good hospital working well).
- Healthcare delivery and accessibility, ie making healthcare more accessible for individuals of all backgrounds + improving the quality of care.

This is what I'd like to dedicate my life and career to. I think an MBA or an MHA might be the best next step for me to pursue but I'd like your advice. Any advice, criticisms, anything. Would it be completely stupid to not do a residency? What type of job should I start with? Do you think it's at all possible to make a difference in the things I mentioned?

At the outset, I'm an outsider (not a US doctor or citizen).

I hear you completely on the 'large-scale impact' front. Are you necessarily looking to accomplish that by 'getting good hospitals working well'? Because there are less complicated, and more large-scale ways of positively impacting healthcare. To give you my drift- 'saving lives, a million at a time'- John Hopkins's MPH program tagline. Either Preventative medicine residency or MPH or both may work better for you, if you're not particular about being on the hospital admin side of things. Epidemiology maybe an appropriate foundation if you want to look into things like applying simple interventions on a large scale and researching their impact, making recommendations founded on your research; you could also look into W.H.O. jobs and make your way up to positions of authority to implement programs. There is a wealth of experience and information to be gained from outside the U.S. and I think it should be, because it can potentially make you discover things you may not know exist and you can bring that experience back to your own country. You could, for example, try and investigate potential variables explaining the disproportionately high cost of healthcare in the U.S, by looking at overseas hospitals with superior or equivalent health outcomes as the top hospitals in your country; looking at places where top healthcare can reside in the individual's pocket in most circumstances and figuring out why healthcare is has gotten of the patient's pocket and is getting out of the provider's hands.

In other words, there are many, many interesting ways you can go about working towards potentially making a large-scale impact. But remember, any positive impact is good and be careful not to let large ambitions prevent small accomplishments, else you will run the risk of not accomplishing anything at all.
However, if it is admin that really does interest you, maybe you should go for that, rather than the preventative medicine side of things, because overwhelming interest alone can override any well though-out counsel or plan and your path may become instinctively clear to you along the way.

I think it's true that doing a residency will make you a more effective hospital administrator. If it's public health you're after, you don't need to waste your time on residency, unless is preventative med residency. If you're on the fence, and want to remain open to a career as a doctor, absolutely apply for residency now, because if you try to return later, you'll find things are darker.

Best wishes. There will be enough things to dampen your spirits- remember to not get bogged down, and doing what you like, rather than what 'appears important', helps those spirits stay high and helps you accomplish more.

 

[thxleave]

I actually disagree with everybody on this forum. I have a Carib MD from SGU and was able to get a health informatics job for an insurance group. I create presentations and deliver data that affects policy (such as if we should cover this under our benefits or not), all without a MPH.

As for other people not "respecting" you, that's true for a while when you start. But if you work hard, and provide solid work. They have no choice to respect you. People can complain about lack of actual clinical experience and all that. But compared to other people in the health admin field..... You wouldn't believe the lack of people that is in the health administration field that have clinical experience. A lot of these companies kill for a CPht and medical assistant experience. So your MD sets you miles ahead.

The tough part is getting your feet in the door. But once you in, it isn't too hard to climb up the scale quick.