Nontrads: Would You Still Consider Doing a Long/Competitive Residency?

[ManimalJax]

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To all of the nontrads here who are starting med school in their mid-20s to late-30s:

Because you are starting medical school at a nontraditional age, do you feel limited in your choice of residencies (disregarding performance on the USMLE steps)? Are you only considering shorter residencies like internal medicine? Or, do you think you can go for the long haul, i.e., orthopaedic surgery, ophthalmology?

 

[Klemptor]

If I were single, I'd be more likely to pursue a long residency. I'm interested in surgery, but I've decided that I'm not going to pursue it unless I feel that there's nothing else in medicine I want to do. The reason for this is that by the time I finish med school, my boyfriend will have been supporting both of us on his salary alone for eight years. He has been delaying starting his PhD so that I can focus on my education. As soon as I can pull in an appreciable salary (as an attending), he can focus on finishing his education. I think that's fair.

 

[doctor712]

Great question. My answer is yes. But I am quite torn some days.

Sometimes I remind myself that I love anesthesia, and that's 4 years. If I wanted to do a 5th, so be it.

Then I go to work and see the Cath Lab, and, more importantly, see what's going on in the cath lab, and want to do Cardiovascular. That's 3 IM years, 3 Cards years, and an Interventional year. Lord.

And I have kids.

Then I observe CT Surgery and that's also 7-8 years, depending on research.

(Often I remind myself: I can moonlight...)

So, the answer is YES, I would consider it. In the BIG scheme, an extra year, or two, when I'm 75, let's hope it doesn't make a big difference, it shouldn't. The payoff, is doing what you WANT.

Which is why I'm here in the first place.

D712

 

[sindadel]

I will make my decision about specialty based on how hard the whole Q4 call is on my kids and husband and my relationship with them. So not at all about the time involved, but about the relationships in my life.

 

[Krisss17]

I would consider it, but it would be a noninterventional cardiology fellowship, not a surgical or interventional cardiology fellowship. But I am single, and even if I should eventually get married...I'm past the kiddie stage. Work will be my life so I might as well enjoy the intellectual stimulation.

 

[Helen Wheels]

I have never wanted to be a surgeon so that isn't an issue. I would definitely consider something long like GI maybe. Length of residency isn't really an issue for me. But then again I am currently single and don't have any/don't want any children.

 

[Law2Doc]

To all of the nontrads here who are starting med school in their mid-20s to late-30s:

Because you are starting medical school at a nontraditional age, do you feel limited in your choice of residencies (disregarding performance on the USMLE steps)? Are you only considering shorter residencies like internal medicine? Or, do you think you can go for the long haul, i.e., orthopaedic surgery, ophthalmology?

Isn't optho only 4 years (a prelim year and 3 optho years)? If so it's pretty much average length. IM is only a year shorter. Nobody makes decisions based on one year. And FWIW you are already a doctor working in your field of choice during residency. So you do what you want. Late 30s is still young enough to have a long career in any field -- people don't retire at 50 the way they used to in medicine, and now more commonly work into their 70s. So in fact the years of employment are probably longer, even for nontrads, then they used to be 30 years ago.

 

[Lindindite]

I will make my decision about specialty based on how hard the whole Q4 call is on my kids and husband and my relationship with them. So not at all about the time involved, but about the relationships in my life.

Ditto. I'm going to suss out how years 3 and 4 go with my baby and SO, but I, too, don't feel that a year or two makes much difference if you're in the specialty you want to be in.

 

[EricH]

Yes, I am not considering surgery at this time due to the long residency. It's bad enough to be a doc at about 40 (post residency), but 45 seems like too little time to prepare for retirement.

 

[Micahfeld]

I'm definitely not going to rule out any specialty at this point. I have a wife and two children, but I'm not going to chase my dream only to settle for something that I may not be happy with in the end.

Things may change down the road, but I hope to pursue the specialty that I have a passion for.

 

[Law2Doc]

Yes, I am not considering surgery at this time due to the long residency. It's bad enough to be a doc at about 40 (post residency), but 45 seems like too little time to prepare for retirement.

You are a doc during your residency. Although it's training, it's not school -- it's a job with a salary. You wear the long white coat, write prescriptions, take care of patients, and people call you doctor. The only thing missing at that point are the perqs of private practice.

 

[Non-TradTulsa]

It's not the length of the residency or the competitiveness, but I am giving a fair amount of consideration to lifestyle issues. But I'm a non-trad non-trad - I was 45 the first week of medical school.

I would never consider surgery, for example, because it's just too grueling of a lifestyle (njbmd did do surgery, and he'll probably correct me if he reads this). Most active surgeons I know slow down some in their late-50s because of the horrible hours. And I can't plan on my hands being steady for as long as I plan to work.

I'm going into Medicine by choice - I'll probably end-up as a Hospitalist, because the 7-on/7-off schedule is quite attractive - as are some of the offers, since the field is generating a demand much higher than the supply.

 

[njbmd]

Started medical school at age 46, graduated at 49, entered General Surgery residency and did Vascular Surgery fellowship. Now, I am having the time of my life and love what I do. Was I limited by age? Not that I could see.

 

[EricH]

You are a doc during your residency. Although it's training, it's not school -- it's a job with a salary. You wear the long white coat, write prescriptions, take care of patients, and people call you doctor. The only thing missing at that point are the perqs of private practice.

I appreciate your point. In truth it's the reputation of long hours, my kids, and the prospect of living on that salary with student loan payments that freak me out.

I got a couple of years before I start worrying about it though 🙂

 

[Trismegistus4]

Before I applied to medical school, I used to think about anesthesia, basically because of the lifestyle and income to be frank. Then I started medical school saying general surgery, because I had shadowed a surgeon and loved it so much. During the first two years I also took an interest in Heme/Onc and Pulm/CC, both of which are 6-year paths. Now, beginning my 3rd year at the tender young age of 32, I find myself thinking about my age more and more. Running around the hospital feeling like I don't know what I'm doing, constantly being evaluated and corrected by residents and attendings, I find myself thinking, "I'm too old for this." I'm beginning to come full circle and gravitate toward anesthesia again, or maybe PM&R. I know Law2Doc said you are a physician within your chosen field within residency, but you're also still getting paid a pittance, taking in-house call, and totally at the mercy of your superiors. I'd like to start having some semblance of a normal life again before age 40.

 

[Excelsius]

Started medical school at age 46, graduated at 49, entered General Surgery residency and did Vascular Surgery fellowship. Now, I am having the time of my life and love what I do. Was I limited by age? Not that I could see.

Wow. And here I am worried about being slightly over my mid 20s when I enter medschool.

I agree with that philosophy though. Medschool is a hard path and you'd do yourself disservice if you do not go into a field you really like simply because of residency duration. I don't know if there is a table of residency durations by field, but it seems that the shortest residency is about 3-4 years. That means that some of the surgical subspecialties take only 3 or so years extra. Finally, here is another point that is often missed on these boards: as a resident, you are actually making money. 40K + is not bad at all considering that people with bachelor's degree can make less than that and that those poor PhDs usually average only 10-20K more than that. Resident's salary is well within the average income of US males. So even if you have a spouse (who works), you should be able to put some money aside if you are parsimonious. The rest of America lives on the same income and manages to have an average lifestyle. Maybe many students entering medschool come from priviledged backgrounds and have never worked in their life. That's why resident salaries seem to be pocket change to them.

Lifestyle of some residents can be tough if you have a family (such as surgery), but different people have different experiences. If you really love what you do, then theoretically you are not really "working." At least it's not a drag to spend 80 hours doing something you love vs 50 hours something you don't like.

Finally, if your SO is not willing to put up with 6-8 post-graduate training years, then you can't be sure if he/she'll put up with 3-4 either. You'll make a big mistake to relax your grades in medschool thinking that taking the longer residency is not possible because of your SO. You might just find yourself alone even before medschool is over and then really regret that you didn't do well enough to choose whatever field you want. So your SO either supports you or she doesn't. +- 3 years shouldn't make much of a difference.

 

[montessori2md]

I appreciate your point. In truth it's the reputation of long hours, my kids, and the prospect of living on that salary with student loan payments that freak me out.

I got a couple of years before I start worrying about it though 🙂

With the exception of the surgical fellowships, my impression of fellows is that their work hours are not necessarily longer than what many attendings work. The real problem w/ fellowship, for me, is the salary, and yet another year of barely being able to pay the interest on those loans, let alone start knocking them out.

I'm not seriously considering surgery, not just because of the length of training but also because I don't think I have the temperament for it. I do sometimes toy w/ the idea of IM + fellowship.

 

[tabishis]

I would love to go for NeuroSurge if I could. Fun stuff!

 

[Trismegistus4]

Finally, here is another point that is often missed on these boards: as a resident, you are actually making money. 40K + is not bad at all considering that people with bachelor's degree can make less than that and that those poor PhDs usually average only 10-20K more than that. Resident's salary is well within the average income of US males. So even if you have a spouse (who works), you should be able to put some money aside if you are parsimonious.

That's true if you're debt-free. $40k is a fine entry level salary for a 22-year-old recent college grad's first job. But you're ignoring the effect of having $200,000 in medical school loans hanging over your head. And keep in mind that even during deferment, interest accumulates on any unsubsidized loans, and during forbearance, it accumulates even on subsidized loans as well. No way you're putting money away during residency unless you're one of those privileged ones whose daddy has always paid for everything.

 

[Excelsius]

That's true if you're debt-free. $40k is a fine entry level salary for a 22-year-old recent college grad's first job. But you're ignoring the effect of having $200,000 in medical school loans hanging over your head. And keep in mind that even during deferment, interest accumulates on any unsubsidized loans, and during forbearance, it accumulates even on subsidized loans as well. No way you're putting money away during residency unless you're one of those privileged ones whose daddy has always paid for everything.

You do have to worry about debt, but most of the specialties that require longer training also pay much more after you finish residency/fellowship and usually doctors say that they are able to get the hang of their debt pretty soon after they finish training. This is something everyone goes through, regardless of age. Plus, if you have a working spouse, you can have close to 100K household income. So I don't think that the loans should keep you out of the specialty you want. Most non-trads are worried about time away from family, rather than loans.

Let's also not forget that the average medschool debt is around 130K. If you have the need, a lot of medschools offer grants up to the full tuition. If you don't have a rich daddy, this can be the case. This is why loans should not be the deciding factor of what you want to do in life.

I have been lucky to play my cards well and keep my undergrad debt to a minimum. However, like most Americans, I still do have debts on cars, small business endeavors, etc. Because I know what lies ahead, my plan of entering medschool debt-free might likely work.

Also realize that you don't have to be at the mercy of large interest rates. Assuming you have to go the unsubsidized route, you can easily "transfer" those loans to credit cards that have locked 1-4% interest rates. All of my interest rates are below 3%. You do have to maintain excellent credit. There are even way to keep things down to 0%, but with these you have to be more vigilant and timing is important. I am not saying that you can easily do this with all 150K of your debt, but you sure can make a big dent in it. It is somewhat tougher now in this economy, but let's hope that credit will start flowing before this time next year.

What is your take on working while in medschool? From what I have learned in Allo is that medstudent have a lot of free time on their hands. You should be able to squeeze in at least a part time job, right? And by that I mean something like research that not only will pay you but also look good on your resume for some specialties. Plus, there is no school during summer, right? So that should be three months of full time work. You can also make some money on the internet if you know how to build a website.

 

[DrMidlife]

Let's also not forget that the average medschool debt is around 130K. If you have the need, a lot of medschools offer grants up to the full tuition. If you don't have a rich daddy, this can be the case. This is why loans should not be the deciding factor of what you want to do in life.

That number is a joke. It's four years shy of being relevant. The average is not as telling as a median would be.

Take a look at the current COA for any school in which you're interested. Play with the numbers - how many students are in public vs. private schools, etc. Speculate how many students are getting support. How many students are going to get a full ride, from the school or the military or public health or what have you. 22,000 students per year, not counting Caribbean et al.

The $130k number includes all students whether they have debt or not. So as policy makers are figuring out what new residents can afford and what they can't afford, they're thinking $130k is the target. The completely realistic debt load of $250k, or even $300k, is not part of the conversation.

Furthermore, the conversation tends to forget about undergrad debt. In my state, Washington, the COA for public undergrad currently adds up to $80k for four years. The COA for public med school adds up to $152k. So the cheapest option has COA well above $130k. And WA is among the cheaper states.

My point is that if you're planning on having $130k debt or less, you're not basing your plan on reality. If you're in TX or you're military or you have family support or whatnot, that's fabulous. Good for you. But if you don't have backup, you need to be planning on $250k or more.

 

[Non-TradTulsa]

Wow. And here I am worried about being slightly over my mid 20s when I enter medschool.

...40K + is not bad at all considering that people with bachelor's degree can make less than that and that those poor PhDs usually average only 10-20K more than that. Resident's salary is well within the average income of US males. ...Maybe many students entering medschool come from priviledged backgrounds and have never worked in their life. That's why resident salaries seem to be pocket change to them.

You have great insight for someone who has not yet reached 30. No, earning a salary in the mid-40's is nothing to be ashamed of by national averages, but when you're older - and the last time you earned $45K was sometime in the Reagan administration - it's hard. I think never-having-had-money is easier than leaving-it-behind-for-medical-training.

I think abject poverty has a certain romantic quality to it when you're younger, but when you're middle-aged, it's not attractive. I can tough it out for three years, but that's getting close to my limit. I'm having to defer major house maintenance, etc, to get through this. Not being able to travel for vacations makes me crabby at times. And being old costs more. I spend a fortune on decent moisturizers for my face just so that I can get up after a call night and not look like John McCain's mother.

But you do mention what I think is rarely-discussed issue - some of us are "medical royalty," and some aren't. My dad was a successful lawyer but unfortunately he's passed away and my elderly mother lives on what he left behind. I'm the first physician in my family. My fellow students whose parents are practicing physicians often have a lifestyle that doesn't resemble mine at all - I'm reminded of that when I'm walking past late-model Infinities and Range Rovers in student parking in order to get to one of my two 10+ year old, paid-off, automobiles.

 

[Krisss17]

Isn't optho only 4 years (a prelim year and 3 optho years)? If so it's pretty much average length. IM is only a year shorter. Nobody makes decisions based on one year. And FWIW you are already a doctor working in your field of choice during residency. So you do what you want. Late 30s is still young enough to have a long career in any field -- people don't retire at 50 the way they used to in medicine, and now more commonly work into their 70s. So in fact the years of employment are probably longer, even for nontrads, then they used to be 30 years ago.

Totally true! Most people can't retire at 50, many can't even retire in their 60s (especially nowadays). The earliest I can be to get SS would be 67 and even that is no guarantee.

I live in Florida so there are definitely a lot of retirement-age people down here, but if people look closer, many will see that there are a lot of 60+ people having to return to work or continue working longer. If I am going to have to work longer, I want to do it in an area that gives me a sense of fulfillment.

For myself, I'm not even considering full-retirement, and as long as I am able, I will work in either in the clinical arena or possibly the academic...they'll have to unclench my hand from around my stethoscope when it is my time to go!

 

[Excelsius]

You have great insight for someone who has not yet reached 30. No, earning a salary in the mid-40's is nothing to be ashamed of by national averages, but when you're older - and the last time you earned $45K was sometime in the Reagan administration - it's hard. I think never-having-had-money is easier than leaving-it-behind-for-medical-training.

I think abject poverty has a certain romantic quality to it when you're younger, but when you're middle-aged, it's not attractive. I can tough it out for three years, but that's getting close to my limit. I'm having to defer major house maintenance, etc, to get through this. Not being able to travel for vacations makes me crabby at times. And being old costs more. I spend a fortune on decent moisturizers for my face just so that I can get up after a call night and not look like John McCain's mother.

But you do mention what I think is rarely-discussed issue - some of us are "medical royalty," and some aren't. My dad was a successful lawyer but unfortunately he's passed away and my elderly mother lives on what he left behind. I'm the first physician in my family. My fellow students whose parents are practicing physicians often have a lifestyle that doesn't resemble mine at all - I'm reminded of that when I'm walking past late-model Infinities and Range Rovers in student parking in order to get to one of my two 10+ year old, paid-off, automobiles.

I understand that being older and not making a lot of money is difficult, but when you realize that it is only temporary, it is not bad at all. As for the national averages, they apply to older males as well. If you want to see real sadness, go to one of the libraries where adults in their 40s are working side-by-side with college students in low-rank positions making around minimum wage. Or what about males in their 50s making pizza deliveries or without any jobs who can't support their family? That is sad and it hurts me every time I see it. On the other hand, you should be proud that you are on a path that will lend you a well-paid position only achieved by the highest level of education available. That is not something to be ashamed of, even if you have to "endure" years of average US income!


$40K is FAR from abject poverty. If you are judging your success based on what cars other people drive and only want instant gratification, I don't think you can ever be happy. You are in Oklahoma. You want to see what real cars look like? Come here to SoCal where almost every day you can see Audis, Lamborghinis, and Ferraris. What will you do then? Become even more depressed? You see, I actually used to be somewhat insecure in this area. You can't assume that because I am younger I don't care about being successful. I mean you want to have a nice car especially when you're young because young people like to brag about their cars, flaunt it, and pick up girls. But what I realized is two things: 1. Most of the younger people driving fancy cars have not earned it themselves. They have a rich daddy who bought it for them, 2. There are many people who drive cars they can't actually afford (this is the largest category). So, I actually bought a new car and my payments are almost as high as it would take me to lease an Infinity or an Audi. Could I drive those cars? Of course! Would I? No, because that is not the most financially sound decision. In fact, except in rare instances, I have no respect for someone who wastes money on an expensive car and for me that is the opposite measure of success. I hang out with some wealthy/rich people. Do you know what they drive? A hybrid. The wealthiest man on earth, the owner of Walmart, drives an old pick up truck. Do you still really think that owning a fancy car is a measure of success? Expensive brands, be it a car or clothing, are especially consumed by people who can't afford them. Why? Because they want everyone to think that they are successful. This is true conspicuous consumption, which is actually ostentatious in SoCal. If you believe in your success, you don't need to spend time and money proving to others that you are successful. Instead, you'll save your money and invest it and stay away from Lambroghinis even if you can afford them. That's not success.

 

[Excelsius]

Totally true! Most people can't retire at 50, many can't even retire in their 60s (especially nowadays). The earliest I can be to get SS would be 67 and even that is no guarantee.

I live in Florida so there are definitely a lot of retirement-age people down here, but if people look closer, many will see that there are a lot of 60+ people having to return to work or continue working longer. If I am going to have to work longer, I want to do it in an area that gives me a sense of fulfillment.

For myself, I'm not even considering full-retirement, and as long as I am able, I will work in either in the clinical arena or possibly the academic...they'll have to unclench my hand from around my stethoscope when it is my time to go!

If you love your job, you wouldn't want to retire in the first place. If you choose a specialty that you don't like (because of shorter residency duration), then you will want to retire ASAP. That's another reason why interest in specialty must supersede any consideration of residency duration.

 

[Excelsius]

... I spend a fortune on decent moisturizers for my face just so that I can get up after a call night and not look like John McCain's mother.
...

P.S.: You don't have to spend fortune on moisturizers. If you do some research, you'll see that some of the best creams are the natural ones and they cost nowhere near a fortune. I got interested in this when my gf started wondering about the science behind the skin. Here is what my research found:

1. The number one enemy of your skin is the sun. So the first thing you have to do before even you think about anything else is use daily sunscreen on your face to protect the skin from UV. Not doing this is similar to intentionally wrecking your car so that you can take it to a body shop. Make sure that the SPF is for UVA and UVB. Also, SPF between 15 and 30 is fine. Anything beyond 30 adds little usefulness.

2. The second enemy is dryness, This is where the moisturizer comes in. The best moisturizers are the natural ones which are very inexpensive. So all you need for your face is natural shea butter. It gets absorbed into the skin and thoroughly moisturizes it. Understand that if you are spending a lot of money on those creams with more chemicals in it than tobacco, you are actually hurting your skin and possibly developing chemical dependency.

3. Be active. Eat healthy and go to the gym.

4. The final step is damage control. This is where you can use natural exfoliators and coenzymes to fight off wrinkles (which will really slow down if you are diligent about #1, #2, and #3 above in the first place).

Anyway, I probably went into too much details, but it serves as an example that nothing is what it seems. Just like with skincare, you can save money in other areas too and actually do better than if you had spent more money. Higher price doesn't equal better product.

P.S.: You also never buy vitamins from a place like Ritaid. Specialty stores have the right vitamin versions at better prices, but the best place to get them is online. You shouldn't be taking any vitamins without researching them. Example: many store vitamins are artificial. Vitamin E is dl-tochopherol and had been found by JHU to actually increase mortality in older people. The natural vit E is d-tocopherol and includes all four forms of tocopherol and tocotrienol. Interpretation: the vitamin E that you buy at the store is only 1/8th vitamin E and 1/2 of it is useless garbage that is not known what effect it has on your body. Doctors are chumps! It is their fault that this industry is not regulated. If it was up to me I'd force such a string vitamin labeling requirements than 80% of the companies doing business right now would go out of business. So wrong.

 

[Non-TradTulsa]

If you are judging your success based on what cars other people drive and only want instant gratification, I don't think you can ever be happy. You are in Oklahoma. You want to see what real cars look like? Come here to SoCal where almost every day you can see Audis, Lamborghinis, and Ferraris. What will you do then? Become even more depressed?

Easy, pony. I was only making the point that some students who are living on loans have access to funds from their physician parents, giving them lifestyles that are different than those of us who actually live on loans. I neither said nor implied that the expensive new cars bothered me - I couldn't care less. Been there, done that, wanted something in my life less vacuous - therefore, medical school.

I live on my loans, but I have access to a whole lot more than that if I were dumb enough to spend it - remember, I was a healthcare executive for over 20 years. Which didn't make me rich, but it did make me comfortable. I rarely if ever invite other students into my home because, while I try to live on my loans, I still live in the house where I lived for many years before I started medical school. Not many students get to live in a comfortable house in the suburbs with things like decent furniture that one collects over a couple of decades. I got to keep my things and still live on loans because most of what I have is paid-for. I'm very fortunate.

And while I will concede that Southern California (both my parents were originally from Los Angeles) is the conspicuous consumption capital of the world, don't be so quick to write off Oklahoma. My home city of Tulsa from the beginning of the 1920s to the end of WWII had more millionaires than anywhere else in the world. There is still a staggering amount of old oil money around here, and a very rich tradition of culture and graceful living that can only be found in the more well-heeled parts of the South. Come visit us here, and I'll show you real wealth that wasn't financed with second mortgages and isn't collapsing like a house of cards. And I'll show you the local Lamborghini and Rolls/Bentley dealerships, of course.

 

[Scottish Chap]

To all of the nontrads here who are starting med school in their mid-20s to late-30s:

Because you are starting medical school at a nontraditional age, do you feel limited in your choice of residencies (disregarding performance on the USMLE steps)? Are you only considering shorter residencies like internal medicine? Or, do you think you can go for the long haul, i.e., orthopaedic surgery, ophthalmology?

Yes. I just finished medical school at 32. People change a lot during medical school. I am also graduating with a three-year-old, and my mindset is very different from when I started. I interviewed for seven-year ABIM Research Track positions (protected time for research and guarantees a cardiology fellowship out of medical school so no need to move the family twice). However, my daughter will be 10 and I'll be 39 if I go this route. I decided to rank tier one three-year programs ahead of the 7-year programs to leave more doors open and to provide an 'out'. If I want to be a hospitalist in three years and work one week on/one week off, I can. If I want to open a practice, I can. If I want to do a fellowship, I can.

Several other things changed after I was accepted to medical school: interest rates for loans increased, tuition increased, locked low interest rate consolidation for loans vanished, automatic loan deferment in residency vanished, family size increased, enthusiasm decreased (only a wee bit 😉) etc. All of these definitely factor into what you want to do and how long it takes. I didn't want to believe this four years ago, but I'm eating my words. If you're >30 and thinking about medical school, think very carefully. Only do it if you absolutely cannot be content doing anything else and only attempt it if your family is 100% supportive.

FYI: ophthalmology is actually a pretty good choice for a non-trad (great hours, great pay, and only three years + a prelim year). It's a GREAT field, and it's interesting. I almost went this route, but I just couldn't surrender all the other medical stuff that I've spent four years trying to master.....

 

[Scottish Chap]

If I were single, I'd be more likely to pursue a long residency. I'm interested in surgery, but I've decided that I'm not going to pursue it unless I feel that there's nothing else in medicine I want to do. The reason for this is that by the time I finish med school, my boyfriend will have been supporting both of us on his salary alone for eight years. He has been delaying starting his PhD so that I can focus on my education. As soon as I can pull in an appreciable salary (as an attending), he can focus on finishing his education. I think that's fair.

Delaying starting his Ph.D.? If you're accepted for next year to medical school, it will be at least 2017 before you pull an attending's salary, and that's doing the shortest residency out there (family medicine, internal medicine, peds). If your boyfriend starts his Ph.D. then, it will be around 2023 before he gets it. It's late, and I'm obviously posting 'tounge-in-cheek' but, unless I'm missing something, how on earth is that "fair"? 😱

 

[DocSomeday]

The length of residency doesn't scare me - I'll do some IM fellowship (Cardio, Onco, Derm, etc) or surgery, hopefully. The competitiveness of certain residencies/fellowships is a huge deterrent for me. A one year layover for not matching to any residency when I support a wife and 2 children is not an option. Not only that but it is hard to uproot a family of four and end up going to my last choice for match. What I end up doing for my residency will be directly correlated to my performance on boards and in medical school. I would definitely be willing to do something shorter/less competitive if it meant matching at my first choice on my first attempted match year. I don't think I would ever do Family medicine simply because there are very little fellowship opportunities post-residency. I'd probably go Psy. if I didn't feel like I could get into a very competitive residency since that area is directly related to my graduate studies.

BTW - great thread.

 

[Law2Doc]

That number is a joke. It's four years shy of being relevant. The average is not as telling as a median would be.
...

I would also suggest that $130k isn't even the number any longer. Last I heard (in the annual financial aid presentations they put folks through in school), the average is more like $160k. And there will be people at every school who break the $200k figure. There will even be people still burdened with undergrad or prior degree debt who break the $300k figure, which I think will impact your livelihood for many years. So I wouldn't plan on paying anything down during residency. You tread water during those years.

 

[Klemptor]

Delaying starting his Ph.D.? If you're accepted for next year to medical school, it will be at least 2017 before you pull an attending's salary, and that's doing the shortest residency out there (family medicine, internal medicine, peds). If your boyfriend starts his Ph.D. then, it will be around 2023 before he gets it. It's late, and I'm obviously posting 'tounge-in-cheek' but, unless I'm missing something, how on earth is that "fair"? 😱

You are missing something, but I think it's because I didn't do a great job of explaining. I put off my education for six years to support us while he worked on finishing college and establishing his career. Then when he began earning enough money to support us both, I quit working and began college. I guess we've been taking turns at getting educated.

It's not like he's spinning his wheels with no forward progress. He works full-time at a job he loves. He's in the middle of doing his Master's program part-time right now, and he hasn't even started his thesis yet. Also, I should mention that he's doing graduate work for his own enjoyment, not for any advantage that it'll give him in industry. So he's happy to focus on his career right now and take his graduate work slowly.

The other option is that he pursue a part-time PhD program (I believe Temple offers one that appeals to him) in which case he could start it sooner and have his job pay for it. But that's his call.

 

[Excelsius]

Easy, pony. I was only making the point that some students who are living on loans have access to funds from their physician parents, giving them lifestyles that are different than those of us who actually live on loans. I neither said nor implied that the expensive new cars bothered me - I couldn't care less. Been there, done that, wanted something in my life less vacuous - therefore, medical school.

I live on my loans, but I have access to a whole lot more than that if I were dumb enough to spend it - remember, I was a healthcare executive for over 20 years. Which didn't make me rich, but it did make me comfortable. I rarely if ever invite other students into my home because, while I try to live on my loans, I still live in the house where I lived for many years before I started medical school. Not many students get to live in a comfortable house in the suburbs with things like decent furniture that one collects over a couple of decades. I got to keep my things and still live on loans because most of what I have is paid-for. I'm very fortunate.

And while I will concede that Southern California (both my parents were originally from Los Angeles) is the conspicuous consumption capital of the world, don't be so quick to write off Oklahoma. My home city of Tulsa from the beginning of the 1920s to the end of WWII had more millionaires than anywhere else in the world. There is still a staggering amount of old oil money around here, and a very rich tradition of culture and graceful living that can only be found in the more well-heeled parts of the South. Come visit us here, and I'll show you real wealth that wasn't financed with second mortgages and isn't collapsing like a house of cards. And I'll show you the local Lamborghini and Rolls/Bentley dealerships, of course.

Pony? You compared your old car to the luxury ones of others... Maybe I misinterpreted the reason you brought it up.

Didn't know that about Oklahoma. I guess besides CA and the east coast I don't know much else about the middle of the country. I have a certain bias about the deep south, but I might be wrong about that too. If I visit OK, I'll let you know.

 

[Excelsius]

I would also suggest that $130k isn't even the number any longer. Last I heard (in the annual financial aid presentations they put folks through in school), the average is more like $160k. And there will be people at every school who break the $200k figure. There will even be people still burdened with undergrad or prior degree debt who break the $300k figure, which I think will impact your livelihood for many years. So I wouldn't plan on paying anything down during residency. You tread water during those years.

As of 2007, which seems to be the latest survey, the debt is $139,517 (AMA). What you're talking about probably includes ALL debt, undergrad and medschool. Note that 25%, which is a large number, graduate with less than $100K debt.

Now average means that half the students have debts far below 130K, especially since you have some who have close to 300K. To me, this means that if you have a much larger debt than the national average than it is your own fault. Probably didn't play the game right. I don't think having an undergrad debt is justified unless you are attending a top private university. There is just no reason not to attend a good state university and go to a similar private university where the tuition is double or triple. The same is true for medschool. If it is not a top school, it is better to go to a state school. You can also choose to apply to schools that have either low tuition or are known for large grants (Mayo, CCLM). And if you attend a school as a non-resident, you should move there before the summer starts, get a job, and after a year you'll be paying a resident tuition (at least this is the CA residency requirement).

Finally, you do have the option to work in the research lab while in medschool and start paying off your debt once you start earning average US income in your residency. Note that it doesn't matter if you have an SO or not. In fact, having an SO will make it easier since two incomes can approach 100K. More like 200K if she's a lawyer.

 

[Scottish Chap]

As of 2007, which seems to be the latest survey, the debt is $139,517 (AMA). What you're talking about probably includes ALL debt, undergrad and medschool. Note that 25%, which is a large number, graduate with less than $100K debt.

Now average means that half the students have debts far below 130K, especially since you have some who have close to 300K. To me, this means that if you have a much larger debt than the national average than it is your own fault. Probably didn't play the game right. I don't think having an undergrad debt is justified unless you are attending a top private university. There is just no reason not to attend a good state university and go to a similar private university where the tuition is double or triple. The same is true for medschool. If it is not a top school, it is better to go to a state school. You can also choose to apply to schools that have either low tuition or are known for large grants (Mayo, CCLM). And if you attend a school as a non-resident, you should move there before the summer starts, get a job, and after a year you'll be paying a resident tuition (at least this is the CA residency requirement).

Finally, you do have the option to work in the research lab while in medschool and start paying off your debt once you start earning average US income in your residency. Note that it doesn't matter if you have an SO or not. In fact, having an SO will make it easier since two incomes can approach 100K. More like 200K if she's a lawyer.

Agree and disagree (mostly the latter). Unless you're talking about medical schools in California or Texas, most state medical schools won't have tuition that's a third of a private medical school.

I hate this fact, but it's true: pedigree matters if you want a competitive residency or if you become interested in a competitive field (impossible to predict before med school...most people change their mind when they gain first-hand experience). Even people graduating at the top of their med school class with stellar board scores from relatively unknown state medical schools are being picked after tier one (and two) private school graduates ceteris paribus. Don't believe me? Take a look at where most of the residents at those programs went to medical school...

Also, wining an offer from any medical school is a massive achievement. It's quite different from being admitted to an undergraduate college. Yes, you can choose to apply to Mayo etc., but you don't choose to win an offer of admission from them. If you get one offer for the former, you're doing amazingly well. At one of my residency interviews last year, I met a New York State resident who was only admitted to a very expensive private medical school in a very expensive city (she didn't get to choose either). With only medical school debt, she told me she owes a little under 300K....before compounding interest, and she wants to do primary care. Why did this happen? It was the only medical school that gave her a shot at the dream.

The number quoted may not represent the big picture. Although the mean med school debt for my year at my school was quoted as 135K, I can tell you that many of my classmates enjoyed full tuition waivers courtesy of their wealthy family. Several graduated with 200K from med school alone.

Also, keep in mind that not every state medical school grants automatic instate tuition after year one and, if they do (like some medical schools out West), they'll get you good in year one with out-of-state tuition in the order of $65,000.....without living expenses.

Lastly, getting a job before medical school or during is not as easy as it sounds and does it really make a difference? (I should know, I worked in MSI). You will see just how different medical school is from undergraduate if you do not give it your full attention and respect every day. You'll be buried. Paying back during residency? (this is the non-trad forum...many of us have kids). It's not going to happen.

It's easy to be flippant about choices. High medical school debt burden is not as black and white as poor choices. Sometimes it's just reality.....

 

[Excelsius]

Agree and disagree (mostly the latter). Unless you're talking about medical schools in California or Texas, most state medical schools won't have tuition that's a third of a private medical school.

I hate this fact, but it's true: pedigree matters if you want a competitive residency or if you become interested in a competitive field (impossible to predict before med school...most people change their mind when they gain first-hand experience). Even people graduating at the top of their med school class with stellar board scores from relatively unknown state medical schools are being picked after tier one (and two) private school graduates ceteris paribus. Don't believe me? Take a look at where most of the residents at those programs went to medical school...

Also, wining an offer from any medical school is a massive achievement. It's quite different from being admitted to an undergraduate college. Yes, you can choose to apply to Mayo etc., but you don't choose to win an offer of admission from them. If you get one offer for the former, you're doing amazingly well. At one of my residency interviews last year, I met a New York State resident who was only admitted to a very expensive private medical school in a very expensive city (she didn't get to choose either). With only medical school debt, she told me she owes a little under 300K....before compounding interest, and she wants to do primary care. Why did this happen? It was the only medical school that gave her a shot at the dream.

The number quoted may not represent the big picture. Although the mean med school debt for my year at my school was quoted as 135K, I can tell you that many of my classmates enjoyed full tuition waivers courtesy of their wealthy family. Several graduated with 200K from med school alone.

Also, keep in mind that not every state medical school grants automatic instate tuition after year one and, if they do (like some medical schools out West), they'll get you good in year one with out-of-state tuition in the order of $65,000.....without living expenses.

Lastly, getting a job before medical school or during is not as easy as it sounds and does it really make a difference? (I should know, I worked in MSI). You will see just how different medical school is from undergraduate if you do not give it your full attention and respect every day. You'll be buried. Paying back during residency? (this is the non-trad forum...many of us have kids). It's not going to happen.

It's easy to be flippant about choices. High medical school debt burden is not as black and white as poor choices. Sometimes it's just reality.....

I don't think we disagree on anything. Sure, if you have been admitted to only one expensive school then you should take it. Wasting an extra year will not make financial sense anyway since as a doctor you will make much more than the annual tuition. However, the question is why did a person get into only one school? There can be several reasons, like maybe the person did not have the grades or, more often, did not apply to the right type and number of schools. So yes, it is still the person responsible for getting a higher tuition. Are there a few exceptions? Sure.

I also completely agree with the bolded part. In fact, it is other medstudents who scream all the time how schools name doesn't matter and I keep reminding them that it does. What I was saying is that if you have a choice to attend an unknown medschool that is private compared to an unknown public medschool, it doesn't make a difference. If we are talking about top 30 to top 50, does it really matter exactly which school is in this range? Likely not. Frankly, I have no idea if pedigree matters at all once you pass the top 20 mark (maybe you can help me here).

There is one more dilemma: let's say you have a full ride at a top 60 state school and you also have been admitted to Hopkins. The price difference here can be over 200K (almost half a million after the interest). So which one do you choose? This is a tough one, but I think that if you're interested in primary care, you should still take the free ride. If you're interested in plastic surgery in SF, then you pretty much have to take Hopkins. What school you go to is very individual specific.

 

[Excelsius]

By the way, check out this thread: School prestige as influence in match

I don't know if you knew about it, but I think that it is important for residents like you who have different opinions to stop by and show us the other side of the story. The main argument by medstudents is that students in low ranked schools blame the school name for not getting a match whereas in fact they just might not be good students and are seeking a scapegoat. I don't agree with this. From what I have seen is that you must be an all-star to even get a shot if you're from a lesser school, whereas those guys from top schools have something extra going for them even if average stats. Compensating for your school names and matching into competitive residency doesn't mean that the school name didn't matter (assuming you even get there).

 

[Non-TradTulsa]

Didn't know that about Oklahoma. I guess besides CA and the east coast I don't know much else about the middle of the country. I have a certain bias about the deep south, but I might be wrong about that too. If I visit OK, I'll let you know.

Now average means that half the students have debts far below 130K, especially since you have some who have close to 300K. To me, this means that if you have a much larger debt than the national average than it is your own fault. Probably didn't play the game right.

Yeah, we're "fly-over" country to you left-coasters. Actually, I've often thought of moving to SoCal for family reasons (plus, there's a lot about it that I like - I've fallen in love with the desert cities) but, for all the natural beauty, life to me out there is a struggle - astronomical housing costs and way, way too many people. But, I think in the final analysis, I would just miss the very unique city that I've always lived in (Tulsa is very much Southern, but Oklahoma is not part of the 'deep' South, BTW... the 'deep' South is the original secession states - in Indian Territory, some of our Native American tribes supported the Union, some the Confederacy - so we tend not to get into those discussions about past unpleasantries).

If you'll allow a CPA to correct you, though, you've confused the meaning of "mean" with "median." Median imples half have more debt, half have less - and that's not what the $130K statistic is - the $130K is a mean... which means if 7 students have $180,000 in debt each and 3 students have no debt at all - the mean is slightly less than $130K. That's why $130K is such a meaningless statistic. Quite a few students have physician parents who can afford to pay tuition and living expenses, allowing their children to graduate with no debt (no I'm no jealous, that's just how it is - and my own medical school class is probably 1/2 children of physicians, not all of whom are getting a paid ride, of course). This fact makes the mean deceiving. Look, just look at any tuition and living expense budget for a good mid-level medical school. Take mine, for instance - at the University of Oklahoma, for an in-state student, tuition and standard living expenses will run $45K years 1 and 2, and $50K for years 3 and 4.

What this means is, unless you have other sources of income, if you are prudent with money and just spend the standard living expense allowance (which means a cheap apartment and lots of Happy Meals), you will graduate from the University of Oklahoma with $190,000 in debt. This is not a big secret - this is based on current OU budgets approved by the Department of Education. If you are unfortunate enough to be OOS, that $190K price tag goes up to $270K. And OU is not an expensive school. I'm not advocating for any particular political solution to the problem of astronomical medical school costs - but I am saying... $130K? For the typical student who does not have an outside source of income, not the mythical "mean" student, my ***** it's 130K.

Also, working during your med school years is not realistic (Excelsius, you're extremely bright, but you're making some statements that are clearly based on your own conclusions, not hard experience). I saw maybe three or four students in my class try to work in the pre-clinical years, and I also saw their grades (and mental health) suffer considerably. If you plan to get six hours sleep a night and have perhaps a few hours a week of free time to keep from going insane, med school is a 100% full-time job. How much of a dent can you make in $50K annual borrowings by working for, let's say, $8-$12/hour for 10-20 hours a week? It's certainly not enough to make it worth the hit in your grades.

 

[Excelsius]

Yeah, we're "fly-over" country to you left-coasters. Actually, I've often thought of moving to SoCal for family reasons (plus, there's a lot about it that I like - I've fallen in love with the desert cities) but, for all the natural beauty, life to me out there is a struggle - astronomical housing costs and way, way too many people. But, I think in the final analysis, I would just miss the very unique city that I've always lived in (Tulsa is very much Southern, but Oklahoma is not part of the 'deep' South, BTW... the 'deep' South is the original secession states - in Indian Territory, some of our Native American tribes supported the Union, some the Confederacy - so we tend not to get into those discussions about past unpleasantries).

If you'll allow a CPA to correct you, though, you've confused the meaning of "mean" with "median." Median imples half have more debt, half have less - and that's not what the $130K statistic is - the $130K is a mean... which means if 7 students have $180,000 in debt each and 3 students have no debt at all - the mean is slightly less than $130K. That's why $130K is such a meaningless statistic. Quite a few students have physician parents who can afford to pay tuition and living expenses, allowing their children to graduate with no debt (no I'm no jealous, that's just how it is - and my own medical school class is probably 1/2 children of physicians, not all of whom are getting a paid ride, of course). This fact makes the mean deceiving. Look, just look at any tuition and living expense budget for a good mid-level medical school. Take mine, for instance - at the University of Oklahoma, for an in-state student, tuition and standard living expenses will run $45K years 1 and 2, and $50K for years 3 and 4.

What this means is, unless you have other sources of income, if you are prudent with money and just spend the standard living expense allowance (which means a cheap apartment and lots of Happy Meals), you will graduate from the University of Oklahoma with $190,000 in debt. This is not a big secret - this is based on current OU budgets approved by the Department of Education. If you are unfortunate enough to be OOS, that $190K price tag goes up to $270K. And OU is not an expensive school. I'm not advocating for any particular political solution to the problem of astronomical medical school costs - but I am saying... $130K? For the typical student who does not have an outside source of income, not the mythical "mean" student, my ***** it's 130K.

Also, working during your med school years is not realistic (Excelsius, you're extremely bright, but you're making some statements that are clearly based on your own conclusions, not hard experience). I saw maybe three or four students in my class try to work in the pre-clinical years, and I also saw their grades (and mental health) suffer considerably. If you plan to get six hours sleep a night and have perhaps a few hours a week of free time to keep from going insane, med school is a 100% full-time job. How much of a dent can you make in $50K annual borrowings by working for, let's say, $8-$12/hour for 10-20 hours a week? It's certainly not enough to make it worth the hit in your grades.

By mentioning the Deep South I meant it as separate from OK and the rest of the middle of the country. I am actually biased towards the Deep South because of the recent civil rights history. Even though OK is so close to the rest of the states that had big problems with civil rights, I don't recall it even being mentioned in my civil rights history readings. You guys must be culturally closer to New Mexico and the east coast rather than Louisiana and the rest of the states.

No, you're right about the mean, assuming that's what they meant by average. The reason I said half was because it seems to me that there are many more students with debts over 200K than students with almost free rides (according to SDN sample, which already has above average and well-informed applicants). Therefore, in order to come up with the mean of 130K when you include all those with 250K+ debts you need even more students with less than 130K to counterbalance those. For example, for every one students who has a 300K debt you need six more students with 100K debt to balance that. Again, assuming that full rides are not that common. But your other point is interesting: if you are right that students whose parents pay off the full tuition are included in that "debt free" category, then the statistics can be skewed. We would have to know for what percentage of students this is true to have a better idea about the average debt.

The reason I said that working in medschool might work was because in the allo forum I see a lot of medstudents bragging about the free time they have and how it is similar to college or easier. Another reason is that you have free summers in medschool, right? If that's the case, you can work full-time and do a part-time in a research lab. Then there is that issue with research that some program directors want to see you have in your resume. You can get paid for this and satisfy the research with one go. The final reason is that for every thousand dollars that you knock off in medschool you will be saving another thousand once all the interest is compounded after an average length residency at current interest rates. So if you are making $8/hr, it is in fact $16/hr. Not a bad deal. If I omitted something, let me know. Since you have been a CPA, you might be able to really exploit your tax deductions once you become a resident. I know that CPAs get $150 or more per tax return. With your skills, don't you think you could do at least 2-3 returns a week? That would be easy money. Then again, nothing beats an escort service! I have heard of couple of premeds do something similar, but don't know if they continued their "passion" once they matriculated. I joke with my friends sometimes that maybe that's what I should do and have to work only one day a month. Maybe I'll get to meet the speaker of the house and get a good recommendation letter for Harvard. Hahahahaha.

 

[Trismegistus4]

What is your take on working while in medschool? From what I have learned in Allo is that medstudent have a lot of free time on their hands. You should be able to squeeze in at least a part time job, right? And by that I mean something like research that not only will pay you but also look good on your resume for some specialties. Plus, there is no school during summer, right? So that should be three months of full time work. You can also make some money on the internet if you know how to build a website.

You might have some spare time the first two years--Lord knows how much procrastinating I did--but it's too unpredictable to commit to a job. The internet, on the other hand, is an idea that could work. I didn't know about for-profit blogging until the beginning of 2nd year, and by then the work was piling up too deep, but I wish I had time to try it. The start-up costs are essentialy zero, and who knows, you could become the next Arnold Kim! Most people won't be that successful, of course, but if all it costs you is a few hours a week and a free Blogger.com account, it's worth a try.

Another reason is that you have free summers in medschool, right?

Only the summer between first and second years. 3rd year starts immediately after 2nd year and takes up all of your time, except the time I'm spending posting on SDN right now, of course. 😀

 

[Non-TradTulsa]

By mentioning the Deep South I meant it as separate from OK and the rest of the middle of the country. I am actually biased towards the Deep South because of the recent civil rights history. Even though OK is so close to the rest of the states that had big problems with civil rights, I don't recall it even being mentioned in my civil rights history readings. You guys must be culturally closer to New Mexico and the east coast rather than Louisiana and the rest of the states.

Ah, no. How old are you? You're beginning to sound like an articulate high school student. Check the history books again - the largest riot ever to occur within the United States was in Tulsa, Oklahoma, in May, 1921. One of the most vibrant and prosperous black enclaves anywhere in the country outside of Harlem, the "Black Wall Street of America," was utterly destroyed. The struggle for civil rights in Oklahoma was (and is) a long and difficult one.

However... not to "get even" or anything silly like that - but did your civil rights readings spend much time on California? How Oriental immigrants were horribly mistreated in California ever since they were imported to complete the trans-continental railroad - mistreatment that culminated in the forced relocation of American citizens who happened to be of Japanese ancestry to internment camps during World War II? The Attorney General of Calfornia at the time, Earl Warren, first suggested the internment to Roosevelt and there was very little Anglo outrage in California. The relocation was perhaps the greatest wholesale violation of civil rights of U.S. citizens in American history. In fact, the wholesale mistreatment of white Oklahomans who emigrated to California in the 1930s (who were frequently arrested, beaten, and - on a few occasions - killed) is another story California has no reason to take pride in. Steinbeck's "Grapes of Wrath" is fiction but based on fact.

My only point here is that, if you're going to dislike certain parts of the country for things that happened 50 years or longer ago, you can find plenty of blame to go around almost anywhere. Having a particular dislike for the South reflects a rather parochial understanding of contemporary U.S. history.

Back to medical school business. Yes, I've seen posts on SDN on how much "free time" certain students claim they have. It's a rather childish game of "mine's bigger than yours." Everyone studies in medical school - it fills almost all of your waking hours in the first 2 years. It's not like your undergraduate years where, if you're smart enough, you can learn all the material in a week before the exam. Nothing in medical school is rocket science, but the volumes of material are absolutely overwhelming. People who say they don't study are lying. Period.

 

[Law2Doc]

...
Now average means that half the students have debts far below 130K, especially since you have some who have close to 300K. ....

I still have to say that your debt numbers are low for the current year based on what they are presenting in med school fin aid meetings (a $160k figure is what's generally mentioned), but we'll put that aside. I'd say that in this average actually more than half have higher than average debts since some percentage have their tuition paid by family - more than those who have $300k debt. So let's say the average is $150k (or 130k or whatever you want), 10% have their bills paid by family with no debt, and something like 1% borrow in the order of $300k, that means the majority likely will be above average. Not, as you say, skewed lower because of the couple of extreme cases with $300k in debt. There are more zero debt people than top number people so of those who borrow the debt is going to be above average.

 

[Doctor Bagel]

To answer the original question, yeah, I'd consider doing a long residency/fellowship if that was what I really wanted to do. Regardless of your age, you're going to be working a lot longer in your field than the time you're going to spend in residency, so if you really like a field with a longer residency, then it's probably worth it.

 

[netminder]

To all of the nontrads here who are starting med school in their mid-20s to late-30s:

Because you are starting medical school at a nontraditional age, do you feel limited in your choice of residencies (disregarding performance on the USMLE steps)? Are you only considering shorter residencies like internal medicine? Or, do you think you can go for the long haul, i.e., orthopaedic surgery, ophthalmology?

Absolutely, absolutely, yes, I will, if God graces me with the Step I scores, apply to a crazy competitive, long residency like orthopaedic surgery. I will be in my late 30's (or maybe almost 40) when I start medical school, but I can't see not doing what you love with a vibrant passion just because it will take say, 11 years (including med school, fellowships, for something like ortho, or neurosurgery) vs. 7 years for something like IM, peds, etc. Don't get me wrong, if I fall in love with IM or peds, I will pursue that with a passion. But right now, I am intrigued by ortho for many, many valid reasons. If I'm in my late 30's, why would I let a four-year difference get in the way of the rest of my life? People in my family live to be >100 and work until their mid 70's, at least. If God gives me this kind of stamina, good health, and good fortune, I have to go for it. I can't wait to get started.

 

[Excelsius]

You might have some spare time the first two years--Lord knows how much procrastinating I did--but it's too unpredictable to commit to a job. The internet, on the other hand, is an idea that could work. I didn't know about for-profit blogging until the beginning of 2nd year, and by then the work was piling up too deep, but I wish I had time to try it. The start-up costs are essentialy zero, and who knows, you could become the next Arnold Kim! Most people won't be that successful, of course, but if all it costs you is a few hours a week and a free Blogger.com account, it's worth a try.


Only the summer between first and second years. 3rd year starts immediately after 2nd year and takes up all of your time, except the time I'm spending posting on SDN right now, of course. 😀

Thanks for clarifying the summer issue. I also didn't know that the guy who owned macrumors.com was a medstudent. He must make a fortune from that website to quit his job as a doctor. Luckily for the rest of us, making a few hundred dollars/month from a website does not require excessive work, though if you could dedicate some serious time for a few months and then hire cheap labor, I guess you can eventually just sit aside and have the money come in. As I have learned from experts on numerous occasions: you don't get rich on a salary; you have to have others work for you and pay them less for the labor than it is really worth.

 

[Excelsius]

Ah, no. How old are you? You're beginning to sound like an articulate high school student. Check the history books again - the largest riot ever to occur within the United States was in Tulsa, Oklahoma, in May, 1921. One of the most vibrant and prosperous black enclaves anywhere in the country outside of Harlem, the "Black Wall Street of America," was utterly destroyed. The struggle for civil rights in Oklahoma was (and is) a long and difficult one.

However... not to "get even" or anything silly like that - but did your civil rights readings spend much time on California? How Oriental immigrants were horribly mistreated in California ever since they were imported to complete the trans-continental railroad - mistreatment that culminated in the forced relocation of American citizens who happened to be of Japanese ancestry to internment camps during World War II? The Attorney General of Calfornia at the time, Earl Warren, first suggested the internment to Roosevelt and there was very little Anglo outrage in California. The relocation was perhaps the greatest wholesale violation of civil rights of U.S. citizens in American history. In fact, the wholesale mistreatment of white Oklahomans who emigrated to California in the 1930s (who were frequently arrested, beaten, and - on a few occasions - killed) is another story California has no reason to take pride in. Steinbeck's "Grapes of Wrath" is fiction but based on fact.

My only point here is that, if you're going to dislike certain parts of the country for things that happened 50 years or longer ago, you can find plenty of blame to go around almost anywhere. Having a particular dislike for the South reflects a rather parochial understanding of contemporary U.S. history.

Back to medical school business. Yes, I've seen posts on SDN on how much "free time" certain students claim they have. It's a rather childish game of "mine's bigger than yours." Everyone studies in medical school - it fills almost all of your waking hours in the first 2 years. It's not like your undergraduate years where, if you're smart enough, you can learn all the material in a week before the exam. Nothing in medical school is rocket science, but the volumes of material are absolutely overwhelming. People who say they don't study are lying. Period.

Whoa, easy there, cougar. It's not like I am attacking your state. Had I discovered SDN when I was in high school, I would have been graduating medschool soon. I have no idea why I don't know about Tulsa. My teacher in civil rights studies was black (in college) and he was pretty prominent too as he himself had been part of SNCC and had published books. As a science major, I took it as an easy class, but boy did I get shafted. I don't think I have ever done so much reading for any other class. We must have gone through many books disguised under "selected readings." I think I have a strong background in here and if he chose not to include the Tulsa riot, it means that it wasn't significant for advancing civil rights. The main part of the civil rights movement was defined to be between 1950 and 1970 anyway. I figure that there were a lot of riots in the country, but very few had any significance in terms of furthering their cause. Anyway, if I am wrong, feel free to correct me. And no, CA was not covered either. When I say "civil rights" I specifically refer to blacks. I know Asians were put in concentration camps around the time of WWII, but I don't know the specifics and dates, sorry. You seem to know a lot about civil rights though. Are you a minority or have been an activist?

I didn't say I "dislike" the Deep South. I just have biases and I am not the only one. Let's not forget, the lynchings in Alabama were less than 60 years ago. That is very recent. My teacher was beaten there. You can say what you want, but people don't change that fast. Many members of KKK and others are still alive in those states and they must be very conservative. It usually takes generations before things are cleansed. Did you see any CNN iReports during the election of people in places like Kentucky writing words "n!gger lover" on whites' properties who supported Obama? I can't imagine anything like that happening in CA. So there is some justification as to why some people are biased when it comes to Deep South or even places like Kentucky or Tennessee.

 

[Excelsius]

I still have to say that your debt numbers are low for the current year based on what they are presenting in med school fin aid meetings (a $160k figure is what's generally mentioned), but we'll put that aside. I'd say that in this average actually more than half have higher than average debts since some percentage have their tuition paid by family - more than those who have $300k debt. So let's say the average is $150k (or 130k or whatever you want), 10% have their bills paid by family with no debt, and something like 1% borrow in the order of $300k, that means the majority likely will be above average. Not, as you say, skewed lower because of the couple of extreme cases with $300k in debt. There are more zero debt people than top number people so of those who borrow the debt is going to be above average.

As I said above, you are right if we assume that students whose parents have paid off their tuition are not counted in the equation. I just thought that the people taking statistics would be smart enough to not do that or at least mention that they are excluding all those students. But again, the question remains as to what percentage of students have rich parents who pay their tuition. Until we know that, neither the 130K nor the 160K estimates mean anything. A better statistic would be how much the average students pays for medschool or what is the average grant for medschool students.

Any of you have used this website: http://www.school-grants.org/medical-grants.shtml ? They are saying that applying to medschool grants is very time consuming, but if you apply to many small grants, they might add up to something useful.

 

[Non-TradTulsa]

Are you a minority or have been an activist?

My apologies - now I understand a little better.

Am I a minority? Depends on how you define it, but probably. "My" people are creating a great deal of heated discussion in California just at the moment. And, yes, I'm fairly liberal - in the reddest of the red states. Most of the people I come into contact with in my daily life, however, see the world pretty much the way I do.

The South has a lot of stark contrasts. Tulsa is an extremely wealthy, well-educated, fairly liberal city - although the memories of the 1921 Tulsa Race Riot are still somewhat sensitive to this day. In the rural areas, it's quite different - you'll meet an awful lot of very poorly educated, poor, prejudiced people. Frankly, it's where the perjorative term "white trash" comes from. I would have to tell you, though, these days it's not so much that these people have a burning hatred of blacks. It's more that these people are dirt-poor with no education and things are only getting worse as the world becomes more technology-driven. For these folks, their European skin - in their minds - is the only thing that gives them a place in the status line that isn't at the absolute back-of-the-line - so they cling to that. That doesn't excuse the behavior - but I think understanding the motivation has some value. In passing, though, I would say that I've seen this same sort of dirt-poor ignorance in the Central Valley of California. Ever been to Tulare County? It's just as bad, or worse, than any of the poverty I've ever seen in Oklahoma. Some of the racism I've seen in inner-city Chicago or Boston is worse than anything I've ever seen in 21st Century Oklahoma - it's almost as if we made some peace with race issues in the South while parts of the Northeast and Midwest never have.

It's just a shame that your course stopped at 1970. The "new South" is kind of a silly buzzword - but there is a lot of truth to it. In the great cities of the South - Atlanta, Dallas - young graduates, black and white, are too busy with their careers and making money to worry much about race. These folks could move anywhere but they live in the South because they like it, just as I do. I was a small child in the 1960s, but I do remember some of the attitudes. They're gone now. Dallas, at the time Kennedy was killed, was the "hate capital of the South." Now, it's one of the most vibrant, progressive cities in the country.

 

[EricH]

Come here to SoCal where almost every day you can see Audis, Lamborghinis, and Ferraris.

I live in OC...and from a car watching perspective there is none better than the stretch of PCH that runs through Laguna/ Newport beach. At ANY given moment there is a handful of $250K cars on the road.

I like to get coffee at starbucks and watch the show. (with my 2000 accord parked out back)

 

[Excelsius]

I live in OC...and from a car watching perspective there is none better than the stretch of PCH that runs through Laguna/ Newport beach. At ANY given moment there is a handful of $250K cars on the road.

I like to get coffee at starbucks and watch the show. (with my 2000 accord parked out back)

Those must be the real housewives of Orange County cruising up and down while their husbands are busy doing surgeries.

I visited UCI medschool a few months ago and Newport was very pretty. However, we couldn't find a single restaurant where we could eat because everything had a wait time of an hour or more. We ended up driving all the way to LA until we could eat something! Those guys must be spending all their time eating and cruising.