NYT article on consulting, i-banking v. public service & med school

[nfg05]

Interesting article just got posted to the NYT homepage talking about how many of the smartest kids at top colleges are going into finance and consulting right now instead of public service, which the article and associated slideshow seems to imply includes med school despite its promise of a relatively high salary down the road.

The Times has written several articles about i-banking & consulting sucking away the top minds from med school but this one was interesting in that it talks about people feeling a moral obligation to serve someone other than themselves with their gifts and education (although who says you can't do that in consulting despite making good money. I-banking, however, is more of a stretch...).

http://www.nytimes.com/2008/06/23/education/23careers.html?_r=1&hp&oref=slogin

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[CoolSpot7Up]

Not too surprised it's happening. A couple of my friends got accepted to med schools, but turned them down for consulting and i-banking job offers with ridiculous salaries.

You get the payoff much faster with those jobs, so it's understandable why students choose it. It's highly respected, pushes your intellect, and makes lots of money. It's the same reasons lots of students choose medicine, except pre-meds usually prefer a more meaningful career over the instant payoff.

 

[nfg05]

Not too surprised it's happening. A couple of my friends got accepted to med schools, but turned them down for consulting and i-banking job offers with ridiculous salaries.

You get the payoff much faster with those jobs, so it's understandable why students choose it. It's highly respected, pushes your intellect, and makes lots of money. It's the same reasons lots of students choose medicine, except pre-meds usually prefer a more meaningful career over the instant payoff.

The point I've been thinking about a lot lately though is that IS medicine necessarily more meaningful service-wise than consulting? I just had a very interesting conversation with a McKinsey consultant in her late 20s now with an MD from Hopkins and MBA from Duke. She said she quit residency because the healthcare delivery system was so broken and she wanted to do something to fix all the problems and inefficiencies she was dealing with.

Healthcare consulting at McKinsey lets her do work that isn't soul-less and isn't all about money while using the knowledge gained from her Hopkins MD?. Take that and not having to deal will the BS of practice including:
1. reimbursement
2. malpractice
3. lack of autonomy due to insurance companies

AND a salary comparable to or more than many practicing specialties, it really starts to look attractive and the "but it's morally bankrupt and won't make you feel good at night" argument doesn't seem to hold water.

 

[CoolSpot7Up]

I think her case is rather unique. The article refers more to those who enter the business world and ONLY focus on business versus those who do medicine and ONLY focus on medicine.

The person you spoke with got her MD then MBA and is fixing the health system as a consultant. She is actually getting the best of both worlds. She gets the satisfaction of helping people by fixing the system, and the perks of being in the business world.

I think the fact that students are choosing the business path over medicine is fine, since those students might not have been dedicated to studing medicine anyway. Maybe those were the people who wanted to be a doctor for the money, learned that business is the new way of getting rich and switched sides. It could be better that the peolpe who truly want to do medicine are the ones sticking to their plan.

 

[dobbysamosa]

It doesn't bother me so much that otherwise talented individuals are being diverted away from medicine into business...they probably wouldn't be as passionate, plus hey, less competition for us

But it is indeed sad that many intelligent people don't feel compelled to use their talents (and the university's educational investment in them) for the greater benefit of society. Some consulting positions can be fulfilling, depending on the field, but man I'd probably shoot myself before going into i-banking...It's all about helping the rich get richer, IMHO.

But then again, I'm planning on going into academic medicine so maybe I'm a tad more idealistic than the average person.

 

[engineeredout]

If you're smart enough, get a degree from an excellent business school like NYU, have the connections, you could find yourself a millioneer in your mid twentys going into I banking. Yeah you'll have to work 80/90 hours a week, but so do residents, for a fraction of the money. Something like that would definitely be very appealing to some, over an extra four years of school + four years of bitch.

 

[TheRealMD]

Medicine = reliable. Business = not reliable. Though a smart person would take the money earned from i-banking and what not and save/invest, most people simply don't do that. If a person is good enough to invest with their own money, they'd be working 80/90 hours for themselves, not for someone else.

 

[Narmerguy]

I-banking isn't as easy as everyone makes it out to be.

 

[Nilf]

Medicine = reliable. Business = not reliable.

No, no, no. Death and taxes, but not medicine.

When you are looking at an established attending, you're looking at the endproduct of a long production line... line that has low but constant attrition rate at all steps. I'd ballpark that every year at medschool, residency, and fellowship and beyond, there is a low but constant dropout/attrition of circa 1-5%. Over years... it adds up... Do math... 0.99 to the power of the number of years of medical education... let's say 0.99^10= 90%. 10% of overall dropout. Not insignificant.


It's actually higher during residency than in medschool. Hell, these days people drop out form medicine and start new careers even when they are attendings. Check out McKinsey website, and you'll find plenty of stories of ESTABLISHED attendings turned consultants.

Then there are dropouts from whatever reason: loss of license, forced out of specialty bc/ of malpractice, can't find jobs, etc...

 

[flip26]

These things go through up and down cycles...medicine is a bit of a precarious choice these days...the people opting out of medicine for I-banking is still pretty small no matter what the anecdotes, and it is probably a wise choice for the people eschewing medicine...our economy has had periods in the last 40 years where Wall Street got crushed and tons of these people got tossed out on their ear...

I say if someone is really having this internal debate and thinks they could go either way, take the path of least resistance, namely I-banking or whatever over medicine...

 

[TheRealMD]

No, no, no. Death and taxes, but not medicine.

When you are looking at an established attending, you're looking at the endproduct of a long production line... line that has low but constant attrition rate at all steps. I'd ballpark that every year at medschool, residency, and fellowship and beyond, there is a low but constant dropout/attrition of circa 1-5%. Over years... it adds up... Do math... 0.99 to the power of the number of years of medical education... let's say 0.99^10= 90%. 10% of overall dropout. Not insignificant.


It's actually higher during residency than in medschool. Hell, these days people drop out form medicine and start new careers even when they are attendings. Check out McKinsey website, and you'll find plenty of stories of ESTABLISHED attendings turned consultants.

Then there are dropouts from whatever reason: loss of license, forced out of specialty bc/ of malpractice, can't find jobs, etc...

Mmk. Edited version:

Medicine = more reliable. Business = much less reliable.*

*These are in comparison to each other and not the most reliable things on the planet: death & taxes.

 

[batman1983]

Im willing to bet with the economic downturn, there are going to be more med applicants soon

 

[nfg05]

The prospects for I-Bank recruiting this year look pretty bleak. Many of my friends at the bulge brackets (I'm a rising senior) are fighting for the precious few full-time offers available at the end of this summer for the summer analysts. They know with just about every bank (including GS) laying off thousands right now, very few I-Banks are going to be in a hiring mood come this fall.

 

[MsJLewis]

A close friend of mine (graduated from an ivy last may) was a first year analyst at an NYC consulting group. Due to the economic crises, they laid off half of the first year class in addition to a variety of cuts in other (more senior) departments. She happened to be one of those that got cut.

So yea, I do think medicine is more reliable. But it may not give you the most bang for your buck (or time).

 

[Wylde]

No, no, no. Death and taxes, but not medicine.

When you are looking at an established attending, you're looking at the endproduct of a long production line... line that has low but constant attrition rate at all steps. I'd ballpark that every year at medschool, residency, and fellowship and beyond, there is a low but constant dropout/attrition of circa 1-5%. Over years... it adds up... Do math... 0.99 to the power of the number of years of medical education... let's say 0.99^10= 90%. 10% of overall dropout. Not insignificant.


It's actually higher during residency than in medschool. Hell, these days people drop out form medicine and start new careers even when they are attendings. Check out McKinsey website, and you'll find plenty of stories of ESTABLISHED attendings turned consultants.

Then there are dropouts from whatever reason: loss of license, forced out of specialty bc/ of malpractice, can't find jobs, etc...

Quitting (attrition) does not mean something is less reliable.

When people are talking about reliability with respect to professions, they mean the security of maintaining your career if you so wish.

Doctors are fired at a rate far far far lower than a consultant/ibanker/etc. and that was the person's point.

 

[jake2]

Can't talk about finance, but I did a summer with the Boston Consulting Group as an MBA-level consultant back in the day after a different graduate degree before going into medicine.

Was a good job. Paid real well, got treated nice, work was interesting enough in its own way. Hours were long but not that bad compared with medical hours.

At the end of the day, though, you're just coming up with new ways to sell soda or toilet paper (no joke, we had several toilet paper clients), and unless you're one of the rare 1 in 30 or so that makes partner, your ultimate exit is into one of random corporations you worked for into an executive position in charge of selling said toilet paper.

And you're still working in a large corporation with all that entails. Jerk bosses, annoying coworkers, lots of time in cubicles (in your client sites), see "office space" and "the office" for more details. Granted modern medicine has turned out to be a lot more like that than I hoped, but you can always opt out into your own practice or into academia in the end.

So in the long run, in my humble opinion, if you just want a job, consulting is a pretty darn good option. If you want anything more fullfilling from work, though, might as well start that "service" career now.