I'm a medical student with several friends from college in pharmacy. Here's my opinion:
First off, you don't have to decide now. You really don't have to decide until your junior year of college, although deciding by sophomore year might make volunteering/clinical time easier. Pre-med and pre-pharm are essentially the same in regards to pre-reqs and there is a lot of overlap between clinical experience for the two (working in a pharmacy will earn you some credit for medical school and working in an ER will earn you some credit for pharmacy school). And whatever you do, don't think you know what you want to go into specialty-wise. You need to be in love with pharmacy or medicine as a profession before you start thinking about clinical pharmacy vs retail pharmacy vs hospital pharmacist or neurosurgery vs cardiology vs emergency medicine. You don't know enough about the science or the clinical practice of these specialties until you are well into pharmacy or medical school.
With that being said I'm sure you want a more immediate answer, so I'll give one. You need to determine what you'll enjoy doing most importantly. If you desperately want to be the one calling the shots, the one with the final authority, and the one with the greatest breadth of knowledge then you should go with medicine. It's not meant as a slap towards pharmacy, but the truth is that pharmacy essentially plays a consulting role in healthcare. In other words, physicians may ask a pharmacists opinion on dosing, drug choice or route, but when decision time comes it is ultimately the physician's decision. Some people may not want that. For other people that may be exactly what they are looking for.
Lifestyle issues and payment issues are important considerations. However, they should play a secondary role to your desire to pursue a given profession. With that said I will comment on these issues briefly.
Income:
There is no question that medicine will give you a much greater reimbursement potential than pharmacy. The lowest earning medical specialties generally make 20% more than the typical pharmacist. The highest earning specialties will earn 4 or 5 times a typical pharmacist's salary. The majority of physicians earn 2-3 times that of a typical pharmacist. Of course, that is after residency, so there is some lost earning potential in those years. You'll hear people say that physicians are doomed to see incomes fall, but that will likely affect all medical professions equally (and I actually doubt that will happen either). Of more concern for pharmacists and pharmacy students (as friend have told me) is that incomes for pharmacists may easily stay flat or decline with the plethora of new pharmacy schools opening. True, there is a pharmacy shortage, but with a significantly increasing supply of pharmacy graduates expected in the next 5 years the supply/demand ratio will change in favor of supply even in the absence of fulling staffing all needed pharmacy positions. Residency for physicians will pay half that of what pharmacy grads will make for the first 3-7 years after graduation. Debt levels are pretty equal for medical school and pharmacy school. Both cost anywhere from $20-35,000/year for state schools and 50% more for private schools.
Lifestyle:
In general, pharmacist have a better lifestyle. Most physicians have some form of "call." Most pharmacists will not. Physicians typically work more hours than pharmacists. However, the 60-80 hour weeks I saw quoted in this thread for physicians are generally for a select group of specialties, namely surgical specialties, cardiology, and oftentimes primary care. Any specialty will allow you to work 40 hours per week if you are willing to take the income hit. For surgical specialties and cards it is harder, and for pathology, emergency medicine, hospitalist medicine, derm, gas, ophtho, and others it is far easier. Most of my pharmacy friends are working closer to 50 hours per week than 40 coming right out of school, but I think they have the option of working less for lesser income.
In summary, you will make a good living with a good lifestyle (if you choose your specialty carefully and keep priorities in order) with either medicine or pharmacy. High income is easier in medicine, cush lifestyle is easier in pharmacy. Both play vital roles in the healthcare of our nation and both will be in demand as the population ages faster than we can adapt. Both are science-based and demand a similar pre-req schedule in college. Medical school is definitely more competitive to gain entrance than pharmacy, but pharmacy is fairly competitive as well. Both will require you to actually study in college.
Hope this helps some.
