Practicing PA making the switch to MD

[TheTao]

Do you have a family? Car payments? Do you want to start saving for retirement? It's not misleading at all
Do you have a mortgage? It seems like you don't because this comment is extremely naive.

My family's financial "house" (pun intended) is more than together for reasons I'm not compelled in the least, to outline for you or anyone else here. But I will say that my med school education is going to be free and that having an income supplemented by a military retirement is a TRUE blessing.

In the past year, I've gained $3000 in student loan debt and $5000 in the value of my home.

If you don't understand the mathematics of why you've invested in med school, then why are you in med school? Isn't that a naive move on your part?

BTW, it appears that maybe YOU went to med school for ALL the wrong reasons. Don't discourage others from doing something that could be great for them, just because it hasn't been good for you.

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[niko327]

I am in the process of becoming an Osteopathic physician after 11 years as a PA. I too have a few kids and well compensated for my work. I was doing the same job as you are (critical care, house officer, cardio, etc), essentially autonomous practice because we just didn't have the physician personnel, it was fine and we made do. I decided to go to med school because I liked the field of Medicine, I wanted to practice at the highest possible level of knowledge and skill. I thought Med school would help me reach that goal.

Anyway, I am in the 3rd year now. 3rd year is just like PA school 2nd year on steroids. So, the first 2 years are tough. I am not going to lie, you got to be studying all the time to do well. But I felt I had a huge leg up on things because of PA. Nothing is really hard conceptually, its just very time consuming due to the sheer volume of material. I kicked @ss on my boards and am in the low single digits as far as class rank is concerned. I credit this to being a PA for a while.

So what about work? Well, contrary to what anyone here well tell you, it is possible to work and attend medical school as a PA. You do not have to forfeit 4-7 years of salary if you don't want to, its just not easy. So here's what I did. I worked full time overnights from Fri-Sat-Sun as I always have. I continued to do this for my first 2 years of medical school. I did well in school. That being said, everyone is different, this is certainly not a strategy for everyone. If you are good at compartmentalizing your life then it is possible do it. If not, then DON'T even try it. No matter what the result, you will be quite tired at times, it's a lot to ask of yourself. I rarely slept more than 4 hours, but again, everyone is different. I am optimal at 4 hours or 7 hours sleep. No more, no less and nothing in between.

As far as family is concerned, your spouse has to be on board with the mission. When the train ride from school was over and I got in my car at the train station, I clicked back in to family man mode. School time was over at that point. Got home, played with the kids, did the dishes, helped make dinner, had family movie time, helped with homework, etc until I went to bed. At 5am, it started all over again, train ride to the city was study time, med school is med school time, train ride back home was study time. If it was Friday, I drove right to work instead of home and did my work thing (I studied in the lounge between patient care responsibilities.) Monday morning, I'd go home and crash or if we had an exam, I took the train back to the city and ran on adrenalin until it was all over.

I only recently stopped working full time because of the start of rotations, but I didn't really need to. The study demand is far less now. And depending on what dept you are rotating through, you still have ample to time to work (just forget about it during surgery rotation!!!).

Um what else.... so I guess you have to take the MCAT and stuff. Best thing I can say is review all that basic chem, orgo, bio and physics on Khan Academy. Khan Academy is a free resource taught by a truly brilliant guy (one of the last few polymaths out there) and it should get you up to speed on what you need to know. Be systematic and practice. You can then take a few practice MCATS and see where you are at. There are some Kaplan courses and Princeton Review Courses out there too, but they are not mandatory. I didn't take a course and I did use the Princeton Review book which was very good. You need to get a pretty good score to get in. Score-wise, it was at least 30 out of 45 when I took the test, but the grading scale has changed now, so whatever the equivalent is.

Ok that's all I can think of for now. Good luck to you.[/QUOTE]

 

[CyrilFiggis]

If you don't understand the mathematics of why you've invested in med school, then why are you in med school? Isn't that a naive move on your part?

Expand upon your logic for my misunderstanding of the mathematics. My comment, that you neatly abridged and took out of context, was simply laying out a rebuttal to your insistence that $200K of medical student debt was a better investment than a $200K mortgage. But if you were trying to say that medical school in an investment in my future income potential, then that's fair. However, let's say that I go into primary care. Average salary right now is $188K, low end is $160K. There are other careers, such as the one I was in prior to starting med school where I earned roughly 70% of the median. I got that job with a BA degree and around $50K worth (or 25% of a $200K med school debt) of student loan debt - debt which had interest 2% lower. So even then, I could make a fair argument that the financial benefits of a med school education aren't as definitive as you say. And for what it's worth, and relating back to OP, I'm adding over $500K in lost income by going to med school.

BTW, it appears that maybe YOU went to med school for ALL the wrong reasons. Don't discourage others from doing something that could be great for them, just because it hasn't been good for you.

So given what I said above, I hope you can see that going to med school and becoming a doctor isn't about the financial benefits. What I am is realistic and pragmatic. If financial success is your motivation, people should be aware it may not be there or come at a greater cost than money. If autonomy and pecking order is your motivation, realize that it comes with it's own set of headaches. I've never discouraged anyone on here from pursuing medicine. If you find pragmatism to be negative, I'm sorry.

PS - you'll learn this once you get into med school, but you NEVER f@#king question the reasons for why someone is here.

 

[TheTao]

And for what it's worth, and relating back to OP, I'm adding over $500K in lost income by going to med school.

You're VERY focused on money and with that in mind, wouldn't a career that makes use of an MBA and/or JD have been a better choice? IJS.

Plus, you seem to have the "half-empty" mindset which means that no matter what field you pursued, you probably would have found fault with it.

PS - you'll learn this once you get into med school, but you NEVER f@#king question the reasons for why someone is here.

Being the spouse of a military officer affords me a free education in explicative filled, "alternative" communication styles. So I'll respond with a "G" rated version to the above statement, though I'd be more than happy to expound by PM with the "military spouse" version should you contact me. This is a public forum , so you can take your "Trump sensitivities" elsewhere if what's being said isn't to your liking.

It's a fact that matriculating to med school for the wrong reasons is a VALID point and more than a few people on SDN seem to relate to IMO, seemingly including you. A PA going to med school would very likely NOT be one of those folks who one days regrets it since they are already very familiar with the nuances of a career in medicine.

 

[CyrilFiggis]

You're VERY focused on money and with that in mind, wouldn't a career that makes use of an MBA and/or JD have been a better choice?

So just because I have a family and am concerned about the impact my debt has on future including the ability to support my children's education means I shouldn't go to med school? Or that I shouldn't be a physician?

Plus, you seem to have the "half-empty" mindset which means that no matter what field you pursued, you probably would have found fault with it.

Half-empty or realistic? Did you know that only 46% of Teach for America teachers stay on past their 2 year commitment and that 30% leave after year 1? It's not because they werent cut out to be teachers, it's because despite noble intentions, the expectation vs reality gap was too great. They thought they'd be these hero teachers and the grind wore them down. Blind optimism can create unobtainable expectations. Does that mean that I'm pessimistic about medicine? no, but I understand that my expectations of the profession may be different than the outcome - from what I match into, to where I live, to the patient population I serve. And to me, that's the sharpest arrow in my quiver - acknowledging the unexpected outcome, knowing I won't save every patient, etc.

I simply pointed out to the PA who originally started this thread, that better aspects in her mind of choosing to go MD, may not end up as the reality and that she should weight those factors into her decision.

It's a fact that matriculating to med school for the wrong reasons is a VALID point and more than a few people on SDN seem to relate to IMO, seemingly including you.

And while you may find my choice of language coarse, you should be proud to know that you're the first person I've responded to like that. You know why? Because you have no idea what my reasons for doing this are. You don't know that my best friend was diagnosed with MS and is now ataxic and requires a wheelchair. You don't know that I nearly lost my dad to cancer and that he was laid up in a hospital recovering instead being able to be at my wedding. YOU. KNOW. NOTHING. So I apologize if I used a censored swear word, but I got a little hot under the collar when a pre-medical dependa decided to assume and question my motivation.

If you want to respond, PM me. I'm done here.

 

[CannonballComin]

OP or anyone else interested: I did this. I've discussed this in some previous posts on here from time to time and would love to offer insight or answer any nagging questions. I enjoy helping people with this decision and I come on here every once in a while to make myself available to answer questions. Best of luck to you and your family!

 

[TheTao]

Also, a mortgage is a commodity backed loan. The value of the house may fall, but not to zero. And those affected by the crash were those with variable rate mortgages.

VERY clearly YOU don't have a mortgage and/or are VERY naive about mortgages. So let me familiarize you with the term "upside down on a mortgage". Never heard of it? That's obvious, but a TON of people DO know what that means. And it means that the value of their homes are NOT only zero, but negative and it happened/happens to more people than those with variable rate loans too..

I personally don't believe in mortgages longer than 10 years and think the entire mortgage industry is ONE BIG SCAM!! BTW, the next/last mortgage we'll have will be paid off in 5 years. Yeah, THAT and for clarity, we won't be living in the hood or podunk rural usa either. It's called being SMART.

At the end of the day, I just want to tell all the people who went into medicine for the wrong/superficial reason to just stuff their negativity up their rears, not a single career decision/choice is perfect.

 

[TheTao]

Counterpoint: Lawyers.

I think med is awesome and I'm all for it, but anything can backfire.

Hence the term RARELY.

 

[CyrilFiggis]

VERY clearly YOU don't have a mortgage and/or are VERY naive about mortgages. So let me familiarize you with the term "upside down on a mortgage". Never heard of it? That's obvious, but a TON of people DO know what that means. And it means that the value of their homes are NOT only zero, but negative and it happened/happens to more people than those with variable rate loans too..

1) Currently on mortgage #2. First one before med school, second one after I sold the first to pay for our new place when I started school.
2) "Upside down on a mortgage" means that you have negative equity in the property which is exactly what I said. It doesn't mean the home value is zero, it just means what your paying for the property is more that the value. But no home value will ever be zero - your equity in the home may be less than zero, but never the value itself. If you're "upside down" or "underwater" with your mortgage, it could be due to a few things:
- you have a fixed rate mortgage, but the value of the property is now significantly lower than what you purchased it for, or;
- You have a variable rate mortgage, and the rates skyrocket while the home value stays the same, meaning you're again paying much more money than the value of the home.

All that said, even if you are "upside down" on a mortgage, it is extremely rare to owe your full mortgage back to the bank because they will seize the home for its value. Whereas with a med school loan, if you don't make it through, don't match, etc. there is nothing to collateralize that debt and you will be stuck with it until you pay it off or die.

Tl;Dr - You seem to be confusing home value with home equity. Value is the appraised worth of the land and property. Equity is the value minus the outstanding principle and interest.

This conversation has moved well beyond OPs stated reason. You seemed to have been very at odds with me from the start all because I disagreed with you about a $200K education always being the smarter choice over a $200K mortgage. You have questioned my knowledge, intelligence, and character/motivation at every point; very rarely responding to any of my specific details. It's borderline Trumpian. I feel that I have stated my case and unless you provide a specific rebuttal, I am done with this conversation.

 

[314117]

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[Giovanotto]

Are you watching?

 

[harrypotterfanatic]

Hey all,

Long-time reader, first-time poster I've done a fair bit of searching on this topic and nothing truly addressed my specific situation!

I'm currently a practicing PA x4.5 years with my time split 50/50 between ER and ICU (our hospital is trialing an "upstairs care downstairs" model, so there's a lot of crossover). I have a fair bit of autonomy ranging from the initial resuscitation, lines, running codes and (rarely) airway management. It's great and all but often feels a bit protocolized at times with LOTS of physician oversight (as it should be in this environment); some individuals at the hospital refer to us as "the tacticians, not the strategists." Nevertheless, it's a good gig--sounds crazy to want to leave and take on a huge financial/time commitment, right? Hear me out.

I wanted to go to med school initially in undergrad. Graduated with chem degree, 4.0 GPA and completed all pre-reqs for med school. I was killing it. My husband and I were married pretty young (20) and we (intentionally) had a kid at 23. All was well until little one was unexpectedly dx'd with Down Syndrome the year before I graduated (lots and lots of doctors, therapies, surgeries...).

Everything was overwhelming at that time and the thought of entering med school/residency/fellowship was pretty much impossible in my mind. I abandoned my dream, bit the bullet and used my prereqs to get into PA school so I'd be able to finish faster, support our little one and have time to be home. In hindsight, was this the smartest choice? Probably....definitely not. I'm aware of the mistakes I made but it's done and it made perfect sense to me at the time.

Now that I'm in my 30s, I find myself completely dissatisfied with my work life. I can give 500 logical reasons/arguments if needed but I really don't want to take the thread in that direction. The bottom line is that I'm just not happy and I KNOW that I want to go the MD route (and have for a long time). Love the patients, love the medicine but I hit a glass ceiling at 2 years; I certainly can't do this forever.

I gave up on my dreams.

Now that I'm older/wiser, have more support & the little one is more self-sufficient I feel ready to start again. Anyone else out there make the PA-->MD switch?

Next steps will be refreshing all that basic science knowledge and studying for the MCAT...

Someone tell me I'm not crazy.

Hi OP, This is amazing that you're considering to switch. It is very brave of you. I am 22 years old and debating PA Versus Medical School as well. When you mentioned you hit your glass ceiling, what do you mean by that? Is that in regards to pay and compensation? If so, how much can a PA in your profession make. I am also interested in working in the ER, since after scribing I have fallen in love with that environment. Any input of yours would be great! Thank You

 

[Darth Doc]

Hi OP, This is amazing that you're considering to switch. It is very brave of you. I am 22 years old and debating PA Versus Medical School as well. When you mentioned you hit your glass ceiling, what do you mean by that? Is that in regards to pay and compensation? If so, how much can a PA in your profession make. I am also interested in working in the ER, since after scribing I have fallen in love with that environment. Any input of yours would be great! Thank You

There are a number of PA vs MD threads on SDN. I've contributed to a number of them myself. I recommend looking them up.
- PA's - $80-110k/year salary (average - I wouldn't take less than $90k without really good benefits)
- glass ceiling - once you max out your salary and have a good job, you don't gain the ability to do or make more
- ER - lots of PA's in the ER. I was never one of them, but they do make good money. In most hospitals they work in the fast-track and don't see the more difficult cases, but there is one PA on SDN who says he runs the ED in a rural area of the US. That's unusual.

 

[Deleted member 750603]

Hey all,

Long-time reader, first-time poster I've done a fair bit of searching on this topic and nothing truly addressed my specific situation!

I'm currently a practicing PA x4.5 years with my time split 50/50 between ER and ICU (our hospital is trialing an "upstairs care downstairs" model, so there's a lot of crossover). I have a fair bit of autonomy ranging from the initial resuscitation, lines, running codes and (rarely) airway management. It's great and all but often feels a bit protocolized at times with LOTS of physician oversight (as it should be in this environment); some individuals at the hospital refer to us as "the tacticians, not the strategists." Nevertheless, it's a good gig--sounds crazy to want to leave and take on a huge financial/time commitment, right? Hear me out.

I wanted to go to med school initially in undergrad. Graduated with chem degree, 4.0 GPA and completed all pre-reqs for med school. I was killing it. My husband and I were married pretty young (20) and we (intentionally) had a kid at 23. All was well until little one was unexpectedly dx'd with Down Syndrome the year before I graduated (lots and lots of doctors, therapies, surgeries...).

Everything was overwhelming at that time and the thought of entering med school/residency/fellowship was pretty much impossible in my mind. I abandoned my dream, bit the bullet and used my prereqs to get into PA school so I'd be able to finish faster, support our little one and have time to be home. In hindsight, was this the smartest choice? Probably....definitely not. I'm aware of the mistakes I made but it's done and it made perfect sense to me at the time.

Now that I'm in my 30s, I find myself completely dissatisfied with my work life. I can give 500 logical reasons/arguments if needed but I really don't want to take the thread in that direction. The bottom line is that I'm just not happy and I KNOW that I want to go the MD route (and have for a long time). Love the patients, love the medicine but I hit a glass ceiling at 2 years; I certainly can't do this forever.

I gave up on my dreams.

Now that I'm older/wiser, have more support & the little one is more self-sufficient I feel ready to start again. Anyone else out there make the PA-->MD switch?

Next steps will be refreshing all that basic science knowledge and studying for the MCAT...

Someone tell me I'm not crazy.

In hindsight we are all geniuses.


It just irritates me to no extent that people start the conversation with lifetime earnings and how much time has been lost and how much you will expect to earn and how much debt will be.

Ridiculous.

What are you supposed to do "work out" the rest of your life and be miserable because "fiances are not heavily in your favor". So much more to life than money.

There are doctors who make a ton of money and are miserable. Money is not the end all be all argument. It's not even a conversation that needs to be had when it comes to doing something you found a passion for in life. Yup I used the "p" word. Cliche yes.

What if you were an athlete and lost a leg and couldn't compete anymore so you wanted to dedicate your life to treating people with birth defects so that they could have a future in athletics. Is that it no should not do it because "money". Life experience is valuable, it is INVALUABLE.

What if you go into medicine and invent something new because of your experience as a PA. What if you become an administrator and help the hospital become more efficient and lower health costs. What if you get a scholarship. What if you win the lottery. Isn't it more rewarding to accomplish something rather than looking at you savings account for the rest of your life?

What if you have debt and love what you're doing. Terrible. How awful.

Being older you can manage it better and get better loan percentages. Some of the younger students don't even know how to manage debt and go well into their 40's and 50's with debt. But so what who cares if you have debt or lost income as long as you feel like you are making a difference and enjoying your life.

I can't tell you how irritated I am by "money considerations" arguments. Maybe I can, is it coming across? I hate this argument because it is myopic and narrow minded and doesn't consider the humanistic side, which is PURPOSE. To have purpose is more important than any amount of money. Money doesn't even mean anything. I am going to implode "millennial literally" from this abstract and absurd concept of "money".

Nothing would be built or invented if people had ABSOLUTELY FAILPROOF NO QUESTIONS NO DOUBT WILL BE MILLIONAIRE plans. Be an entrepreneur of your own life not a slave to making decisions based on money. We grow, we change, our interests evolve, our philosophy changes, we are not static beings. What is money anyway? A thing that was invented from us destroying ourselves for resources.

Yes finances are a "thing" but at the end of it what do you want to accomplish? Save money or provide something to the world. The way our politics are right now a dollar today is not a dollar tomorrow. Do something you enjoy day to day. That's what any profession is about. If you hate yours now then what's the point of it? Just to "exist"? We are not robots that can mindlessly perform same task over and over without exhaustion or question as to the purpose of it.

 

[CyrilFiggis]

It just irritates me to no extent that people start the conversation with lifetime earnings and how much time has been lost and how much you will expect to earn and how much debt will be.

Ridiculous.

Is it? Medical school is a massive financial commitment. The average debt is around $200K. add in the fact that average starting salary for a recent college grad is ~$45K and you're talking about around a $500K net loss. It's also worth noting that when surveyed, many physicians that have depression or burnout site debt and finance as the #1 cause. So I really don't think it's ridiculous to have that be front and center in the discussion.

Money is not the end all be all argument. It's not even a conversation that needs to be had when it comes to doing something you found a passion for in life.

It's not the end all be all, but is should certainly be a strong consideration. In fact, Medscape's Physician Lifestyle Report found that professional fulfillment was the lowest cause of burnout. Again, #1 was compensation/debt.

 

[Deleted member 750603]

Expectations, expectations, expectations.

Debt is a contributor not a THE CAUSE of physician burnout. Having unrealistic expectations about finances as a physician can contribute to burnout if your heart is not in it and you thought you would just be a millionaire and work 30 hours a week. If you have unrealistic expectation about making money as a physician you will point to debt as a cause, but it isn't though is it. Unrealistic expectations are at the root of it. So no "money" is not a valid argument.

Again, fulfillment is strongly correlated with expectations. If you're expectations are not aligned with reality you will get burnt out no matter what you're doing therefore what I am saying is that you consider going into the profession because you LOVE IT. Not because of money. Money is associated with EVERYTHING in this world and physicians are not an exception of a rule or a measurement of anything.

You could easily make an argument about not buying a house because of the debt you are about to take on and that you should just rent for the rest of you life. So what are you supposed to do? Have a house you love that you owe money on or rent and hate your apartment but knowing you are financially stable.

Do what you love and everything else will fall into place. To design an entire life based on money is just sad and not our purpose.

Let's break down this fallacious argument about 45K a year or more easily understood as 3,750 monthly before taxes that somehow equals 500K over 10 years. Money you would have "missed out on" if you went to medical school.

After taxes (say 20% REAL bracket) you are left with let's say 3,000. Subtract 1K for rent/house, subtract 1K for food/going out, subtract 300 random expenses, and let's say you save 700 a month. In reality people with 45K would at most save about 5K a year, assuming no health issues and no major life breakdowns and major expenses like buying a car. So 5K*10 years = 50K. Woohoo.

Now let's say you at the least you go into family medicine of around 170K a year or 14,150 a month before taxes and 9,000 after taxes (around 35%). You pay 2,000 for student loans that leaves you with 7K. Let's say your expenses are more because you are a DOCTOR NOW and you subtract 2000 for mortage, subtract 2000 for food and miscellaneous you give yourself 1000. So you save 2K a month which is 24K a year. That's already more money than you would have saved in 5 years out of college.

For every 1 year you save as a doc = 5 years in saving as a college grad. Assuming those numbers you mentioned.

Which do you choose financially and more importantly wholeheartedly?

 

[Deecee2DO]

I'm a 28 year old chiro who went to chiro school for four years and will be starting medical school in August because that is my true passion. I went through 8 years of school including undergrad and chiro school and STILL am going back. If I can do it you can. Go with your dream, if you love medicine and want to be an MD/DO then go that route and you will be satisfied. Be a PA rest of your life and hate it? Or be an MD/DO and love what you do. You're only in your 30s, some people don't start medicine until their late 30s and 40s. I would go to work everyday as a chiro and literally hate my job. Although lucky to have had a job at all and very fortunate at that, I literally loathed going to work everyday. I hated it and it showed because the practice was going to crap since my heart wasn't in it. I practiced chiro for a year and got burned out. 1 YEAR. All I would do is adjust patients, stretch them and take a few x-rays here and there and see the same crap over and over again, and you know what? I wasn't even held that accountable because the patients really weren't THAT bad, health wise (and insurance would pay me literally nothing for my services but thats another whole story). Please anyone considering being a chiropractor DO NOT DO IT. My patients had neck and back pain, they didn't have serious illnesses and I felt that to make more of a difference I wanted to treat and help people with more serious conditions and make a serious impact on their life where I was truly held accountable for their health and well being. When patients would would come in to our practice as a chiro with systemic issues that I could do nothing about as a chiro and would do nothing about since it was out of my scope I would get all excited inside and didn't want to leave work, yet I would refer them out to a medical doctor. True story. Good luck and make the switch. The money will follow your heart/passion (please don't hit me with hate mail SDNers with this statement anyone who has a passion for something and wants it bad enough can do well as a physician despite the loans). yes there will be downsides to medicine like loans and insurance reimbursements and hospital bureaucratic headaches but other than that as a whole physicians make good money, have great job security and it is something you can do for a long time with a MUCH higher financial ceiling than a PA. Honestly, med school classes will be easier (not easy) but easier for you having been a PA for so long and having gone through PA school already.

 

[Deecee2DO]

You're VERY focused on money and with that in mind, wouldn't a career that makes use of an MBA and/or JD have been a better choice? IJS.

Plus, you seem to have the "half-empty" mindset which means that no matter what field you pursued, you probably would have found fault with it.



Being the spouse of a military officer affords me a free education in explicative filled, "alternative" communication styles. So I'll respond with a "G" rated version to the above statement, though I'd be more than happy to expound by PM with the "military spouse" version should you contact me. This is a public forum , so you can take your "Trump sensitivities" elsewhere if what's being said isn't to your liking.

It's a fact that matriculating to med school for the wrong reasons is a VALID point and more than a few people on SDN seem to relate to IMO, seemingly including you. A PA going to med school would very likely NOT be one of those folks who one days regrets it since they are already very familiar with the nuances of a career in medicine.

JDs honestly do not make that much money at all. My lawyer friends are struggling. You have to graduate from a T14 law school and/or be at the top of your class to make it to the big firms to make a lot of money. Law is difficult to make good money in. I would never suggest law to someone who simply wants to make a lot of money. If you want to simply make a lot of money, go into investment banking or be a dentist lol. Lower cost of education overall, less time in school, more money in the long run.

 

[CyrilFiggis]

Do what you love and everything else will fall into place.

Banalities are worthless. Everyone seems to think that my posts imply somehow that my only focus of the reason that I'm going into medicine is simply for the money. Just because I acknowledge that money exists and is worth factoring into any major life decision doesn't mean that's my motivation. But when you're like me and you come from a non-science background and decide when you're already established in your career and life to suddenly change that, it matters.

Money you would have "missed out on" if you went to medical school

It's not money that you "missed out on" its about the total net change. You can adjust for taxes, but state/local taxes, deductions, etc make that too convoluted, so I'll stick to just gross salary. Also, you can make all the daily living deductions you want, but this isn't about savings, it's about total income. You can live like a pauper and save a ton on $45K/year. So let's drop the confounders and look at the bare minimum dollars and cents.

$45K/year x4 years out of undergrad = $180,000 (unrealized)
income during 4 years in medical school = $0
debt during 4 years in medical school = -$189,000
interest accumulated during school/repayment = -$71,000 (standard 10-year)
Total Net Change = $440,000


That is not insignificant when looking at your future, esp when you're like OP or myself and you come from a prior career that pays well and have a family to support. You can be trite and say "do what you love" but that's selfish if you don't recognize what that means in terms of sacrifice. You don't have to have dinner table talks with your spouse about how you're going to pay for day care or summer camp or medical bills or holidays and also pay for exam fees and interview travel only to reluctantly have to shrug and say, "I can always take out more loans."

Money is a very real factor, not only in the here and now but in the future and to be so arrogant as to say it doesn't matter is the true fallacy.

 

[Deleted member 750603]

Banalities are worthless. Everyone seems to think that my posts imply somehow that my only focus of the reason that I'm going into medicine is simply for the money. Just because I acknowledge that money exists and is worth factoring into any major life decision doesn't mean that's my motivation. But when you're like me and you come from a non-science background and decide when you're already established in your career and life to suddenly change that, it matters.


It's not money that you "missed out on" its about the total net change. You can adjust for taxes, but state/local taxes, deductions, etc make that too convoluted, so I'll stick to just gross salary. Also, you can make all the daily living deductions you want, but this isn't about savings, it's about total income. You can live like a pauper and save a ton on $45K/year. So let's drop the confounders and look at the bare minimum dollars and cents.

$45K/year x4 years out of undergrad = $180,000 (unrealized)
income during 4 years in medical school = $0
debt during 4 years in medical school = -$189,000
interest accumulated during school/repayment = -$71,000 (standard 10-year)
Total Net Change = $440,000


That is not insignificant when looking at your future, esp when you're like OP or myself and you come from a prior career that pays well and have a family to support. You can be trite and say "do what you love" but that's selfish if you don't recognize what that means in terms of sacrifice. You don't have to have dinner table talks with your spouse about how you're going to pay for day care or summer camp or medical bills or holidays and also pay for exam fees and interview travel only to reluctantly have to shrug and say, "I can always take out more loans."

Money is a very real factor, not only in the here and now but in the future and to be so arrogant as to say it doesn't matter is the true fallacy.

Doesn't matter does it? Net change? Honestly, it's the money in the bank that people can do something useful with. What does net change of 400K really mean in real life terms it's just book keeping. It has no real value in life, it's not even money you did something with or spent or lived or even had access to at any time. What decisions can be made when someone says "it's a net change of 400K in your life". Ok now what, how do you move forward with your decision based on that number?

You won't have 400K if you stay in current job and you won't lose 400K if you pursue a different career. So what good is it.

I don't consider doing what you're passionate about "trite". Your words.

As someone who has also had a career I don't think it is arrogant, it is my experience and I would not base my decision to go into medicine based on money (one way or the other). It is the rest of your life so if you want money to dictate your life that's your choice but you get one shot. If you've not been in a position where you realize your passion and you are counting the hours in the day to get through every day then you will not know that feeling of stagnation and discontent and maybe see it from a financial side of things rather than the humanistic side.

Also, I am not telling anyone to abandon their family responsibilities am I? If you are not in position to switch careers because of other responsibilities that is an ENTIRELY different conversation than simply how much money I can make in a lifetime and "net change in earnings".

Read what I said carefully and don't overextend what I said.

 

[Deecee2DO]

Banalities are worthless. Everyone seems to think that my posts imply somehow that my only focus of the reason that I'm going into medicine is simply for the money. Just because I acknowledge that money exists and is worth factoring into any major life decision doesn't mean that's my motivation. But when you're like me and you come from a non-science background and decide when you're already established in your career and life to suddenly change that, it matters.


It's not money that you "missed out on" its about the total net change. You can adjust for taxes, but state/local taxes, deductions, etc make that too convoluted, so I'll stick to just gross salary. Also, you can make all the daily living deductions you want, but this isn't about savings, it's about total income. You can live like a pauper and save a ton on $45K/year. So let's drop the confounders and look at the bare minimum dollars and cents.

$45K/year x4 years out of undergrad = $180,000 (unrealized)
income during 4 years in medical school = $0
debt during 4 years in medical school = -$189,000
interest accumulated during school/repayment = -$71,000 (standard 10-year)
Total Net Change = $440,000


That is not insignificant when looking at your future, esp when you're like OP or myself and you come from a prior career that pays well and have a family to support. You can be trite and say "do what you love" but that's selfish if you don't recognize what that means in terms of sacrifice. You don't have to have dinner table talks with your spouse about how you're going to pay for day care or summer camp or medical bills or holidays and also pay for exam fees and interview travel only to reluctantly have to shrug and say, "I can always take out more loans."

Money is a very real factor, not only in the here and now but in the future and to be so arrogant as to say it doesn't matter is the true fallacy.

Unless you are going into primary care after switching to medicine from a previously well paid career with a family, the money thing will be less significant, especially if you are going into some of the higher paying specialties like Ortho, Ophtho, ENT, Derm, plastics, anesthesia, rads etc. Yes they take longer to get through and are harder to match into, but once you get into practice, even with loans over your head, your salary is pretty healthy. I most likely wouldn't recommend switching careers with significant debt with a family only to go into Peds or FM. It can be done but it may be harder to sustain yourself financially unless you have other forms of income or are a smart investor in other sectors. This is just MY opinion, not fact.

 

[DokterMom]

Which is the better deal?

- Loving what you do all day, stretching your generous paycheck to cover a pretty significant debt load, then dying with $1 mil in the bank. or

- Decidedly NOT loving what you do all day, living within the confines of your less-generous paycheck, then dying with $1.5 mil in the bank.

 

[RNthenDoc]

Which is the better deal?

- Loving what you do all day, stretching your generous paycheck to cover a pretty significant debt load, then dying with $1 mil in the bank. or

- Decidedly NOT loving what you do all day, living within the confines of your less-generous paycheck, then dying with $1.5 mil in the bank.

Whoever dies with the most money wins!!!

 

[CyrilFiggis]

Honestly, it's the money in the bank that people can do something useful with. What does net change of 400K really mean in real life terms it's just book keeping. It has no real value in life, it's not even money you did something with or spent or lived or even had access to at any time.

Okay fine, you win. The $100K I'm no longer pulling in every year and the $20K I contributed to my 401K is just total bookkeeping. I mean, I really should just ignore it all. It's all just money I'm borrowing against my future. It totally doesn't affect when I can retire or anything.

You won't have 400K if you stay in current job and you won't lose 400K if you pursue a different career.

No, but if you read my post, for people like OP and I that have others that rely on our incomes, you do have an immediate loss of income - so when we decide to go to school, we actually did lose income.

I don't consider doing what you're passionate about "trite".

I don't consider it trite either, just your tired, hackneyed euphemisms.

dying with $1 mil in the bank.

I'd prefer to retire with that money in the bank. And when you're changing careers in your 30s and sacrificing income and accruing debt (which according to some doesn't really exist in real life) it pushes the goalposts back. It's not wrong to love what you're doing, but also have reasonable expectations about when you'd like to call it quits.

higher paying specialties like Ortho, Ophtho, ENT, Derm, plastics, anesthesia, rads etc.

All those specialties only make up 17% of all practicing physicians..... Family, Peds and IM make up over 25%.

Is it really that hard to simply agree that, in fact, money and the financial risks you take by pursuing a medical degree later in life does have consequences? That's the point I've been trying to make the whole time on this thread. Net income/lost income call it what you want, it's part of it. All I know is my situation and what I personally had to figure out. Everyone is so quick to tell OP to just go for it, but I'm trying to show that these are worth consideration and not totally dismissible.

 

[Deleted member 750603]

Okay fine, you win. The $100K I'm no longer pulling in every year and the $20K I contributed to my 401K is just total bookkeeping. I mean, I really should just ignore it all. It's all just money I'm borrowing against my future. It totally doesn't affect when I can retire or anything.
No, but if you read my post, for people like OP and I that have others that rely on our incomes, you do have an immediate loss of income - so when we decide to go to school, we actually did lose income.

I don't consider it trite either, just your tired, hackneyed euphemisms.

I'd prefer to retire with that money in the bank. And when you're changing careers in your 30s and sacrificing income and accruing debt (which according to some doesn't really exist in real life) it pushes the goalposts back. It's not wrong to love what you're doing, but also have reasonable expectations about when you'd like to call it quits.

All those specialties only make up 17% of all practicing physicians..... Family, Peds and IM make up over 25%.

Is it really that hard to simply agree that, in fact, money and the financial risks you take by pursuing a medical degree later in life does have consequences? That's the point I've been trying to make the whole time on this thread. Net income/lost income call it what you want, it's part of it. All I know is my situation and what I personally had to figure out. Everyone is so quick to tell OP to just go for it, but I'm trying to show that these are worth consideration and not totally dismissible.

You’re putting away 20K on a 45K salary? The number keep changing I’m a little confused.

Because again a 100K salary is not the 45K you were talking about earlier.

I also didn’t say anything about your 401K being bookkeeping. Hard to have a real conversation when you’re constantly shifting the details of your arguments and introducing overriding information and twisting my words.

I mean let’s be real here yes money matters but being miserable all your life just because of “net change” is not the answer and in my opinion desire wins out over money. You say be miserable or go for it? I mean what is your final answer?

Net change has been calculated, 401K has been determined, net present value is predicted, mortgage rate is locked in, credit history reported, stock market is doing great, my neighbor bought a Mercedes haha now what?

Maybe let’s just agree that we disagree.

 

[Deecee2DO]

You’re putting away 20K on a 45K salary?

I mean let’s be real here yes money matter but being miserable all your life just because of money is not the answer and in my opinion wins out over money.

Amen

 

[frosted2]

Most Americans don't have the opportunity to make 150K+ in their careers either.

Focusing on the 3-5 average years of working 50-60 hrs/week at 50K+, is not only misleading, it's kinda ridiculous.

PS- People go into debt to live in 200K-300K homes ALL THE TIME. And they don't have incomes in the upper 10% of all US incomes like Docs do either.

IMHO, investing 200K-300K in an education is rarely going to be a bad move. But the housing market collapse showed us that spending 200K-300K on a house could be.

In the end, it's ALL relative to your goals, financial priorities, and more importantly, how you see life in general i.e. half empty or my preference, half full!

Could be worse... could be $118,000 in the hole for a degree in theatre and communications.