Psychiatry as a 2nd career?

[Esquire]

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[Doc Samson]

If you're going to do it, do it because you'll enjoy the process as well as the end result. Psychiatry is great for all the reasons you list (and more), but most of us didn't start out wanting to be psychiatrists, we wanted to be physicians. If the prospect of long hours studying things you may never use again is not tempered by the knowledge that you will get to see some of the most awe-inspiring intricacies and frailties of humanity, then you won't make it through the 5+ years before you could even call yourself a psychiary resident.

 

[masterofmonkeys]

If you're going to do it, do it because you'll enjoy the process as well as the end result. Psychiatry is great for all the reasons you list (and more), but most of us didn't start out wanting to be psychiatrists, we wanted to be physicians. If the prospect of long hours studying things you may never use again is not tempered by the knowledge that you will get to see some of the most awe-inspiring intricacies and frailties of humanity, then you won't make it through the 5+ years before you could even call yourself a psychiary resident.

Just to add to what Doc Samson said, I came to medical school knowing I wanted to be a psychiatrist. There were three of us. One is now heading for anesthesia. Between the two who stuck with it, one didn't have much interest in other aspects of medicine. It made it hard to put up with the rigorous studying, the disappointment at getting lower grades than you'd like despite the time put in, and the onerous schedule of third year medical school. The other had a great interest in medicine as a whole, and although they never really considered other specialties too strongly, they had plenty of personal and professional interest in them and genuinely enjoyed other aspects of medicine. They had a lot better time in school (not necessarily grade or board score wise, just in terms of frustration and stress). In the end both thought it was worth it to go to medical school, though.

There's always the PsyD/PhD option if other aspects of medicine don't interest you. The pay is a bit more varied (many make less than psychiatrists, but many make as much as the highest paid psychiatrists), but there's also a shortage of them so there's a lot of geographic flexibility as well. Downsides are you'd be limited in psychopharm and clinical care of the more seriously mentally ill (schizophrenia, bipolar, etc). Upside is that PsyD can be completed in 3 years (not a minimum of 8). And a Phd can be completed in 4-6 years.

Just something to think about. *shrug*

 

[2tall]

Is this decision primarily motivated by financial reasons? You've considered that you may have to uproot your family to a different part of the country... Will your current savings and spouse's income be enough to support your lifestyle during 4 years of medical school at 0K/yr and 4 years of residency training at 40-50K/yr?

Years 2-5 of this 9-year plan are very time-consuming (and I'm just a selfish single). I've always said I don't know how the marrieds but especially the parents do it. There are several non-trads in my class and God bless 'em. It's rough.

I'd make sure I'd educate my family understands what this transition really means. When you go to med school...the whole family goes to med school.

 

[peppy]

I started off med school mostly interested in psych, but I also liked the other areas of medicine too and seriously thought about going into other specialties before concluding Psych was the best fit for me. Having a general interest in medicine does definitely help make med school more interesting and easier than if you only like psych.

I do think that Panda Bear's blog has a lot of truth to it, especially in regards to the primary care residencies, but that sometimes he does exaggerate for comic effect. It might help if you could point out specific things that worry you and we can then confirm or deny it.
Medical school is definitely hard at times. I've had very stressful periods where I didn't get to see my loved ones much because I had to study (especially during Step 1 studying - probably similar to how you studied for the bar exam, I would expect) or was rotating on a very time-consuming rotation like surgery. On clinical rotations, I have certainly been yelled at and insulted, given arbitrary evaluations, assigned tasks of dubious educational value.
But I'd still say it was worth it in the end. In spite of the stressful and hard times, I have also had days when I felt very privileged to have such an interesting and meaningful career. I've learned a lot, seen many things that most people never get to see, and I feel like I've helped a few people here and there.

If you could handle law school, I bet you can handle med school too.

The stress of residency can certainly take a toll on people, and I am sorry to hear your friend ending up committing suicide. The "lifestyle" during residency is variable depending on where you do residency, but in general psych residents work fewer hours than IM residents do and don't take as much call. Of course, if you don't like working with psychiatric patients and are not comfortable with being on a psych floor, it isn't something you want to do just for the hours.
Good luck deciding this.

 

[CaMD]

I think the question comes down to whether you've investigated and given it tons of thought and you've decided that you really want to become a physician/psychiatrist. In that case, go for it. (Assuming the finances work out.)

HOWEVER, if you're just worried about the job market and looking for something lucrative/stable, I don't think medicine is worth it.

I would suggest a. a lateral move into some other aspect of the law or b. if you know you want something heathcare related, investigate pharmacy school. It's shorter and it's good $ and great hours.

 

[BobA]

I'd like to challenge the notion that psychiatry leads to "economic security."

I'll graduate with about 250,000 in debt, and my annual loan payments will be about 20K for 30 years.

If I want a "lifestyle" psychiatry practice (~50hrs/wk, minimal call) I can expect to make about 150K. The psych docs making 175-200K are working some hours, constantly doing med checks. (Note: child psych docs & forensics can make more) Once you take taxes and debt payments out of that 150K I'll be taking home about 100K. Good money, but not amazing money.

Factor in the opportunity cost of those 9 years it'll take to become a psychiatrist and it's even more clear that psychiatry isn't the road to financial wealth. Over those years that I returned to do a post-bac, applied to med school, the 4 years of med school and 4 years of residency I could've been earning a salary and socking it away. When you factor in the miracle of compound interest even a more modest salary of 60-80K would come out ahead of psych.

If you're truly passionate about medicine, I'd strongly urge you to consider PA or NP school. (2 and 3 years, respectively) and you're earning right away. Psychiatric Nurse Practitioners are basically psychiatrists without having to go through all the BS of med school. http://nursing.yale.edu/Academics/

Med school and residency is a long, grueling process, and I'd urge you to only do it if you really really want it.

One other thing: I'm told MD/JD's can make really good money in malpractice law (no residency) and forensic psych (residency +/- fellowship)

 

[abcxyz0123]

I'd like to challenge the notion that psychiatry leads to "economic security."

I'll graduate with about 250,000 in debt, and my annual loan payments will be about 20K for 30 years.

If I want a "lifestyle" psychiatry practice (~50hrs/wk, minimal call) I can expect to make about 150K. The psych docs making 175-200K are working some hours, constantly doing med checks. (Note: child psych docs & forensics can make more) Once you take taxes and debt payments out of that 150K I'll be taking home about 100K. Good money, but not amazing money.

Factor in the opportunity cost of those 9 years it'll take to become a psychiatrist and it's even more clear that psychiatry isn't the road to financial wealth. Over those years that I returned to do a post-bac, applied to med school, the 4 years of med school and 4 years of residency I could've been earning a salary and socking it away. When you factor in the miracle of compound interest even a more modest salary of 60-80K would come out ahead of psych.

If you're truly passionate about medicine, I'd strongly urge you to consider PA or NP school. (2 and 3 years, respectively) and you're earning right away. Psychiatric Nurse Practitioners are basically psychiatrists without having to go through all the BS of med school. http://nursing.yale.edu/Academics/

Med school and residency is a long, grueling process, and I'd urge you to only do it if you really really want it.

One other thing: I'm told MD/JD's can make really good money in malpractice law (no residency) and forensic psych (residency +/- fellowship)

In my opinion this is garbage. First of all if you are making only 150k/yr working in private practice 50+ hours a week, you are doing something wrong. You can't just throw a random low salary number and then assert that becoming a JD and NP is the better choice. Second, you don't need a JD to practice forensic psych. Third if you want to practice malpractice law, you just go to law school, you absolutely do not need an MD, and if you have one, its pretty much useless. And making good money as a mallpractice lawyer is far less straightforward and far less likely compared to psychiatry.

 

[notdeadyet]

Psychiatric Nurse Practitioners are basically psychiatrists without having to go through all the BS of med school. http://nursing.yale.edu/Academics/

Really? I have a hunch Psych NPs are to Psychiatrists as vanilla NPs are to Family Practice docs. I'll go to a NP to get a scrip for an antibiotic, but I wouldn't go to an NP to have him/her diagnose a complicated health issue and come up with a treatment plan. I find it hard to believe that it's different with psychiatric NPs.

One other thing: I'm told MD/JD's can make really good money in malpractice law (no residency)

If I met an MD practicing malpractice law, the first question that would come into my head was "did you lose your license due to drink, drugs, or sex?"

Malpractice law is practiced by lawyers. If you need medical insight, you hire an expert witness. An MD/JD is truly not necessary.

 

[Doc Samson]

Psychiatric Nurse Practitioners are basically psychiatrists without having to go through all the BS of med school.

Slow down there, tiger. Psych NPs are a lot of things, but they are not "basically psychiatrists."

 

[BobA]

In my opinion this is garbage. First of all if you are making only 150k/yr working in private practice 50+ hours a week, you are doing something wrong. You can't just throw a random low salary number and then assert that becoming a JD and NP is the better choice. Second, you don't need a JD to practice forensic psych. Third if you want to practice malpractice law, you just go to law school, you absolutely do not need an MD, and if you have one, its pretty much useless. And making good money as a mallpractice lawyer is far less straightforward and far less likely compared to psychiatry.

1) I never said private practice. I said what I consider "lifestyle" psych - which happens to be community psych. Personally, I'd much rather work with those with severe presisent mental illness than the "worried well." 150K is a decent salary for a community psych doc.

2) I never asserted you needed an MD to practice malpractice law. However, I've been told that MD/JD's can command higher salaries than JD's alone.

3) an MD/JD may be able to practice forensics without a forensics fellowship.

 

[BobA]

Slow down there, tiger. Psych NPs are a lot of things, but they are not "basically psychiatrists."

Saying that PNP's are basically Psychiatrists was probably overstating things. However, from a personal standpoint I think it's important to consider alternatives to the 9 year post-bac, med school, residency parade. NP school is a much more direct route to actually working with patients, and it might be a good route for someone into their 30's before undertaking a decade of training and lost income. It's my understanding that in some states NP's have almost equivalent legal rights as MD's and actually don't need a supervisor, although in practice most NP's do have one.

I'll add that one of the benefits of being an PA or NP over a residency-trained MD is how easy it is for midlevels to switch fields. If you get 5 years into psych and are bored or want more money you can switch to something else without having to go through residency all over again.

 

[Doc Samson]

Saying that PNP's are basically Psychiatrists was probably overstating things. However, from a personal standpoint I think it's important to consider alternatives to the 9 year post-bac, med school, residency parade. NP school is a much more direct route to actually working with patients, and it might be a good route for someone into their 30's before undertaking a decade of training and lost income. It's my understanding that in some states NP's have almost equivalent legal rights as MD's and actually don't need a supervisor, although in practice most NP's do have one.

I'll add that one of the benefits of being an PA or NP over a residency-trained MD is how easy it is for midlevels to switch fields. If you get 5 years into psych and are bored or want more money you can switch to something else without having to go through residency all over again.

All true - though whether NPs can practice independently in some states is a far different question from whether they should practice independently.

 

[nancysinatra]

In my view, there's more than income to consider when you are thinking about devoting several years to a career change. I'm a non trad too, although I originally thought I'd go into emergency medicine or anesthesia. I'm now really excited to be going into psych, because, like you said, it is an intellectual challenge. Medical school itself must seem different for everyone, but the way I would describe it is that very large parts of it are primarily a memorization challenge. Think about whether that's your cup of tea. It won't be at all like law school. And med school alone will take up 4+ years in your 30s and 40s. Just be sure you know this. Once you graduate and move on to residency and beyond, well, that's different, and it really might be worth it, but in any case, remember, you go through the prereqs plus the four years to get there. Within those four years, you are exposed to many fields. You might end up picking a completely different specialty! Personally I found a lot of specialties fascinating, but in a way, it was all kind of beside the point because medical school is so heavily geared towards rote memorization of facts, which engages some folks better than others. And, again, at least in my experience, medical students often don't get to see patients for the first time themselves. Instead we see patients who have been worked up three times over with a known diagnosis. If you are seeing previously worked-up patients you don't get to "think" about what the patient has for yourself. This makes it hard to improve your clinical reasoning skills and again adds to the drudgery of the four years. Drudgery is one thing when you're 22. It's another when you're 32, and another when you're 42. At the same time, if you're still excited about the long term goal, then go for it!

Med school and the prereqs are also very different. The prereqs--you either love em or hate em. (I loved them!) They have almost no connection to actual medicine, although not everyone would agree with me about that. But you could certainly start with those and see how they go. There's another website for non-trad premeds--I think it's linked to this one, and they're very helpful and friendly!

Medicine also operates under a strict hierarchy. It can be hard, knowing you could have been in the top of the profession you started in, but now you're at the bottom of a different one. And I mean, the very bottom. You won't even have time to wash that silly short white coat of yours that stamps you as a med student when you're rushing around on your rotations, half the time! You get used to being told how important it is to be "professional" (you'll have a required class on that, at most places) but then not having ANY means at your disposal to actually conduct yourself in what you probably are used to thinking of as a professional manner. And your classmates will be 22 and they will hold something resembling a prom every year. (But it will be fun!)

I'm just saying, it can be a great life change, but be sure you are aware of all the implications. I doubt it's worth it for financial reasons, unless you're currently a poet. If you PM me I will send you a link to that webpage I mentioned.

 

[Good Solutions]

All true - though whether NPs can practice independently in some states is a far different question from whether they should practice independently.

Should isn't even an issue. That doesn't matter. Should is determined by insurance companies who only care about a cheap warm body pushing meds. Should is determined by the government who cares only about a cheap warm body pushing meds. Should is determined by the free standing Nursing board which oversees their field as 'nursing practice' instead of medicine. As long as these factors remain should will never be a consideration. It is a wonder we even have medical licenses or care about things like board certification. A third year medical student can function as an NP or PA. The ease at which a psych NP can practice medicine has even been an arguing point for psychologists to get prescribing rights.


Here is a link showing the states and how they break down for their practice abilities:
http://www.webnp.net/downloads/pearson_report08/ajnp_pearson08.pdf

 

[Esquire]

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[YOOOUK09]

If you're thinking you'll be a psychiatrist because you like the status of being a "professional" you might want to know that the field isn't held in high regard by other medical specialists.

I don't want to give the impression that it should be put-down by other docs - it's very valuable work and mental illnesses are very serious conditions.

However, don't expect to get a ton of respect just because you're a psychiatrist. Most people in the medical world will view you with skepticism until you've proven your worth.

 

[notdeadyet]

5. Don't many NP and PA programs require 2000+ hours of clinical experience, have more pre-reqs than med school and/or require pre-reqs to be taken within the past 5 years?

I'd have to redo 2 years of pre-reqs and change bed pans for 1 year just to be able to apply!

Applying to medical school without clinical volunteering is a good way to fail. You need to do a fair bit of volunteering to show that you know what patients smell like and want to spend your day with them anyway. You don't need to necessarily change bedpans, but watching autopsy shows doesn't qualify for clinical experience. Non-trads are not exempt from this.

Check with the schools you are interested in. Some MD programs will not take pre-reqs over five years old. I have no idea which schools these are, as my coursework was all pretty fresh.

 

[OldPsychDoc]

I was a science major, I'm fascinated by the mind, I've had a pharma case and found the scientific literature on how the drug binds to brain receptors fascinating, I can't resist watching autopsy or plastic surgery shows.

But as a non-trad, I'm not the typical pre-med who since childhood has a burning desire to save people, kiss attendings' butts, show up at the hospital at 5 am, or fill out Medicaid forms.

However, I'm attracted to the professional practice of medicine. By profession, I mean a skilled trade where you are decently compensated for your knowledge, practice independent judgment, work with fairly intelligent people, are in demand, have a readily accessible practice pool, and are more insulated from the economic cycle than regular people.

I'd say you can probably count on all of that, and more.

I have that as a lawyer, but not to the same extent as a doctor does. I don't really practice law because I don't have clients in the same way doctors have patients, and my judgment is not the final word despite over a decade of experience. I work for someone else's clients and am more of an employee than a true professional with a practice. Not having a practice, along with the shrinking demand of my field, is a huge risk. I don't want to wake up in 9 years and be obsolete and too old to start over.

You MAY find yourself in something that looks more like an employed position, or a hybrid thereof, however. e.g.--the world of health care is moving toward a provider-customer model, and you may NOT always be the "final word" in a patient's care. Just offering fair warning...

...

4. Isn't the typical salary $130,000-$150,000 for a 45-50 hour psych position with no call?

That's fine for me since I'd prefer to relocate to a low cost of living area.

Ironically, the compensation for psychiatry is often much higher in low cost of living/underserved areas. So you win twice over!

 

[nope80]

Hi all,

I'm looking for some input here as a potential non-trad in their 30s. I've read stuff from Med School Hell and Panda Bear and it scares the bejeezus out of me.

Is med school and psychiatry at all like that? How tough is it really? And how hard is it on family life?

Right now, I am a lawyer and I'm happy with the pay (which is less than the lowest paid medical specialty) and lifestyle (I work about 50-55 hours a week, 1 or 2 weekend days a month, plenty of time for the family). However, I am in a field that is very geographically confined and is rapidly shrinking and will probably disappear some time in the future due to Wall Street's implosion.

Psychiatry seems to be the perfect blend of intellectual challenge, economic security, geographic mobility, and lifestyle.

But it's hard to tell, and hence my questions. I personally know only 2 medical folks. One thought IM residency was hell, but they're now in greener pastures as a subspecialist. The other killed himself during residency, yikes!

The 9 years it will take (counting pre-reqs) gives me pause. Although I would graduate with little to no debt, the prospect of spending my entire life savings on med school and having no savings in my forties gives me greater pause.

(I would also consider dental school because I have good spatial skills and work well with my hands. It's shorter than med school + residency. However, the $300-400,000 debt load to start a dental practice is a huge business risk and obstacle for someone my age.)

Any advice would be appreciated.

I guess I'm wondering what your motivations are for wanting the career change? Is it financial? If that is the reason, I'd focus more on the career you are in now and try to expand within it - I always thought lawyers make comparable $$ to physicians and sometimes even more. So if it is about money, I definitely don't think its worth it. Med school is very hard - it takes enormous dedication, patience and an inherent love for the field. It is long as well and so for someone at a more established age in life, I'm not sure if it is justifiable unless of course its your dream to be a doc, practice as a physician etc.

 

[Headshrinker]

Maybe I'm misreading the tone of your questions but you seem to be operating under the assumption that knowing you want to be a psychiatrist opens some sort of royal road to get around the work of being a medical student and an intern.

It doesn't work that way. You still get up at 5:00, you still get to fill out the Medicaid forms, you still get to kiss ass. The whole C=MD thing is, at the risk of sounding like a jerk, a little disturbing. You don't know enough as a medical student to say if something you're learning is going to be important to you or not. When you are an intern, if not before, there will be patients who's health will depend on some of the information you told yourself you wouldn't need to know.

 

[nope80]

Thanks for all the feedback. I've added some more questions/details. Any answers and comments people can provide would be appreciated.

1. What's an interest in medicine sufficient to sustain you through the school/residency process?

I was a science major, I'm fascinated by the mind, I've had a pharma case and found the scientific literature on how the drug binds to brain receptors fascinating, I can't resist watching autopsy or plastic surgery shows.

But as a non-trad, I'm not the typical pre-med who since childhood has a burning desire to save people, kiss attendings' butts, show up at the hospital at 5 am, or fill out Medicaid forms.

However, I'm attracted to the professional practice of medicine. By profession, I mean a skilled trade where you are decently compensated for your knowledge, practice independent judgment, work with fairly intelligent people, are in demand, have a readily accessible practice pool, and are more insulated from the economic cycle than regular people.

I have that as a lawyer, but not to the same extent as a doctor does. I don't really practice law because I don't have clients in the same way doctors have patients, and my judgment is not the final word despite over a decade of experience. I work for someone else's clients and am more of an employee than a true professional with a practice. Not having a practice, along with the shrinking demand of my field, is a huge risk. I don't want to wake up in 9 years and be obsolete and too old to start over.


2. What is MS III and PGY 1 really like?
What is a typical day/week for PGY 1?
Do you really average 80 hours/week?
Are the people abusive?
How does your body and mind deal with it?
How physically and mentally demanding is it for you? For your family?

The only reference I have is working for big law firms averaging 58-60 unpredictable hours a week. Getting called out of the blue at 5 pm on Friday and being told to hop on a plane to somewhere, not knowing if I'd be there 3 days or 3 months and putting my life on hold. I disliked the 24/7 on-call culture of large law firms and having to ask permission to go home even when nothing was going on. I eventually took a huge pay cut for a more controllable lifestyle.


3. Long hours studying isn't an issue, I did that for 3 years under the gun (there's only 1 exam per class, and a .01 difference in GPA is the difference between a good job at the best firms or being shut out and barely being able to repay crushing debt).

As I understand it, C=MD and psych residencies aren't hung up on stellar board scores. True?

C's in med school would be fine for me. Beyond getting my first law firm job, studying just to graduate with honors was a waste of time as I look back.

And aren't MS IV and PGY 4 pretty cush with electives?


4. Isn't the typical salary $130,000-$150,000 for a 45-50 hour psych position with no call?

That's fine for me since I'd prefer to relocate to a low cost of living area.


5. Don't many NP and PA programs require 2000+ hours of clinical experience, have more pre-reqs than med school and/or require pre-reqs to be taken within the past 5 years?

I'd have to redo 2 years of pre-reqs and change bed pans for 1 year just to be able to apply!

I think you should pursue it if you will go on the rest of your life regretting and feel unfulfilled in law and are ready to take on an enormous change in lifestyle and begin a challenge. I think having a family makes it even harder. Med school starts out hard, gets harder, and only gets more demanding. I can't imagine having a family to feel financially and emotionally responsible for through this process; if they are taken care of $ wise and are emotionally willing to make sacrifices, great. You will be working very hard, especially if you have been away from the sciences for some time.

There is an older woman in our class that decided to change careers and start medical school (she was in health care before so it wasn't completely different). She is married to medicine life body and soul. She doesn't have a husband or family and is constantly working. I think this is probably a bit extreme and you can take it to whatever level you want but its definitely going to be the first 2 days days full of classes and nights full of studying.

I think if financially your family will be okay with having you in school and are willing to support you through the journey, then definitely do it. If you are interested, motivated, and the other two things are in place then you should be fine.

 

[Little Ruby]

I am a 4th year med student, who has a JD, is a mother of 2, will be 40 next month and is going into psychiatry. This is my 2 cents:

1.) med school is not like law school...it is harder with longer hours....it is like the first year of law school with more material to master for 3 years....plus no control over your schedule during clinical rotations which is difficult with children

2)If you feel you will be unfulfilled for the rest of your life not being a doctor (not just specifically a psychiatrist), as I did, then consider it. I caution anyone taking on the challenges of med school about thinking about one area only.

I have seen too many people plan to be one thing and are unhappy when they find out their "dream specialty" isn't what they hoped. I would not have made it through med school without interest in medicine generally...there is just too much you are required to know.

The tone of your post makes me think maybe you see this as another career path, not a "calling" to use an over used sentiment. If that is the case find something else...the path is too long...there are many other professions that may be satisfying without the time and commitment to training.

3)Be sure you have complete support of family/spouse....it can be a big marital strain...marriages fail without the added stress of children

4) Think carefully about finances...you will have a shorter career to pay back debt....you say you won't have any but using savings still may leave you feeling you are starting over....that has been a bit hard for me

5) it can be happily and successfully done, but only you can decide...though your family will be strained it will be the hardest emotionally and physically on you. ..I am happily married, kids thriving and still half way sane....to change careers was a very hard decision to make and I do not regret it....am excited to start residency and plan on doing some forensics.

If you have any more questions, feel free to PM me.

 

[notdeadyet]

The tone of your post makes me think maybe you see this as another career path, not a "calling" to use an over used sentiment. If that is the case find something else...the path is too long...there are many other professions that may be satisfying without the time and commitment to training.

I think all of your advice in the post is spot on with the exception of this bit.

I get a little weary of the "calling" vs. "profession" discussion. Medicine can be either. Many great physicians view it as either. You can have a wonderfully satisfying career as either.

I personally view it as a profession, not a calling (though I don't begrudge those who view it as the latter). There are many careers I could find satisfying (including my last), but I prefer medicine. I carefully weighed the blood/sweat/tears that go into a medical degree and felt it worth it. It's a great job that requires a lot of sacrifice, but it's not the priesthood.

In fact, I've found that the folks so far in the process most miserable with medicine are those that came in viewing it as their "calling". When they began medicine, they then found that it wasn't walking around the halls with people throwing rose petals in your path and listening to your words like gospel. They realized, "holy $hit, at the end of the day, it's a job". Some of these folks get very deflated and end up unhappy.

So I'd caution against chiding those who view medicine as a career path. I lack doctor-worship and it hasn't hurt me any. Though some of us woke up one day with the "ah-ha" moment that makes for very cliche'd personal statements, many of us came to medicine as a process that made sense to us. But I leave "callings" for men and women of the cloth. I'm pursuing medicine to provide a service to those in need, but I don't think of our field as any more noble than social work or teaching.

That said, I think the rest of your advice was right on target and are words the OP would be wise to listen to.

 

[Little Ruby]

I think all of your advice in the post is spot on with the exception of this bit.

I get a little weary of the "calling" vs. "profession" discussion. Medicine can be either. Many great physicians view it as either. You can have a wonderfully satisfying career as either.

I personally view it as a profession, not a calling (though I don't begrudge those who view it as the latter). There are many careers I could find satisfying (including my last), but I prefer medicine. I carefully weighed the blood/sweat/tears that go into a medical degree and felt it worth it. It's a great job that requires a lot of sacrifice, but it's not the priesthood.

In fact, I've found that the folks so far in the process most miserable with medicine are those that came in viewing it as their "calling". When they began medicine, they then found that it wasn't walking around the halls with people throwing rose petals in your path and listening to your words like gospel. They realized, "holy $hit, at the end of the day, it's a job". Some of these folks get very deflated and end up unhappy.

So I'd caution against chiding those who view medicine as a career path. I lack doctor-worship and it hasn't hurt me any. Though some of us woke up one day with the "ah-ha" moment that makes for very cliche'd personal statements, many of us came to medicine as a process that made sense to us. But I leave "callings" for men and women of the cloth. I'm pursuing medicine to provide a service to those in need, but I don't think of our field as any more noble than social work or teaching.

That said, I think the rest of your advice was right on target and are words the OP would be wise to listen to.

I don't think I was "chiding those who view medicine as a career path" or was doing "doctor worship". If that was the way I came across it was not intentional. I was simply stating in the shortest way I could that it is a commitment that is different than any other field I know. I can't think of any type of professional training that requires this kind of sacrifice or blood/sweat/tears as you term it. Clearly it is a "career path" that is unlike few, if any, others. I totally agree with you that it is a job, and as I was both a social worker and a teacher in my day I see this profession as no more noble, but certainly much more of a commitment and family sacrifice. It is a job, and I try hard to leave my work at work, but in this field is harder when you have longer hours that cut into family time more than most professions. My only concern is that the OP understands this going in.

 

[notdeadyet]

I don't think I was "chiding those who view medicine as a career path" or was doing "doctor worship".

You're right and I apologize. Reading over my post, I realize I was using stronger language than I intended. This is what I get for posting on inadequate sleep.

I was simply stating in the shortest way I could that it is a commitment that is different than any other field I know. I can't think of any type of professional training that requires this kind of sacrifice or blood/sweat/tears as you term it. Clearly it is a "career path" that is unlike few, if any, others.

It is definitely in the top percentile in terms of the difficulty and length of training. And when you start working you do so in the top percentile in terms of salary and job security.

I agree that medicine is a hard row to hoe and that folks should do so with both eyes wide open. And it's expensive enough that once you start, it can be very difficult to leave for financial reasons. I just disagree at the notion that medicine is a "calling" and not a "career path".

I totally agree with you that it is a job, and as I was both a social worker and a teacher in my day I see this profession as no more noble, but certainly much more of a commitment and family sacrifice.

For the training, to be sure. For your working career, the nice thing about medicine is that you have a lot of choice in terms of how big a family sacrifice it need be. Most psychiatrists I know socially work far few hours than most attorneys I know. Different for surgeons, surely, but if the long hours are a negative, you can avoid specialties that leave you no time for family.

Total agreement with you about people going in with both eyes wide open though. If my post was overly harsh, I apologize. I blame lack of sleep, or maybe I'm just getting crabby as I age.

 

[Esquire]

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[Esquire]

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[silas2642]

Hi all,

I'm looking for some input here as a potential non-trad in their 30s. I've read stuff from Med School Hell and Panda Bear and it scares the bejeezus out of me.

Is med school and psychiatry at all like that? How tough is it really? And how hard is it on family life?

Right now, I am a lawyer and I'm happy with the pay (which is less than the lowest paid medical specialty) and lifestyle (I work about 50-55 hours a week, 1 or 2 weekend days a month, plenty of time for the family). However, I am in a field that is very geographically confined and is rapidly shrinking and will probably disappear some time in the future due to Wall Street's implosion.

Psychiatry seems to be the perfect blend of intellectual challenge, economic security, geographic mobility, and lifestyle.

But it's hard to tell, and hence my questions. I personally know only 2 medical folks. One thought IM residency was hell, but they're now in greener pastures as a subspecialist. The other killed himself during residency, yikes!

The 9 years it will take (counting pre-reqs) gives me pause. Although I would graduate with little to no debt, the prospect of spending my entire life savings on med school and having no savings in my forties gives me greater pause.

(I would also consider dental school because I have good spatial skills and work well with my hands. It's shorter than med school + residency. However, the $300-400,000 debt load to start a dental practice is a huge business risk and obstacle for someone my age.)

Any advice would be appreciated.

Perhaps you should pm law2doc, who is a 4th year. Obviously she was a former lawyer before deciding to change careers to medicine.

 

[nancysinatra]

I was simply stating in the shortest way I could that it is a commitment that is different than any other field I know. I can't think of any type of professional training that requires this kind of sacrifice or blood/sweat/tears as you term it.

I think the professional training that dancers and athletes go through requires more blood, sacrifice, and often far greater disappointment than what doctors have to endure. Often athletes and dancers will have to sacrifice large parts of their own youth to their sport or art, such as by not even going to a regular high school at all. That's on a whole different level than having to miss going to your child's activities because you are on call. Athelets suffer injuries like ACL tears that require surgery and may never properly heal, whereas we are complaining about being up for 24 to 30 hours at at time. They can even have fatal head injuries (I'm thinking of ski jumping, gymnastics, etc.). They can train for years and never reach their dream. I am just pointing these things out, not trying to take issue with what you were saying. A lot of times, though, people in medical school claim that it's the most taxing training there is, when in fact, a lot of professions are very demanding. The more demanding and selective they are, the fewer people do them.