STAT: Why Medical School Should Start at 28...

[drusso]

Why medical school should start at age 28

The axe of autonomy must rip at the root of doctors' dependence on the fickle medical profession for career and life satisfaction and financial security. Medicine should be an individual's second profession.

www.statnews.com

"Every generation of physicians must be free to act for itself. Claims to a physician’s 20s have withered away. Corporate health care has deemed physicians replaceable, either by those who accept lower pay or by nonphysician practitioners. Doctors of medicine and osteopathy are starting side jobs, from selling stick-on nail colors to dog walking. Modern physicians see a second line of income as a necessity, a hedge against the new uncertainty in the formerly most-certain job of them all."

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[Ligament]

That was depressing.

Unfortunately, the article assumes the years up until age 28 would be in some lucrative job where one can make some money, invest it, and use it as a nest egg once one starts med school.

Thats not how it works any longer. Hopeful physicians routinely graduate undergrad then must waste a few years padding their resumes with meaningless volunteer actvity and social justice activity subjugation. They are required to shadow here and there, work as a scribe for a year or two, etc etc. Apply for a few cycles of med school admissions before they are finally granted the glorious reward of med school admission and incurring $500,000 in medical school loans they will never be able to pay off. "Congrats, you will be a doctor! Congrats, you'll never pay this debt off and your income will statistically decrease EVERY YEAR until you die."

So, they can't really pursue a lucrative job for 5-6 years prior to med school; they need to devote those years towards APPLYING to med school. Its a waste of time and demoralizing, especially since the reward will not be there once, and if, they finally gain admission. It is terribly sad.

Sure there are some superstars that get in med school right from undergrad but that is becoming increasingly rare. Yes, a very small % will become ortho spine surgeons, plastic surgeons, and cosmetic dermatologists and make a ton of money to pay off that $500k loan. I have no idea why anybody wants to become a physician in America any longer.

 

[Ferrismonk]

That was depressing.

Unfortunately, the article assumes the years up until age 28 would be in some lucrative job where one can make some money, invest it, and use it as a nest egg once one starts med school.

Thats not how it works any longer. Hopeful physicians routinely graduate undergrad then must waste a few years padding their resumes with meaningless volunteer actvity and social justice activity subjugation. They are required to shadow here and there, work as a scribe for a year or two, etc etc. Apply for a few cycles of med school admissions before they are finally granted the glorious reward of med school admission and incurring $500,000 in medical school loans they will never be able to pay off. "Congrats, you will be a doctor! Congrats, you'll never pay this debt off and your income will statistically decrease EVERY YEAR until you die."

So, they can't really pursue a lucrative job for 5-6 years prior to med school; they need to devote those years towards APPLYING to med school. Its a waste of time and demoralizing, especially since the reward will not be there once, and if, they finally gain admission. It is terribly sad.

Sure there are some superstars that get in med school right from undergrad but that is becoming increasingly rare. I have no idea why anybody wants to become a physician in America any longer.

Wow, you read my mind. Only caveat I would say it that I enjoy being a physician, it's all the non-medical crap involved I don't like.

I was a non-trad student, entering Medschool at age 28, and now I'm 40 with $500K in loans. Thank God I didn't do primary care.

 

[SommeRiver]

Med school at 28 here, prior military. About to be 3 yrs out of training and med school loan gone 2 months from now...

 

[Ligament]

I entered med school at 27, I did have a corporate job prior to med school as a GUI designer for a couple years. It's not like I made $200k / year, socked away tens of thousands in my 401k and purchased a house during that time.

 

[Piebaldi]

Wow, you read my mind. Only caveat I would say it that I enjoy being a physician, it's all the non-medical crap involved I don't like.

I was a non-trad student, entering Medschool at age 28, and now I'm 40 with $500K in loans. Thank God I didn't do primary care.

Wow how do you have 500k in loans? I only took out like 90-100k in loans - went to state school, lived with my parents for most of med school until I got married, bundled my MPH with my MD, with I guess free food/cable/utilities while living with parents, and then paid it off ASAP. 500k in loans is like 100k/year, plus the interest I guess from residency? How is that possible? Did you go to a pricey private school?

 

[Ferrismonk]

Wow how do you have 500k in loans? I only took out like 90-100k in loans - went to state school, lived with my parents for most of med school until I got married, bundled my MPH with my MD, with I guess free food/cable/utilities while living with parents, and then paid it off ASAP. 500k in loans is like 100k/year, plus the interest I guess from residency? How is that possible? Did you go to a pricey private school?

Non-trad student. I had a family I had to support during medical school. In-state school, but supporting a family is expensive, even when you keep expenses down. Graduated with about 220K if I recall correctly, but then compound interest during residency and fellowship.

 

[clubdeac]

Med school at 22, finished fellowship at 31. Been in practice 10 years. Ready to retire!

 

[cowboydoc]

That was depressing.

Unfortunately, the article assumes the years up until age 28 would be in some lucrative job where one can make some money, invest it, and use it as a nest egg once one starts med school.

Thats not how it works any longer. Hopeful physicians routinely graduate undergrad then must waste a few years padding their resumes with meaningless volunteer actvity and social justice activity subjugation. They are required to shadow here and there, work as a scribe for a year or two, etc etc. Apply for a few cycles of med school admissions before they are finally granted the glorious reward of med school admission and incurring $500,000 in medical school loans they will never be able to pay off. "Congrats, you will be a doctor! Congrats, you'll never pay this debt off and your income will statistically decrease EVERY YEAR until you die."

So, they can't really pursue a lucrative job for 5-6 years prior to med school; they need to devote those years towards APPLYING to med school. Its a waste of time and demoralizing, especially since the reward will not be there once, and if, they finally gain admission. It is terribly sad.

Sure there are some superstars that get in med school right from undergrad but that is becoming increasingly rare. Yes, a very small % will become ortho spine surgeons, plastic surgeons, and cosmetic dermatologists and make a ton of money to pay off that $500k loan. I have no idea why anybody wants to become a physician in America any longer.

Do we need to call a welfare check to the 206? Maybe a SAD lamp to get you through until summer?

Unfortunately, I think you are right on all counts.


Amazon product ASIN B07L332B52

 

[Ligament]

Wow how do you have 500k in loans? I only took out like 90-100k in loans - went to state school, lived with my parents for most of med school until I got married, bundled my MPH with my MD, with I guess free food/cable/utilities while living with parents, and then paid it off ASAP. 500k in loans is like 100k/year, plus the interest I guess from residency? How is that possible? Did you go to a pricey private school?

This is very common nowadays. Kids getting $200k + in loan debt from UNDERGRAD is a thing.

none of this education is worth more than $10k per year. Its all a scam, stealing the future from today's youths.

 

[Ligament]

This predatory student debt scam being thrown at our youth is going to cause irreparable harm.

 

[SommeRiver]

This predatory student debt scam being thrown at our youth is going to cause irreparable harm.

Agreed.

 

[Piebaldi]

This is very common nowadays. Kids getting $200k + in loan debt from UNDERGRAD is a thing.

none of this education is worth more than $10k per year. Its all a scam, stealing the future from today's youths.

That's crazy. I double majored and double minored, and I got a full ride to several places. I could not imagine having hundreds of thousands of dollars in debt. I had a classmate who had 500k in loans before starting residency I think - that must be like 600-700k by the time residency ends?

 

[gaseous_clay]

“The rampant bullying, intimidation, and harassment by attending physicians would diminish by their teaching older students who have worked in other fields.”

Lol - the attendings at my med school went out of their way to berate older, non traditional students. In fact, some of the more grueling residencies often discriminate against older students with the notion that they will burn out faster than the youngins.

 

[mememaster9000]

How about why medical school should start at 18 and be a 6 year MBBS with free tuition? Every year delaying getting to attending salary is a huge loss unless you know of 22 year old's getting $300,000 jobs out of undergrad.

 

[Ligament]

I do think med school should start at 18 actually. Undergrad was a COMPLETE waste of time and money.

 

[Ferrismonk]

How about why medical school should start at 18 and be a 6 year MBBS with free tuition? Every year delaying getting to attending salary is a huge loss unless you know of 22 year old's getting $300,000 jobs out of undergrad.

As a medical student I did a mission with doctors/trainees in the Dominican Republic who are trained this way. Granted this is a 3rd world country, and while I admired their clinical skills which were far above ours at that stage of training, the "science" part of their education was shall we say... lacking.

Other than our ridiculous debt ratio and downward pressure on physicians as a whole, I think we train decent doctors. The 6-year plan you mentioned is already happening in the US though. We just call them PAs and (Doctor) NPs.

 

[deleted993114]

Med school at 22, finished fellowship at 31. Been in practice 10 years. Ready to retire!

Ready to retire? You can't be serious.

Keep in mind that the federal government spent a ton of money financing your education (most medical schools and all residencies are federally supported to some degree). Quitting early is a waste of the money and effort that went into your training.

If medically able, I think that all physicians have a moral duty to put in at least 30 years after training. In doing so, you are fulfilling your obligation to the public from the training they (the tax payers) helped pay for. Medicine is not just a job, it is a service industry that has requirements and commitments that go far beyond that of regular "jobs".

 

[Ferrismonk]

Ready to retire? You can't be serious.

Keep in mind that the federal government spent a ton of money financing your education (most medical schools and all residencies are federally supported to some degree). Quitting early is a waste of the money and effort that went into your training.

If medically able, I think that all physicians have a moral duty to put in at least 30 years after training. In doing so, you are fulfilling your obligation to the public from the training they (the tax payers) helped pay for. Medicine is not just a job, it is a service industry that has requirements and commitments that go far beyond that of regular "jobs".

I get what you're saying, but I disagree. I pay a ridiculous percent interest on student loans which are owned by the government, pay a ridiculous share of my income in taxes, and grovel daily for the scraps that Medicare and Medicaid offer for our services. I think we're more than even.

 

[lonelobo]

Ready to retire? You can't be serious.

Keep in mind that the federal government spent a ton of money financing your education (most medical schools and all residencies are federally supported to some degree). Quitting early is a waste of the money and effort that went into your training.

If medically able, I think that all physicians have a moral duty to put in at least 30 years after training. In doing so, you are fulfilling your obligation to the public from the training they (the tax payers) helped pay for. Medicine is not just a job, it is a service industry that has requirements and commitments that go far beyond that of regular "jobs".

If you started practicing 20 yrs later you might have a different perspective

 

[Ligament]

I get what you're saying, but I disagree. I pay a ridiculous percent interest on student loans which are owned by the government, pay a ridiculous share of my income in taxes, and grovel daily for the scraps that Medicare and Medicaid offer for our services. I think we're more than even.

You owe the government and society nothing. They've profited immensely off of any "investment" they've made in you. Not to mention the taxes you've paid and the ancillaries you've generated for your hospitals and labs. If you can retire immediately after residency, do it!

 

[TheIllusionist]

lol above at comment implying cosmetic derm, plastics, and ortho spine being the *only* stuff that can pay off 500k in loans. Be smart and even primary care and psych can do it with right practice model. Being a hospital slave relegates you to a bad situation. Sacrifice location and chase guap in area with scarcity. Many of my family members have done this. And it works oit fine regardless of speciality. Granted none of them are rad oncs or pathologists...

 

[Ligament]

lol above at comment implying cosmetic derm, plastics, and ortho spine being the *only* stuff that can pay off 500k in loans. Be smart and even primary care and psych can do it with right practice model. Being a hospital slave relegates you to a bad situation. Sacrifice location and chase guap in area with scarcity. Many of my family members have done this. And it works oit fine regardless of speciality. Granted none of them are rad oncs or pathologists...

You are a medical student. You can "LOL" once you are an attending struggling with debt like this while seeing your paycheck drop every year.

 

[deleted993114]

You owe the government and society nothing. They've profited immensely off of any "investment" they've made in you. Not to mention the taxes you've paid and the ancillaries you've generated for your hospitals and labs. If you can retire immediately after residency, do it!

Well...………………. I understand. However, I personally do feel that we have a moral obligation to practice for an extended period of time, as the funds spent on training for most med students and all residents is significant.

This is why the increasing number of women in medicine has been detrimental to training and providing a sufficient number of physicians to the public. Many tend to quit or go part time after having children, thus all the time and funds spent on their training goes to waste for a significant number of female physicians and puts the system in a manpower bind. My daughter is a 3rd year medical student and I fully applaud women going into medicine. However, the system needs to train more physicians due to women falling out of practice at a much higher rate. I am certainly not suggesting that women should be discriminated against in medical school admissions- absolutely not. We just need to train more providers.

 

[lonelobo]

Dealing With the Guilt of Early Retirement - Physician on FIRE

One of the downsides of FIRE is dealing with the guilt of early retirement. Should we feel guilty, what do we owe others, and how do we deal with the guilt?

www.physicianonfire.com

 

[Ligament]

Well...………………. I understand. However, I personally do feel that we have a moral obligation to practice for an extended period of time, as the funds spent on training for most med students and all residents is significant.

This is why the increasing number of women in medicine has been detrimental to training and providing a sufficient number of physicians to the public. Many tend to quit or go part time after having children, thus all the time and funds spent on their training goes to waste for a significant number of female physicians and puts the system in a manpower bind. My daughter is a 3rd year medical student and I fully applaud women going into medicine. However, the system needs to train more physicians due to women falling out of practice at a much higher rate. I am certainly not suggesting that women should be discriminated against in medical school admissions- absolutely not. We just need to train more providers.

I generally heartily agree with your comments except here. Med students are paying a literal fortune for the opportunity to get ripped off for four years of school. Some are coming out with $500,000 in loans just for med school. Combined with undergrad I've read about some students in $700,000 of school debt. It is a fallacy that med schools and the government pay for such educations. Sure the hospital and med school may get funding but that is not for education. Thats corruption and waste. There is nothing worth more than $10-$15k / year for med school education.

I agree it is extremely wasteful (and frankly profoundly stupid waste of time) to become a physician just to quit immediately but up to the individual.

There is no moral obligation to be treated like crap for an entire career. You had it good and did well, at least financially. The new docs will not have a it good and will not have a far lesser opportunity to do well financially. The vast majority of young physicians are going to see ever decreasing salaries and ever increasing paper pushing and getting yelled at by know-nothing administrators. They are going to spend hours per year being told how terrible they are in "sensitivity training" classes. They are going to suffer midlevel creep as NPs and PAs push for independent practice rights with no qualifications to do so. They will be told they "just need to do yoga" when they are suffering moral injury from becoming EMR data entry clerks instead of actual physicians and going into a mountain of debt to do so.

 

[DOctorJay]

Well...………………. I understand. However, I personally do feel that we have a moral obligation to practice for an extended period of time, as the funds spent on training for most med students and all residents is significant.

This is why the increasing number of women in medicine has been detrimental to training and providing a sufficient number of physicians to the public. Many tend to quit or go part time after having children, thus all the time and funds spent on their training goes to waste for a significant number of female physicians and puts the system in a manpower bind. My daughter is a 3rd year medical student and I fully applaud women going into medicine. However, the system needs to train more physicians due to women falling out of practice at a much higher rate. I am certainly not suggesting that women should be discriminated against in medical school admissions- absolutely not. We just need to train more PHYSICIANS.

Sent from my iPhone using SDN

 

[clubdeac]

Ready to retire? You can't be serious.

Keep in mind that the federal government spent a ton of money financing your education (most medical schools and all residencies are federally supported to some degree). Quitting early is a waste of the money and effort that went into your training.

If medically able, I think that all physicians have a moral duty to put in at least 30 years after training. In doing so, you are fulfilling your obligation to the public from the training they (the tax payers) helped pay for. Medicine is not just a job, it is a service industry that has requirements and commitments that go far beyond that of regular "jobs".

I spent 6 1/2 years giving back to the government by working at the VA. And my clinic was the most productive, highest revenue clinic all 6 years. I'd say I did my time. I was half joking about retirement. I however would argue as a doctor I am padding the pocket books of hospital admin and CEOs as much as I'm providing a service to my patients, which is quite disheartening.

 

[deleted992230]

Ready to retire? You can't be serious.

Keep in mind that the federal government spent a ton of money financing your education (most medical schools and all residencies are federally supported to some degree). Quitting early is a waste of the money and effort that went into your training.

If medically able, I think that all physicians have a moral duty to put in at least 30 years after training. In doing so, you are fulfilling your obligation to the public from the training they (the tax payers) helped pay for. Medicine is not just a job, it is a service industry that has requirements and commitments that go far beyond that of regular "jobs".

By this logic, you would have to admit only men to medical school considering 40% of women physicians stop working or go to part time. within 8 years of graduating from residency.

Why aren't you demanding this if you are so concerned with "paying back society" with this "investment" or are you only concerned when its a male physician who doesn't "pay back" to society?

 

[gaseous_clay]

Ready to retire? You can't be serious.

Keep in mind that the federal government spent a ton of money financing your education (most medical schools and all residencies are federally supported to some degree). Quitting early is a waste of the money and effort that went into your training.

If medically able, I think that all physicians have a moral duty to put in at least 30 years after training. In doing so, you are fulfilling your obligation to the public from the training they (the tax payers) helped pay for. Medicine is not just a job, it is a service industry that has requirements and commitments that go far beyond that of regular "jobs".

This isn’t 1955. Medicine is no longer a “calling” like it was at one time. Try giving this speech to millennials entering medical school and residency and see what they have to say about it. Furthermore, doctors are no longer respected like they used to be and private practice/autonomy is slowly dying as hospitals try to engulf everything and attempt to replace us with midlevels.

 

[gaseous_clay]

Dealing With the Guilt of Early Retirement - Physician on FIRE

One of the downsides of FIRE is dealing with the guilt of early retirement. Should we feel guilty, what do we owe others, and how do we deal with the guilt?

www.physicianonfire.com

so this guy averaged $153,000/yr in taxes for 13 yrs. assuming a 39% tax bracket, he was averaging about $392,000 per year gross income. I’m two years younger than this guy, but there is no way I could retire based on these numbers without significantly compromising my upper middle class lifestyle. I’m assuming he must have made some wise investments early on or got incredibly lucky.

 

[Ligament]

40% of women physicians stop working or go to part time. within 8 years of graduating from residency.

is this true? If so, what a monumental waste of time!

 

[deleted131481]

Eliminating Residents Increases the Cost of Care - PMC

Academic health centers are facing a potential reduction in Medicare financing for graduate medical education (GME). Both the Medicare Payment Advisory Commission and the National Commission on Fiscal Responsibility and Reform (Deficit Commission) ...

www.ncbi.nlm.nih.gov

While the government does pay its share for resident education, they are not the ones who should be paying it back. Training residents is profitable for the hospital. I have seen this - institutions are happy to employ more residents and fewer attendings/midlevels.

 

[lonelobo]

is this true? If so, what a monumental waste of time!

Maybe this has something to do with it


"At the same time, there’s evidence that household responsibilities are a greater burden for women physicians than men. Studies show that despite the increasing number of women entering the medical workforce, women still take on an average of 8.5 hours more work at home each week than men. Married men with children worked 7 hours longer and spent 12 hours less per week on parenting or domestic tasks than women, the research shows. "

 

[deleted992230]

is this true? If so, what a monumental waste of time!

https://docs.wixstatic.com/ugd/3fdf20_b47503c5516f4b61b42dc04b94605f15.pdf

61.3% continue at full time work by 6 yearrs.

 

[deleted992230]

Maybe this has something to do with it


"At the same time, there’s evidence that household responsibilities are a greater burden for women physicians than men. Studies show that despite the increasing number of women entering the medical workforce, women still take on an average of 8.5 hours more work at home each week than men. Married men with children worked 7 hours longer and spent 12 hours less per week on parenting or domestic tasks than women, the research shows. "

Female physicians are free to marry house husbands that can manage all of that stuff as long as they support him.

Female physicians in general aren't willing to marry house husbands in general. Female physicians arent interested in supporting a husband to do the housework.

The comparison is illogical since a large % of male physicians marry women who don't work or work part time since they aren't as concerned with their wife's income.

 

[callmeanesthesia]

Female physicians are free to marry house husbands that can manage all of that stuff as long as they support him.

Female physicians in general aren't willing to marry house husbands in general. Female physicians arent interested in supporting a husband to do the housework.

The comparison is illogical since a large % of male physicians marry women who don't work or work part time since they aren't as concerned with their wife's income.

Yes, NiceGuy0183, tell us all about “females.”

 

[deleted992230]

Yes, NiceGuy0183, tell us all about “females.”

Is anything im saying wrong?

That is why I wouldn't care what some old men say to younger men about "duties" or some other nonsense.

Doctors dont owe anyone the "duty" to work especially when admission to Medical School isnt based upon longevity of career. Its not like society cares to admit based on who will "work the longest to give back to society", then we should be worried about it.

Academic Medical School Admission committees dont take into account longevity of career when it comes to admission (neither do residency program directors) right? So why should we care then?