The "Lost Year of Income" Argument

[JESSFALLING]

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What happens if you die when you're thirty?

Life insurance😎

You will probably still be strapped for cash after 30-40 years off the job market.

Please don't introduce me to your financial planner! If properly done, one's wealth should remain steady or increase throughout retirement.

Losing a hundred thousand dollars or so isn't that important over the long (or short) run.

What matter's is that you're happy with your career choice and lifestyle.

My take: If you won't be satisfied going DO, then don't apply!!

 

[drizzt3117]

I kind of find it doubtful that a marginal (or less than) candidate for an M.D. school would magically match into Derm, or Plastics regardless of the school they went to.

There's a whole bunch of people here on sdn that barely made it into med school but cranked out 250+ once they got in MD programs. I'm not going to name names but they're out there, some might even be reading this thread. Pre-med performance doesn't predict med school performance.

 

[NickNaylor]

There's a whole bunch of people here on sdn that barely made it into med school but cranked out 250+ once they got in MD programs. I'm not going to name names but they're out there, some might even be reading this thread. Pre-med performance doesn't predict med school performance.

Definitely true. Just look at the people from Caribbean schools that get ridiculous scores on here. I think we can all agree that the best students don't go to Caribbean schools, yet many of their students knock out astronomical numbers.

 

[drizzt3117]

Definitely true. Just look at the people from Caribbean schools that get ridiculous scores on here. I think we can all agree that the best students don't go to Caribbean schools, yet many of their students knock out astronomical numbers.

Part of that is just having 6+ mo to study for step 1. I think that'd be brutal but I definitely feel I could have done a little better with 4.75 more months to study for the test.

 

[willen101383]

The argument is stupid when you are a 21 year old because 1 year off is really no big deal. But when you are age 27, and finally in a good spot to apply to med school after taking 5 years off to repair your GPA, any additional time off to increase your stats to apply MD is stupid. (Which was my situation). All my friends are residents and attendings and I am an MS2....it sucks...and another year off to retake an MCAT or something would have been a waste of time.

So one year is a different period of time for the 21 year old vs the 27 year old.


And to the guy who thought pre med performance= med school performance: Not even close. I am 9 months away from step 1 so I cannot give you my step one score but my grades went like this:

ugrad: 2.4
masters: 3.78
Med school 3.5

zero bearing my friend.

 

[gettheleadout]

There's a whole bunch of people here on sdn that barely made it into med school but cranked out 250+ once they got in MD programs. I'm not going to name names but they're out there, some might even be reading this thread. Pre-med performance doesn't predict med school performance.

Out of curiosity, would you argue this works the opposite way too? Is it as common for people who get high GPA's and MCAT scores in college to epic fail in med school?

 

[ensuii]

Out of curiosity, would you argue this works the opposite way too? Is it as common for people who get high GPA's and MCAT scores in college to epic fail in med school?

I've seen several cases of this happening. I don't think it happens with extreme frequency however. Most of medical education involves requiring the motivation to remember a certain number of topics to a specific resolution of detail. Most of the time in my opinion, people who have high GPAs and high MCAT had to work moderately hard for it. If you translate the work ethic to medical school (which I think most people do rather well), the content presented shouldn't be anything you aren't capable of mastering.

 

[drizzt3117]

Out of curiosity, would you argue this works the opposite way too? Is it as common for people who get high GPA's and MCAT scores in college to epic fail in med school?

Of course it can happen, but I don't hear about it as much. That's probably b/c it's not publicized. That being said, if you go to a top school, the chance of you doing poorly is really really low.

 

[MSU2009]

ugrad: 2.4
masters: 3.78
Med school 3.5

inspirational

 

[gettheleadout]

Of course it can happen, but I don't hear about it as much. That's probably b/c it's not publicized. That being said, if you go to a top school, the chance of you doing poorly is really really low.

Assuming you're saying if you go to a top medical school and don't mean come from a top undergrad, would you attribute this to grade inflation-esque factors or the quality of education, care for students' learning, or the like?

 

[postbacpremed87]

Sure. One could wait an extra year and be admitted MD. Are you absolutely certain you can match into a competitive residency? Sure you can work hard, but your peers may work harder. Nothing in life is certain. For every risk there is possible reward.

 

[HumbleMD]

Wow. The naivate here is stunning. Oh to be 21 again...

I want you kids to first, as others have said think about what you're doing when your scoff at $150,000. There's this concept called *opportunity cost* which is what puts us at such a disadvantage compared to our equal-aptitude peers who are earning incomes while we're paying for school, and then in residency at only $45K/year.

The other big concept you need to think about is interest, and how it compounds. This is VERY pertinent if you're rocking some undergraduate college loans, which are getting bigger by the day.

Finally, med school gets more expensive every year. In my 5 years at Penn tuition has increased by $1-3K/year, above and beyond inflation which puzzles me.

These concepts also nullify the MD/PhD argument being a money-saver. The opportunity costs *might* make it cost neutral overall, if you're lucky. Someone could fairly easily do the math, but it won't be me - I'm already looking at my mountain of debt.

If you didn't have everything ready by your senior year of college and have to take a year, that's fine. So you had to take time off. Those are the cards you were dealt (or maybe te bed you made), and the reality of your situation. I'm pretty risk averse, but I'd never gamble a year of my life, and income, against "maybe" doing better next application cycle to "maybe" match into a better specialty and "maybe" make a higher income. That's a lot of maybes guys.

In the words of Judge Judy though, "don't pee on my leg and tell me it's raining."

 

[NickNaylor]

Wow. The naivate here is stunning. Oh to be 21 again...

I want you kids to first, as others have said think about what you're doing when your scoff at $150,000. There's this concept called *opportunity cost* which is what puts us at such a disadvantage compared to our equal-aptitude peers who are earning incomes while we're paying for school, and then in residency at only $45K/year.

The other big concept you need to think about is interest, and how it compounds. This is VERY pertinent if you're rocking some undergraduate college loans, which are getting bigger by the day.

Finally, med school gets more expensive every year. In my 5 years at Penn tuition has increased by $1-3K/year, above and beyond inflation which puzzles me.

These concepts also nullify the MD/PhD argument being a money-saver. The opportunity costs *might* make it cost neutral overall, if you're lucky. Someone could fairly easily do the math, but it won't be me - I'm already looking at my mountain of debt.

If you didn't have everything ready by your senior year of college and have to take a year, that's fine. So you had to take time off. Those are the cards you were dealt (or maybe te bed you made), and the reality of your situation. I'm pretty risk averse, but I'd never gamble a year of my life, and income, against "maybe" doing better next application cycle to "maybe" match into a better specialty and "maybe" make a higher income. That's a lot of maybes guys.

In the words of Judge Judy though, "don't pee on my leg and tell me it's raining."

The combination of your username and the condescension present in all of your posts is amusing. Naive though they may be, you don't have to call everyone "kids."

 

[HumbleMD]

The combination of your username and the condescension present in all of your posts is amusing.

Don't worry, my narcissism stems from a genuine lack of positive self worth 😀. That, or being beaten down while studying for Step 2 after being away from medicine for a year.

 

[willen101383]

The combination of your username and the condescension present in all of your posts is amusing. Naive though they may be, you don't have to call everyone "kids."

Yeah it may be a bit condescending...but when you are almost 30 you see things a lot differently than when you are 21.

 

[startswithb]

Yeah it may be a bit condescending...but when you are almost 30 you see things a lot differently than when you are 21.

Who's 21?

 

[willen101383]

Who's 21?

You? I dont know I am just throwing out ages...I saw you were class of 2015. I am 28 and most ms1s at my school are like 21/22/23. The crap that meant so much to me as a 21 year old is totally meaningless to me as a 28 year old.

 

[startswithb]

You? I dont know I am just throwing out ages...I saw you were class of 2015. I am 28 and most ms1s at my school are like 21/22/23. The crap that meant so much to me as a 21 year old is totally meaningless to me as a 28 year old.

Well that's an incorrect assumption. Other people's choices shouldn't bother you so much.

Also, being a 28 yo M2 means that you wasted time and incurred opportunity cost by pursuing a masters and medical degree when you could've been doing *insert other career here*. The argument just doesn't make sense though, because you wanted to be a doctor. People just get mad when others talk about wanting to go to a specific school or follow a specific career path (that they themselves did not do). Doesn't make sense. I didn't want the rest of my career dictated by how I performed in undergrad at age 19/20. So I paid back those two years to reach my potential and go to a school I felt comfortable with. I'll spend a few more years making less money. No one is handing me $150,000 and I'm saying no thanks.

 

[HumbleMD]

Well that's an incorrect assumption. Also, other people's choices shouldn't bother you so much.

A child burning their hand on a hot stove doesn't "bother" me either. I'll still tell them not to do it.

We said 21 because most of the kids commenting here were pre-meds. Lets get back to a real discussion on this. I'd love to see someone do the math.

 

[startswithb]

A child burning their hand on a hot stove doesn't "bother" me either. I'll still tell them not to do it.

We said 21 because most of the kids commenting here were pre-meds. Lets get back to a real discussion on this. I'd love to see someone do the math.

The point is, opportunity cost is lost in a lot of cases, but that it doesn't bother some of us. 21 or 25 or 35. Sometimes in life we take circuitous paths. Happiness and self-satisfaction is much more important than rushing to your 9-5, getting married, having kids, and saving for retirement all in that order. So everyone who didn't have the stats for MD school at age 21 should have given up and gone to podiatry or whatever other career, based on the "math" as you say, choosing the career that would net them the most money at the end of their career? Ok, well, I have yet to meet anyone who thinks that way.

 

[HumbleMD]

The point is, opportunity cost is lost in a lot of cases, but that it doesn't bother some of us. 21 or 25 or 35. Sometimes in life we take circuitous paths. Happiness and self-satisfaction is much more important than rushing to your 9-5, getting married, having kids, and saving for retirement all in that order. So everyone who didn't have the stats for MD school at age 21 should have given up and gone to podiatry or whatever other career, based on the "math" as you say, choosing the career that would net them the most money at the end of their career? Ok, well, I have yet to meet anyone who thinks that way.

That's wonderful for you. Congratulations. I hope the best for you, and hope that you feel the same way when you are 50 and still paying off your med school loans (I sincerely hope you will have no regrets). It was clear when you said earlier "That argument meant absolutely nothing to me" that categorizing the dollar amount would be moot. Other's without your value system need to understand the reality of the situation, however.

And please don't malign math. It's not befitting of an applied scientist.

 

[Barcu]

A child burning their hand on a hot stove doesn't "bother" me either. I'll still tell them not to do it.

We said 21 because most of the kids commenting here were pre-meds. Lets get back to a real discussion on this. I'd love to see someone do the math.

How would you do the math?

By making one decision over the other, you may be significantly altering the direction of your life. Will you end up at the same med school, doing the same specialty, doing the same residency, etc if you applied one year or waited til the next year? If so, the lost year of income would be a convincing argument. However, I have a hard time believing everything will work out exactly the same, just one year later.

You could argue opportunity costs, but I believe that actually figuring out if it would save you money in the long run or not is literally impossible.

 

[startswithb]

That's wonderful for you. Congratulations. I hope the best for you, and hope that you feel the same way when you are 50 and still paying off your med school loans (I sincerely hope you will have no regrets). It was clear when you said earlier "That argument meant absolutely nothing to me" that categorizing the dollar amount would be moot. Other's without your value system need to understand the reality of the situation, however.

And please don't malign math. It's not befitting of an applied scientist.

Yes, I am sure "when I am 50 and still paying off my med school loans" I will be thinking, "man, should've gone DO." Which is essentially the argument here. Luckily, no undergrad debt and my state school is considerably less expensive than the DO schools around here. $150,000 less, as a matter of fact...

 

[Gut Shot]

An argument you see over and over on these threads (usually in referencing putting off applying for a year or to take the DO offer over reapplying) is that you "lose a year of income."

Do you think it is a good argument? Do you actually consider it in your decisions?

I don't find it convincing. To me, it assumes that you are going to do the exact same thing (such as go to the same school) but just delay a year. And this would never happen. What if you declined a DO offer, made it into MD the next year, and then got into a high-paying, DO-unfriendly specialty? You would lose a whole life of income. I'm not trying to make this another MD vs. DO thing, but I just thought of that example because that is where you see this argument most often.

The point is that choosing a different option will lead you in a completely different path, and it is impossible to say that you will "lose a year of income" by starting med school one year later (for whatever reason). Because that one year can drastically change the direction of your life whether it be due to going to one school vs. another, living in a different geographic location, getting a new experience, etc.

I'm just curious how many people think this is a good argument and why they think so. Maybe there is some angle that I just haven't thought of. Everytime I see it, I just don't get it.

Perhaps you should stop looking at the argument from an individual's perspective and look at it as a population study. Say you have 1,000 medical students who delay matriculation for a year (for whatever varied reasons) and 1,000 who do not. Perhaps there is some data supporting a significant difference in specialty selection between such groups, but I doubt it exists. We cannot, therefore, reject the null hypothesis, and the aggregate career trajectory of each group should be similar.

This frees us to consider the effects of matriculating at different times. Yes, if you go to school later you will be older, tuition will be higher, and you will have one less year of income, and one less year of compounding interest, unless you choose to delay retirement. That could be a very substantial chunk of money down the road. But alas, it is down the road, so we have to consider the time-value of money. I would rather have $50,000 right now than $1,000,000 in 2041, but that's a matter of personal judgement.

So, in purely monetary terms the so-called "lost year of income" argument is perfectly valid. However, given the time-value of money and life experiences the choice may not be so simple.

I can tell you that I delayed school for too long, and the pain hasn't been so much about the presumed size of my future nest egg, but rather the annual ritual of seeing where I was versus where I could have been. Starting M3 or finishing M3, starting intern year or finishing intern year, starting fellowship or finally starting a real job with a real paycheck. Yes, it's the little things that kick you in the gonads sometimes.

 

[willen101383]

Well that's an incorrect assumption. Other people's choices shouldn't bother you so much.

Also, being a 28 yo M2 means that you wasted time and incurred opportunity cost by pursuing a masters and medical degree when you could've been doing *insert other career here*. The argument just doesn't make sense though, because you wanted to be a doctor. People just get mad when others talk about wanting to go to a specific school or follow a specific career path (that they themselves did not do). Doesn't make sense. I didn't want the rest of my career dictated by how I performed in undergrad at age 19/20. So I paid back those two years to reach my potential and go to a school I felt comfortable with. I'll spend a few more years making less money. No one is handing me $150,000 and I'm saying no thanks.

Did I say anything you do/did bothered me? And FYI I did have another career and I made plenty of money/bought a house/nice car etc. So yeah, didnt really waste any time there. I am pretty outspoken on the cons of going DO so im not going to say I blame anyone for doing this....just that I think its sort of a stupid reason to bail on your DO acceptance for an MD acceptance a year later. Dont really get where you think having a DO degree is going to "affect the rest of your career," unless you are referring to having certain ROADS doors closed for you.