thoughts from a non-trad who just started internship

[startoverat40]

somebody messaged me with these questions, I thought I'd share my response with everyone.

. Obviously Med school is tough, but is it manageable with kids. Did you have enough time/ stamina at the end of the day for your family. E.g. Homework with kids etc what were your typical hours In School and what is your schedule now.
. Are there other non traditional students with you who are older than most other students, are there groups and comrades to help each other or is it cut throat competition all the time.
. Since you are starting your internship, do you find your self happy with the overall decision of going back to school. Do you find that there is a lot of changes happening within the profession such as managed care and insurance interference, and with all the changes, are other MDs happy with their career choice.
. Is there still a strong job market for future doctors, or is the competition growing with huge influx of foreign grads.
Do you absolutely have to be top 10% to get into some of the competitive fields.

Thank you for offering to help, I really appreciate your time.

i started med school at age 41. there have been multiple men and women in every class of our school who have had kids of various ages, who successfully made it through med school. but it does take a lot of support from spouse/family/pets/friends/etc to make it happen. best thing would be to finish all studying, assignments, notes, etc, at school, hospital, library, etc, before you go back home cause once you go back home and spouse and kids demand your attention, then its very hard to put focus back on school/work stuff.

study hours were 4-6 hours a day during 1st and 2nd year, and 12-15 hours a day during 6 weeks prep for Step1. i suggest firecracker and picmonic. in 3rd year do UWorld questions for each clerkship, with couple hours of study time a day.

i was 2nd oldest in my class. average age was 27, with many students in late 20's and mid 30's. it wasn't cut throat at my school. there was no grades per se, just pass/fail, and top points on exams (93% and above) made it for AOA, otherwise it didn't matter. we had the choice to include our grades compared with class average on dean's letter or not.

I'm happy overall with my choice, but there are many days when my resolve gets tested. I had a nervous breakdown in 2nd half of 4th year and took me a year to get over it. took some counseling and few months of medications. keep exercising and eating healthy and staying connected with friends and family to avoid or minimize mental health issues.

changes in medical profession will provide challenges, but they're not impossible to deal with. nothing is easy. medicine might be one of few career fields to be somewhat protected from automation, artificial intelligence etc. although radiology and pathology might not be totally immune. anyway can't protect yourself 100% from all risk. just move forward with a plan and go through with it.

i don't know how "huge" influx of foreign grads is, but I think with the political situation, global warming, more natural disasters, etc, there will be more and more demand for doctors, especially primary care.

if you are open to moving to any part of the country, there is always chance that you can match into any field. in med school they told us don't worry about your step1 score too much. it's better to get highest score you can, but even if you are average you can still match somewhere. it might take more effort/networking/research etc, but it's doable.

hope that helps. feel free to ask more.

 

[esob]

Do you think your age played a factor in your choice of specialty or were you always planning on family medicine regardless?

 

[startoverat40]

If I were in my 20s and single, I might have considered a surgical specialty. actually, general surgeons and family docs can do the most good for the most people. and if they pair up in a small community, together they can take care of 99% of people's needs.
I chose family medicine for many reasons: personal values, consideration of what the world needs, variety in patients and issues, wide range of practice settings, job security,... take a look at this:

 

[Ad2b]

I'll be (hopefully) 53 when I start MS1... that's a BIG hopefully Son is an adult, he's a premed now too. No matter what, we're not doing med school together (I'm hoping he'll app @gyngyn's school so I can be helo-parent or not).

Stamina is not something I lack (up at 6:30ish and often on the go until midnight or 1 AM - like today). I'm healthy, no pre-existing anything; generally sane ... say I do get in this cycle (sheer luck being so late)...

What would you say I should do over the summer? Did you notice any big difference during intern year between energy of you and your peers? The CEO of the multi specialty I consult at told me that intern year was the worst; that he'd never been made to feel like such an insignificant piece of guano by everyone (patients, other residents, attendings - think I have that right?)

As for FP, I see that going the way of NP/PA for the younger folks. No reason from a financial aspect for clinics to pay the RVU of a doc when they can pay much less for "similar" service of NP and make more money (not saying that's how *I* see it just that I'm in finance and people who've never been to med school or attempted any science class don't seem to grasp the aspect that an NP/PA =/= MD/DO )

Anyway, thank you for chiming in - have a friend who's MS3 now at 57 or 58? I pick her brains too

 

[startoverat40]

for cough and cold NP/PA will be fine, but good luck if you want them to handle your DKA, COPD or CHF exacerbation! family docs can work as hospitalists or ER docs. they can deliver babies, and they can do minor surgical procedures. etc etc.

Practice Options for Family Physicians

 

[Ad2b]

for cough and cold NP/PA will be fine, but good luck if you want them to handle your DKA, COPD or CHF exacerbation! family docs can work as hospitalists or ER docs. they can deliver babies, and they can do minor surgical procedures. etc etc.

As I said, I do not disagree with you BUT the finance groups of not only where I'm at now but in previous places... they don't exactly see it that way.

 

[startoverat40]

There is definitely a difference in my stamina and energy level and that of my younger colleagues, but I wouldn't say a big difference. I know docs in their 50's who still work 80-100 hrs a week. so internship isn't necessarily the end of working long hours :/

 

[startoverat40]

As I said, I do not disagree with you BUT the finance groups of not only where I'm at now but in previous places... they don't exactly see it that way.

The beauty of primary care is that you can make your own rules. ultimately it is between you and your patient. I can accept chickens for payment if I want to

Direct Primary Care

 

[Ad2b]

The beauty of primary care is that you can make your own rules. ultimately it is between you and your patient. I can accept chickens for payment if I want to

Would you agree that many FP work in hospitals/clinics and not as sole practitioners? Serious question because the only FPs I know are in private practice in large/rural clinic groups or hospitals affiliated with the same.

 

[Ad2b]

There is definitely a difference in my stamina and energy level and that of my younger colleagues, but I wouldn't say a big difference. I know docs in their 50's who still work 80-100 hrs a week. so internship isn't necessarily the end of working long hours :/

That sounds like the first 3 years of Sarbanes-Oxley attest... I can do that! as long as there is a cot around somewhere with a jacket to cover my shoulders

 

[startoverat40]

Would you agree that many FP work in hospitals/clinics and not as sole practitioners? Serious question because the only FPs I know are in private practice in large/rural clinic groups or hospitals affiliated with the same.

There has been a lot of big groups buying out solo practices, cause it's hard for solo to compete with large groups. But with DPC you're not playing the same game (getting paid by insurance, paperwork, headache), so I think it can be a way to keep the independence of solo practice.

Dr Rob Lamberts, LLC