Too Old For An MD/PhD?

[RyanT731]

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Hey SDN! I'm a first time poster, so forgive any prospective deviations from posting standards, etc.

I just wanted to get some advice on MD-PhD prospects. I'm heavily interested in research and am up for the challenge. I have an extensive graduate background in research and know what it's like from being a microbiology slave as an undergraduate to pulling all nighters in the lab getting a uniporter imaging code in Java to compile. Here are some stats.

Age: 31 years old turning 32 in March.

Undergraduate Major:

B.S. Mathematical Biology, B.S. Biomedical Engineering double major
Cumulative GPA: 3.79, conferred degrees at 22


Graduate Majors:
M.S. Mathematical Biology, GPA: 4.0, conferred degree at 25
M.S. Biomedical Engineering, GPA: 3.83, conferred degree at 29
M.S. Biochemistry GPA: 3.85, will confer this summer

I've been blessed to latch on with jobs as TA's, RA's, and government funding for research to pay for graduate school and living expenses. I'm a little bit in debt (~$12,000..)

I've done extensive research in the use of partial differential equations in modeling microbial, molecular, and viral population dynamics, writing code for molecular imaging, and genetic engineering.

I've done internships over the summer with Amgen and Celgene, and as an undergrad got invited for REU's at UCSD and UC Berkeley. I also had the honor of being a biosciences researcher at Livermore National Labs for a summer. I still remain in contact with a lot of my professors who are willing to write me LORs.

I took my MCAT, but will have to apply next round for personal reasons and to focus on my thesis. I got a 35.

I can program heavily, sharp in physics and math. I have published literature (even one in Science as a lead author).

My fiance, who is finishing up her master's in Psychology will also be applying to medical school. We will be applying to the same institutions, and ones that offer MD-PhD for me.

I'm shooting for (not in order):

Brown University
Albert Einstein College of Medicine
SUNY Stony Brook
Georgetown
UT Southwestern
Texas A&M


I've been discouraged to apply as I'm "too old" to matriculate through the process and be worth an investment for stipends, medical insurance, tuition, etc. Is this true?

I plan on getting a PhD in Biophysics or Biomedical Engineering and an MD in Oncology.

If it doesn't work out, hopefully I'll just apply for a PhD in Biophysics and become a college professor. Being around academia over the years has been interesting, and it is an avenue to do research and still be around the academic material.


Thank you in advance!

 

[TriagePreMed]

You can't get an MD in oncology. You get an MD and then specialize through residency and fellowships. To answer your question, yes it is true that combined programs don't prioritize older students as you'll be in training well into your mid to late 40s when the bulk of your research should be coming out as a PI, but each case is unique. I think many programs will also be wary of the fact that you seem a career student more than anything. If research is truly your objective, a PhD should suffice.

 

[RyanT731]

Sorry, I'm tired, haha, it's 3:05 A.M. where I am.

I wanted to specialize in Oncology and become an Oncologist after the cascade of specializations and training. There's probably other typos in there, so I'll collect those and apologize for them all at once here.

Also, just being around medical culture has fascinated me and really galvanized me to push through and get the MD. Being a doctor has been something that got me around halfway through my MS in BME while I did rotations in nearby hospitals and medical labs. Currently I'm in Texas, and I've done some light work at UT Southwestern. The place is beautiful. I'm aware that they offer their own PhD's there and have bioscientists that are not MDs still working in labs and intermingling with the doctors and other medical scientists, so there's that...

 

[TriagePreMed]

Sorry, I'm tired, haha, it's 3:05 A.M. where I am.

I wanted to specialize in Oncology and become an Oncologist after the cascade of specializations and training. There's probably other typos in there, so I'll collect those and apologize for them all at once here.

Would you mind saying why you even want to be an MD given that you have such a strong focus on research? I can't see a net benefit to your research by spending 10 or so years in medical and clinical training when you could be publishing.

 

[RyanT731]

Well, I've had an extensive history of being exposed to illness. My mom is a two time surviving cancer patient, and my dad passed away from a stroke. Only reason I ever got undergraduate assistance was that we had very low income. Coupled with two younger sisters, we all collectively felt jealous and insecure about the lack of income we had and jealousy of classmates over material items and intact families. Reflecting on that made me understand the emotional aspect of medicine, healthcare, and biology. It was sort of sad growing up, getting that look from a cashier when you went to WIC, or feeling like a loser that isn't self sufficient getting help from our local church. I want to help prevent or at least abate that in some sort of way. Although I love research, I've felt like so far my research has been publishing, and waiting for a cascade of citations and critiques. I haven't really developed anything direct in the sense of altruistic benefit, mostly the elucidation of biological phenomena that other scientists will use in their work. That feeling hit me the hardest when I went to graduate school for mathematical biology, and my days just consisted of scribbling Lesbegue integrals and partials on the board. It was sort of detachment from humanity. I'm fully aware than an MD-PhD is already research intensive and has elements where you are detached from humanity (I'm aware most, if not all, don't really treat patients), but I feel like an MD can steer me in the right direction and give me a spark with exposure to something more humanistic. That feel is why I steered to returning to bioengineering and biochem in general, because of the human application. I feel like I can maximize my aspirations through an MD.

If all else fails though, I know my dissertation for a PhD will probably be in something relating to medical hardware or diagnostic tools to benefit humans directly.

Talking about having kids one day with my fiance a couple of years ago also cemented a lot of this in, and I've noticed that a lot of the time I spent in grad school in biological fields was a misconstrued desire to do something about humanity. Unfortunately, few academics that I've been around do something "revolutionary" in terms of direct patient benefits. It's mostly theory that other people use. A good analogy is mathematics and physics. A lot of mathematicians in the 18th and 19th century had no idea about the application of the mathematics they were theorizing with the exception of some dual mathematicians/physicists like Newton or Bernoulli. They set up the idea, and physicists along the way picked up the math to explain the phenomena.

 

[darkpassenger]

It sounds like you already have an extensive research background with a lot of publications, so I'm not sure the PhD will provide you much benefit unless you want to drastically change research fields. You could consider getting an MD only, as you will still be able to do research at an academic medical center. Its a much shorter route, and I imagine MD-only programs would be more willing to take someone at your age. Also, it will be easier for both you and your fiance to attend the same institution if you apply MD-only.

 

[dl2dp2]

I feel like an MD can steer me in the right direction and give me a spark with exposure to something more humanistic. That feel is why I steered to returning to bioengineering and biochem in general, because of the human application. I feel like I can maximize my aspirations through an MD.

To be honest, you are both too old and your motivation to go into medicine will not jive well with the admissions committees and I don't think it's a wise career move for you. You don't go into medicine to "get more exposure" to anything. You go into medicine to practice medicine and become a doctor. Furthermore, as one previous poster hinted, your three MS and a lack of significant work experience are troubling elements in your CV, and your motive for career transition is unclear.

Nevertheless, given that your numbers are within a reasonable range and research experieence, if you applied, there is a chance that you might still be offered a spot, especially for some of the lower ranked schools on your list. However, I would strongly caution against proceeding in this career because from what you wrote, it sounds to me like you have very little understanding of what MD/PhD is about and what being a doctor is about.

The safer option for you, if you are 100% committed to medicine and becoming a practicing doctor, is to proceed and apply for medical school. Even then, though, there is a high likelihood you'll be dissatisfied with what medical education and medical practice looks like once you spent years getting there.

 

[TriagePreMed]

Unfortunately, you're not going to be Newton by being an MD/PhD. Instead, you will spend at most 1 day in clinic if not just straight up research. If you're interested in human application, perhaps you should be going into a lab that does things like that more directly instead of spending 10 years of medical training (not PhD included) to just do a diagnosis here and there. The truth is that at the end of the day you may never become a PI because you'll be too old by the time you have strong papers to get that position, and you may never be a top clinician because 80-90% of your time is spent away from patients. If I were you, I would go into Biomedical Engineering PhD, go into an applied lab and move on. Getting a PhD in Biophysics is going even further away from human application.

Well, I've had an extensive history of being exposed to illness. My mom is a two time surviving cancer patient, and my dad passed away from a stroke. Only reason I ever got undergraduate assistance was that we had very low income. Coupled with two younger sisters, we all collectively felt jealous and insecure about the lack of income we had and jealousy of classmates over material items and intact families. Reflecting on that made me understand the emotional aspect of medicine, healthcare, and biology. It was sort of sad growing up, getting that look from a cashier when you went to WIC, or feeling like a loser that isn't self sufficient getting help from our local church. I want to help prevent or at least abate that in some sort of way. Although I love research, I've felt like so far my research has been publishing, and waiting for a cascade of citations and critiques. I haven't really developed anything direct in the sense of altruistic benefit, mostly the elucidation of biological phenomena that other scientists will use in their work. That feeling hit me the hardest when I went to graduate school for mathematical biology, and my days just consisted of scribbling Lesbegue integrals and partials on the board. It was sort of detachment from humanity. I'm fully aware than an MD-PhD is already research intensive and has elements where you are detached from humanity (I'm aware most, if not all, don't really treat patients), but I feel like an MD can steer me in the right direction and give me a spark with exposure to something more humanistic. That feel is why I steered to returning to bioengineering and biochem in general, because of the human application. I feel like I can maximize my aspirations through an MD.

If all else fails though, I know my dissertation for a PhD will probably be in something relating to medical hardware or diagnostic tools to benefit humans directly.

Talking about having kids one day with my fiance a couple of years ago also cemented a lot of this in, and I've noticed that a lot of the time I spent in grad school in biological fields was a misconstrued desire to do something about humanity. Unfortunately, few academics that I've been around do something "revolutionary" in terms of direct patient benefits. It's mostly theory that other people use. A good analogy is mathematics and physics. A lot of mathematicians in the 18th and 19th century had no idea about the application of the mathematics they were theorizing with the exception of some dual mathematicians/physicists like Newton or Bernoulli. They set up the idea, and physicists along the way picked up the math to explain the phenomena.

 

[tortuga87]

I think it's generally true that an MD and a PhD degree can help you perform research that more directly benefits healthcare, in the sense that you can direct your research to things that work well with the hospital. I see MD/PhDs do this type of research more often than PhDs at least in my department (Biomedical Informatics)

Several issues you may want to consider:
1. Medical school & residency take up a lot of time from research
2. A lot of the really novel things (i.e. ideas from left field) require more basic research that will require some time to be actually applied in the clinic. I notice that people who perform more direct research use well-established ideas in a specific way (typically)
3. There is a tendency for people in academia to create general ideas or proofs of principle that industry takes up to really apply to the clinic. There's a lot of minutiae involved in actually making things happen in the clinic, even if you have a good idea. Have you considered looking up careers in biotech companies?

 

[gbwillner]

You are not a good candidate because you are extremely high risk for dropping out based on your age. Regardless of your motivations, you will be 39-42 by the time you finish your MD/PhD. That means you will be 42-48 by the time you finish residency, and if you want to do a fellowship, will be 43-52 before finishing training. Let's not even talk post-doc, I think most posters are throwing up in their mouths a little bit just looking at those numbers.

 

[ratherbefishing]

Agree with all above. For many, the phd is a tool to train you to think like a scientist, not necessarily the topic you will research for your career. Sounds like you already have great research training (if not a desire to avoid getting a real job). MD-only would be a good way to go although it doesn't seem like you appreciate how different medicine is and why you're going in to it.

We don't talk about it too much on this forum, but even at the normal MD-PhD age, it kind of stinks being older and still going through training. Your friends have moved on, it's harder to relate to your younger peers, you will want things (security, income, kids, status, questions from family to stop, etc). It causes strain on you to have to delay life (retirement savings, kids) that makes you likely to either drop or not be as happy as you might think.

 

[QofQuimica]

I don't think you have a very good idea of what the day-to-day job of a physician entails. Have you shadowed any physicians? If so, you should shadow some more. And I agree with the others that while a PhD may or may not be necessary for your career aspirations, an MD is for sure not necessary unless you want to take care of patients.

Speaking as someone who went to med school in my 30s after completing a PhD, I would not consider you to be a good candidate for med school. Not because of your age, but because you have provided no good reason for getting a medical degree. Medical training isn't an intellectual exercise, and the system isn't set up to allow for attrition due to loss of interest the way graduate training is. So if you're not in for the full pound (becoming a licensed, practicing physician), then best to avoid spending that first penny.

 

[Doctor246853]

Damn guys 🙁 OP I have been wondering this too (Im 29 and will be applying just before my 30th birthday) and these responses are very discouraging...

 

[Underarchiever]

The age of 32 is also a bit old for a Ph.D. program. But a lead author in Science may offset some of the doubt. The best route for OP is to enroll in the Ph.D. program where his/her master credits can be counted towards his Ph.D. degree.

 

[gbwillner]

I just hope you don't intend on having a family any time soon, because you'll make more money as a store clerk than you will as a PhD or MD/PhD student. And at least McDonalds won't have you going Q3 call.

 

[Guyton Killah]

The age of 32 is also a bit old for a Ph.D. program. But a lead author in Science may offset some of the doubt. The best route for OP is to enroll in the Ph.D. program where his/her master credits can be counted towards his Ph.D. degree.

Exactly.

 

[TriagePreMed]

Damn guys 🙁 OP I have been wondering this too (Im 29 and will be applying just before my 30th birthday) and these responses are very discouraging...

Don't feel bad. A lot of people find ways around this. They go into a residency that has a focus on research. Then they do a research fellowship (3+ years). These people are great candidate for any job that an MD/PhD would apply to. The only reason to really do an MD/PhD is to avoid the debt and the need for a research fellowship.

 

[Rucap09]

.

 

[StilgarMD]

I think the question of "How old is too old" is very personal. Some people think the path itself, at any age, is insanity. You just have to decide if you're prepared to be a certain age at each of the stages of training, and whether it will interfere with other plans you have in life.

 

[Leforte]

To the OP - Not sure what the advantage of a PhD would be for you. Presumably with your several MS degrees, you have been involved with bench level science and know what is involved with that career choice. There are many, many physicians/surgeons without a masters or PhD who are very active in research. A PhD will be an additional 2-5+ years to your medical degree - time that you can focus on getting ABIM certification and an oncology fellowship. Even if you did a PhD, you will then spend 2 more years in med school, 3 years in IM and 3 years in fellowship - before you can even think about getting your own funding.

If you are worried about the cost of med school - 2-5+ years of an attendings salary vs a MD/PhD stipend will quickly pay off that debt.

In fact, there are many articles looking at the success of MD vs MD/PhD in obtaining funding and there really is little difference.

 

[PathToMDPhD]

I'm 32.

I have both MD and MSTP interviews this fall.

I have had only a handful of outright rejections thus far, with lots of time left in the cycle.

Don't say it can't be done.

Lastly, food for thought: There is a fine line between constructive advice and destructive negativity. The advice, I get. Not the negativity. It's pointless, and only tears people down and discourages them.

Let someone make up his/her own mind about the future, whether you personally think it's crazy or not.

Don't judge me until you've walked a mile in my shoes ...

 

[gonogo]

You are not a good candidate because you are extremely high risk for dropping out based on your age. Regardless of your motivations, you will be 39-42 by the time you finish your MD/PhD. That means you will be 42-48 by the time you finish residency, and if you want to do a fellowship, will be 43-52 before finishing training. Let's not even talk post-doc, I think most posters are throwing up in their mouths a little bit just looking at those numbers.

There are too many variables to consider. For example, you may start your md-phd at age 24 and then have a long PhD (5 years, not really that unusual). You may be done at age 33. Then you decide to do neurosurgery and you won't be an attending until age 40. On the other hand, you can start md-phd at age 30, have a short PhD and be done at 36. Do internal medicine or some other short residency and you'll be an attending at age 40. So really the whole age thing depends on many factors.

 

[uniqenam]

There are too many variables to consider. For example, you may start your md-phd at age 24 and then have a long PhD (5 years, not really that unusual). You may be done at age 33. Then you decide to do neurosurgery and you won't be an attending until age 40. On the other hand, you can start md-phd at age 30, have a short PhD and be done at 36. Do internal medicine or some other short residency and you'll be an attending at age 40. So really the whole age thing depends on many factors.

A 2 year PhD? That seems ... optimistic.

 

[gbwillner]

....So really the whole age thing depends on many factors.

That's why I gave the age ranges. Given the OP's stated age, assuming they apply NEXT year as stated and matriculate the following year, is 33 (age) + 6-9 year MD/PhD = 39-42. This is already kinda unrealistic since a 6 year MD/PhD is very, very unlikely (I've only seen it once). The mean is north of 8 years. 10 years is more common than 6. Probably so is 11 or even 12. Personally, I know a handful who took more than 11 years, and lots who took 10 years.

For residency, the shortest track would be clinical pathology, at 3 years. This comes with a built-in research year, but a vast majority of residents will be forced to do either a clinical fellowship or at least a post-doc. But without it, the bare minimum will be 42, assuming a 6 year (highly improbable) MSTP + a 3 year CP residency, without any post-doc or fellowship. The odds of getting a decent research-based faculty position with the above is almost zero.

It's kind of silly with these best-case scenarios- almost no one will ever meet this. Let's look at more reasonable numbers...

More commonly would be a medicine residency with a fellowship. If you are 33 and and do an 8 year MSTP (which means working very hard, being both productive and lucky), you graduate at 41. You then do a 3 year residency and a 3 year fellowship. Now you are 47. Depending on fellowship and research experience, you probably don't have any NIH grants at this point, meaning you probably will do a post-doc. This may be 1-3 years. Now you are almost 50, and you've just gotten your first career development grant. By the way, you've been earning a resident salary or worse for 3/5 of your life. Welcome to junior faculty status. Hopefully you land your first R01 by 55, and you don't die of old age before then.

But what is FAR more likely to happen is that you get to 2nd year of the PhD, when all your 24 year old kid-"colleagues" are graduating medical school, and here you are a 37 year-old adult surrounded by 22 year old graduate students. You may be married and have a family. You realize that you've got about 10 or more years of training ahead of you, and bench work isn't as easy or rewarding as you thought it would be. Plus, you are TIRED. So you quit and go back to salvage a reasonable medical career that is already going to be pretty short. And that's why you are a bad candidate. It's not YOU specifically, it's that this scenario is played out over and over and you fit the profile of someone who is not going to make it.

 

[gonogo]

That's why I gave the age ranges. Given the OP's stated age, assuming they apply NEXT year as stated and matriculate the following year, is 33 (age) + 6-9 year MD/PhD = 39-42. This is already kinda unrealistic since a 6 year MD/PhD is very, very unlikely (I've only seen it once). The mean is north of 8 years. 10 years is more common than 6. Probably so is 11 or even 12. Personally, I know a handful who took more than 11 years, and lots who took 10 years.

For residency, the shortest track would be clinical pathology, at 3 years. This comes with a built-in research year, but a vast majority of residents will be forced to do either a clinical fellowship or at least a post-doc. But without it, the bare minimum will be 42, assuming a 6 year (highly improbable) MSTP + a 3 year CP residency, without any post-doc or fellowship. The odds of getting a decent research-based faculty position with the above is almost zero.

It's kind of silly with these best-case scenarios- almost no one will ever meet this. Let's look at more reasonable numbers...

More commonly would be a medicine residency with a fellowship. If you are 33 and and do an 8 year MSTP (which means working very hard, being both productive and lucky), you graduate at 41. You then do a 3 year residency and a 3 year fellowship. Now you are 47. Depending on fellowship and research experience, you probably don't have any NIH grants at this point, meaning you probably will do a post-doc. This may be 1-3 years. Now you are almost 50, and you've just gotten your first career development grant. By the way, you've been earning a resident salary or worse for 3/5 of your life. Welcome to junior faculty status. Hopefully you land your first R01 by 55, and you don't die of old age before then.

But what is FAR more likely to happen is that you get to 2nd year of the PhD, when all your 24 year old kid-"colleagues" are graduating medical school, and here you are a 37 year-old adult surrounded by 22 year old graduate students. You may be married and have a family. You realize that you've got about 10 or more years of training ahead of you, and bench work isn't as easy or rewarding as you thought it would be. Plus, you are TIRED. So you quit and go back to salvage a reasonable medical career that is already going to be pretty short. And that's why you are a bad candidate. It's not YOU specifically, it's that this scenario is played out over and over and you fit the profile of someone who is not going to make it.

You're making a lot of valid points, and I agree that going the md/phd route may not be the best career choice for the OP. I just wanted to give a different perspective regarding age, and I just think it means something different for everyone. If you're a typical md/phd and finish at age 30 (around average?) and then decide to do a long residency + fellowship, you won't be done until your late 30s. For many people it would be 'crazy' to train for so many years, yet, for the person doing it, it may be normal. So as I said it's all relative. Maybe for the OP it's fine not being done until age 45, maybe he doesn't see other career choices as viable alternatives.

 

[QofQuimica]

I'm 32.

I have both MD and MSTP interviews this fall.

I have had only a handful of outright rejections thus far, with lots of time left in the cycle.

Don't say it can't be done.

Lastly, food for thought: There is a fine line between constructive advice and destructive negativity. The advice, I get. Not the negativity. It's pointless, and only tears people down and discourages them.

Let someone make up his/her own mind about the future, whether you personally think it's crazy or not.

Don't judge me until you've walked a mile in my shoes ...

I would argue that if anything, the OP appears to need some serious straight talk, especially given his/her lack of a realistic reason for wanting to go to medical school in the first place. Several of us who responded to his/her questions have adcom experience, and most of us have also successfully gone through the med school app process and some or all of the medical/graduate degree training process. The OP asked for and received our input for these reasons. I don't think anyone gave him/her "destructive negativity."

The fact that you have received some interviews is great, but that doesn't mean that what is right for you is also right for the OP. I'd also gently point out that getting an interview is not the same as getting an acceptance. I hope everything goes well with your app season and you do get into the MD/PhD program of your choice, but please understand that you will be more of the exception if you start an MD/PhD program at age 33, not the rule. That is not negativity; that is a statement of fact, verifiable by looking at MD/PhD program admissions statistics.

 

[OCDOCDOCD]

I would argue that if anything, the OP appears to need some serious straight talk, especially given his/her lack of a realistic reason for wanting to go to medical school in the first place. Several of us who responded to his/her questions have adcom experience, and most of us have also successfully gone through the med school app process and some or all of the medical/graduate degree training process. The OP asked for and received our input for these reasons. I don't think anyone gave the him/her "destructive negativity."

The fact that you have received some interviews is great, but that doesn't mean that what is right for you is also right for the OP. I'd also gently point out that getting an interview is not the same as getting an acceptance. I hope everything goes well with your app season and you do get into the MD/PhD program of your choice, but please understand that you will be more of the exception if you start an MD/PhD program at age 33, not the rule. That is not negativity; that is a statement of fact, verifiable by looking at MD/PhD program admissions statistics.

Seriously, I'm 25 and at the two interviews I've attended so far I've been the oldest interviewee at both by a substantial margin. Most interviewees are 21-22, and I've seen a couple 19-20 year olds as well. I think I might have seen a 23 year old at one interview. It's got me seriously reconsidering my original plan of reapplying MD/PhD next cycle if I don't get in this year. I'm starting to feel like matriculating at 26 is already pushing it.

 

[StilgarMD]

Seriously, I'm 25 and at the two interviews I've attended so far I've been the oldest interviewee at both by a substantial margin. Most interviewees are 21-22, and I've seen a couple 19-20 year olds as well. I think I might have seen a 23 year old at one interview. It's got me seriously reconsidering my original plan of reapplying MD/PhD next cycle if I don't get in this year. I'm starting to feel like matriculating at 26 is already pushing it.

I'm 23, and at times I feel old. I have no idea how people manage to be so competitive so early on. I did start college a year late, but that would still make me only 22, and only if I applied Junior year and not taken a gap year would I be 21... you play the hand you're dealt. you're the only one who can decide if a path will make you happy in the end, I know one reassuring thought is, either way, the time will pass. I'm my case, I'll reach 32 eventually (assuming nothing bad happens), and What I decide today is if I will be happier at 32 having gone through medical school and done research or happier doing something else. Currently, my choice is the former.

 

[Cnote81]

guys i thought i'd chime in on this- i'm finishing an md/phd this year and currently applying for ptsp residencies. i started back in 2006 at the age of 25, and i turn 32 very soon. my third year classmates, when i returned to med school, were all ~24 and had much different tolerances and expectations from their experience than i did. as you get closer to 30 you see a lot of your cohort go off and start living normal, adult-ish lives, while you're still stuck in a weird in between world. i could not imagine being 40 and stuck in the same spot. i would really advise the OP to think about other options.

 

[crimsonkid85]

I entered into my md/PhD program when I was 21/22 and I still wish I could have started earlier. I know this is not what most want to hear but I'm just sharing my personal experience.

 

[Fencer]

My first "real" job, t-t assistant prof, started at age 34 with single income family of 4 (2 kids 8 and 6). When I was chief resident (before 80 hrs/wk), one of my first year residents was 52 (MD track). Everyone treated her just like anybody else and her energy level was similar also indistinguishable from other people in the team. I saw her earlier this year at a professional conference, 16 years later. I did not see evidence of burn-out and she is still practicing... Age is something relative. A lot of it is mental attitude. If this is your dream, pursue it with "fire" in the belly.