Well... I don't have insight into completion of a PhD program. So, you've definitely got more of a perspective there, but I do have a single friend in Chemistry who completed his post doc and is now in a tenured position. That being said, I'm sure the job market, and post doc experiences drastically differ from field to field, so I can't speak on that. However, you can't ignore the copious partial and complete tuition and fee waivers. Some of the requirements in various states/universities are ridiculous and anybody who puts forth a little effort can obtain them. That's unless you're going to MIT or Harvard I would imagine... I also doubt as a post doc you were working 60-80hrs/week with your post doc salary and significantly less debt burden compared to an MD, but I could be wrong. My friend was not, but that's a post doc appt in Chemistry.
Is the PhD track long and arduous? Sure... but you have an enormous chance at mitigating the financial cost and debt burden. I'm not arguing that gaining a PhD is any less difficult and perhaps it is more "risky" but that's a little subjective. (PhD in English or Chemical Engineering?, etc..) You owe much less debt and have nothing close to the financial burden that an MD does, and probably risk trying for several years to get the type of faculty assignment that you want. My understanding is that most who reach 5 years post doc start looking for a position in the industry.
Honestly, I find the whole PhD vs MD comparison from a financial "fairness" perspective to be more than bit skewed. After all, the PhD doesn't have to worry about medmal, isn't making decisions every day that affect the lives of patients, isn't having end of life discussions, etc... Any of us could go on. That's worth arguing that the stress/strain/risk could and should equate to a financial gain. That doesn't make a doc greedy, that's just fair. At the moment, that financial gain is being hacked away by inflation of federal interest rates and the lengthening of residency programs.
Regardless, you sound similar to myself in that you are probably older having come from a previous educational/career track, so that begs even more financial planning... If you come from money, great. I don't. I'll be 38 when I graduate next year from a 4 year residency with a 300K debt burden. It's not something I like to think a lot about.
My primary point in all of this discussion is that I think residencies are TOO long and lengthening them while doing nothing to mitigate or lessen the financial burden/risk makes no sense. Also, you are much closer to minimum wage than you think by the above examples. The financial risk and debt burden are extensive for most graduating physicians and I think it's absurdity to lengthen residencies while medical education becomes even more expensive and interest rates have launched into the stratosphere with IBR as a piss poor way to ameliorate the raping of your financial future in accrued interest during your training. Is IBR possible? Sure, but how many guys do you know actually pay IBR? I know a few, but certainly not the majority of residents. I don't have any numbers but that seems to be the general consensus. If I'm making upper 40's salary, that's $400 a month that honestly, I needed most months when I was not able to moonlight. If you've got a car payment, house/apt note, etc.. $400 is a lot of money to most residents who are tempted to just forego and worry about it all after their training. If you're making 50's, then you owe probably around $500 a month. I don't know about you, but when I first started out in the field of IT (before grad school), I made close to 50K in my first job (I was ecstatic.). I couldn't have paid an extra $500 a month easily at all and I live in one of the parts of the U.S. with the lowest cost of living. If I had lived in NY as I did previously... forget about it.
So, here's my concise opinion for anyone who cares and then I'll shut up, I promise.
1) Lengthening residencies = Bad idea.
2) Medical education cost = Too Much. Not enough incentive for primary care which is becoming overrun by NP's. Med students and residents don't want to take on enormous financial burden to pursue a field that makes half that of many other specialties. With the enormous inflation of federal loan interest, it makes little financial sense.
3) Medical students and residents are overwhelmingly undereducated about their own financial picture, especially post 2005/6 with the debt burden and 6.8% - 7.9% interest rates. Most residents and students I speak with are under the impression that, like their predecessors who took loans out at 2.5%, they can just graduate residency, buy that big house and maybe splurge on a fancy car and pay on their loans over the course of their entire career. Financial suicide. If anything Uncle Sam has taught us with the new overhaul in educational lending... is that he wants his money back, but he wants it back NOW opposed to later.
Seriously, get a financial planner to anyone out there with big loans and in a similar financial picture. It will save you a world of hurt in the long run.
Ok, that's it from me.
