Who regrets going to med school and what would you have done instead?

[Raidergate]

you thinking axis I or II?

After reading this thread, axis 2 for sure.

My .02:

First two years:

Were the suck for me. I'm naturally very gregarious and like to be around people. I made the mistake of studying on my own at least 70% of the time, so the school aspect was horrible for me. As with other posters, I came damn near quitting studying for step 1. Looking back, though, I had a great time outside of school. Had some of the craziest parties, went to the lake, went skiing 2x each winter, made some good friends, met some good people, and so on and so forth. The school aspect sucked, no doubt, but I made it through.

I have 2 weeks left in my 3rd year now, and I'm on call with my medicine team tonight, admitting all kinds of "friday night lights" type things, couple of suicide attempts with tylenol, a man with lung mets, the typical old man from the nursing home with AMS, and so on and so forth.

All I know is, 3 more calls, one more NBME, Step 2 in 5 weeks and I'm freakin' done with med school tests!

(aside from Step 2 CS, which mainly tests if you can successfully speak the english language).

Third year has been absolutely great for me. Once again, my personality has been better cut out for this year, and I've loved interacting with all kinds of patients/residents/attendings (when they aren't bitching). I've placed a couple of central lines, several chest tubes, intubated people, sewed up about 20 drunks, delivered 15 babies (when the resident wasn't shoving me out of the way) seen people get better, seen people die, and seen people being taken care of in hospice by some of the best people I've ever met, sat through another 400 lectures, although these are only an hour at time, along with a ton of other things. A few rotations sucked, and since I'm going into gen surg, they're predictable (psych, fam med). But, overall, this year has been very reaffirming for me when thinking about my career, and has absolutely flown by.

4th year? It's gonna rock. Surgery sub-I in July, followed by visiting rotations the next three months in gen/trauma at programs I'm looking at, and a burn month. After that? Donecakes, pretty much except for some ambulatory months, where they could care less if the 4th year is around. And, I'm getting married to my fiance next April. She's a peds resident at a big-time program, and is only about 50 times smarter/better at school/better looking/more compassionate/tougher than I am.

So, yes, a year and a half ago, I hated what I was doing, hated the time I had to put in, hated the fact that my personal life was on hold, hated the fact that most of the people in my class seemed like real ball busters, and hated the idea of 2 more years of school. I'd have straight killed it on this thread griping about everything, and I'm pretty sure I did at some point during that time.

Now? Looking back, it wasn't so bad. I acted like a huge pansy at times, but I made it through. The light at the end of the tunnel is starting to shine my way.

(Remind me to post again in two years when I've had an intern year in surgery under my belt, and see what I have to say.)

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[Kajukenbo]

the average medical student could do well anywhere given his/her propensity for hard work.

the hot shot cardiothoracic surgeon would be king anywhere. he was king in med school, king in undergrad, and could be king in law/engineering/business if he wanted.

leaders aren't leaders in one specialty. its not a god-given gift in a specific field. it's an inherent quality in them that makes them so great. the cream rises to the top, no matter what.

all medical students are the cream. you have a population of people who maintained 3.5+ GPA's in non-bull**** fields that actually takes intelligence and work to achieve. Then, we achieved 30+ MCAT scores. In high school a very large number of us probably easily beat a 1400 SAT hands-down. When compared to the average, we shine. When you put the shining stars together, it's harder to stand out.

you take any medical student out of the medical school element and put them among average joes, theyll shine again. they may not be the brightest star, but in a field of the average drudgery, you can bet we'll be a world apart.

this may not apply to nontraditionals who are 50 and in medicine, but for those of us right out of college, this is generally true.

job security? medicine has incredible security. but in any job we'd be far beyond the curve (at the very least one standard deviation), and in general that in itself affords some security.

gujudoc - you mention relatives who lost their jobs because there was no work. i'm willing to bet they got back on their feet. in the real world, goliath destroys david 99 out of 100 times. in the real world, medical students are overachieving hard workers, and would do well as a result of their deligience 99 out of 100 times.

we are the goliaths of society; we put ourselves through weeks of sleepless nights, on call, in the library, etc with ever-increasing piles of work, stress, and tension that destroys our vision, shoots our kidneys, and gives us tension headaches that no ergotamine will ever cure. i'm not saying we're the ONLY kings out there, there are plenty of talented engineers, lawyers, businessmen, etc. but we rank among them, and will thus, in general, do quite well in a more "average" field

Each individual in medicine as well as people in other fields have strengths and weaknesses. Here is an example: there are people in medicine who found math (it wasn't high level math either) to be extremely difficult and did not do well as hard as they tried. Some found the first course in Calculus to be like pulling teeth. These individuals would have never been able to do well in an ugrad math/physics/chem, program etc. let alone even think about pursuing graduate education in these areas.

Everyone in medicine did not always excel throughout their lives for various reasons, but they had opportunities to redeem themselves. This is why they have post-bacc programs, etc. This is why some decide to go for another second degree.

As far as hard working, believe it or not, there are many people NOT in medicine that are also extremely driven and very intelligent. I experienced this as I pursued a doctorate before going to med school.

I am familiar with people that were psych grad students ( as a ugrad I worked for a psych dept). They were very hard working and academically strong individuals. Competition to get in to these programs are extremely tough and the programs are also very rigorous.

 

[fractalgal]

I am not a medical student. I found the SDN by accident, and I am amazed by what I read in some of these posts. I had this perception of what the life of a doctor and/or medical student was like, and after reading these forums I can tell you that I had no idea how stressfull it was to become and be a physician.

I have a graduate degree in mathematics. Graduate school was challenging and it forced me to go out of my comfort zone, however, those feelings of accomplishment are something that I look back on fondly.

I could never be a doctor because I would have too difficult of a time separating myself (emotionally) from my patients. I am too sensitive.

We need good doctors , and I hope you all stick it out. There will come a time when you will look back on these difficult times when you were a medical student and you will be proud for getting through it.

 

[MarzMD]

Glad you found this site. I wish more people outside of the medical field undertood what we have to go through and why we complain about the things we do as medical students and physicians.

 

[Kajukenbo]

I do love medicine and the specialty that I had chosen. At times I wish I had done this the first time around. Because of imbreeding (unable to get a spot in the dept one gets a doctorate in) and the overall competition for an academic position, the job outlook for a doctorate isn't as good. I would agree that there is more job security in med.

 

[rowdybow]

you know, i don't really like med school either. I am literally tired if it. When it gets bad, I just don't go. My main regret is that I didn't take (another) year off, cash that savings account, and go around the world (but I will do it one day).

I got the same complaints everyone else does. I don't like med school, cause I don't like school. Its boring. Its not interactive. I have to deal with a surprising amount of unreasonable people (but even more good ones). We learn lots of stuff that I probably won't remember. People go into minutaem but I never get a clear explanation of a lot of basic things, which I have to look up. I work hard and dont do as well as I like (but I will get better). When I complain, people think I am weird. There's a lot of idealistic/sheltered classmates who don't want to hear about certain things (although I am not one to talk, but I at least know there is bad stuff our there). The job is probably going to take a lot of time in my life, time I could have spent having fun...like my friends are now. One just got offered a permanent position in London doing financial. One substitute teaches/coaches waterpolo/lifeguaurds. All are lifestyles I would like, and I probably won't ever have lots of time off. I full on expect my life to be BUSY ALL THE TIME (now I can't be dissapointed ;-) ) and to be nagged at by superiors. I probably should have got more clinical experience before I went, but oh well. Maybe I should have done something else. Maybe I should have done a lot of things.And since I am a worrier, the stress BLOWS. Changes my personality man. But I try to keep a handle on it. Should-time is gone, now it's do-time But I have a goal, I made a decision, and I'm sticking to it. I see one way out, and it ain't easy, and I'm gonna do it. And I am gonna laugh cause I made it. I am so pumped for my Anatomy final now.

What keeps me going is:
1. I will have a *REAL* useful skill set that few people have. Not a paper pusher, law interpreter, or money middleman. You feel bad? I can fix it or tell you what to do (or at least what it might be, most of the time).

2. Role model: People listen to doctors. I look forward to being a voice in my community, and being in touch with health issues from citywide to my kids school. And the only boring docs I have met, were boring people too. I am not boring.

3.Money: I ain't gonna lie. I know its not a fortune, heck maybe I could make more doing something else. But it ain't bad pay to talk to sick people and solve problems. And its a good foundation to use to make real money if you want. I can't take all that stuff with me anyways.

4. wide range of work areas: Medicine is pretty darn broad. I basically really pick my career fourth year. Even then, theres so many different ways to practice. Easy opportunites, I think, to travel, especially EM. I would like to live an uncommon life. People might shut down those who want "dream jobs" but you know what? I had people tell me I wouldn't be able to do a lot of things, and I did them anyhow.

5. Residency will suck. But res is only, what, 3-5 tops for most people. If its longer than that, my friend, you don't hate what you do, you love it. Better than 40-50 years doing a job I couldn't make myself feel worthy about. I'm crazy.

If you hate it, pay off most of the loan, and get a different job. Desk job for bio company. Expert witness for a lawyer. Move to another country. Be a fisherman. Work in a bike shop. If you can learn biochem, you can learn any skill pretty fast. Who wouldn't hire you? (this last paragraph is moot if you have the "double whammy": I really hate my job that is eating my life, but I can't leave it cause I have a wife and kids. Now you are in the seventh circle.)

Remember, you are the iron: if you wanna become something, you got to be forged.

 

[Kajukenbo]

you know, i don't really like med school either. I am literally tired if it. When it gets bad, I just don't go. My main regret is that I didn't take (another) year off, cash that savings account, and go around the world (but I will do it one day).

I got the same complaints everyone else does. I don't like med school, cause I don't like school. Its boring. Its not interactive. I have to deal with a surprising amount of unreasonable people (but even more good ones). We learn lots of stuff that I probably won't remember. People go into minutaem but I never get a clear explanation of a lot of basic things, which I have to look up. I work hard and dont do as well as I like (but I will get better). When I complain, people think I am weird. There's a lot of idealistic/sheltered classmates who don't want to hear about certain things (although I am not one to talk, but I at least know there is bad stuff our there). The job is probably going to take a lot of time in my life, time I could have spent having fun...like my friends are now. One just got offered a permanent position in London doing financial. One substitute teaches/coaches waterpolo/lifeguaurds. All are lifestyles I would like, and I probably won't ever have lots of time off. I full on expect my life to be BUSY ALL THE TIME (now I can't be dissapointed ;-) ) and to be nagged at by superiors. I probably should have got more clinical experience before I went, but oh well. Maybe I should have done something else. Maybe I should have done a lot of things.And since I am a worrier, the stress BLOWS. Changes my personality man. But I try to keep a handle on it. Should-time is gone, now it's do-time But I have a goal, I made a decision, and I'm sticking to it. I see one way out, and it ain't easy, and I'm gonna do it. And I am gonna laugh cause I made it. I am so pumped for my Anatomy final now.

What keeps me going is:
1. I will have a *REAL* useful skill set that few people have. Not a paper pusher, law interpreter, or money middleman. You feel bad? I can fix it or tell you what to do (or at least what it might be, most of the time).

2. Role model: People listen to doctors. I look forward to being a voice in my community, and being in touch with health issues from citywide to my kids school. And the only boring docs I have met, were boring people too. I am not boring.

3.Money: I ain't gonna lie. I know its not a fortune, heck maybe I could make more doing something else. But it ain't bad pay to talk to sick people and solve problems. And its a good foundation to use to make real money if you want. I can't take all that stuff with me anyways.

4. wide range of work areas: Medicine is pretty darn broad. I basically really pick my career fourth year. Even then, theres so many different ways to practice. Easy opportunites, I think, to travel, especially EM. I would like to live an uncommon life. People might shut down those who want "dream jobs" but you know what? I had people tell me I wouldn't be able to do a lot of things, and I did them anyhow.

5. Residency will suck. But res is only, what, 3-5 tops for most people. If its longer than that, my friend, you don't hate what you do, you love it. Better than 40-50 years doing a job I couldn't make myself feel worthy about. I'm crazy.

If you hate it, pay off most of the loan, and get a different job. Desk job for bio company. Expert witness for a lawyer. Move to another country. Be a fisherman. Work in a bike shop. If you can learn biochem, you can learn any skill pretty fast. Who wouldn't hire you? (this last paragraph is moot if you have the "double whammy": I really hate my job that is eating my life, but I can't leave it cause I have a wife and kids. Now you are in the seventh circle.)

Remember, you are the iron: if you wanna become something, you got to be forged.

I can relate to your frustration. The one problem with leaving medicine is that the loans are so high that many are just stuck with it. Obviously, each year of school, the debt accumulates. If we ditch the profession, we may never make enough to pay those horrendous loans back.

What year are you? I think you will find it to be more interesting as you move through your program. Your clinical years are going to be very different than the first two years of basic science.

Your lifestyle will really depend on your specialty. I am familiar with attending psychiatrists that work on a 9-5 basis. They do not take calls after hours. No hospital work. All crisis calls are referred to the suicide and crisis center, or the ER (life threatening ones). They don't even take crisis calls during their work hours.

 

[old_boy]

What keeps me going is...

Great post! You articulate the plusses of medicine very well.

 

[gujuDoc]

Great post! You articulate the plusses of medicine very well.

Yes I agree.

I'd like to also add that medicine has a lot better job security.

 

[da8s0859q]

Yes I agree.

I as well.

 

[lilnoelle]

What keeps me going is:
1. I will have a *REAL* useful skill set that few people have. Not a paper pusher, law interpreter, or money middleman. You feel bad? I can fix it or tell you what to do (or at least what it might be, most of the time).

2. Role model: People listen to doctors. I look forward to being a voice in my community, and being in touch with health issues from citywide to my kids school. And the only boring docs I have met, were boring people too. I am not boring.

3.Money: I ain't gonna lie. I know its not a fortune, heck maybe I could make more doing something else. But it ain't bad pay to talk to sick people and solve problems. And its a good foundation to use to make real money if you want. I can't take all that stuff with me anyways.

4. wide range of work areas: Medicine is pretty darn broad. I basically really pick my career fourth year. Even then, theres so many different ways to practice. Easy opportunites, I think, to travel, especially EM. I would like to live an uncommon life. People might shut down those who want "dream jobs" but you know what? I had people tell me I wouldn't be able to do a lot of things, and I did them anyhow.

5. Residency will suck. But res is only, what, 3-5 tops for most people. If its longer than that, my friend, you don't hate what you do, you love it.

yep, couldn't have said it better myself. these are some things that attracted me to medicine and I still feel this way. I can add one as well: we get the opportunity to learn some pretty fascinating stuff and do some pretty fascinating things (i.e. surgery).

 

[gujuDoc]

Each individual in medicine as well as people in other fields have strengths and weaknesses. Here is an example: there are people in medicine who found math (it wasn't high level math either) to be extremely difficult and did not do well as hard as they tried. Some found the first course in Calculus to be like pulling teeth. These individuals would have never been able to do well in an ugrad math/physics/chem, program etc. let alone even think about pursuing graduate education in these areas.

Everyone in medicine did not always excel throughout their lives for various reasons, but they had opportunities to redeem themselves. This is why they have post-bacc programs, etc. This is why some decide to go for another second degree.

As far as hard working, believe it or not, there are many people NOT in medicine that are also extremely driven and very intelligent. I experienced this as I pursued a doctorate before going to med school.

I am familiar with people that were psych grad students ( as a ugrad I worked for a psych dept). They were very hard working and academically strong individuals. Competition to get in to these programs are extremely tough and the programs are also very rigorous.

Yeah I know quite a few examples of people outside of medicine who are very driven as well. My cousin in computer programming for one. He had barely any money when he first came here in 1998 and now he's a millionaire in less then 10 years working he pushed real hard to get to the top and still pushing real hard to go further and possibly start his own business in computer programming. His sister in India with just her bachelor's in business is another example of really driven people.

But what I think N.B. was saying is that the really driven people (in his opinion) outside of medicine are a handful while he believes those really driven people in med school are all driven and the kind of people that would succeed in something else if they really wanted it.

To a certain degree I don't discount his opinion. Yet, I have known many current med students who are somewhat lazy and don't fit that bill. There's one guy who nearly flunked his first year who fits that bill. As an undergrad many told me he used to cheat a lot. He had claimed he wanted to be a surgeon but i often question whether he'd have the grades or board scores to get into surgery. There are others I know who are like him. There was one guy who was even kicked out of medical school cuz he failed step 1 3 times and he failed it cuz he was lazy and did not study for it. Not everyone who makes it in would be in that top tier. Maybe those who make it out however are another story altogether.

 

[Kajukenbo]

Again, medical people like anyone else have their strengths and weaknesses. I have met many in medicine that could barely do math beyond the first semester of calculus. As hard as they tried, they still received poor grades. They could not even get a ugrad degree in the physical sciences let alone a doctorate in one of them. One student of mine wanted to get an engineering degree, but couldn't get through the pre-reqs no matter how hard she tried. Her next back up plan was medicine because she was interested in it and the courses were not very math intensive.

Not everyone with the ability and drive to pursue medicine will do so. Some have no interest in this and may even hate hospitals. So, they pursue other fields of interest that require just as much education, work and stamina. And there are a lot of careers that do require an enormous amount of it. There are also some people with a lot of drive that just can't afford to go to college and end up having to drop out.

Having been through several jobs and careers including a doctorate program, I have met many many non-medical people that are very driven. So, I am going to be fair. I will not generalize by saying that most people outside of medicine lack motivation and intelligence. That would just be plain wrong and selfish.

 

[TheDrugMan]

I don't know how true this is but I have heard from a future med student that most people cheat through their first two years of medical school. I dont know how this would be possible. Is there any validity to this?

 

[Mr. Freeze]

My wife would kill me...

 

[Shredder]

I've posted already but I'll post again. I regret coming here and now even after my first year I am looking for escape routes. If only I had stronger work experience I could land a solid Wall St job as I have the grades and test scores, being the dedicated and misguided premed I was for all those years. Nobody in the real world cares about dumb labwork, shadowing, and tutoring positions. Test scores I don't know how valuable they are.

Lemme know how to get outta here and to a respectable firm with potential to rise up fast. I will work my ass off. First year of med school was a breeze, I had so much free time and partied so much it made me angry. Throughout the year I was pissed off I couldn't finish in 3 years--2 years for basic sciences is ridiculous and I've voiced this on other threads. Utilize the summers before and after med 1 (or at least make this an option) and cram USMLE and preclinical things into post M2 year. I'll see what other bitching I can do as needed (normally I wouldn't do so but given the nature of the thread I feel it's ok).

Also med students aren't smart, they are dorks. They're not even very good at studying, they study all the wrong stuff and the wrong way and live in the library. Oh yeah they're not driven either unless driven means matching into a cush specialty and playing golf in afternoons. Or, like other peers of mine, going into medpeds and working in free clinics and third world trips. So if you call that driven I will give you that but my definition's a bit diff.

 

[TheDrugMan]

I've posted already but I'll post again. I regret coming here and now even after my first year I am looking for escape routes. If only I had stronger work experience I could land a solid Wall St job as I have the grades and test scores, being the dedicated and misguided premed I was for all those years. Nobody in the real world cares about dumb labwork, shadowing, and tutoring positions. Test scores I don't know how valuable they are.

Lemme know how to get outta here and to a respectable firm with potential to rise up fast. I will work my ass off. First year of med school was a breeze, I had so much free time and partied so much it made me angry. Throughout the year I was pissed off I couldn't finish in 3 years--2 years for basic sciences is ridiculous and I've voiced this on other threads. Utilize the summers before and after med 1 (or at least make this an option) and cram USMLE and preclinical things into post M2 year. I'll see what other bitching I can do as needed (normally I wouldn't do so but given the nature of the thread I feel it's ok).

Also med students aren't smart, they are dorks. They're not even very good at studying, they study all the wrong stuff and the wrong way and live in the library. Oh yeah they're not driven either unless driven means matching into a cush specialty and playing golf in afternoons. Or, like other peers of mine, going into medpeds and working in free clinics and third world trips. So if you call that driven I will give you that but my definition's a bit diff.

Shredder

Some of the smartest people in the world are the big players in the financial markets. They are not out there trying to cure cancer or help people. Why would they if they can extract large amounts of money out of the markets?
It's a very tough business and very few become superstars.

Medical school may be full of dorks and people living in the library but most of those people make it past an above average income which is good seed money for investing/trading. You should use it as a stepping stone and in the meantime since you have so much free time in medical school go pick up some books on technical trading and sytem/model design and testing. Get a backtesting program like Tradestation to test out any possible idea or edge you may have and make sure you DO NOT curve fit the sytems. If you can develop a solid track record in your trading account then you can get your foot into one of the hedge funds. If you have no trading capital you can also try to go the finance career route and just drop out of medical school. Maybe you can start out with a decent market making firm. You should be young and have the finance degree (good school, GPA) to get in. I personally would find doing quantitive analysis and sharing my ideas with a private hedge fund more enjoyable. Either way you approach it you have to learn how to trade and see market mechanics in action.

I have designed a few systems myself, but lack the capital and time to get them rolling. I've traded sporadically for the last 8 years. The first 3 years I was a losing to breakeven trader, probably because I had unrealistic expectations. After that I started to make money but my track record was never consistent enough to land a job with a firm. I could have got in as phone clerk at the CBOE through my brother but I turned it down years ago. I want to put my own ideas to work and not just be a salaried trader who does what they are told. Realistically to make a good living on Wall Street one would need $500K because if you can make 20% in the markets then you are a king. Using anything more then 2:1 leverage is an invitation to get your head handed to you. Google search "Long Term Capital Management" and you will see why. Although they had some of the smartest people in the world working with them, they were struck by a black swan event which destroyed them. Go watch the movie "Trillion Dollar Bet". It is a documentary about the downfall of LTCM. Very interesting movie. One final piece of advice. If you think it's hard to compete with med students then you haven't seen anything. Proceed with caution because the big boys see you coming. They thrive off of neophytes with $10,000 trading accounts. Donate as little as possible until you learn. You can PM/email me if you want to talk markets. Good luck

 

[uvce]

.....I regret coming here and now even after my first year I am looking for escape routes. If only I had stronger work experience I could land a solid Wall St job ...

Lemme know how to get outta here and to a respectable firm with potential to rise up fast. I will work my ass off. .....

The escape route is to get out of med school to Wall St. and take up any job, particularly since you say that you are willing to work your a$$ off, and not expect that you are going to land a solid job with the potential to rise up fast right away - that is totally unrealistic in any field. It might happen, might not, anybody's guess. Why spend years in a field which you don't seem to be interested in, and complain about it?

 

[da8s0859q]

The escape route is to get out of med school to Wall St. and take up any job, particularly since you say that you are willing to work your a$$ off, and not expect that you are going to land a solid job with the potential to rise up fast right away - that is totally unrealistic in any field. It might happen, might not, anybody's guess. Why spend years in a field which you don't seem to be interested in, and complain about it?

That little piece of advice, combined with some self-honesty among premeds, could probably spare the world some future unhappy doctors.

 

[Mr. Freeze]

Shredder, your posts are sad. You are, and I mean this in the best possible way, a perfect example of people who don't do enough homework before they get into the field, or at least feel out a couple of areas before coming to medicine. It is pretty obvious you'd be happier elsewhere. There are a lot of things I don't know yet, and I'm sure things will crop up that I get jaded about, but the overall theme is that I'm pretty happy doing what I'm doing so far. Is it a calling? Not at all. It's a job, and for me, the simple fact of the matter is that even with all the sky is falling SDN paranoia about salaries, there isn't anything legal I personally could do that will pay me as much. There aren't very many firemen making six figs...

I know you're all about the Street. My career in medicine is a means to an end; I wouldn't have the capital to get ahead without it. So I plan to use that to invest heavily, and in riskier equities because I can make that money back if the house takes it.

Something else that crossed my mind as a career option the other day while doing some "homework" was a medical consultant/analyst for a firm or bank. Look at the analysts covering pharm stocks. They're MD's. Something to think about.

 

[YupGypsy]

shredder, why don't you give the foreign exchange market a shot?

 

[stat3113]

Here is what someone posted:

"4. wide range of work areas: Medicine is pretty darn broad. I basically really pick my career fourth year. Even then, theres so many different ways to practice."

Reading the stats/speculation that the vast majority (say 70%) of med students place into IM/ped/etc residencies really seems to contradict this statement. What this says to me is that unless you are in the top 10-20% of your class (grades, usmle, etc), you are restricted to a lifetime of being an internist. (NB: I'm a pre-med so excuse my ignorance)

Does your type of residency determine what kind of doctor you will be? Does this say that everyone except the upper echelons in med school have no career paths open to them upon graduation except becoming a family physician?

A side question: I can see myself doing research (after med school) or perhaps even teaching, etc. What are the career paths (within medicine) that lead to these?

 

[smq123]

"4. wide range of work areas: Medicine is pretty darn broad. I basically really pick my career fourth year. Even then, theres so many different ways to practice."

Reading the stats/speculation that the vast majority (say 70%) of med students place into IM/ped/etc residencies really seems to contradict this statement. What this says to me is that unless you are in the top 10-20% of your class (grades, usmle, etc), you are restricted to a lifetime of being an internist. (NB: I'm a pre-med so excuse my ignorance)

Does your type of residency determine what kind of doctor you will be? Does this say that everyone except the upper echelons in med school have no career paths open to them upon graduation except becoming a family physician?

1) I hope that you won't "pick your career" 4th year. If you want to do anything remotely competitive (I'd say even including general surgery, or internal med/family med/peds at a top notch place), then you need to have your **** together by the end of third year. You need to have an idea of where you're going to do your electives, what programs you're competitive for, etc.

2) The phrase "restricted to a lifetime of being an internist" is poorly phrased, and ignores how hard many general internists work. A good primary care doctor has to balance packed (and unpredictable) schedules with patient needs. A lot of them are well-trained and very good teachers. Don't knock them, and don't assume that they were "forced" to become family med doctors because they were lazy/not very smart. I can't tell you how many family med doctors/pediatricians that I have met were in the top 5% of their med school classes.

3) No, just because your grades aren't outstanding doesn't mean that you have to be a family med physician. There are other specialties that are less competitive, but are not general/primary care related. Example: pathology, OB/Gyn, emergency med (in some areas), neurology, psychiatry.

Furthermore, if you want to become a cardiologist / pulmonologist / oncologist / etc., then you MUST spend your residency as a general internist, before pursuing further training in these sub-specialties.

4) [MOST IMPORTANT] If you're pre-med, why are you worrying about this NOW? Isn't your first priority supposed to be actually getting IN to med school?

A side question: I can see myself doing research (after med school) or perhaps even teaching, etc. What are the career paths (within medicine) that lead to these?

If you see yourself doing research, think long and hard about just getting a PhD and not going to med school.

 

[Shredder]

The escape route is to get out of med school to Wall St. and take up any job, particularly since you say that you are willing to work your a$$ off, and not expect that you are going to land a solid job with the potential to rise up fast right away - that is totally unrealistic in any field. It might happen, might not, anybody's guess. Why spend years in a field which you don't seem to be interested in, and complain about it?

Looking into this right now--have a connection, might start something up over summer and perhaps into next yr. May do leave of absence from school if it's worthwhile. Will update shortly when things become more clear. Wall St!

Gypsy I can't get actively involved in investing currently due to lack of capital. It's one of my big qualms about med school, no money to play with and steadily decreasing net worth due to heavy loans. It gets into present/future value (can't remember) of an MD degree though so it's complex I guess. Freeze I see what you mean about med as means to end but I just find business more inherently interesting and universally applicable than med. Med seems blue collar to me somehow. White coat or not you are still dealing with ostensibly gross stuff and cases. Also lots of interactions with commoners and yeah this is a turn off for me

I think a lot about the opportunity cost and accruing debt over the next several yrs of my medical path. I too viewed med as a means to an end, but how far can you justify the means? Can't find Trillion Dollar Bet on Netflix, DrugMan--I did recently enjoy "Barbarians at the Gate" though. I want to read Liar's Poker soon, supposedly a Wall St classic.

Btw all of the most fantastic skyscrapers in the world and the world's greatest cities are all financial hubs! Always financial. Money is too important

 

[Bahadur]

plan before med school: become doctor, settle down, have a family, learn how to hyperlink

plan after med school: find this guy to get me to look more like this guy so this girl and this girl would follow me to this state and they would repeal this lawand i can drop out of med school

at least one of my original plans followed through

HAHAHAHAH, sorry i'm not a Med Student, but i just wanted to say I also LOVE Bollywood women, especially the gorgeous Aishwarya Rai, haha.

k, i'm done. Once again sorry, anything remotely Bollywood related excites me like a little kid in a candy store.


btw- Who is the first plastic surgeon? he looks familiar, i think i saw him on Dr. Phil once.

 

[JacobSilge]

Here is what someone posted:

"4. wide range of work areas: Medicine is pretty darn broad. I basically really pick my career fourth year. Even then, theres so many different ways to practice."

Reading the stats/speculation that the vast majority (say 70%) of med students place into IM/ped/etc residencies really seems to contradict this statement. What this says to me is that unless you are in the top 10-20% of your class (grades, usmle, etc), you are restricted to a lifetime of being an internist. (NB: I'm a pre-med so excuse my ignorance)

Does your type of residency determine what kind of doctor you will be? Does this say that everyone except the upper echelons in med school have no career paths open to them upon graduation except becoming a family physician?

A side question: I can see myself doing research (after med school) or perhaps even teaching, etc. What are the career paths (within medicine) that lead to these?

The numbers you are working with are innacurate. Here is some data from a paper written by Paul Jolly PhD titled "Charting Outcomes in the Match."

In the 2005 match there were a total of 14719 US Allopathic seniors in the main match. There were combined 10565 positions available in IM, Peds, FM, and IM/Peds. All other specialties constituted 8887 positions, however this number is a bit lower than the actual number because a number of specialties (mostly surgical subspecialties) use the early match (Neurosurg, Neurology, Urology, ENT, and Opthamology). Just based on number of positions available, there are a little more than 45% specialties and a little less than 55% "primary care." In reality, US Allo Seniors are over represented in those specialty fields relative to FMGs and IMGs and (looking in the MSAR it seems like most US Allo schools seem to have about 50% going into IM/FM/Peds, with a greater percentage in primary care focused schools and less in many private schools). So a conservative estimate would put the percentage of US MD's going into non-IM/FM/Peds fields to be a little over 50%, not the 30% you mentioned.

But that's not all! Half of those IM/FM/Peds spots were internal medicine (5058), and about 40% of IM trained physicians do further fellowship training to enter specialties like Cardiology, Oncology, Gastroenterology, Endocrinology, Rheumatology, Infectious Disease, Allergy/Immunology, and Nephrology (a smaller percentags of Peds will sub-specialize too). So that's about another 2000 specialists. Many of the remaining 3000 future internists will choose to be hospitalists instead of primary care, and many competitive students will choose IM/FM/Peds out of interest rather than desperation.

Therefore, when all is said and done I can say relatively conservatively that much more than the top 50% (not 10-20% as you said) of a given US Allo Med Class will be able to avoid IM/FM/Peds if he or she so chooses.

Disclaimer: Yes, it is very difficult to get into competive specialties like Plastics, Derm, Rad Onc, Radiology, Surgical Subspecialties, or Cardiology (after fellowship) and being in the top 10-20% with great USMLE scores may not even be enough. However, there are a number of specialties that don't require this (sure, it helps for top programs) such as Psychiatry, Pathology, Emergency Medicine, General Surgery, Neurology, or Physical Medicine and Rehabilitation and some IM Subspecialties. Hell, even within IM you can have a clinic, be a hospitalist, make hospice/nursing home work a large part of your practice. So there really is a large amount of variety available for the average US grad. The real question is if you're interested in any of it !

 

[TheDrugMan]

Can't find Trillion Dollar Bet on Netflix, DrugMan--I did recently enjoy "Barbarians at the Gate" though. I want to read Liar's Poker soon, supposedly a Wall St classic.

http://cgi.ebay.com/Trillion-Dollar...goryZ309QQssPageNameZWDVWQQrdZ1QQcmdZViewItem

Here is a VHS on Ebay. It's highway robbery but it's a documentary no longer produced. Last time I checked, my local library had it in their video section so you should try there. You definitely have to watch it. It's a great lesson about the consequences of using leverage, regardless of how smart one may be.

Shredder. Like you I also have a fascination with the the supply and demand of the markets, but also love science. From my years of observing the markets it all comes down to a very simplistic scenario. The markets either go up, down, or sideways. That's it This is probably why I am choosing medicine as a career path. The complexities of life and existence itself fascinate me more then anything. There is always something new to learn.

I do some stuff on the side for a little lunch money, but was never able to make a living from it. No matter how many books you read or how much you learn it all comes down to your psychological makeup. This is what seperates the winners from losers. You must use discipline/money management but at the same time be able to pull the trigger when the opportunities present themselves. Besides that, defining your edge constantly is what gives you the confidence to execute. You should never ever take a shot in the dark, regardless of your performance. Every move should be pre-calculated before you go into battle.

Liar's Poker is a good book but the all time classic is Reminiscences of a Stock Operator by Edwin Lefevre. It's almost 100 years old but still very popular. It is about Jesse Livermore. One of the greates investors of our time. He made and lost millions in the 1930's (which would be like billions today). It's a great book on the psychology of a trader. I wish you good luck on whatever path you may take.

 

[Shredder]

Haha...I love the tone drugman, very Sun Tzu like. After my first year of med school though I too have found many things boil down to high or low. There's a saying in derm, "if it's wet, dry it; if it's dry, wet it". This seems to apply to much of medicine--identify what's high or low, big or small, hot or cold and bring it back to homeostasis via some drug or procedure. It was astounding how algorithmic some of my questions and cases were on tests.

Maybe this is a grass is greener on the other side thing for me right now. I don't know, I haven't had enough exposure to fields outside of medicine yet. Perhaps I'll get some and reevaluate.

 

[cfdavid]

Haha...I love the tone drugman, very Sun Tzu like. After my first year of med school though I too have found many things boil down to high or low. There's a saying in derm, "if it's wet, dry it; if it's dry, wet it". This seems to apply to much of medicine--identify what's high or low, big or small, hot or cold and bring it back to homeostasis via some drug or procedure. It was astounding how algorithmic some of my questions and cases were on tests.

Maybe this is a grass is greener on the other side thing for me right now. I don't know, I haven't had enough exposure to fields outside of medicine yet. Perhaps I'll get some and reevaluate.

Hey man, I was pretty underwhelmed by 1st year as well. I thought the science was cool, but it's not like we really were DOING anything. I'm looking forward to 2nd year since now we'll be learning the bread and butter of medicine, more or less. Stuff we can apply a bit more.

Perhaps you'll feel differently as time goes on. Also, someone else stated that you could use medicine as a platform to build up some capital (hopefully, you'll get SOMETHING out of medicine). Then, you can pursue your entrepreneurial desires. Who knows, maybe you'll find such opportunities in medicine.

I would caution you on the grass is greener phenomenon. This could be a problem for you if you don't rain it in, assuming you're sticking this out. Cause, it's gonna get pretty tough at times (internship/residency) and the last thing you'll need during those times is to be thinking about what you "should be doing".

 

[Kingora]

Can someone tell me how to start a thread start a thread

 

[fractalgal]

Maybe this is a grass is greener on the other side thing for me right now. I don't know, I haven't had enough exposure to fields outside of medicine yet. Perhaps I'll get some and reevaluate.

My husband is a financial (actuarial) executive. His job is financially rewarding; however, his type of career would not offer the healing rewards that I think a medical career would give a person.

His job is stressful at times - as I am sure a medical career/and or medical school is.

He has NEVER had any educational debt. I think the amount of debt one has to take on to get a medical degree is outrageous! Its a barrier for many people. (If a parent/someone else helps to pay for it, that is different.)

Nonetheless, some people would not enjoy working with numbers all day.

Having the satisfaction of knowing you helped a child to walk better (etc.) would be very rewarding IMHO.

 

[jimmys]

Help...
$ 64 for 4 years membership. How does that sound. Anybody tried it. Should I go for it. Is it worth it?

 

[menaniac]

Can someone tell me how to start a thread start a thread

If you look at the top of the page in the section you want to post in (like "allopathic" or "non-trad students", etc.) you will see a button the says "new thread". Click that, and post away! Good luck!

 

[Cirrus83]

Yes I agree.

I'd like to also add that medicine has a lot better job security.

Heh, especially if you own your own private practice You could show up an hour late every day, and sure your patients who scheduled early appointments would eventually ditch you for another doctor, but you still wouldn't be fired

 

[sirus_virus]

If you are just in your first year, I am going to guess you probably owe <70k in loans. If you don't like what you are doing already, I would say you cut your loses RIGHT NOW and go pursue your "true love".

 

[Shredder]

his type of career would not offer the healing rewards that I think a medical career would give a person.

Having the satisfaction of knowing you helped a child to walk better (etc.) would be very rewarding IMHO.

See I think the satisfaction of completing big deals is much more rewarding than dealing with people one by one. Big deals ultimately impact far more people. Some people go into orthopedic surgery bc they like the immediacy of the results--person rolls in with broken bones, days later they are up and walking and thanking you for bolting and screwing them together.

Big deals are not things that exist separately from humans. They could result in thousands of productivity and pay increases that allow employees to buy car or medical procedure they always dreamed of. So I'm reluctant to accept the argument that doctors help people and businessmen etc dont. It comes down to providing the greatest increase in utility for the greatest number of people, and thus one is paid accordingly. Radiologists and Pathologists too do not often see the end result of their work but still contribute.

Incidentally actuarial science is pretty neat

 

[Cirrus83]

BTW my official answer to this question is:
Dot.com billionaire. It's pretty obvious really.

Or maybe 10 time World Series of Poker winner. That's a job right?

 

[fractalgal]

See I think the satisfaction of completing big deals is much more rewarding than dealing with people one by one. Big deals ultimately impact far more people. Some people go into orthopedic surgery bc they like the immediacy of the results--person rolls in with broken bones, days later they are up and walking and thanking you for bolting and screwing them together.

Big deals are not things that exist separately from humans. They could result in thousands of productivity and pay increases that allow employees to buy car or medical procedure they always dreamed of. So I'm reluctant to accept the argument that doctors help people and businessmen etc dont. It comes down to providing the greatest increase in utility for the greatest number of people, and thus one is paid accordingly. Radiologists and Pathologists too do not often see the end result of their work but still contribute.

Incidentally actuarial science is pretty neat

I agree that businessmen help people. Many businesses also donate to charities. Insurance is a form of finance that protects many people - even doctors.

I was referring more to the personal affect of seeing the impact your work [as a doctor] has on people that you heal.

 

[megadon]

Here is what someone posted:

"4. wide range of work areas: Medicine is pretty darn broad. I basically really pick my career fourth year. Even then, theres so many different ways to practice."

Reading the stats/speculation that the vast majority (say 70%) of med students place into IM/ped/etc residencies really seems to contradict this statement. What this says to me is that unless you are in the top 10-20% of your class (grades, usmle, etc), you are restricted to a lifetime of being an internist. (NB: I'm a pre-med so excuse my ignorance)

Does your type of residency determine what kind of doctor you will be? Does this say that everyone except the upper echelons in med school have no career paths open to them upon graduation except becoming a family physician?

A side question: I can see myself doing research (after med school) or perhaps even teaching, etc. What are the career paths (within medicine) that lead to these?

The majority of breadth of medicine is within IM/Peds/FP. Look at all the specialties that come out of IM and Peds. So pre-med, wait until you go through physiology and pathology and realize how much is going on with IM. FP, hats off to those guys, you have no idea what your are going to be looking at before you grab the chart and walk through the door. At least with the specialties, like GI, you see mostly the same crap over and over. IBS, reflux, Hep. And peds, you're working with kids, not the easiest group of pts to examine.

 

[mjl1717]

Its always " if I knew then what I know now"

But at my undergrad- Boston U. I walked pass the School of Nursing every day. I didnt know nursing would be like that!! Also at that time I couldnt get in the brain a male nurse, although today 13% of nurses are male.. Actually one doesnt need a Phd. in nursing, a Masters can probably get him or her over the six figure mark.. With the Masters you can do clinical medicine as Nurse practioner, get tired of that and do academic medicine. And never retire doing administration! Sometime in between I would have catapulted into conventional medicine.. [Be the big fat nurse in the office pointing fingers] But dont get me wrong I didnt "throw in the towel"!

 

[brewmeistervi]

I think that everyone should remember that doctors are not the smartest people in the world, and money isn't something that necessarily is thrown at the smartest people. Most successful people I've met are go-getters, hard working, self reliant, and don't expect to receive anything. They work hard to get the competitive edge, and they will usually get lucky in the process...

Doctors are hardworking, and most are quite competitive... but I feel that there is a thin line that separates the doctor from other professions. The basis of the profession has moral and ethical guidelines that are followed with more scrutiny than other "sworn in" professions (though Nifong is now catching some hell). Though I feel that some some doctors need to develop a stronger business mentality... these unique professional obligations don't allow them to care more about the bottom line, at least for fields that don't have elective treatments ...

in other words... there are a lot easier ways to make money... you certainly don't have to be a doctor...

 

[chrisjohn]

Oh how easy it is to spout that first year was a walk in the park. I didn't see too many folks in my class chilled out constantly. Yea we have a few, who can really blow and go, 3 standard deviations above the mean IQ, but damn those people are the exception. If you didn't honor Gross, don't talk smack.

Shredder if you're such a genius, dude/dudette put your money where your mouth is and go beat on the doors of big finance. Your big brain will wow your interviewer, ensuring you the position of your dreams. You might find out that it isn't exactly a perfect meritocracy. Medicine is about as close as it gets, to a meritocracy that is.

Medical school isn't hard. Just a lot of work.

 

[TheDrugMan]

Medical school isn't hard. Just a lot of work.

This is kind of the impression I have been getting.

 

[gostudy]

Medical school isn't hard. Just a lot of work. Which is hard.

Fixed.

 

[da8s0859q]

Fixed.

Was wondering when someone would fix that.

 

[cfdavid]

See I think the satisfaction of completing big deals is much more rewarding than dealing with people one by one. Big deals ultimately impact far more people. Some people go into orthopedic surgery bc they like the immediacy of the results--person rolls in with broken bones, days later they are up and walking and thanking you for bolting and screwing them together.

Big deals are not things that exist separately from humans. They could result in thousands of productivity and pay increases that allow employees to buy car or medical procedure they always dreamed of. So I'm reluctant to accept the argument that doctors help people and businessmen etc dont. It comes down to providing the greatest increase in utility for the greatest number of people, and thus one is paid accordingly. Radiologists and Pathologists too do not often see the end result of their work but still contribute.

Incidentally actuarial science is pretty neat

One of my best friends works for a large bank doing mergers and aquisitions. It's a grind, and I'm not really all that sure that he feels much satisfaction from the job. He makes about 150k, but he's only 32, and has much more upside.

My first cousin started off at Merrill buying up struggling companies. There was a time when it was depressing to him cause they'd come in like sharks, buy already struggling companies at greatly discounted rates, then liquidate or bring in management of their own to shake things up. Then, they'd sell it off for a profit. He left the group because he felt kind of crappy about the whole thing. Then he went back cause the money was very good. Now he's at a private equity hedge fund bringing down over 500k. He's 33 and a VP, but has the pedigree.

You can make money in "big finance" but these guys are more the exception. Not everyone with a finance degree heads (or CAN head) down these paths.

Shredder, you sound a bit naive, frankly. Since you're so smart, I'm sure you could get into a reputable MBA program. But, you might try to do an internship at one of the big IB firms in NY first. Then, you'll have some experience. THEN, do the MBA.

It sounds like you need to do some serious soul searching as to where you want to go. I understand it can be a tough thing to sort out. I'll give you that. I did other things for 9 years after undergrad, but then came back to medicine for many reasons. You're in med school right now, so my advice would be to sh.t or get off the pot so to speak. Also, I'm not sure what you're going to get out of just doing med school, and not pursuing an internship/residency. What do you think that's going to do for you exactly?? You could probably get into medical device sales very easily, in which case you can make some nice cash and work your way up to regional and then national responsibilities. You WILL make money doing that.
But, finance?? You won't have the skills.

However, if you DID do a residency, and then went out and worked for a few years, you'd at least have some real world experience in which to offer a firm. Then, you very well MAY be qualified to become some sort of healthcare sector related analyst.

 

[PeepshowJohnny]

Being a doctor is all I want to be, and I don't regret going in to medical school.

However, while I realize none of my other interests would be as satisfying as medicine, they do offer things medicine doesn't.

I wish I could have tried my hand at being a comic book writer. I can't draw for a damn, but I'm a decent action writer, and I've always loved the serialized, linked natures of comic books. Or maybe a writer of those silly fantasy type novels, or video games. But something where I can flex a complete different side of my brain.

It'd be interesting to go into research as well. I'm not one of those idealists who think my studying some pathway is going to be the silver bullet for cancer, but it would be interesting and a change of a pace to approach science from that angle.

And while I hate business, I kind of wish I could have gone into business or finance or something like that. There's always the "I'm not into medicine for the money" where people bring up they could go work for a big time company or Wall street and make mad bank with less work. It's incredibly shallow and I know it wouldn't make me happy, but the part of me that loves competition would love to take part in that.

 

[maxbaner]

So what would any of you consider the avg amount of physicians who would have chosen a different path?

I'm in my undergrad phase and I have a strong interest in medicine. Aside from all the basic things I like in medicine like getting to treat and help patients, I really would like to have the knowledge and skills of a physician in such an interesting area of science involving the human body. I know that it will be rewarding.

However, I want to be realistic. I really enjoy relaxing and working on my hobbies and interests. I also want a lot of time with family. Basically I want to work to live and not live to work. I have received a job offer if I go into a different health profession where I would have my tuition paid for with extra spending money and make around $120,000 plus or minus depending on how many hours I want to work and take over the business which generates anywhere from six to seven figures.

So now that I look at it, I am hanging on to medicine hopefully for the right reason and not necessarily money, I think that I would go into family practice. But I'm going to have children one day and I want to fund their education and I want to have some expensive toys. I guess that medicine doesn't seem to provide me with the financial incentive to hook me on for good.

Another thing is that ever since I got into this pre-med lifestyle, I became less outgoing and did not have as great of a 'college life', I have friends but I feel guilty when I have fun. It is something that I kind of regret. Is there anyone who has switched out of medicine into another field, especially health field? Or anyone who switched from a different health field to medicine? What can you tell me about your choice and experience? Anyone with advice or opinion is much welcomed!

Thanks

 

[riverie]

I'm willing to bet that a lot of people don't hate medicine. They are burned out. Medical school is hard. And when you are physically and emotionally exhausted, and can't possibly study anymore, and still have piles of work to do, and maybe are wondering what specialty you want to go into, or if your grades are good enough, and a million other things, and you come on SDN to vent, having some cheerful premed talking about how your opinions are wrong, and you should love medicine or do something else with your life even though you've spent a ton of money, years of your life, and effort on this process, is unnecessary and annoying.

Amen, brother (or sister!)

 

[Elias]

Ever since I started medicine, I wasn't 100% sure I really wanted to do it. I started studying it out of idealism becausly I greatly admired doctors (which I still do) and because I thought it was very interesting, but I've always had a part of me wanting to do something creative (eg design, acting, art, research in some basic science eg physics, chemistry etc). During my years of medicine this initial intuition always remained that I don't know if this study and profession actually matches my personality.. I've discovered that I'm generally a more introverted, creative and sensitive person than my fellow medical students, I even have a different sense of humor. I'm also (a lot) less organized, less of a leader-personality and I generally need more time to make good friends (whereas I've found the regular med student to be a hypersocial human being - a skill I greatly envy but that I, in comparison to my classmates, lack).

In spite of my eternal doubt, I've always tried to study the best I could and have quite good grades. I also have the advantage that I live in a country where studying barely costs 800 $ a year (all material, books and courses included) and I live at home so that's also no extra expense. I'm in my 3rd year now and it's become increasingly difficult to tell this to my friends and family... There are multiple reasons why I still want to continue:
1. feeling of guilt towards parents and friends (who got less chances but took them with both hands)
2. somewhere I still have the idealism and I know there's still a chance I might find a specialty I would possibly like (eg research, neurology, rheumatology, ...)
3. some courses still interest me
4. job security

Only two of those reasons are good ones however, and my deep intuition remains that I'm not enough of an organized, people-oriented person to 'find myself' in this profession, plus I stronly dislike routine, which is something you have to be able to deal with as a good doctor... I'm really scared of studying the wrong thing and regretting this for the rest of my life. This has been taking so long that I really want to deal with this: either I change my mindset and start being a motivated medicine student, or I quit right away. It's driving me insane and emotionally it's too draining to keep myself motivated day in day out. I want to deal with this, and now.

There is, however, a complicating factor which has nothing to do with my studies. Recently, I was - to my own surprise - addressed by a model scout in the street. I've been doing some research on modeling and have been offered a contract by a big modeling agency in my country, and there has been interest from foreign agencies too, which makes me think I might actually have a real chance at this... Should I quit my medicine studies and model to hopefully gain some financial independence to be able to pay for a study I really love? I don't think I'd model for more than a few years and I don't think it's my dream job, but on the other hand, it's a big chance...

I know I have to make this decision myself, but I was wondering what people would do. Thanks for any response! I truely appreciate it,

Elias

Edit to add: Some info about the medical school system in my country, as it's very different from the US: We don't have an undergraduate/pre-med (?) phase. So most 1st year medical students are 18 years old and come right out of high school. So at 21 I'm already in my 3rd year, but our study takes 7 years instead of 4. You only start being a resident in your 8th year, after you chose your specialty in you 7th.