Will medical school acceptance become more difficult?

[AnatomyGrey12]

In the end it may very well be the discovery of SDN that gets me into medical school. Never listen to pre-med advisors, they are full of it....

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[Doudline]

Nope. See Mad Jacks post above. We have a distribution problem for sure (everyone wants to work in NYC, Boston, SF, LA and nobody in underserved parts of Iowa) but not a shortage or expected shortage. And med school seats have nothing to do with the number of physicians -- residency seats are where the bottleneck is. You could double the number if med school seats and not increase the number of doctors.

There IS a shortage. Distribution is -or might be- the cause of the shortage.

 

[Gandyy]

There IS a shortage. Distribution is -or might be- the cause of the shortage.

Yea but its not a shortage in the sense that there arent ENOUGH doctors. There are enough doctors, but everyone wants to practice plastic surgery in NY rather than be a primary care doc in Mississippi.

 

[Doudline]

Yea but its not a shortage in the sense that there arent ENOUGH doctors. There are enough doctors, but everyone wants to practice plastic surgery in NY rather than be a primary care doc in Mississippi.

If there are more openings than physicians willing to take them, for whatever reason, it means there aren't enough physicians. It's as simple as that. And the problem will not go away by saying "Come on guys, people need you in rural Dakota!". It'll go away by: 1. giving financial incentives; 2. training more physicians -or NPs/PAs- to pressure the market.

 

[Gandyy]

If there are more openings than physicians willing to take them, for whatever reason, it means there aren't enough physicians. It's as simple as that. And the problem will not go away by saying "Come on guys, people need you in rural Dakota!". It'll go away by: 1. giving financial incentives; 2. training more physicians to pressure the market.

Well i agree about the financial incentives. Thats actually the only fix required. Training more physicians might make things worse on other fronts though.

 

[AnatomyGrey12]

Financial incentives definitely need to be added for those who practice rural primary care. Lack of pay is what keeps a bunch of people out of these fields, medical school is expensive and no one wants to be paying off debt for 15+ years.

Not only will training more physicians not help but also training more NPs/PAs won't help either. They don't want to practice rurally any more than the docs do.

 

[Stagg737]

I'm thinking farther along down the road. My theory is that most of the jobs currently out there for newly-minted CS grads (webdev) can and will be fully automated in 10-15 years to a big enough extent that most businesses wont feel the need to invest in human beings to do it. Before long white collar jobs will be just as endangered as the baristas, cashiers etc. It's not so much that ex-baristas are going to go back to school to pursue medicine, it's that decreased maximum employment will create fear in the job market and fear in the job market is directly correlated with volume of medical school applications.

I'm not exactly savvy to the intricacies of the technological industry, so I can't say whether or not they'll become automated. Still, going back to school for 6 years, then going through 3-6 more years of training to change careers, or even longer if you're going into medicine from the start is more time than a lot of those people would likely want to commit, even if they are white collar and want security.

Plus, I'd be hesitant to make a generalized statement like the bolded above. Yes, job security is a great aspect to being a physician, but there are plenty of other jobs, even within healthcare, which offer strong job security that don't require 10+ years of training and taking on extreme amounts of debt. Maybe there will be some increase in applicants, but I don't think it will be significant to the point that large portions of very strong applicants will not be able to make it in like some people here are suggesting.

If there are more openings than physicians willing to take them, for whatever reason, it means there aren't enough physicians. It's as simple as that. And the problem will not go away by saying "Come on guys, people need you in rural Dakota!". It'll go away by: 1. giving financial incentives; 2. training more physicians -or NPs/PAs- to pressure the market.

No, it means that there aren't enough physicians willing to practice in the areas of shortage. In certain cities like NYC or certain specialties like radiology, over-saturation of the physician market is a problem. The only real solutions are either significantly incentivized pay/loan repayment forgiveness or setting up a system like Canada where they strongly limit the number of people who can specialize and force more physicians into primary care (which is not something I think most physicians would advocate).

 

[Gandyy]

Financial incentives definitely need to be added for those who practice rural primary care. Lack of pay is what keeps a bunch of people out of these fields, medical school is expensive and no one wants to be paying off debt for 15+ years.

Not only will training more physicians not help but also training more NPs/PAs won't help either. They don't want to practice rurally any more than the docs do.

Exactly.

Dont you guys think its just gross though?

A primary care physician still goes through 7 years of hell to get where they are, but are only compensated for about 160k a year. They have the same loans that specialists pay off.

Yet specialists tack on a few more years of training than PCP's yet make 1.5-5 times more depending on the speciality.

So absolutely gross. When you have to pay off a giant 250k loan, its no wonder medical students are flocking away from Primary Care. Can you blame them?

 

[deleted702880]

Nope. See Mad Jacks post above. We have a distribution problem for sure (everyone wants to work in NYC, Boston, SF, LA and nobody in underserved parts of Iowa) but not a shortage or expected shortage. And med school seats have nothing to do with the number of physicians -- residency seats are where the bottleneck is. You could double the number if med school seats and not increase the number of doctors.

Ah I see, that definitely makes more sense and i do understand that there is a serious shortage of residencies.

 

[AnatomyGrey12]

Exactly.

Dont you guys think its just gross though?

A primary care physician still goes through 7 years of hell to get where they are, but are only compensated for about 160k a year. They have the same loans that specialists pay off.

Yet specialists tack on a few more years of training than PCP's yet make 1.5-5 times more depending on the speciality.

So absolutely gross. When you have to pay off a giant 250k loan, its no wonder medical students are flocking away from Primary Care. Can you blame them?

I know. There is no blame on the students. Someone has to really love primary care, or not have the app for a specialty, to put up with the loan repayment. This is sad seeing as primary care docs are usually the first line of defense for any patient. What you said earlier Gandy about loan forgiveness is the way to go I think. More people would head to primary care knowing that at least part of their loans were covered.

 

[Law2Doc]

Ah I see, that definitely makes more sense and i do understand that there is a serious shortage of residencies.

Again no there is no shortage of residencies. there are enough doctors being generated, they just aren't distributing to where they are needed. And that won't be fixed by more residency spots.

 

[Neutropix]

Again no there is no shortage of residencies. there are enough doctors being generated, they just aren't distributing to where they are needed. And that won't be fixed by more residency spots.

So what is the solution then?

 

[Law2Doc]

If there are more openings than physicians willing to take them, for whatever reason, it means there aren't enough physicians. It's as simple as that. And the problem will not go away by saying "Come on guys, people need you in rural Dakota!". It'll go away by: 1. giving financial incentives; 2. training more physicians -or NPs/PAs- to pressure the market.

Nope, you are redefining "shortage". If there are enough doctors to fill the number of jobs, by definition there is no shortage, whether they choose to take those jobs or not. It's as simple as that. Number of physicians = number of jobs, then no shortage. there are a number of places trying to lure doctors to underserved areas with financial incentives, but so far that hasn't made a dent. If you dream of being a doctor in New York, you aren't going to move away from family and friends for a few more bucks in Wyoming. Training more physicians likely wont work -- you'll just make the gluts worse in the popular places, and the underserved areas will still be underserved. I don't know why you are advocating more NPs to pressure the market, but that doesn't fix this problem, it only creates another. And fwiw, most if them prefer the popular coastal cities as well.

 

[Law2Doc]

So what is the solution then?

A combination of financial incentives (especially mortgage help to get people locked in) and some educational forgiveness for longterm commitments to underserved areas probably would help. Throwing federal and state research money to fund physician projects and labs in these regions in exchange for clinical commitments could also attract some of the applicants who otherwise wouldn't look at the region.

 

[AnatomyGrey12]

A combination of financial incentives (especially mortgage help to get people locked in) and some educational forgiveness for longterm commitments to underserved areas probably would help. Throwing federal and state research money to fund physician projects and labs in these regions in exchange for clinical commitments could also attract some of the applicants who otherwise wouldn't look at the region.

This.

 

[Doudline]

Nope, you are redefining "shortage". If there are enough doctors to fill the number of jobs, by definition there is no shortage, whether they choose to take those jobs or not. It's as simple as that. Number of physicians = number of jobs, then no shortage. there are a number of places trying to lure doctors to underserved areas with financial incentives, but so far that hasn't made a dent. If you dream of being a doctor in New York, you aren't going to move away from family and friends for a few more bucks in Wyoming. Training more physicians likely wont work -- you'll just make the gluts worse in the popular places, and the underserved areas will still be underserved. I don't know why you are advocating more NPs to pressure the market, but that doesn't fix this problem, it only creates another. And fwiw, most if them prefer the popular coastal cities as well.

"In economics, a shortage or excess demand is when the demand for a product or service exceeds its supply in a market."

"In economics, supply is the amount of something that firms, consumers, laborers, providers of financial assets, or other economic agents are willing to provide to the marketplace"

I am not redefining anything. Supply is not capacity [the total number of physicians], it's the offer [number of physicians willing to work in the current conditions of the market]

Financial incentives definitely need to be added for those who practice rural primary care. Lack of pay is what keeps a bunch of people out of these fields, medical school is expensive and no one wants to be paying off debt for 15+ years.

Not only will training more physicians not help but also training more NPs/PAs won't help either. They don't want to practice rurally any more than the docs do.

I did not imply that new physicians and mid-levels would establish a rural practice immediately.

If you train more providers and they all rush to desirable locations, it will engorge the market and force down salaries and job conditions (call, job security, etc - nevermind everyone waiting on the bench with 0 income and the interest on their student loans piling up). At a certain point, it will provoke an exodus to less desirable locations.

Imo it's the less humane solutions of the two, because many people will suffer in the short run, but I'm not sure it's the most expensive.

 

[Neutropix]

A combination of financial incentives (especially mortgage help to get people locked in) and some educational forgiveness for longterm commitments to underserved areas probably would help. Throwing federal and state research money to fund physician projects and labs in these regions in exchange for clinical commitments could also attract some of the applicants who otherwise wouldn't look at the region.

Man, that still wouldn't convince me. I'm so accustomed to living in the bustling city, I don't think I could ever live in a small town again (at least not by choice).

I used to shadow a hand surgeon in Bull Head, Arizona, which is quite honestly one of the most depressing towns ever. This surgeon would commute there and back from LV everyday. Finally he got so sick of the commute and the sh**** location he just moved back to LV. The dude was miserable.

I also know an ER doctor who flies into Ohio for the weekend to work some shifts. I guess it all comes down to location, location, location.

Maybe there should be GP programs that are easier, cheaper, and faster to get into (I know there are a few). Then more people would hopefully become GPs eventually forcing them elsewhere to practice due to saturation. What if for 10 years extremely competitive honors high school students could go straight into medical school with a binding contract for primary care. Essentially, they would skip undergrad.
100% spitballing here.

 

[AnatomyGrey12]

"In economics, a shortage or excess demand is when the demand for a product or service exceeds its supply in a market."

"In economics, supply is the amount of something that firms, consumers, laborers, providers of financial assets, or other economic agents are willing to provide to the marketplace"

I am not redefining anything. Supply is not capacity [the total number of physicians], it's the offer [number of physicians willing to work in the current conditions of the market]



I did not imply that new physicians and mid-levels would establish a rural practice immediately.

If you train more providers and they all rush to desirable locations, it will engorge the market and force down salaries and job conditions (call, job security, etc - nevermind everyone waiting on the bench with 0 income and the interest on their student loans piling up). At a certain point, it will provoke an exodus to less desirable locations.

Imo it's the less humane solutions of the two, because many people will suffer in the short run, but I'm not sure it's the most expensive.

This is already happening and/or happened..... An orthopod working in NY will generally have a smaller starting salary than one in Wichita, Kansas for example. People still flock to the cities. Big cities=more potential patients, more social life, more percieved prestige, and often more advanced tech. And Ortho continues to be one of the most competitive fields.. again, this is just an example.

And training more providers just exacerbates the issue..

 

[Gandyy]

This is already happening and/or happened..... An orthopod working in NY will generally have a smaller starting salary than one in Wichita, Kansas for example. People still flock to the cities. Big cities=more potential patients, more social life, more percieved prestige, and often more advanced tech. And Ortho continues to be one of the most competitive fields.. again, this is just an example.

And training more providers just exacerbates the issue..

Well the other big reason that everyone wants to be a physician in the big town is what you said: Social Life.

Seriously small towns suckkkkkkkkkkkkkkk really bad, and there is absolutely nothing to do or see usually.

 

[Doudline]

This is already happening and/or happened..... An orthopod working in NY will generally have a smaller starting salary than one in Wichita, Kansas for example. People still flock to the cities. Big cities=more potential patients, more social life, more percieved prestige, and often more advanced tech. And Ortho continues to be one of the most competitive fields.. again, this is just an example.

And training more providers just exacerbates the issue..

If a proven recipe does not work, I'd be more inclined to doubt myself than the recipe.

(There are already financial incentives too btw, and they do not seem to work very well.)

edit: And if you read this: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071163/

You'd see that the number of rural physicians/100000 pop has actually increased almost systematically from the 1960s through 1995, though I don't know how it looks after that.

 

[Lucca]

I'm not exactly savvy to the intricacies of the technological industry, so I can't say whether or not they'll become automated. Still, going back to school for 6 years, then going through 3-6 more years of training to change careers, or even longer if you're going into medicine from the start is more time than a lot of those people would likely want to commit, even if they are white collar and want security.

Plus, I'd be hesitant to make a generalized statement like the bolded above. Yes, job security is a great aspect to being a physician, but there are plenty of other jobs, even within healthcare, which offer strong job security that don't require 10+ years of training and taking on extreme amounts of debt. Maybe there will be some increase in applicants, but I don't think it will be significant to the point that large portions of very strong applicants will not be able to make it in like some people here are suggesting.

I dont mean unemployed people returning to school, I mean people already in the university system (if that doesn't radically change in the near future...) currently choosing their future profession. My statement is actually not that bold. If you look at historical data this is precisely what you see. College grads go to professional school more often if they feel that the job market is too risky. Medical school applicants in particular are a very risk averse group (that I say from observation rather than authority). We are also defining the "job market" in a very specific way. Including "welder" or even "nurse" in some cases does not make sense even though they might have similar remuneration and job security. This is because most people who would be competitive players for MS are also only thinking about engineering, business, tech, medicine or other jobs within a similar class as medicine. It is when fear in those spheres increases that apps increase. You are right that even as a historical trend it isnt super significant like OMG EVERYONE APPLY TO MS and then NO ONE GO TO MS LOL CHUMPS GO GET REAL JOBS. It's just a very predictable trend that is significant enough to exist.

 

[jl lin]

It's actually the inverse of the business cycle (in tough times people are more apt to hide out in a four year professional school rather than look for a job).

An interesting thought on the dynamic, but I find it enormously ridiculous in the long run--financially as well as otherwise (otherwise being those that aren't truly interested in clinical medicine). If the latter, it will be complete drudgery to those without interest in a particular medical field--as well as in the desire to treat and interact with, well, people--all kinds of people. I will refrain from including the pathologists and such, b/c depending upon where one is looking, overall, the needs are more for primary and clinical medicine. Even so, with pathology, one would think a high degree of interest would be important for longevity in the field. So it seems completely idiotic to me that people would seek the path toward medicine primarily to avoid looking for work. They ultimately may find medicine to be a living hell, when in fact, they may have indeed found something more enjoyable or something to which they would be better suited if only they had persisted in the primary hunt.

 

[Stagg737]

"In economics, a shortage or excess demand is when the demand for a product or service exceeds its supply in a market."

"In economics, supply is the amount of something that firms, consumers, laborers, providers of financial assets, or other economic agents are willing to provide to the marketplace"

I am not redefining anything. Supply is not capacity [the total number of physicians], it's the offer [number of physicians willing to work in the current conditions of the market]

I did not imply that new physicians and mid-levels would establish a rural practice immediately.

If you train more providers and they all rush to desirable locations, it will engorge the market and force down salaries and job conditions (call, job security, etc - nevermind everyone waiting on the bench with 0 income and the interest on their student loans piling up). At a certain point, it will provoke an exodus to less desirable locations.

Imo it's the less humane solutions of the two, because many people will suffer in the short run, but I'm not sure it's the most expensive.

The problem wasn't your definition of shortage, it was how you were defining the market. If you're looking at the level of cities or even certain states, then yes, there are shortages in some areas. However, there are also places and fields that are grossly oversaturated. On a national scale, there is a relatively small shortage, if any.

As nice as the economic supply/demand laws sound, the human element here changes everything. There's a large portion of people that would rather change careers or just retire than leave the city to go practice medicine in bumblef*** Wyoming or any other small town. So in that sense you're just as likely to cause an exodus from medicine altogether as you are likely to cause an exodus to underserved areas. The only sure-fire way to fix the issue is to train people with contracts that say they will only practice in underserved area X. Basically, taking in-state bias on applications to the next level.

If a proven recipe does not work, I'd be more inclined to doubt myself than the recipe.

(There are already financial incentives too btw, and they do not seem to work very well.)

edit: And if you read this: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071163/

You'd see that the number of rural physicians/100000 pop has actually increased almost systematically from the 1960s through 1995, though I don't know how it looks after that.

I didn't read the article, but I'm guessing the number of physicians/100,000 in most other fields has increased just as much as in rural settings. Though I'd like to think that some of the repayment incentives and in-state bias would have made some kind of difference like it was meant to...

 

[Law2Doc]

An interesting thought on the dynamic, but I find it enormously ridiculous in the long run--financially as well as otherwise (otherwise being those that aren't truly interested in clinical medicine). If the latter, it will be complete drudgery to those without interest in a particular medical field--as well as in the desire to treat and interact with, well, people--all kinds of people. I will refrain from including the pathologists and such, b/c depending upon where one is looking, overall, the needs are more for primary and clinical medicine. Even so, with pathology, one would think a high degree of interest would be important for longevity in the field. So it seems completely idiotic to me that people would seek the path toward medicine primarily to avoid looking for work. They ultimately may find medicine to be a living hell, when in fact, they may have indeed found something more enjoyable or something to which they would be better suited if only they had persisted in the primary hunt.

This isn't even a new thing. People used to hide out in law school for three years to weather bad economies when there were still jobs in law. Now it's med school.

 

[Law2Doc]

An interesting thought on the dynamic, but I find it enormously ridiculous in the long run--financially as well as otherwise (otherwise being those that aren't truly interested in clinical medicine). If the latter, it will be complete drudgery to those without interest in a particular medical field--as well as in the desire to treat and interact with, well, people--all kinds of people. I will refrain from including the pathologists and such, b/c depending upon where one is looking, overall, the needs are more for primary and clinical medicine. Even so, with pathology, one would think a high degree of interest would be important for longevity in the field. So it seems completely idiotic to me that people would seek the path toward medicine primarily to avoid looking for work. They ultimately may find medicine to be a living hell, when in fact, they may have indeed found something more enjoyable or something to which they would be better suited if only they had persisted in the primary hunt.

This isn't even a new thing. People used to hide out in law school for three years to weather bad economies when there were still jobs in law. Now it's med school.

 

[gyngyn]

Ah I see, that definitely makes more sense and i do understand that there is a serious shortage of residencies.

There were 30,212 residency positions offered in the last Match.
There were only about 17,ooo US seniors.
There are many residency positions.
http://www.nrmp.org/press-release-2...r-30000-residency-positions-in-4756-programs/

 

[Rdejong]

The U.S. is facing a physician shortage, if anything there'll be more spots for us.
When I say us I mean let's disable the ability to create new accounts and access the site so only we can bask in the knowledge that has been posted here. ( ͡° ͜ʖ ͡°)

Love your profile pic. LONG LIVE THE ORANGUTAN.

 

[deleted702880]

There were 30,212 residency positions offered in the last Match.
There were only about 17,ooo US seniors.
There are many residency positions.
http://www.nrmp.org/press-release-2...r-30000-residency-positions-in-4756-programs/

Yes it is becoming exceedingly apparent that I have no idea what I'm talking about on this matter haha.

 

[coldcase331]

I was once shadowing anesthesiologist from Bulgaria, and here's what he had to say about the socialization of medicine in his country:

"Socialization of medicine created an isolated government insurance that controlled the rate of compensation for physicians. This insurance cut the pay of physicians by 25-30%. Because the compensation of doctors went down, less people decided to pursue a career in medicine (no one should pursue medicine for the money, but that's beside the point). This creates a shortage of doctors and applicants for medical school, driving competition down. This led to less qualified physicians and overall lowered the level of healthcare in the long run."

I don't know if these facts or completely true, but the main idea makes sense. The world does run on incentive in a way, and some people may be deterred from the field of medicine if tuition costs rise and compensation goes down. My solution would be that the government creates a cap on tuition (say 20k) and subsidizes the rest of the program. The way I see it, competition may be going down in the long run based on the anesthesiologist's example.

 

[Gandyy]

I was once shadowing anesthesiologist from Bulgaria, and here's what he had to say about the socialization of medicine in his country:

"Socialization of medicine created an isolated government insurance that controlled the rate of compensation for physicians. This insurance cut the pay of physicians by 25-30%. Because the compensation of doctors went down, less people decided to pursue a career in medicine (no one should pursue medicine for the money, but that's beside the point). This creates a shortage of doctors and applicants for medical school, driving competition down. This led to less qualified physicians and overall lowered the level of healthcare in the long run."

I don't know if these facts or completely true, but the main idea makes sense. The world does run on incentive in a way, and some people may be deterred from the field of medicine if tuition costs rise and compensation goes down. My solution would be that the government creates a cap on tuition (say 20k) and subsidizes the rest of the program. The way I see it, competition may be going down in the long run based on the anesthesiologist's example.

It actually makes crystal clear sense.

 

[jl lin]

This isn't even a new thing. People used to hide out in law school for three years to weather bad economies when there were still jobs in law. Now it's med school.

I do not doubt you at all. I still find it incredibly foolish to go into medicine primarily b/c of money. It's a waste of time, effort, and a ton of money as well to do so. We all should agree on this, I am sure.

 

[wasteofspace323]

I do not doubt you at all. I still find it incredibly foolish to go into medicine primarily b/c of money. It's a waste of time, effort, and a ton of money as well to do so. We all should agree on this, I am sure.

Dat prestige doe

 

[altblue]

Exactly.

Dont you guys think its just gross though?

A primary care physician still goes through 7 years of hell to get where they are, but are only compensated for about 160k a year. They have the same loans that specialists pay off.

Yet specialists tack on a few more years of training than PCP's yet make 1.5-5 times more depending on the speciality.

So absolutely gross. When you have to pay off a giant 250k loan, its no wonder medical students are flocking away from Primary Care. Can you blame them?

$160000/yr, bummer

 

[Spinach Dip]

I do not doubt you at all. I still find it incredibly foolish to go into medicine primarily b/c of money. It's a waste of time, effort, and a ton of money as well to do so. We all should agree on this, I am sure.

Foolish? Yes it is.

But do people still do it? Yes they do.

 

[Giovanotto]

I often times fear that I am going into medicine because of the numerous societal pressures/factors that are being discussed here. Even if, some of them may have influenced me subconsciously at first. Medicine appeals to me for many reasons, some noble, most probably selfish (assuming that separating them even makes sense).

 

[Neutropix]

I often times fear that I am going into medicine because of the numerous societal pressures/factors that are being discussed here. Even if, some of them may have influenced me subconsciously at first. Medicine appeals to me for many reasons, some noble, most probably selfish (assuming that separating them even makes sense).

Don't be fooled by the ostensibly altruistic pre-med who just wants to "save lives." We all have different motivations and agendas for why we want to do what we do in.

Some people want to feel financially secure and simply be able to take care of their family. Some people want to drive a Mazarati and bang hot chix in their high rise. Other people want to push themselves to their maximum potential and possess rare skill-sets known by few, like surgery. Some nerds want to study pathology and look through microscopes.

All I am saying is do not feel bad about your motivations because we all have them, and like the physicians of today, we are probably going to regret our pursuit of medicine at some point anyways. We just have to try to enjoy the journey while it lasts lol.

 

[DubVille]

$160000/yr, bummer

Take out 30-40% for federal, state, local, property, social security, and medicare. Disability and life insurance too. Then if you have 300k loans thats 3500 a month on 10 year repayment. Enjoy your lavish lifestyle. Oh btw, you are 8 years behind for retirement savings.

Not saying you will be poor but that doesn't leave you alot of money. My advice, marry another doctor.....thats what I did.

 

[Lucca]

I was once shadowing anesthesiologist from Bulgaria, and here's what he had to say about the socialization of medicine in his country:

"Socialization of medicine created an isolated government insurance that controlled the rate of compensation for physicians. This insurance cut the pay of physicians by 25-30%. Because the compensation of doctors went down, less people decided to pursue a career in medicine (no one should pursue medicine for the money, but that's beside the point). This creates a shortage of doctors and applicants for medical school, driving competition down. This led to less qualified physicians and overall lowered the level of healthcare in the long run."

I don't know if these facts or completely true, but the main idea makes sense. The world does run on incentive in a way, and some people may be deterred from the field of medicine if tuition costs rise and compensation goes down. My solution would be that the government creates a cap on tuition (say 20k) and subsidizes the rest of the program. The way I see it, competition may be going down in the long run based on the anesthesiologist's example.

I categorically disagree with your doc's assessment. Most countries providing some form of universal healthcare have comparable if not better healthcare outcomes than the U.S. and medicine is just as competitive to get into there as it is here (albeit the barrier might be at undergrad rather than postgrad). Among the ten most developed of those countries, they all perform better on most metrics than we do (with the UK sitting at number one). Doctors there are also paid considerably less with the exception of Canada who have their own special system that seems to be working very well for them.

The Allo forum likes to perpetuate this idea that as physician compensation goes down so does the general desire for people to do medicine. Perhaps this is true but if it is it is true within a population that is easily replaced with individuals who can provide good care and be satisfied with that compensation. At the end of the day, people want to do good work that pays well and many "socialist" healthcare schemes allow for that.

Now, why wouldn't that be true in the U.S.? Because here with a highly inequitable healthcare system and the decreased compensation one faces might not be worth playing social worker, nutritionist, insurance jockey etc all alongside the job you signed up for, I.e seeing patients. In a functioning socialist state (aka not Bulgaria) doctors spend less time concerned with these burdens since they are taken care of by other parts of the system.

I'm from a similarly dysfunctional "socialist" state in the Western Hemisphere and all I can say is that the politically and economically complex situations found in such states are too easily ascribed to a failure of socialism. More accurately, they are typically a failure of a "type" of socialism which is, more often than not, more reminiscent of sectarian, jingoistic, oligarchy than it is of true socialism.

 

[Cotterpin]

I was once shadowing anesthesiologist from Bulgaria, and here's what he had to say about the socialization of medicine in his country:

"Socialization of medicine created an isolated government insurance that controlled the rate of compensation for physicians. This insurance cut the pay of physicians by 25-30%. Because the compensation of doctors went down, less people decided to pursue a career in medicine (no one should pursue medicine for the money, but that's beside the point). This creates a shortage of doctors and applicants for medical school, driving competition down. This led to less qualified physicians and overall lowered the level of healthcare in the long run."

Obviously this is beside the point, but I just want to rant about this for a second. It is a huge pet peeve of mine when people use "less" instead of the grammatically correct "fewer." I don't know why. It just drives me crazy.

 

[altblue]

Take out 30-40% for federal, state, local, property, social security, and medicare. Disability and life insurance too. Then if you have 300k loans thats 3500 a month on 10 year repayment. Enjoy your lavish lifestyle. Oh btw, you are 8 years behind for retirement savings.

Not saying you will be poor but that doesn't leave you alot of money. My advice, marry another doctor.....thats what I did.

For sure.

I was more talking about his "this is a disgusting travesty" Rhetoric, if that makes sense. Even if you take things out, pcps are still solidly middle class. Sure, the compensation is to other specialties is relatively quite poor, but they can still make ends meet.

That counts for a lot!

It's not unfair to say This pales in comparison to other, more pronounced forms of economic unfairness, which I would describe as travesties.

 

[moisne]

MCAT scores for matriculated students are risking every year... so.... :/

 

[jl lin]

Don't be fooled by the ostensibly altruistic pre-med who just wants to "save lives." We all have different motivations and agendas for why we want to do what we do in.

Some people want to feel financially secure and simply be able to take care of their family. Some people want to drive a Mazarati and bang hot chix in their high rise. Other people want to push themselves to their maximum potential and possess rare skill-sets known by few, like surgery. Some nerds want to study pathology and look through microscopes.

All I am saying is do not feel bad about your motivations because we all have them, and like the physicians of today, we are probably going to regret our pursuit of medicine at some point anyways. We just have to try to enjoy the journey while it lasts lol.

LOL. I am not at all one of those people. I have helped save lives in my profession. Just saying it's a bit insane to go through all the hoops, only to hopefully get accepted, and then go through almost infinitely more hoops, and then maintain certification and grow in practice b/c of six figures. A number of people, who are not physicians, make six figures and are happy in their lives and work.

Scratching head here, b/c it's just so much, and then there is all the politics, stress of dealing with more than a few difficult patients and families, long hours, endless demands, and at times, capricious systems of evaluation--something that can blow all one's work and financial commitment towards this endeavor out the window. It's just plain nuts to do any of these things if one is not even remotely interested in medicine--or if one is not interested in those that are on the receiving side of medicine.

Nothing wrong with being altruistic, and there is nothing wrong with desiring a commensurate income for the responsibility, investment, blood, sweat, and tears. Residency will beat the nonsensical desire to be a doctor for both money and title right out of a person--and IMHO, it should, b/c that's not what should motivate people to take on this role.

Still Spinach Dip is right. People are still going to foolishly forge ahead kidding themselves and then ultimately hating medicine, and in some cases, even the people in which they treat. That's where wrong motivations will lead a person that opts for something like this.

Sadly, schools will let such students move forward, b/c they have numbers or interview well or whatever. There is no solid way of always telling who is deceiving oneself re: internal motivation and who is not.

There's a former MS student that dropped out not too long ago. He literally hated every minute of med school from day one. He was all hot to get in, but he did nothing but regret his choice, until finally he surrendered to the reality that it just really wasn't for him. And that is fine. He cut his losses before the debt and regret got too out of control.

There's another person here that openly admitted he pursued medical school b/c he thought being a doc would help him get women--or at least that special one. He was already in it up to his chin, so he made the most out of it and went into a nice-paying specialty. I'd have to work with him to know how much of his hatred and bitterness toward medicine affects his practice. I sure don't want someone caring for my family or me that hates what they are doing.

Thing is, it's surprising how many people end up hating being a physician and would not do it again. Some go through a temporary (doesn't feel that way) transitional period of hating medicine--often seen in residency; but once they get over the hurdles in that phase of training, they actually find that they do enjoy it. It was all just a bit taxing without a decent break for a while--and the other aspects of life were often interrupted by the lengthy pursuit of medicine. They get past that though. Others do not. The former still pretty much like what they do. The latter never will.

Money and title is not enough to compensate if it's not truly what one is interested in doing, hasn't the ability to care about and then work with patients and others well, and if he or she dreads waking up to the work of people and medicine every day. It just won't make up for it.

 

[jl lin]

Take out 30-40% for federal, state, local, property, social security, and medicare. Disability and life insurance too. Then if you have 300k loans thats 3500 a month on 10 year repayment. Enjoy your lavish lifestyle. Oh btw, you are 8 years behind for retirement savings.

Not saying you will be poor but that doesn't leave you alot of money. My advice, marry another doctor.....thats what I did.

Or marry someone that has an equivalent income, and work hard to compensate for opportunity losses during the process.

 

[Law2Doc]

I was once shadowing anesthesiologist from Bulgaria, and here's what he had to say about the socialization of medicine in his country:

"Socialization of medicine created an isolated government insurance that controlled the rate of compensation for physicians. This insurance cut the pay of physicians by 25-30%. Because the compensation of doctors went down, less people decided to pursue a career in medicine (no one should pursue medicine for the money, but that's beside the point). This creates a shortage of doctors and applicants for medical school, driving competition down. This led to less qualified physicians and overall lowered the level of healthcare in the long run."

I don't know if these facts or completely true, but the main idea makes sense. The world does run on incentive in a way, and some people may be deterred from the field of medicine if tuition costs rise and compensation goes down. My solution would be that the government creates a cap on tuition (say 20k) and subsidizes the rest of the program. The way I see it, competition may be going down in the long run based on the anesthesiologist's example.

It makes sense BUT (a) it takes a long time, probably a generation before people totally shun a field. There will be people who go into medicine because it's what they decided they wanted to do early on, people who think the government will reverse course, people who see prestige, honor, altruism, public service benefits as a draw, and (b) medicine has a big salary cushion to work down before its lost all its appeal. You could cut salaries in half and you will still fill all med schools. Won't be the best and brightest, but you'll still have college grad bodies filling those seats. So given that a real shortage won't likely be felt in our lifetime even after pretty hefty salary cuts, i suspect your Bulgarian warning will fall on deaf ears.

 

[Law2Doc]

LOL. I am not at all one of those people. I have helped save lives in my profession. Just saying it's a bit insane to go through all the hoops, only to hopefully get accepted, and then go through almost infinitely more hoops, and then maintain certification and grow in practice b/c of six figures. A number of people, who are not physicians, make six figures and are happy in their lives and work.

Scratching head here, b/c it's just so much, and then there is all the politics, stress of dealing with more than a few difficult patients and families, long hours, endless demands, and at times, capricious systems of evaluation--something that can blow all one's work and financial commitment towards this endeavor out the window. It's just plain nuts to do any of these things if one is not even remotely interested in medicine--or if one is not interested in those that are on the receiving side of medicine.

Nothing wrong with being altruistic, and there is nothing wrong with desiring a commensurate income for the responsibility, investment, blood, sweat, and tears. Residency will beat the nonsensical desire to be a doctor for both money and title right out of a person--and IMHO, it should, b/c that's not what should motivate people to take on this role.

Still Spinach Dip is right. People are still going to foolishly forge ahead kidding themselves and then ultimately hating medicine, and in some cases, even the people in which they treat. That's where wrong motivations will lead a person that opts for something like this.

Sadly, schools will let such students move forward, b/c they have numbers or interview well or whatever. There is no solid way of always telling who is deceiving oneself re: internal motivation and who is not.

There's a former MS student that dropped out not too long ago. He literally hated every minute of med school from day one. He was all hot to get in, but he did nothing but regret his choice, until finally he surrendered to the reality that it just really wasn't for him. And that is fine. He cut his losses before the debt and regret got too out of control.

There's another person here that openly admitted he pursued medical school b/c he thought being a doc would help him get women--or at least that special one. He was already in it up to his chin, so he made the most out of it and went into a nice-paying specialty. I'd have to work with him to know how much of his hatred and bitterness toward medicine affects his practice. I sure don't want someone caring for my family or me that hates what they are doing.

Thing is, it's surprising how many people end up hating being a physician and would not do it again. Some go through a temporary (doesn't feel that way) transitional period of hating medicine--often seen in residency; but once they get over the hurdles in that phase of training, they actually find that they do enjoy it. It was all just a bit taxing without a decent break for a while--and the other aspects of life were often interrupted by the lengthy pursuit of medicine. They get past that though. Others do not. The former still pretty much like what they do. The latter never will.

Money and title is not enough to compensate if it's not truly what one is interested in doing, hasn't the ability to care about and then work with patients and others well, and if he or she dreads waking up to the work of people and medicine every day. It just won't make up for it.

For any job there are strong motivators and weak ones. Altruism, money, prestige, job security, making your parents happy are weak motivators. You might suffer your way through school and residency because of one of these, but it will be very hard, and you will end up pretty miserable. Actually liking some significant component of the job function, finding it interesting, having an interest in learning, teaching, research tend to be stronger motivators; you won't hate your life, dread Monday's or live for the weekends if you have these. One lesson I think the career changers on here can best tell you is that the people smart enough to get into med school have choices in life. Find something you enjoy, not that just pays the bills. You aren't stuck with a job, like the guy pumping gas at the corner filling station.

 

[Medgrant]

The only thing that's getting difficult is the competition. There are a lot of talented and gifted people in the States and that number is growing by the day.

 

[jl lin]

For any job there are strong motivators and weak ones. Altruism, money, prestige, job security, making your parents happy are weak motivators. You might suffer your way through school and residency because of one of these, but it will be very hard, and you will end up pretty miserable. Actually liking some significant component of the job function, finding it interesting, having an interest in learning, teaching, research tend to be stronger motivators; you won't hate your life, dread Monday's or live for the weekends if you have these. One lesson I think the career changers on here can best tell you is that the people smart enough to get into med school have choices in life. Find something you enjoy, not that just pays the bills. You aren't stuck with a job, like the guy pumping gas at the corner filling station.

I would say, then, that we agree. The choices, however, become more limiting the further one moves along in the process. At some point, once you are into the actual thick of it (time and money) you will be less apt to find a ton of other choices other than something within medicine. People that are miserable in their roles IMHO will find it difficult, if not impossible, to be excellent physicians.

Also, miserable people are terribly draining people with which to work. I don't stand and condemn them at work, as others may. I do, however, limit my interactions with them as much as possible. When I can't help but be forced to work with them, I put on my mental bubble, stay courteous, and actually feel badly for them that they are so miserable. One has to have an indefatigable spirit when interacting with them.

And then there are those that hate that they can't seem to make you as miserable as they are. They seem to go out of their way until they "break" you. It may be rare that you make such people smile or laugh, so you quietly forge ahead with your business, and thank God that you don't have to sleep with them at night.

I am simply saying that making a poor choice about pursuing this role can lead to toxic physicians, and a generally pernicious environment for both patients and other physicians and staff. But at least with the clearly miserable people, you are clear on their stances.

It's those people that can win academy awards, while being the most amazingly backbiting and pernicious (covertly miserable) people--someone of them even garnering some favor and promotions--that are particularly difficult to stomach. They learn to become quick to find fault in others but haven't the substance to be self-effacing or God-forbid, ever admit they were somehow wrong. These traits become heightened when they feel forced to practice in something to which they are unsuited or don't particularly like. Some of us can usually discern their level of authenticity. Eventually, what they are will manifest in time. I keep a hidden smile for those patients that are able to see past their BS and discern their level of sincerity.

Ultimately these people are unhappy in what they are doing, are probably unhappy with themselves in general, and patients often aren't satisfied with their services. It is also important to emphasize that as a physician, one is working with a lot of people, in general, over long periods of time. Everyone has bad days, but overall, you had better really like what you are dong, b/c it will spill out on others with whom you will be interacting over long periods of time. Misery may like company, but good company rarely likes needless, endless hours of misery.

 

[Seth Joo]

Take out 30-40% for federal, state, local, property, social security, and medicare. Disability and life insurance too. Then if you have 300k loans thats 3500 a month on 10 year repayment. Enjoy your lavish lifestyle. Oh btw, you are 8 years behind for retirement savings.

Not saying you will be poor but that doesn't leave you alot of money. My advice, marry another doctor.....thats what I did.

There are people on the Osteopathic forums claiming family docs can earn 200 to 250k a year working a major US metro area which I find to be ridiculous.

I have heard a number of inflated numbers on physician incomes which are out of touch with reality.

 

[medic86]

There are people on the Osteopathic forums claiming family docs can earn 200 to 250k a year working a major US metro area which I find to be ridiculous.

I have heard a number of inflated numbers on physician incomes which are out of touch with reality.

It's probably possible if you're a good businessman/woman... but it likely won't be the average salary.

 

[Seth Joo]

It's probably possible if you're a good businessman/woman... but it likely won't be the average salary.

If you are working in the middle of nowhere, but not a top 10 US metro city.