Medschool/doctor path... Im not sure that its worth it anymore.

[Venom]

I think at one time, it may have been worth it. In todays world, i just dont think its worth it anymore. Im starting to wonder how being in school another 6 years (plus minimum wage residency; it almost counts as school) is worth it.


1. The path has become ridiculously longer than it needs to be. There is this sense of "I did it, so should you". Engineers are NOT: doing internships in physics labs, having to take ridiculous tests on physics to get into graduate engineering schools that then after 4 years of undergrad bullshit allow them to actually LEARN engineering rather than just advanced physics. Engineers are NOT then waiting until afterinsanely selective grad school, to then, finally be allowed to do a REAL internship with PRACTICING engineering for minimum wage. That is exactly what it would be like if every other profession was run like medicine. They try and convince everyone that all of it is necessary. But many other European nations show differently.

ochem, genchem, physics etc are never EVER used on the job! They should make medschool a 5 year thing you do right from high school. Right now, it justs wastes peoples lives for more years than it should.

2. Because of the ridiculously long path and limited spots (no new med schools in 30 years), the salaries have been artificially propped up. There are a ton of people who are willing to do this no matter how bad the conditions get. The conditions have gotten bad. the standards it takes to get in now, pretty much demand that you give up relationships, going out, and even then you aren't garunteed anything. A 3.6 student with a 34 MCAT can still get rejected from schools without it being a fluke. Im not just someone whose just bitter and who cant make it (A on my last ochem test ).

3. Even with the salaries artificially propped up. It takes a long time for the opportunity costs to be caught up to. Plus, you have to factor in that you've given up the one youth you will EVER have.

-In the eleven years after high school (how long it takes for a GP to get through it all), Bob who starts out at 35 grand a year, works hard for a 5% raise a year, ends up with 500,000 grand earned in those eleven years. (without the raise, he still makes 385,000)

-by those same eleven years, John, on the medschool path, now has undergrad debt 120,000 + medschool debt 200,000, plus the lost wages of 500,000. To catch up, he is going to have to have to start out 820,000 behind Bob, who just started working out of highschool.

4. Its not the same job it was 20 years ago. People do not treat doctors like God anymore. Patients more then ever trust the internet and compliance is becoming an issue. Doctors spend MANY hours fighting insurance companies on the phone for the payments that the insurance companies don't want to make. Even the more cush "lifestyle" specialties, can still work 60 to 70 hours a week.

5. Its not that doctors dont ever catch up on pay. Its not that im not willing to work 60 to 70 hours a week. if thats what this all ends up being, 70 hours a week for a job thats not as glamorous as it used to be, there are easier ways to get a job like that paywise, without wasting an extra 7 years of your life (on top of undergrad).

 

[ptgatsby]

3. Even with the salaries artificially propped up. It takes a long time for the opportunity costs to be caught up to. Plus, you have to factor in that you've given up the one youth you will EVER have.

-In the eleven years after high school (how long it takes for a GP to get through it all), Bob who starts out at 35 grand a year, works hard for a 5% raise a year, ends up with 500,000 grand earned in those eleven years. (without the raise, he still makes 385,000)

-by those same eleven years, John, on the medschool path, now has undergrad debt 120,000 + medschool debt 200,000, plus the lost wages of 500,000. To catch up, he is going to have to have to start out 820,000 behind Bob, who just started working out of highschool.

One thing to note is that the income determines living standard. The only way to work out income differential is pick a point in which the "investment income" of the opportunity cost would match the Doctor's income, which would adjusted for his loans (the other side of the opportunity cost).

Generally the doctor ends up ahead, still, due to the restrictions on doctors (notably specialties).

However, given that doctors tend to be above average, the entrance level of 35,000 is not representative of those that would be likely to become doctors. That is, if you are able to be in the middle of the pack of doctors (~discipline and IQ), you have more options than are available to the average person, in terms of professional ability. That is, your floor is higher and 35,000 is not really a reasonable estimate - it should be higher.

The model for this is... complex... to say the least. However, doctors do come ahead, ignoring the "QOL" of the 11 years (which is hell, having several friends going through it), and then the "QOL" of the job (which also sucks if you want to pull down large amounts of money). That is, unless you get into a specialty, but that can be more than 11 years!

FWIW, 820,000 is only about 40,000 dollars in interest income, reasonably. The gap in salaries far exceeds that.

 

[Jack Flak]

Some seem to appreciate and take pride in the huge amount of work. It has a point, of course, in this "rigid" society it's probably better to have high standards for people who decide what's best for the function of people's bodies.

You could always move to remote Africa and become a de facto doctor, an amateur, and help people perhaps even more. Because money, after all, has little to do with satisfaction, especially considering how most people spend it.

 

[FDG]

It can be understood as the price to pay for something (being a doctor, in this case) that guarantees high returns with next to zero risks. Of course, the price is definitely going to be high (other paths - like the engineering one you mention - definitely embed an higher amount of risk, and the average return is also likely lower).

By the way you talk, it seems like you're less risk-averse and value expected monetary return. So being a doctor doesn't look like the optimal choice, excluding for the moment the fact that it may be a "dream" of yours to become a doctor (so, supposing you were trying this path only for the monetary reward).

 

[01011010]

NEJM -- Relevance and Rigor in Premedical Education

 

[Venom]

One thing to note is that the income determines living standard. The only way to work out income differential is pick a point in which the "investment income" of the opportunity cost would match the Doctor's income, which would adjusted for his loans (the other side of the opportunity cost).

Generally the doctor ends up ahead, still, due to the restrictions on doctors (notably specialties).

However, given that doctors tend to be above average, the entrance level of 35,000 is not representative of those that would be likely to become doctors. That is, if you are able to be in the middle of the pack of doctors (~discipline and IQ), you have more options than are available to the average person, in terms of professional ability. That is, your floor is higher and 35,000 is not really a reasonable estimate - it should be higher.

The model for this is... complex... to say the least. However, doctors do come ahead, ignoring the "QOL" of the 11 years (which is hell, having several friends going through it), and then the "QOL" of the job (which also sucks if you want to pull down large amounts of money). That is, unless you get into a specialty, but that can be more than 11 years!

FWIW, 820,000 is only about 40,000 dollars in interest income, reasonably. The gap in salaries far exceeds that.

i dont doubt that the doctor EVENTUALLY catches up. what im saying is that, with all that lost time. someone with the IQ of a doctor, could of done as well on a much easier path. Part of why I factored in a 5% raise into "Bob's" salary was because I was trying to compare the IQs here assuming that Bob, a smart guy, got stuck with a shit job.

Some seem to appreciate and take pride in the huge amount of work. It has a point, of course, in this "rigid" society it's probably better to have high standards for people who decide what's best for the function of people's bodies.

You could always move to remote Africa and become a de facto doctor, an amateur, and help people perhaps even more. Because money, after all, has little to do with satisfaction, especially considering how most people spend it.

I agree that money isn't everything. However, the money is lets face it, important, if you're going to throw away your twenties.

I did mention that I didn't have problem working 60 hours a week. What I had a problem with, is that their are easier ways to get a 60 hour a week job that pays well, that wouldnt require you giving up your twenties.

It can be understood as the price to pay for something (being a doctor, in this case) that guarantees high returns with next to zero risks. Of course, the price is definitely going to be high (other paths - like the engineering one you mention - definitely embed an higher amount of risk, and the average return is also likely lower).

By the way you talk, it seems like you're less risk-averse and value expected monetary return. So being a doctor doesn't look like the optimal choice, excluding for the moment the fact that it may be a "dream" of yours to become a doctor (so, supposing you were trying this path only for the monetary reward).

I fit into exactly what you describe. I had a kind of dream of being a doctor. I think it would be awesomely cool to have a job like that where you aren't stuck at a desk all day. Doing things like surgery etc sound so much different than the avg worker gets to do.

however, the security of being a doctor is exactly what scares me. You are stuck. There isnt any growth beyond just seeing more patients in a day. There is no master scheming to take you to the next level. The things that used to justify that dance with boredom, pay and lifestyle, are no longer really as glamorous as they used to be.

 

[01011010]

Honestly, it's changing. When Harvard speaks up, people listen. Intro o-chem will probably always be mandatory, but they think an emphasis on biochemistry is more important than organic. As far as o-chem is concerned, I think it's mostly used as a tool to weed out people that aren't intelligent enough to become doctors. Even now, everyone that becomes a doctor isn't that smart. There are subpar people that hit the mark and are allowed to go.

Nonetheless, I also think med school should be a 5-6 year program right out of high school.

 

[Angry Ayrab]

I'll tell you the ultimate motivator for me. Sure I started off with the noble idea of opening a low income clinic in the middle of a struggling inner city communitty and to be a coach carter type of person active in the place, but guess what, thats not all its about for me.

When I had a one on one with myself (took a long time and was very hard) I found out that internally I fear gridlock. What does that mean? Well I am scared to have 7 kids I gotta feed someday and do something I hate just because i have to. With an MD, I knew my options would be straight up wide open. If I ever chose to be a high school teacher, I could do it while taking classes at night to complete a masters in secondary ed. If I wanted to teach college, I would be already qualified to teach med school. If I wanted to do research, I would just join a lab and start working with them on a problem I wanted to research. If I wanted to be a fed ex delivery guy, I could quit and do that. I know I can do this because I would not have to worry about being able to find a job once my fun novelty stint was over.

That is the straight honest selfish answer.

The funny thing is that I keep telling myself that I am wasting my life, but what have I really wasted. I am still fit, I got my health and friends, sure I didn't travel europe, but does everyone get to do that. Hell I think I am better off than 95% of the people on earth.

I am lucky, debt = 0 as of right now because I got a scholarship for public state schoo in undergrad, and I go to public med school with an under represented minority (from a financial perspective) scholarship. I had a shitty gpa around 3.4 ish but rockin mcats (99 percentile). If I can do it, anyone can.

 

[tenINsFJ]

Nonetheless, I also think med school should be a 5-6 year program right out of high school.

Essentially, all the entire Med School program is designed for, is to weed people out by keep it a 13 yr program[4 under + 4 med + 5 Residency, unless they changed it since the last time I looked].

And to be honest, if it's 5-6 years, you're going to have a lot more people joining that profession to acquire a "title" of doctor. I'd rather know that my Doctor really wanted to be in that profession, and dedicated a tough 11-13 years of schooling to treat patients. If someone is going to be dealing with my health, I want it to be the best, not someone that just wants the easy way in, and easy way out.

 

[Angry Ayrab]

And to be honest, if it's 5-6 years, you're going to have a lot more people joining that profession to acquire a "title" of doctor. I'd rather know that my Doctor really wanted to be in that profession, and dedicated a tough 11-13 years of schooling to treat patients. If someone is going to be dealing with my health, I want it to be the best, not someone that just wants the easy way in, and easy way out.

You want 11-13 of my best years, and I want your money, I think we can work something out.

 

[01011010]

Essentially, all the entire Med School program is designed for, is to weed people out by keep it a 13 yr program[4 under + 4 med + 5 Residency, unless they changed it since the last time I looked].

And to be honest, if it's 5-6 years, you're going to have a lot more people joining that profession to acquire a "title" of doctor. I'd rather know that my Doctor really wanted to be in that profession, and dedicated a tough 11-13 years of schooling to treat patients. If someone is going to be dealing with my health, I want it to be the best, not someone that just wants the easy way in, and easy way out.

This is why I think the requirements to get in, in the first place should be even more rigorous than they are now. I wasn't counting residency and or fellowship in the 5-6 year program. I have quite a few people close to me that are doctors, and I will most likely follow suit. I understand where your coming from, but I believe only two years of undergrad prep are necessary before entering med school. I wasn't suggesting med school be cut short. Just undergrad.

 

[tenINsFJ]

You want 11-13 of my best years, and I want your money, I think we can work something out.

Deal.

And PS, what year are you in? the last two years of med school are a lot easier than the first two, and residency isn't extremely bad. you still can enjoy yourself and have a life.

And if you aren't enjoying it, and claiming it's taking the best of your years, then why pursue it?

just for money?

 

[tenINsFJ]

Interesting suggestion about cutting undergrad short. I know what you mean. I was on the MCB route for three years, and then switched over to another major.

Essentially the prerequirements to get into med school are:
1 year bio w/ lab
1 year chem w/ lab
1 year gen physics w/lab
1 year organic chem w/lab
1 year calc

not too bad.

so.. you cut undergrad short. do you get a degree? if not... you do your two years of undergrad and go into medical school and pick your specialty. you end up finding it very difficult and drop med school. you wasted a good year or two, where are you at now? no degree.

what if someone does the pre reqs for med school and wants to major in music, english, or whatever. they have to get a degree in that first, and then pursue medical school, or any other class beside the pre reqs for med school wouldn't matter. you can't assume everyone is taking strictly science courses before heading into med school.

it's a career path that only the dedicated will truly take, those with passion for the job, or just sheer determination.. both of those traits I think make for good physicians. to cut things short(even undergrad by two years), IMO, wouldn't work out.

 

[Angry Ayrab]

Deal.

And PS, what year are you in? the last two years of med school are a lot easier than the first two, and residency isn't extremely bad. you still can enjoy yourself and have a life.

And if you aren't enjoying it, and claiming it's taking the best of your years, then why pursue it?

just for money?

#2 and you betcha, I see the light at the end of the tunnel and it looks sexa. No no, I was kidding, I love it. Well, I see it as a job as of right now. Honestly who the hell bust nuts off of taking the USMLE's and mock case presentations?

 

[Venom]

Interesting suggestion about cutting undergrad short. I know what you mean. I was on the MCB route for three years, and then switched over to another major.

Essentially the prerequirements to get into med school are:
1 year bio w/ lab
1 year chem w/ lab
1 year gen physics w/lab
1 year organic chem w/lab
1 year calc

not too bad.

so.. you cut undergrad short. do you get a degree? if not... you do your two years of undergrad and go into medical school and pick your specialty. you end up finding it very difficult and drop med school. you wasted a good year or two, where are you at now? no degree.

what if someone does the pre reqs for med school and wants to major in music, english, or whatever. they have to get a degree in that first, and then pursue medical school, or any other class beside the pre reqs for med school wouldn't matter. you can't assume everyone is taking strictly science courses before heading into med school.

it's a career path that only the dedicated will truly take, those with passion for the job, or just sheer determination.. both of those traits I think make for good physicians. to cut things short(even undergrad by two years), IMO, wouldn't work out.

ill be the first to admit that i am in a way, "selling out". I went from "being a doc would be nice, I can help people without having to starve, im kind of a generalist and they need GPs anyways...I dont want work in an office building for 12 hours a day, 6 days a week like my dad" to "well today, you have to be a specialist for it to be worth it" to "well even the specialists have to work 60 to 70 hours a week to make the money that breaks even with their investment (including non material investments)" to "well I guess if I'm a [insert grossly $$$rich$$$ specialty] then Im motivated" and finaly to "I have other connections. I have much easier ways to get a high paying 60-70 hour a week job...without all this hoop jumping"

Maybe you're right. Clearly there are tons people who will put up with the way it is, so why change it and risk leading people without the "determination" down a path they may end up hating?

I think what it comes down to for me, is that being a Doc lacks the kind of growth potential/master scheming that I find fun. Once you're a doctor, the most you can do is try to see more patients (referring to growth). The job's biggest bonus (security) is was originally attracted me. Now however, I view that security as its biggest drawback (I fear boredome/complacency...not enough 'achievement' beyond actually getting the MD letters--which is a big achievement that i dont mean to belittle)

 

[Giggly]

Are you in undergrad or med school?

Edit: Nevermind I see that you are in undergrad.

Do you have an another career path in mind yet?

 

[Angry Ayrab]

Are you in undergrad or med school?

Edit: Nevermind I see that you are in undergrad.

Do you have an another career path in mind yet?

I personally think he should go to med school, just to prove to himself that he can, and then drop out and do whatever he wants. That way, he can be part of the cool but small/rare elite that dropped out of med school, cuz they found it boring or something of that nature...

EDIT: I just read over it, and damn does it sound mean... It was not intended as a mean thing, I was just saying that I believe you are better than 117 premeders combined. Your rock wall-e

 

[Venom]

I personally think he should go to med school, just to prove to himself that he can, and then drop out and do whatever he wants. That way, he can be part of the cool but small/rare elite that dropped out of med school, cuz they found it boring or something of that nature...

EDIT: I just read over it, and damn does it sound mean... It was not intended as a mean thing, I was just saying that I believe you are better than 117 premeders combined. Your rock wall-e

I currently have an A in organic chem... If I can keep that, thats good enough for me as far as the "At least I know I could of gotten in". Does an A in Ochem prove you can be a doctor? No. Will it satisfy that inner voice that wants to know if I'm even smart enough to GET IN to medschool (as apposed to the bigger deal of surviving medschool)? Yes.

 

[Domino]

I'm sorry it's been so hard for you, BC. They shouldn't discourage such bright willing people from being medical professionals. A good doctor is like a good mechanic: there may be 20 garages in town, but only 5 are worth the money and confidence.

 

[Angry Ayrab]

I currently have an A in organic chem... If I can keep that, thats good enough for me as far as the "At least I know I could of gotten in". Does an A in Ochem prove you can be a doctor? No. Will it satisfy that inner voice that wants to know if I'm even smart enough to GET IN to medschool (as apposed to the bigger deal of surviving medschool)? Yes.

Hell yeah an A in o-chem is pocketable braggring rights. Keep up the good work and good luck in anything you choose to do.

On a side note, I think I finally come to terms that I will never ever be an OB/GYN, by choice that is. Hell, most guys love coochi, but my god...

No offense to the other half of the population or the great doctors that work with them. It's just one of those things you know you won't be good at. Dang... Now I feel sexist...