5.10.2008

Reasons not to go to medical school

The Lone Coyote posted an interesting article the other day from Forbes that has gotten me thinking about my choices over the past few years and the state of medicine...did I actually know what I was getting into?

I thought that I knew what was up a few years ago when I started my pre-medical education. Do well in college, pad your resume with research and medical related stuff. Apply, get accepted and spend 2 years of studying your life away in the library followed by 2 years of being nearly purposeless in the hospital. Do some scut, apply for residency and get a job. Great, grand wonderful...piece of cake I would think to myself.

Then you get to a point where you've put in 8 years of higher education at your own expense and people call you Doctor. But you're paid less than burger flipping wages for 3-6 years of 30 hour shifts and night swing coverage while being to be one of the most productive members of the staff, bouncing around between services, all the while jumping through hoops to keep everyone happy so you don't get fired from your indentured servitude. Not too bad, I can do that.

Now you're 30-35 years old and just finally for the first time cut free from the bonds of the medical education system and expected to tackle the immense task of building a practice or desperately launching yourself into academia. You'll be paying off loans into your 50's and you're probably going to end up divorced 2 or 3 times with a couple different kids who hate you. You're going to be sued, you're going to kill 3 patients (on average). Whatever, that's like decades from now...not my concern.

Boy was I naive thinking that was all there was to it...

You build up a perfect little image of your future. I can distinctly remember thinking about all the cool things I would do, but I never really thought about what the nitty-gritty of being a doctor would be all about. I knew there would be missed soccer games/dance recitals/school plays/birthday parties...that comes with the territory. I observed a couple of shifts at UMass in college and pictured myself as one of the ER docs flying around in their Chopper. I worked at Children's Hospital and I saw myself becoming a surgeon and doing cool Pediatric operations like you see on TV. I sprained my ankle pretty badly and went to an orthopod's office and saw myself in a sports medicine practice dealing with sprained ankles and scheduling rehab for athletes. I still can see myself doing a lot of things...I must be delusional!

Soon I'm going to be pulling my head out of my books and getting to learn the practice of medicine for myself. I'm going to see it in all of it's horrific glory...and for better or worse, I'm financially destined to continue to this path to being a doctor.

6 comments:

Dragonfly said...

Yeah. It could be a lot worse though (could still be working guts out to get in).

M said...

What is this fixation with money that so many med students have? Maybe I'm delusional. Med school in Australia is dirt cheap. Tuition itself is about AUD$50000 all up-- and this is for six years, as opposed to the four you get in the states. Textbooks and materials throw on another AUD$2000. It's a fraction of the cost US students have to deal with.

I promised myself I'd never let a salary determine my happiness. I'm just hoping I can stick to it.

Bostonian in NY said...

Firefly- Very true!

M-
First of all, the article was in Forbes, a magazine centered around the financial world and being rich. When I read it the first time, it was flanked by ads for Jaguars and Land Rovers...just for context.

Second of all, I'm in about $180,000 (193,000 AUD) of debt for the first 3 years of this ordeal, and fourth year isn't looking much better on the financial front.

Comparing Aussie to US dollars (1:0.93) one year of my education (62,000 USD/67k AUD) costs more than all 6 of yours. It's a huge burden to look at beginning your career with a quarter million dollars (269,000 AUD) of debt without a substantial paycheck coming your way before your 30th birthday.

To put that into perspective, I'll be throwing $1500 (1612 AUD)for the next 20 years just to cover loans, effectively cutting my income in half during residency (4 years) and costing more than a mortgage on a modestly sized 3 bedroom house.

From another angle, someone who with a high school education that starts making $30,000 a year and investing 10% of their income will amass a larger net worth than I ever could because of 8 years of lost earning potential, the lost compounding gains on an investment and the obscene debt that I'll be carrying...and

I'll likely be making around $200,000.

It was never a question of letting money determine my happiness, it's a question of being completely overwhelmed by debt before I've even started a job. It's not that I'm equating happiness with dollars, it's questioning whether going into medicine is a sound financial decision compared with other careers that I would have persued.

The Lone Coyote said...

I think people fixate on $$$ here because they suddenly realize they may be leaving school owing as much as over $250,000 at some places. Throw in a rising cost of living, supporting a kid or two, and wanting to buy a home before you're 50, and it makes primary care seem unpalatable for many people.

I don't think you're delusional. I think it's just different systems-- gov't funded v. largely individually funded.

M said...

Note that all of this is coming from the girl that wanted to be a hedge fund manager/investment banker between the ages of 13-17 (good grief I'm young). Forbes is a bit of a hit and miss for me as I gave up reading that magazine when I decided to forego said life for med school.

I've never really appreciated the gravity of sitting in a quater of a million dollar hole. Sid at Surgeonsblog recently linked back to a post discussing the very same thing. I suppose it's the ultimate proof that doctors are really altruists. There's no way they're in it for the money because, quite frankly, what money?

So that leaves one question-- what the hell convinces an American to go to medical school? (Asinine question.)

What I find a bit twisted is that Australian students can finish up their education in Australia, hop over and take the boards and start working-- without having to repay their student debt until they return to Australia, if ever. (It's not exactly illegal, just severely frowned upon by our government.)

I appreciate my position a lot more now. At the same time, I admire American medical students that much more. It's hard enough having to get through school, let alone with that sort of debt over your head.

Bostonian in NY said...

This American was convinced by a naive vision of being able to help people while making a decent living at the same time and not having to listen to other people tell him what to do every day of his life.

I'll be happy driving my compact car, living in a modest house and paying back my loans as long as I have something interesting/altruistic to do at work every day.