pre med then med school factors

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goru1
Posts: 318
Joined: Thu Jun 14, 2007 12:14 pm

pre med then med school factors

Post by goru1 » Sat Oct 06, 2018 4:12 pm

I am asking this question to learn about this topic.

Is pre med then med school a good option?

factors:

4 years of college, 4 of medical school, 3-5 of internship/residency, 3-5 of fellowship
lots of competitive exams
stress
sleepless nights
student loans

enter the workforce late
long job hours
on call
see death, suffering and pain on a daily basis
depression
weekends and holidays are never guaranteed free time

work life balance
delay getting married
delay having children

sued

Thanks,
Last edited by goru1 on Sat Oct 06, 2018 4:24 pm, edited 2 times in total.

arsenalfan
Posts: 667
Joined: Mon Dec 09, 2013 12:26 am

Re: pre med then med school factors

Post by arsenalfan » Sat Oct 06, 2018 4:18 pm

If that's the young person's perspective going in, then no.

That's pretty cynical and jaded thinking already, and they won't enjoy "giving up their 20s" for medicine, and probably be a lousy doctor if they're already thinking this way already.

The best physician colleagues I have enjoy going to work everyday, tolerate the grind, and enjoy the privilege of taking care of their fellow human beings.

Lots of other careers!

delamer
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Re: pre med then med school factors

Post by delamer » Sat Oct 06, 2018 4:23 pm

A 3 to 5 year fellowship and not being in the workforce until age 40 are exceptions.

Not all doctors have significant weekend and night work.

I agree with arsenalfan. If that’s a person’s attitude going in, then it is not the right field for him/her.

There are other high-paying careers that don’t have all the perceived negatives.

mhalley
Posts: 6303
Joined: Tue Nov 20, 2007 6:02 am

Re: pre med then med school factors

Post by mhalley » Sat Oct 06, 2018 4:30 pm

"Medicine" is a very diverse profession. There are many fields that do not have patient care, thus eliminating malpractice. There are also many options with good work life balance, but if you come out with huge debt you might need to work a lot fotlr a free years until you can back off the hours.
That being said, I think going into medicine requires you to have a calling, not just wanting the salary you can achieve. There are many fields that can generate a high income. The sacrifices and stress are real, as are the rewards.
Last edited by mhalley on Sat Oct 06, 2018 4:33 pm, edited 1 time in total.

HEDGEFUNDIE
Posts: 1215
Joined: Sun Oct 22, 2017 2:06 pm

Re: pre med then med school factors

Post by HEDGEFUNDIE » Sat Oct 06, 2018 4:31 pm

Which one is worse, having realistic expectations upfront, or starting down the MD path purely out of passion and then burning out from the issues mentioned by the OP?

arsenalfan
Posts: 667
Joined: Mon Dec 09, 2013 12:26 am

Re: pre med then med school factors

Post by arsenalfan » Sat Oct 06, 2018 4:38 pm

HEDGEFUNDIE wrote:
Sat Oct 06, 2018 4:31 pm
Which one is worse, having realistic expectations upfront, or starting down the MD path purely out of passion and then burning out from the issues mentioned by the OP?
Both are no-win.

If those are the OP's expectations, would you want that person being you eventual doctor? Med student/intern/resident/fellow? Partner/spouse? Parent? You should enter a profession with your eyes wide open. With the OP's negative expectations, I contend you will see what you want to see, and find it a self-fulfilling prohphecy. The MDs that feel something is "owed" to them ($$, prestige, honor, etc) are among the unhappiest, from what I have seen - I suspect this is true of any professional who feels something is owed to them. To them, I say find another profession, for yourself and for everyone around you!

Also, I guess you imply the OP's expectations are true for a medical career. My experience and my peer cohorts' experience has been different, for those who go into medicine with the attitude that it's a calling and an adventure. Again, the same can be said for any profession. I know career military/construction contractors/police/architects/teachers who are burnt out and all snark, and others who live and breathe it.

YMMV.
Last edited by arsenalfan on Sat Oct 06, 2018 4:42 pm, edited 1 time in total.

Elysium
Posts: 1382
Joined: Mon Apr 02, 2007 6:22 pm

Re: pre med then med school factors

Post by Elysium » Sat Oct 06, 2018 4:41 pm

goru1 wrote:
Sat Oct 06, 2018 4:12 pm
I am asking this question to learn about this topic.

Is pre med then med school a good option?

factors:

4 years of college, 4 of medical school, 3-5 of internship/residency, 3-5 of fellowship
lots of competitive exams
stress
sleepless nights
student loans

enter the workforce late
long job hours
on call
see death, suffering and pain on a daily basis
depression
weekends and holidays are never guaranteed free time

work life balance
delay getting married
delay having children

sued

Thanks,
With that view, don't.

You seem to be focused on doing the maximum dollars for the effort kind of evaluation. Go for CS, 4 years of college, job straight out of college, good pay, good career until 50 (may be less)

ENT Doc
Posts: 118
Joined: Sun Jan 22, 2017 9:14 pm

Re: pre med then med school factors

Post by ENT Doc » Sat Oct 06, 2018 4:46 pm

You’ve taken a cynical view of this and haven’t expressed why you or anyone might be interested in medicine. You also leave out significant upsides. My suggestion is to keep looking.

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Doom&Gloom
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Joined: Thu May 08, 2014 3:36 pm

Re: pre med then med school factors

Post by Doom&Gloom » Sat Oct 06, 2018 4:47 pm

OP, it sounds as if your mind is made up already. What does the young person think and want to do?

oops. Looks like the OP was edited after I first read it. Is the young person you? If so, my suggestion is don't waste any more time investigating this. Find something else to do with your future.

uberdoc
Posts: 73
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Re: pre med then med school factors

Post by uberdoc » Sat Oct 06, 2018 4:49 pm

Don’t do it. After all those years, insurance companies, hospitals and lawyers will make money of your work hard and society will think you are the culprit for high healthcare costs and deride you.

RockLobster
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Joined: Wed Aug 01, 2018 8:35 am

Re: pre med then med school factors

Post by RockLobster » Sat Oct 06, 2018 4:54 pm

I agree with other posters, and you should do an attitude check about if that's your description of a career in medicine, or the opinion of the young person you're inquiring for. Also, I think it's way too much of a generalization because there is SO MUCH variability in the field of medicine.

For someone graduating medical school after four years of college, without gap years or other breaks in between, you enter the workforce around 29. Residency is still training, sure, but you are paid (spitballing that average intern makes ~55k/year). Granted, it's not much, and there's a lot of debt accompanying that small paycheck, but I was able to contribute to my Roth IRA, and residents (nearly?) always get excellent benefits from their hospital employers. Many of my colleagues were married either in medical school or during residency, and some even had kids!

The big question is what does your young person want to do with a career in medicine? Do they want to be a surgeon, requiring a long residency and additional fellowship? Or something more general where you can work in the clinic on a regular basis and maybe not require as much training. It only takes 3 years of residency to become a general practitioner. Those specialties have their own headaches, sure, but you have the flexibility for a set schedule, regular hours and holidays, and generally avoid the death, suffering, and pain you'd see in more acute settings.

My story:

4 years of undergrad as a French major + premed requirements, tuition scholarship and working as RA for housing. Sure, I worked hard, but had a great time and had more freedom than perhaps someone in engineering or hard sciences.
4 years of med school, total debt ~150k.
3 years of Emergency Medicine residency. Made 55-65k/year salary, worked average 60hrs/wk. Made ~$10k moonlighting my last year.
I'm now a few years out, did not do a fellowship, and make ~250k/year salary, bonuses and extra shifts add ~$60k, have paid off my loans, work some holidays (we rotate schedule), and love my job. I make on the lower end for my specialty because I work in an academic institution in a large city. My hours are shorter than many other specialties, but range from am to pm to overnight shifts. I see plenty of suffering and death, but I also have a change to save lives and heal people. For me, that's worth it. Medicine in general not for the faint of heart, and (my specialty in particular) has high rates of burnout and depression. You should encourage your friend to talk with a few physicians, maybe find someone to shadow, and when they get to college, get involved in premed activities and student groups.

There is no shame in being undecided about it when you start college, either. Someone interested in premed is probably also interested in the sciences, so have them think about what they would want to do if not medicine. Plenty of students change their mind and go in a different direction, and plenty of others steer towards medicine as they go through college.

Maybe you should do some research and get in touch with practicing physicians as well, because it seems that your view of the medical field is unfairly focused on many of the negative aspects of the job that aren't necessarily applicable to all practice settings.

Would be more than happy to answer any questions!

Balefire
Posts: 59
Joined: Thu May 04, 2017 10:17 am

Re: pre med then med school factors

Post by Balefire » Sat Oct 06, 2018 4:54 pm

That is probably the most negative point of view possible for physicians.

A more balanced outlook would include

Daily gratification from helping individuals
Daily gratification of technical success if procedure physician
Daily gratification of working with a team (RNs, assistant to, etc) to accomplish good patient outcomes
Daily gratification in teaching students, residents, and fellows of at academic setting
Daily gratification from generous stable income
Daily gratification from respect in community, family
Occasional gratification from helping society if a part of social or research endeavors

And ironically I like when I kick butt on tests.
I imagine I'm not the only one
Last edited by Balefire on Sat Oct 06, 2018 5:38 pm, edited 2 times in total.

HEDGEFUNDIE
Posts: 1215
Joined: Sun Oct 22, 2017 2:06 pm

Re: pre med then med school factors

Post by HEDGEFUNDIE » Sat Oct 06, 2018 4:55 pm

arsenalfan wrote:
Sat Oct 06, 2018 4:38 pm
HEDGEFUNDIE wrote:
Sat Oct 06, 2018 4:31 pm
Which one is worse, having realistic expectations upfront, or starting down the MD path purely out of passion and then burning out from the issues mentioned by the OP?
Both are no-win.

If those are the OP's expectations, would you want that person being you eventual doctor? Med student/intern/resident/fellow? Partner/spouse? Parent? You should enter a profession with your eyes wide open. With the OP's negative expectations, I contend you will see what you want to see, and find it a self-fulfilling prohphecy. The MDs that feel something is "owed" to them ($$, prestige, honor, etc) are among the unhappiest, from what I have seen - I suspect this is true of any professional who feels something is owed to them. To them, I say find another profession, for yourself and for everyone around you!

Also, I guess you imply the OP's expectations are true for a medical career. My experience and my peer cohorts' experience has been different, for those who go into medicine with the attitude that it's a calling and an adventure. Again, the same can be said for any profession. I know career military/construction contractors/police/architects/teachers who are burnt out and all snark, and others who live and breathe it.

YMMV.
Just spent an hour on the phone catching up with a close friend of mine who just started a competitive endocrinology fellowship. She works 12 hour days in the hospital and then is on call 6 nights a week. The majority of calls that wake her up in the middle of the night are issues that can be handled by the hospitalist or even RN, but their CYA attitudes force her to get involved unnecessarily.

And then there are the patients, 80% of whom are in the hospital because they are too poor to afford preventative care, or have personally neglected their own health, leading to loss of limbs, kidney/digestive function, and in some cases their lives. She is the person they come to for a shred of hope, in many cases only to be told there is nothing she can do. Hospice or a lifetime of dialysis awaits.

She has two more years of this. Doesn’t know if she can make it through.
Last edited by HEDGEFUNDIE on Sat Oct 06, 2018 5:00 pm, edited 1 time in total.

arsenalfan
Posts: 667
Joined: Mon Dec 09, 2013 12:26 am

Re: pre med then med school factors

Post by arsenalfan » Sat Oct 06, 2018 5:00 pm

I empathize.
Endocrinology can suck. Presented as a bunch of tightly regulated feedback loops...then the real world of non compliant diabetics/vasculopaths enters, complete with all the individual, social, and economic failures contributing to the problem.
But it sounds like her system is suboptimal if RN or mid-level providers can be handling the calls.
Residency/Fellowship is filled with suboptimal systems. Heck, they just passed the 80 hour work week when I was in residency. Wahoo!!
OTOH, you got to do the coolest stuff in the wee hours, stuff that usually was way above your pay grade.
I digress - be sure she's not losing the forest for the trees. I hated my first SICU rotation and almost quit; my second one was great.
And private practice is a whole different experience.

In the end, you get one life. You're not guaranteed anything. Make your best educated decision with the info at hand, and be flexible.
Why did you choose endocrinology? What do you want out of life? Don't like it? Change. Don't succumb to sunk cost fallacy, in investing or in life.

But when you present it as the OP has...why start?
Last edited by arsenalfan on Sat Oct 06, 2018 5:40 pm, edited 3 times in total.

sambb
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Joined: Sun Mar 10, 2013 3:31 pm

Re: pre med then med school factors

Post by sambb » Sat Oct 06, 2018 5:01 pm

healthcare is a altruistic profession and thanks to those who are in it. never worth it for the money alone however. I suppose similar could be said about religious professions, and other ones in which you are a provider to others.

jhwkr542
Posts: 38
Joined: Tue Jun 28, 2016 9:51 pm

Re: pre med then med school factors

Post by jhwkr542 » Sat Oct 06, 2018 5:52 pm

goru1 wrote:
Sat Oct 06, 2018 4:12 pm
I am asking this question to learn about this topic.

Is pre med then med school a good option?

factors:

4 years of college, 4 of medical school, 3-5 4 of internship/residency, 3-5 1 of fellowship
lots of competitive exams (1 highly competitive exam in med school, minimum competency ever since)
mild stress
sleepless nights
student loans

enter the workforce late (turned 31 upon leaving fellowship)
long job hours (7:30 - 4, 4.5 days a week)
on call (4 weekends a year, been called in once in 2+ years)
see death, suffering and pain on a daily basis (I don't work in hospice care)
depression (not for me)
weekends and holidays are never guaranteed free time
(I am on call one holiday a year)
work life balance (pretty good for me)
delay getting married (yep, at age 25)
delay having children (yep, at age 28)

sued

Thanks,
My experience above. Pretty much nothing like you described.

helloeveryone
Posts: 204
Joined: Sun Sep 04, 2016 5:16 pm

Re: pre med then med school factors

Post by helloeveryone » Sat Oct 06, 2018 6:24 pm

goru1 wrote:
Sat Oct 06, 2018 4:12 pm
I am asking this question to learn about this topic.

Is pre med then med school a good option?

factors:

4 years of college, 4 of medical school, 3-5 of internship/residency, 3-5 of fellowship depends
lots of competitive exams yes
stress not all the time
sleepless nights not all the time
student loans yes

enter the workforce late theoretically just four years later (you start making >50k once you hit internship)
long job hours specialty dependent and even then not all the time
on call specialty depending and even then not all the time
see death, suffering and pain on a daily basis specialty dependent
depression greater than the average population but not 100% incidence
weekends and holidays are never guaranteed free time not all the time

work life balance specialty dependent but can be done
delay getting married person dependent but maybe self selection bias?
delay having children likely but also maybe self selection bias?

sued possible but focus on good patient care, good documentation and risk will be minimal

Thanks,
the list of benefits/joys are much longer in my opinion.

arsenalfan
Posts: 667
Joined: Mon Dec 09, 2013 12:26 am

Re: pre med then med school factors

Post by arsenalfan » Sat Oct 06, 2018 6:44 pm

How people feel about their careers is hugely anecdotal. I know professionals, in and outside of medicine, who say they couldn't have done anything else. Conversely, I know professionals who say they wish they'd done anything else.

If it is OP's perspective going in as a college kid, then do something else. You're already damaged goods.

If it is a relative's perspective going in about your kid/someone else's kid, empower the kid to be smart, open minded and nimble of thought. And don't pollute them with your negative nancy thinking about a particular field. Or steer them away or towards anything. Let them find their own way.

Afty
Posts: 842
Joined: Sun Sep 07, 2014 5:31 pm

Re: pre med then med school factors

Post by Afty » Sat Oct 06, 2018 6:49 pm

Rather than reporting more anecdotes, I was curious what the data say -- what do physicians as a whole think about their career/profession?

I found 2 surveys that ask such questions, the Great American Physician Survey and the Physicians Foundation Survey.

The 2018 Physicians Foundation Survey reported the following:
  • Which best describes your professional morale and your feelings about the current state of the medical profession? 44.7% somewhat or very positive, 55.4% somewhat or very negative
  • Which best describes how you feel about the future of the medical profession? 38.4% very/somewhat optimistic, 61.6% very/somewhat pessimistic
  • Would you recommend medicine as a career to your children or other young people? 51.3% yes, 38.7% no
  • If you had your career to do over, would you choose to be a physician? 72.6% yes, 27.4% no
The 2018 Great American Physician Survey reported the following:

To what extent do you agree with the following statements (1: strongly disagree to 5: strongly agree, weighted averaged):
  • I like being a physician: 4.3
  • I would recommend this career path to young people: 2.8
  • I used to enjoy being a physician much more, but today it's more stressful: 4.1
  • I am happy with the direction healthcare is headed: 1.7
My takeaway from this is that physicians generally like their work and, if given the opportunity to do it over again, would choose to be a physician. However, there's also a feeling that the profession is headed in the wrong direction, and that they're split on whether they would recommend this career path to young people. I'm curious how this compares to other professions.

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