Is becoming a doctor worth the sacrifice?

mlj wrote:

Good point. I know a pedodontist that makes a stupid amount of money. He works 4 days a week and takes probably 6 weeks vacation per year.

Dentists have a great racket. They live very comfortable lives. Great work environment, great pay. Downside is that you look at teeth and mouths all day, but if you like that.

As for the negatives, yup there are negatives to the job. I'm an ER doc. I see the shit of society on a daily basis. Drunk and drug addicts. Gang bangers.

But I also do some incredibly awesome stuff. Two months ago a guy walked into the front of the hospital stabbed in the chest and collapsed - dead, no pulse.

I went up there, and me and another doc cut the guy's chest open, and plugged the stab wound in his heart with my finger as they prepped the operating room. People were doing CPR as I rode the elevator with my finger in this guy's heart - open chest and all. Guy walks out of the hospital a week later.

One in a million case? Maybe. But once a month I shock people back to life, reverse a drug overdose, and treat heart attacks. Last week I intubated a septic young lady (21 years old with a bad pneumonia), resuscitated her, and she lived.

So yes, people bitch about Obamacare and long hours, and having to memorize a bunch of stuff. But in the end, there's no sacrifice, only challenges and opportunities.

pre-med dude wrote:

What initially drew me to medicine was its scientific competent, and the whole "detective" style work of getting a problem and fixing it. The money and status are added bonuses, but not really the reason I decided to pursue it. It's just something I think I would be good at, but currently the main things that are turning me off from doing it are:

I am not a physician, though I am aware of the relatively high pay and very high status that doctors enjoy in the US.

Recently I read a very insightful blog post, which I wish I'd saved, which contrasted the medical field with engineering. The basic point was that being a practicing physician, despite the pay and prestige, is really a lot like being a car mechanic - intellectually, it is at the bottom of the pyramid.

As a physician, you are not doing blue sky research, nor are you figuring out how to apply that research to create new therapies ... you are at the end of the pipeline, memorizing a bunch of stuff that other people have figured out, so that you can apply it again and again when people come to you with their (99% of the time) completely routine, boring and pedestrian complaints.

More personally: I go to the doctor very infrequently, and on average they've been wrong well more than half the time (on first visits). They're overworked, they don't really listen, their knowledge is a mile wide and a millimeter deep. Most of them have neither the time nor the inclination to "think." And this is in a pretty high rent neighborhood - these are presumably the "best."

In short, while it may be a great job for some, practicing medicine is not at all the intellectually rewarding career someone is trying to sell you. Of course, an MD can be a great stepping stone to all sorts of related careers in science and business.

Final advice: talk to lots of practicing physicians in your chosen specialty, young, middle aged, and older.

(Also, for $600, I think the test at jocrf.org is very worth it. Definitely was for me.)

Good luck.

As long as you aren't in it for the money. Obamacare won't have MDs making $500K+. Single-payer, baby!!!

Being a doctor is at the bottom of the intellectual totem pole? I think that depends on the type of doctor.

If you are involved in your own research, and you make a point to stay up to date on the most cutting edge research done by others to incorporate into your practice, you will constantly be challenged. Not to mention if you're a highly regarded specialist who takes on interesting and novel cases.

One of the fundamental tenants of medical school is "preparing future physicians for lifelong learning."

The amount of intellectual challenge and creative latitude required by specialists is amazing. But if you're thinking of being a primary care physician or in pediatrics, etc, then I understand your point.

If you're intellectually lazy, you will be intellectually lazy in whatever career you choose, even medicine.

I think its one of those..."if you have to ask you'll never know" type questions.

I was pretty successful in the financial world only three years after undergrad but now I'm finishing my premed requirements and preparing to take the MCAT this summer and apply. You do realize that you can have your 20's to yourself and revisit the med school thing later right? I turn 30 in a month and wont be starting school til I'm 31, if I get in on the first try.

If you want to be succesful or make money in ANY field you will work just as hard, if not harder, than a doctor. Want to be successful on wall street? you're working 15 hour days. If you want to own a restaurant you might work more than that. You get the point.

For me I just got kind of burnt out on working for nothing but money. Being a trader paid great but was essentially soul-less. I'm not religious at all but I needed to do something that would energize me more than once a year when I got my bonus.

Anyway good luck figuring it out. Just don't forget that you dont need to go right from college to med school....take some time to find yourself and if you come back to it then go for it.

My plan anyway was to not go straight to med school, and at the soonest enroll a year after graduation. My dilemma now is if I decide that I am currently unsure, do I continue taking the pre-med requirements (just in case I decide to commit to medicine sometime after graduation) or stop taking the prerequisites in favor of another major/minor.

I'm with you Dent, as much as i enjoy the paramedic life, at some point i want to be a little more relaxed in the ER...I think it's the only place to be. i'll be damned if i'm going to get called on for one of my patients. work your rotation and walk away for a few days, can't get much better than that imo.

dude-

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Of course, an MD can be a great stepping stone to all sorts of related careers in science and business.

[/quote]

Is this true? I hear people say similar things about law (being a "stepping stone" to other things, that is) all the time, and as a lawyer know it to be false.

I can tell you doing taxes that from a tax standpoint, Doctors are very screwed over. They are part of the "rich" that Obama (and Republicans for that matter) want to tax more. You do make very good money once you are in practice. But you only start making that when you are in your 30s with a ton of student debt. A doctor can get some good tax benefits. But they basically fall between the cracks of not getting the tax benefits that lower and middle class taxpayers get, nor the tax benefits that the super wealthy have. A lot of tax benefits that lower income people get are phased out because they make too much income. Student loan interest, child tax credit, personal exemption, some itemized deductions are examples.

At the same time they don't get the tax benefits of the super wealthy who have accumulated a critical mass of wealth and have ways of perpetually deferring income and letting their wealth accumulate returns.

Moreover, by the nature of their occupation, they can't create wealth by building up economies of scale or engage in "free trade" with communist countries like a corporate executive can.

From the 50s through the 80s Doctors did pretty well. The debt burden for schooling was lower and they could invest into a stock market that was generally rising. But if you became a doctor in the 90s its much bleaker. A lot more debt, and buying into an inflated housing market and stock market.

This is something that doesn't get talked about near enough with health reform. Promoting an economic system that rewards being a doctor rather than someone having a lot of wealth.

A Skeptic wrote:

Is this true? I hear people say similar things about law (being a "stepping stone" to other things, that is) all the time, and as a lawyer know it to be false.

The MD degree brings a great degree of credibility. You can work on Wall Street (as a banker, sell side analyst, or a fund), for a medical device company, as a VC, for McKinsey, as a politician, for the World Bank or many government entities ... everyone respects the MD. Of course, none of those paths is well paved - it's up to the individual to make it happen.

I couldn't go through the effort of getting an advanced degree in a field that didn't interest me. But that's me.

Some doctors are very good at problem solving, and others suck at it. I think the good ones are good because they actually like the profession, and the crappy ones joined up because of family pressure, greed, or what have you. Please, only become a doc if you really want to!

Me, I'm a GIS Analyst. I love the problem solving aspect. It requires way less education than doctors but just as much problem solving.

Good luck!!!

after watching several seasons of scrubs, i think the answer is no

I think you have some misconceptions.

There is a lot of memorization the first couple of years but unless you are internally driven to be first in your class, you do the best you can and it's not bad. I trained and ran marathons in med school. Not world class or anything, but I had a life, was married and even had our first kid my last year.

Clinical medicine is all about problem solving. Not every case is fascinating. But I work with kids and there is something very appealing and satisfying to me to be able to see an ill child and worried mom who has been multiple other docs, examine the kid, listen carefully to the story, figure out what's wrong, and help them out. It feels really good to be good at that, and having the respect and love of your community and colleagues is a really good feeling.

I work in a poor area and have awesome partners. We share call and I take night call maybe once a week and have to be on for the weekend maybe once every 6 weeks. Many weeks I work just 4 days a week. I often hike in Zion and the Grand Canyon on days off. Some of our new residents opt for shift work as hospitalists and work great hours and make a very comfortable living. I've gotten to travel the world with CDC and WHO and have worked in war zones and natural disasters. It's been awesome. Honestly.

Going into medicine was the best decision I ever made. It's what you want to make of it. You can be miserable and work all the time. Or you can lead a full and satisfying life doing good work, and make a comfortable income, too.

Well said. I also agree with Med Runner about the "laziness" aspect. You can find that in ANY profession or job.

To the OP, we have few friends who used to be engineers or didn't start med school until they were early to mid 30s and they are much happier.

I second this. Medicine is a great career, and there are many many options to choose from. Private practice, teaching, research, non-govermental agencies (doctors without borders, WHO, etc), government (CDC, state public health departments). Work schedules are also more flexible now- hospitalist work (full-time is generally 2 weeks on, 2 weeks off), clinic work (m-f, some pay extra if willing to cover a weekend on-call, or even the solo-practitioner (always on).

Re: memorization. Well, yes, you have to learn things. But after medical school, there is far more pattern recognition, setting priorities, working with multiple disciplines, and weighing different probablities. The book "how doctors think" by Jerome Groopman may help you get an idea of the issues you deal with in day-to-day practice, or any of Atul Gawande's books.

Re: pay. No physician goes hungry. Currently, procedures are much more heavily re-imbursed than thinking (I can have an hour-long discussion with a patient to convince him to take life-saving HIV medications, and then choose from among 30 potentially toxic meds (needing to interpret a resistance genotype to do so), and at the end of the visit quick freeze a few warts off: the 1 minute of freezing will bring in more than the hour of thinking. So, if money is important, do vasectomies, cataract removals, knee replacements; basically any routine procedure that is usually done on healthy people (avoid the sick ones- they have complications).

With almost any specialty (except pediatrics, sadly) you will make at least 125-150k after residency. In some, much more. In residency, pay is about 50k/year. In year 2 and 3, presuming you are competent enough to pass step 3 of the USMLE exam, you can moonlight in urgent cares, hospitals, etc, and more than double that. During my 2nd and 3rd years of residency, and my fellowship (another 3 years after residency) I did three overnight shifts a month, which more than doubled my salary.

Outside interests:

No trouble maintaining running, social life, marriage. Resident duty hour restrictions put into place in 2003 or so have made the extremely long hours a thing of the past, and the council for graduate medical education is planning on further restricting them. My intern year was the only unrestricted year I had- maxed out at 100 hours. After that, the cap was 80, which only happened on harder rotations (5/year or so). Future cap likely to be 60. Currently, I put in 50 hours or so a week, but could do 40 (as long as I see my patients and justify my research time with publications, my time is my own).

I have absolutely no regrets. Those telling you that Obamacare is going to destroy medicine are are coming from a position that any decrease in their salary is being "destroyed". And they have a point- the pay of prceduralists will likely go down. Perhaps those making 500,000 will only make 300,000. Boo hoo. Still among the wealthiest 1% of Americans. They'll survive.

"I hated memorizing"

Memorizing during premed is like doing your "base work" in running. It gives you the internal resources to "problem solve". How well are you going to problem solve if you have to look everything up (granted kids these days have blackberries and Iphones)?

You will need to memorize medications, lab values, drug interactions, let alone classification/grading schemes for diseases, injuries, deformities, etc; if anything to "appear" competent, let alone actually being competent.

You can go into a more kick back specialty if you're really worried about "sacrificing time" like radiology or pathology (and look things up since you're not dealing with live patients).

TV likes to show how "intense" residency; and surgery and medicine residents always talk about their 36 hour shifts they have during the hospital rotations. No one brags about their "regular hours" during clinicals. In other words, the intensity is overstated.

Put in another way, the geekiest, physically meek nerd can survive it. I wouldn't worry about it being too physically or mentally challenging. Plus a lot of times in those call shifts you're doing it as a team.

The whole premed/med school/residency is a screening process like football training camp. Those who have the "love of the game" as well as adequate mental and physical gifts will make it. Plus it's not really "work" if you enjoy it, if you believe you're improving yourself (like putting in the miles for running).

consider this wrote:

A Skeptic wrote:

Is this true? I hear people say similar things about law (being a "stepping stone" to other things, that is) all the time, and as a lawyer know it to be false.

The MD degree brings a great degree of credibility. You can work on Wall Street (as a banker, sell side analyst, or a fund), for a medical device company, as a VC, for McKinsey, as a politician, for the World Bank or many government entities ... everyone respects the MD. Of course, none of those paths is well paved - it's up to the individual to make it happen.

I couldn't go through the effort of getting an advanced degree in a field that didn't interest me. But that's me.

I'm guessing that doctors get into such alternate careers because some people go to medical school and end up hating medicine, and, being bright, get into something else. That's the reason that so many lawyers do something in another field.

i'm a dentist. undergrad then 4yrs of dental school. i elected to do a 1yr residency to gain more experience. i love the lifestyle. 30hrs per week(tuesdays off). good pay. 5-6 weeks of vacation. i'm not stressed at all at work. it's great. retirement savings is growing well. married with no kids. (and i just turned 30).

If you are a junior what "pre med" classes do you have left? All you need to take the mcat and apply is a year each of bio, physics, gchem and ochem, which most people complete by the end of sophmore year.

If you have things left to take you can always come back and take them later on. I was a finance major and had never taken a single science course other than high school bio until I came back to school at 28. Remember that if you decide to apply after a year or more off you will need to relearn everything in order to take the mcat anyway.