Wednesday, August 22, 2012

Should I go to med school?

This should probably be a weekly whine, but I've got WW's scheduled till like 2015, so I'm just making it a regular entry.

It really irritates me when someone presents their story to a large community and asks the question, "Should I go to med school?"

The reason it bugs me is because the answer is usually no. It's usually some crazy situation where the person should do ANYTHING BUT go to med school. But of course, the person posting doesn't want to hear anything besides a unanimous yes.

For example, in some med school community I was reading, someone posted (paraphrased, but not made up):

I'm a college sophomore and it's my dream to become a doctor. However, I've been recently diagnosed with lupus and I'm concerned about how this will affect my dream. Recently, I've been put on immunosuppressants, and I'm not allowed to go into a hospital. Also, due to my medical issues, I haven't been able to make it to many of my classes and I've been about an hour late every day.

Is this a joke? Are you serious?? You want to become a doctor, but you can't even set foot in a hospital?? What am I supposed to say to that? Do I think it's a good idea to become a doctor if you can't do your classes and can't enter a hospital? Do I really have to dignify that with an answer?

Another example is that of the new mother of an infant, who wanted to go to medical school. The catch? She's divorced. She is already struggling to pay the bills. She has no nearby family to help with childcare. "Should I go to med school?"

No problem! The dog can babysit for free, right? Wait, they can't?? That's considered child neglect and you can go to jail? Well, damn. Then I don't know, maybe med school isn't such a great idea.

Of course, in both these cases, when it was even suggested that med school might not be the best choice, both of these individuals were enraged.

Here's a controversial opinion: med school ain't for everyone. If you have a serious medical condition, maybe it's not such a great idea. Especially if that medical condition precludes you from entering a hospital. If you have a small child and no means to get childcare, maybe it's not such a great idea.

Can you go to med school if you have lupus or are a single mom with no family support or financial resources? Yes, of course! But just know, it's going to be really, really hard. And you should probably look into other possible career options first, and be really sure that's what you want before you invest a lot of time and money. And if you don't want to hear that, then why the hell are you asking in the first place?

43 comments:

  1. thank GOD. i am tired of reading these posts as well. if something is your 'dream' then you shouldn't need someone to tell you whether to do it or not....

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    1. That's my whole point. If it's your dream and nothing will stop you, no matter how bad an idea it is, why bother asking?

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    2. Yes! Absolutely, even all the naysayers in the world won't stop you!

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  2. I agree. When I replied to one such post and suggested the person be realistic, the whole blog community was enraged with me and started ridiculing me. Strangely the person responded that yes, she thought about details and trying to be realistic already. I do not read that blog anymore. People loose their senses in current paradigm "Yay! Follow your dreams!"

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    1. There's something a little arrogant about insisting that only medical school is good enough. There are plenty of careers out there that are very similar to being a physician (such as PA/NP) without quite as grueling a training and much less incurred debt. But try suggesting that to someone dead set on med school and see how angry they get.

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  3. I think that people romanticize what med. school is going to be like and think, "Well, I've studied hard! I can do it again!" Then, the fools like you and me who actually go through with it realize that it's an overrated near-death experience (excuse my sarcasm, I'm fresh off of Step 1)! There was a girl in my class who was divorced, working full-time, and had a kid. She was super behind & always falling asleep in lecture. She asked me if I could tutor her & I had to say no b/c 1. Try asking someone who's top of the class, not ME and 2. There is not enough time in med. school to privately tutor your classmates along so they don't fail, without failing yourself.

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    1. Medical school is hard. And financially, it's not worth it if you go into primary care, especially as a woman. I think that's an important fact to keep in mind.

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    2. I agree with Red Stethoscope. Man, if you need to a lot of tutoring in med school, you're going to fail all your classes.

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    3. Fizzy, why do you say it's not financially worth it for women to go into primary care? The average salary for PM&R doctors is only a few thousand dollars higher than for Family Medicine doctors.

      I'm thinking about going into primary care, and with my projected debt of $200K (and 6.8% interest), I'm hoping it'll be worth it as long as I can get a $180,000 salary job. I'll have a LOT more debt to pay off in the end if I do a much longer residency!

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    4. Andrea, check out this article:

      http://www.theatlantic.com/health/archive/2012/07/is-medical-school-a-worthwhile-investment-for-women/260051/

      Obviously, there's more to it than just money though. Also, my understanding is that you're unlikely to find a primary care job out of residency that will pay $180K.

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    5. @Andrea -- Academic general peds pays 90K per year to start. An academic hospitalist job pays 100K per year to start. Granted, things are better in private practice, but it's not unheard of to make in the 40-70K range your first couple of years while you're trying to establish your practice. To make in the 180K range in primary care... well, I don't know anyone in primary care who makes that much, but I also don't ask a lot of attendings about their salary. Suffice to say, you'll need to go into something like cards or anesthesiology to start off with #s like that.

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    6. OMDG: Yeah, that was the impression I got about salary too. Several of the people I knew who got primary care jobs were disappointed with their starting salaries.

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    7. I started in primary care around 180,000.... I know another person in my class did the same... It does exist but I guess I should count myself lucky!

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    8. Oh please, Fizzy. You're really going to bring up that article from Atlantic Magazine?? That magazine is sooo conservative and biased.

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    9. I'm only quoting it because it was cited on the MiM facebook page. I'm not sure about the accuracy, but I do know that people end up like $250K in debt out of school with barely six figure starting salaries in some parts of the country.

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    10. Wow -- I'm genuinely surprised at these salary figures. I live in Canada and have several friends who do primary care (emergency medicine, hospitalist) who easily made upwards 200k their first year out. Depending on the practice type, some ED physicians make substantially more than that. Seriously people, consider Canada as an option -- it's not just snow and caribous up here!

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    11. An ED physician is NOT considered primary care. ED physicians probably make that much over here or more.

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    12. I guess the practice patterns are different here than in the U.S. Here, a primary care physician is essentially anyone who is not a specialist --i.e. a first-line physician (we also don't have internists doing primary care -- which i remember from an earlier post is commonly done in the U.S.). Many family physicians do emergency and in-patient medicine as well (even in the big cities and major centres) and we have more FM-trained ED docs working in the EDs than those trained through the EM residencies.

      But, yes, if you are a family doc working exclusively in the office, you make substantially less money - though still more than 120K right out of residency.

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  4. I firmly believe in finding a way to make things work, but I also believe in being realistic. If there's a chance a person will come off immunosuppressants then yay, reconsider the dream when that happens. Same with IF the single mother finds someone who CAN help with childcare and a way of dealing with financial issues.
    The blogging community has a nasty habit of ousting anyone who dares to be realistic. Me? I say they must grow up.

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    1. I wasn't planning on doing this, but this is the comment thread started by K that set me off:

      http://www.mothersinmedicine.com/2012/08/mim-mailbag-mention-daughter-in.html

      Admittedly, I was a little immature in my shoefir comments, but that said, nobody was trying to be cruel to this woman when they commented on her situation. She was a single mother of a 9 month old baby with no family support or financial resources. I didn't think it was inappropriate to suggest waiting or other options.

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  5. So much for the American dream, right? ;)

    I've always wondered about the 'road to med school' in the USA. I'm from The Netherlands. After high school (age: 13-19 years), we can try to get into med school at the university. The curriculum consists of a 3 year bachelor (for most part theoretic) and 3 year master (mostly clinical, 'intern'/'clerkship'/whatever you want to call it). After that, you're a doctor (comparable to a resident, as far as I understand). Thus, most get their degree when they are about 25-27 years.

    Am I correct that this is far younger than in the USA? Perhaps age accounts for some of the troubles people face when going to med school in the US? As a 22 year old, I'm not yet married (or divorced) nor a father to a child, I don't have a mortgage et cetera.

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    1. That's true. The average age to enter medical school in this country is around 24 or 25, an age when people in other countries are finishing!

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    2. Lars may well live at home too. At least that's what my husband's cousin did in Italy when he got his MD. He lived with his parents for part of residency too.

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    3. I dunno how expensive applying for school is in other countries, but in the U.S., it's freakin' expensive.

      At 22 (fresh out of college with a Bachelor's) I would have had difficulty paying for the $240 MCAT exam out of my own pocket. Cough up another thousand USD for the primary/AMCAS application? Then another couple thousand for secondary apps? Even if I traveled cheap and couch-surfed/hostel-surfed, not frickin' happening.

      Lots of people have to work to do all those things, while paying off loans from undergrad, and not everyone qualifies for fee waivers.

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    4. Haha, I have moved out of my parents house a long time ago, ever since I went to university. The Netherlands are a rather small country, yet I'd still had to travel 7+ hours every day if I'd stayed at my parents house.

      Studying isn't as expensive here in The Netherlands. We have a quite complicated system of tuition etc., but if you finish med school within the six year period, the government will have covered most of your tuition and study related costs. I still have to pay for my own food and housing, but who doesn't? Its perfectly possible to go trough med school without any (sizeable) debts, as long as you stick to the 6 year limit.

      However, compared to other interns, medical interns over here get no payment whatsoever, while nursing interns, or basically any other kind of intern in the Netherlands, do get a decent 'apprenticeship fee'. Still, I can't complain ;)

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    5. My point, which I completely forgot to state, is that a lot of people have to work for a few years or borrow money to afford the application processing fees. This is why some people opt to wait at least one year: to find a job that can pay for applications (and, while they're at it, travel a little). That's purely what I've gathered from people that I've talked to in person or on forums, though. Can't speak for the nation.

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  6. In my country, Portugal, by the way, there is a physical and psychological test students applying to med school have to pass to get into that career... I profoundly believe many of those people wouldn't pass. I understand dreams... Well, I have many, but sometimes I just think we should be realistic and choose an option we can handle. That's even more important in medicine, as you deal with the OTHER'S health, which is a great responsability. But that's just my opinion.
    By the way, Dr. Fizzy, I would like to conglatulate you for your blog! I'm a great fan and have already spent great moments reading it. I wish you and your daughter =) a lot of luck!

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    1. I don't know about you, but I'm a freshly graduated doctor from Portugal (studying Harrison's right now, btw - NOT FUN!) and the only pre-requisite I needed to apply to med school was a doctor's signature on a piece of paper stating that I didn't have any severe physical or mental debilitations. There is in no way a structured test or examination you have to pass.

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    2. I had to make the test before my doctor signed that piece of paper... I guess that's your doctor's option. I was not the only one making that test.
      Oh, and by the way, I wish you a lot of luck for Harrison's. =)

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  7. Yeah, I don't get why someone would specifically write in to ASK FOR ADVICE on the internet and then get bent out of shape that the advice wasn't what they wanted to hear. If you know what you want to do, just freaking DO IT instead of hemming and hawing. If you want blind unconditional cheer-leading, go to your mom or your dog. If you ask me my opinion, I will be honest, otherwise what's the point? The one example you mention (single mom) was really bizarre to me.

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    1. Did you read the post I linked to in the comments above? Apparently, we infuriated her by our polite replies that maybe she should wait a few years or consider becoming an NP/PA. It apparently made her so angry, she couldn't even respond.

      I didn't say to her what I was really thinking, which was that following a dream that will take up all your time and financial resources when you are the single mother of a small baby strikes me as incredibly selfish. And she probably knew that, which was why she was hemming and hawing so much.

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  8. MIM has become so much less interesing lately. What happened to regular post contributors? 'Cause all you get from "mailbag" is "Help! Can I be a doctor?!"

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    1. I think MiM has good posts, although I may be biased. I usually like the mailbag posts, but I don't like the "Can I be a doctor?" posts anywhere.

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  9. Yikes. I just read that post and the comments. Didn't realize I made a cameo.

    If I had to answer her question today, I am not sure how positive I'd be. I'm heavily relying on others to help me with my kids, and some days it royally sucks.

    I am busy. And, I don't appreciate being spoken for or dragged into drama. So, yeah.

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    1. I'm sorry if you felt I was dragging you into drama. I've been a part of MiM for four years now, and I feel compelled to defend it. This woman said that nobody made an attempt to help her or give her encouraging advice, and I had to point out to her that several people (including you) took the time to give her a lot of encouraging advice. What she said was a blatant lie and I couldn't stand by while she attacked MiM. For what it's worth, I thought I was defending you as well. (I replied to a comment you had made on my blog letting you know it was going on, but I guess you never saw it.)

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    2. No, I didn't see it. Do you have any notification options on your comments? I would totally do that if there is.

      I didn't think you dragged me into it. I thought you accurately defended the site and my contribution to the comments. What got me upset was her speaking for me. She did email me and complain about some of the replies, and I replied with something to the effect of "there, there, it's ok." She made it sound like I was wholeheartedly cosigning her diatribe against the site, and I most certainly was not.

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    3. There should be an option to subscribe to a post's comments, although then you end up getting ALL the comments, which I'm sure you don't want.

      I'm glad what I said didn't offend you in any way... as I said, I was trying to defend you and MiM. As I said, I was angry that after you took so much of your precious free time to respond to her, she would say that "nobody on MiM" could offer any encouragement to a single mom. And it wasn't just you... several other single moms weighed in. Plus most of the other people just suggested waiting a few years till her life was more stable. I am baffled that our responses made her so angry that she "couldn't even reply." I think it IS legitimate to question what she's going to do about her baby when she has no money or family nearby.

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  10. I also hate those "What are my chances guyz?!?!" posts. If people are that insecure of their scores to announce it to the internet, they should shut up and beef up scores or write some kick-ass essays >:[

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  11. this is so funny. i remember one of those "do you think i should go to med school?" posts from a message board, back when i was pre-med. the post said (paraphrased but accurate): "my grades aren't very good, i bombed the MCAT, and i'm generally not very good at taking tests, and frankly, i'm just not that smart." (yes, he actually said that last part.)

    i gently suggested that if he wanted to go to med school, he would need to get good grades, do well on tests (not just the MCAT but about a million more), and that he should probably be smart, and that the ability to post on a pre-med message board is not in and of itself proof that a person will make it in med school. this was in response to him but also in response to the dozens of other posters who had already said, "go for it!" i got reamed good for that, including by people who said things like, "i know LOTS of med students and doctors who aren't smart. that's no deal-breaker!"

    facepalm.

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    1. I agree!!

      Consider a thread like this: http://premed101.com/forums/showthread.php?t=65683

      The OP had a GPA of 2.89 and is unwilling to accept the lost income incurred by taking a second degree full-time (essentially the *only* path left).

      On the other hand, since this was posted on an occasionally nasty premed forum, the responses aren't especially unrealistic.

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  13. Just wanted to add that I am presently a non-traditional pre-med student ( I am 35), and I wouldn't dare ask anyone IF I should become a doctor, frankly it is nobody's business. Secondly,I rarely tell anyone my goals, unless they ask something condescending like " why would YOU need a degree in Biochemistry. I say " I would like to go into medicine", and with that( not unlike people feeling compelled to touch the belly of pregnant woman) I get unsolicited advice because of my age. Well, we can't all have mommy and daddy paying for prep classes and college and allow you to live with them, have them pay for your car , bills, books, etc. I had to make a living at a young age, and now working full time, while going to school and still pulling in almost a 4.0 gpa. Not everyone has the perfect high school to med-school template. You just try to do the best you can with the resources you have to live out your dream. And honestly, my hard road to med-school will just me a freaking AMAZING doctor!

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