what would you do? try to go to med school?

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taxmagic
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what would you do? try to go to med school?

Post by taxmagic »

I know ERE is the wrong place to post this as most people here are trying to retire early, but I was wondering if you may be able try to help out with my situation (kind of give my head a shake). I have a pretty good paying job right now and have a lot of flexibility in terms of time. I may be able to save significant amount of money until I am 40 years old. maybe enough to work part time after that...The other option I am considering is to work and try to get into med school, start practicing by say age 40, and earn significantly more money. I also "vision" that I would be more fulfilled. Has anyone talked to doctors about their job or know any personally? Any reasons on why this is a really bad idea? I have no ego

Dragline
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Re: what would you do? try to go to med school?

Post by Dragline »

Yes, I have several doctors in the family and know several others. They all are very committed to their jobs, but its a long row to hoe to get through all of the education, residencies, etc. Once you go down that path you are pretty locked in, because of the relatively high investment to get started. So I think you need to be committed to the idea of being a doctor apart from what you might make.

But you can do extremely well financially, especially if you are willing to move to a city in a more rural area of the country. In many places in the US, doctors are among the highest paid in the locality. But this is generally not true in large urban areas.

bradley
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Re: what would you do? try to go to med school?

Post by bradley »

Like Dragline, I have several doctors in the family, too. They're all committed, but that commitment makes up for the arduous work I see most of them do. Now, they're mostly hospital doctors, which means long hours, having to be on-call, etc. I suppose the life of a doctor with a practice might be less hectic, but it is a long road until you're established (education, residency, etc.).

Maybe try and find a doctor that you know who will be honest with you, and ask them their opinion. If someone asked me honestly if I recommend that they go into my profession, I would most likely discourage them, even though it's considered what some may call fulfilling, altruistic, etc.

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Re: what would you do? try to go to med school?

Post by jacob »


DutchGirl
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Re: what would you do? try to go to med school?

Post by DutchGirl »

I'm a doctor.

I am an atypical one, very likely. That is probably because when I started studying, I planned on working in the lab. Then I was singled out for getting good grades, and was offered to be trained as a doctor as well, and I said yes to that proposal. So I ended up having two diplomas, one as a biomedical scientist, one as a doctor.

When I did my two years of err, placements or rotations in the hospital, I noticed how I didn't really like it. I still don't like the responsibility, the fact that in one split second you can make or break someone's life. (Work with the wrong work hypothesis, drop a pair of scissors in someone's abdomen when operating on them, not manage to get the breathing tube in in one or two goes thus causing brain damage due to oxygen depletion, etc). Sometimes people get killed or are handicapped for the rest of their lives because their doctor had an off day. They say each doctor has his own private graveyard of patients that died because the doc made a mistake. I'm not sure whether I could live with that.

I was also very impressed by the emergency cases, by the suffering and the deaths. But one doctor who worked on the ER, told me about his way of looking at it: "We follow this protocol for stabilizing a patient. It gives the patient the best possible chance of survival. We do our best. If the patient dies, then he or she was beyond saving by us.". For him, this worked. I think it is also quite rational to think like that. Still, I was sometimes left wondering whether we could have done more... I guess different people can experience this in a different way, depending on your character.

So I work at the blood bank, where healthy people come to donate blood to people who need it. My job is to keep the healthy people healthy (which is most often pretty easy) and to make sure donating is safe and the donated blood is safe (tests are also run, but the pre-selection before donation is important). This is a level of responsibility that I can handle, even though there's still the possibility that one day a donor gets a heart attack and I'll have to step in and get him/her treated asap (just like a person can get a heart attack while being in a supermarket or in a theater, it can also happen at the blood bank - risks aren't increased at the blood bank, but it can happen there too).

What I like about being a doctor (at the blood bank) is talking to people. Most people who come to the blood bank are nice and kind, and they are healthy and we do some small talk while we wait for some blood test results. I do actually also like the few times when I made a difference in someone's life - for example the blood donor who had a very low hemoglobin level and who was sent to the ER by me, and who lived to tell the tale (he had a benign growth of his colon that caused the blood loss). I know he could have died if the low levels had not been detected on time (his wife had encouraged him previously to go see a doctor because he was so tired all the time, but he had refused, saying that "nothing was wrong" with him). There are also some other times where I think I really helped a person with a health problem, and when I think about those times, I smile and am happy with my contribution.

If you work as a doctor in the hospital, generally speaking the hours will be long, the demands and stress levels will be high. Depending on the exact profession, some will have physically hard work (lots of standing and not enough time to eat or drink), some won't. Some people find a place where they are more or less an independent contractor, or where they set up their own little shop. They have to deal with bills, administration, employees, buying equipment, etc. Can be fun if you like being an entrepreneur. Others become an employee from a hospital and they make less decisions on their own.

Sometimes you'll feel like you made a difference in someone's life, for good. Sometimes you might lose sight of the difference that you make now and then, through a haze of bureaucracy, mundane illnesses ("another person who has the flu and should just stay home and rest"), long days, etc. Sometimes you won't make a difference anyway, no matter how hard you try. You will not like some of your patients, but of course you will still have to be a professional and treat them.

Some people really like their particular field of medicine. They are fascinated by how the kidney works or by how the nerves work. For them, part of the reward is learning more about that particular part of the body, what can go wrong, and how we can treat it.

For me, I finished my studies at age 25 with just a little bit of student debt (roughly $7k or so). I paid that off, quickly. My salary is higher than that of other people my age, due to the diploma. I make roughly 25 euros per hour. I don't have to pay for a professional liability insurance, here in the Netherlands. I know that specialists in the hospital make much, much more. But they also work many more hours, work weekend and night shifts, and many of them have a very inflated lifestyle to seemingly compensate for all the time spend in the hospital (a cleaning lady, flying to the other end of the world to make the most of the two weeks of holiday that you get, eating expensive meals at expensive restaurants when you're not working and thus eating the hospital food, etc). I remember one day when I was doing a rotation at the surgery department, the surgeon in training (my boss at that time) got a call from his wife: "I'm outside now, come and say hi to your son.". I was asked to come along; and so I saw how he went to the parking lot, where his very nice BMW was, with his wife and his 5-month old kid in it. He kissed his wife, he kissed his kid, and then we had to go back into the hospital. He had been on duty for roughly 6 hours at that point, and would have an added evening shift, so he would be in there for 12 more hours. That was one moment in time when I wondered "Is it all worth it?".

You could read "The House of God", by Samuel Shem. He talks about being trained as a doctor for a year in a specific hospital. While my experiences weren't as bad as his, some of the de-humanisation of patients that he talks about, I recognize.

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Sclass
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Re: what would you do? try to go to med school?

Post by Sclass »

Thanks DutchGirl, that was really interesting. I have a relative who killed a lot of patients in the OR. She was dismissed but came back to another hospital after laying low a couple of years.

I think the op should go if he or she wants to be a doctor more than anything else. Doing that for more money has return on investment issues. Draglines long row to hoe says it all.

All I can suggest is to do a calculation as to where you'll be at year 0, 1, 2,3...n for both paths since money is a big motivator for the OP. There'll be multiple variables and paths, like specialty, hospital or private practice, return on retirement investments, etc. but it'll give some indication of the worth it factor from a purely money point of view. (Which is naive because medicine looks to me like a labor of love).

The doctors I know have huge variability in what they earn. My GP is on one end and a couple of medical device manufacturers are on another. So projecting earnings will give varied results.

taxmagic
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Re: what would you do? try to go to med school?

Post by taxmagic »

thanks everyone. thank you dutchgirl .
Yes, financial stability is a major factor. If I compare keeping my same pay until 65, or going to med school and working till 65, my total earnings will be double or triple as a doctor depending on the specialty. this does not take into account time value of money, or the fact that if I stay in my current position I will be financially secure by age 40 vs probably no savings and who knows if I will want to keep working hard at age 40. It also does not that in account my current job is very insecure. Also, sometimes people switch jobs to make more money. something I may consider my current career.
do you guys know of any other method on how I should calculate this as a financial decision?

dutchgirl,
thanks for sharing. really interesting. you mentioned that you still don't like the responsibility, the fact that in one split second you can make or break someone's life. I think I would enjoy that pressure, but ive never been in that situation. I also don't know how much I will care about learning about the body and disease. I've actually tried to skim and read a few pages of a med text book at the library. Seemed pretty interesting. Do you recommend volunteering to learn more about the profession?

DutchGirl
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Re: what would you do? try to go to med school?

Post by DutchGirl »

Volunteering might be smart. Doing a first aid course could be an option as well. In the Netherlands, volunteers who had first aid courses work / volunteer at events; it might be a first taste of what it's like to help people with (possible) medical problems.

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Sclass
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Re: what would you do? try to go to med school?

Post by Sclass »

taxmagic wrote: do you guys know of any other method on how I should calculate this as a financial decision?
?
Play it out on paper (or Excel). Step by step. Year by year. When you finish a year, repeat the calculation for another year given your results of the prior year. (This is simulation 101 ignore me if you know it). You only have sixty years or less to simulate. Count time value of money if you think it matters in your situation. Count a divorce at X years if you want.

I did something like this when I started to second guess the continued pursuit of a doctoral degree. I had been informed that I'd never make it back to par with a bachelors grad who just continued working. Try it. Make an independent calculation for with and without med school. The first years will certainly cost you. Later on? You'll have to work it out and compare.

Spend some time on it. More elaborate simulations can be done with more time. Play out several paths. The question you want to always be asking is "where will this lead in N years".

This can be enlightening in simple situations from a purely financial perspective. Unfortunately, med school isn't all about money if that's all you want. IMHO there are easier ways to make money. YMMV.

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Re: what would you do? try to go to med school?

Post by jacob »

I believe Thoreau has a good quote on the time of arrival if you just started walking now compared to having to earn money to buy a horse or a ticket before starting towards your destination.

Med school and law school are both places where you spend years in the negative and then become really fast at the end. PhD school is a place where many spend years in the negative ... and then become kinda mediocre towards the end ;-P
It's becoming common knowledge now that many college educations never catch up with a technical education because of the head start.

The most powerful way to make a lot of money in the span of 10-20 years is to become a UPS driver (80k USD/year, 3 months of company school(*)). You could clear 1M in accumulated income by the time you turn 30!
https://ups.managehr.com/drivers.htm (must be able to lift 70 pounds, but no bachelors required)
http://www.glassdoor.com/Salary/UPS-Dri ... KO4,10.htm (yeah, average salary is +80k!)
http://www.howtoworkatups.com/ups-drive ... -physical/
(*) Remember hearing this mentioned somewhere. Verify!

It's important to acknowledge (and having had a real job already makes this a lot easier) that the best attitude for jobs that require extended educations (HS + 8 some years) is to be inherently interested in the subject matter AND preferably not be too ideological about it. You must also be able to maintain this interest for 20-40 years. There's little worse than to work a highly demanding technical job you have lost interest in. It's like a 24/7 mental prison. Also, you need to be very realistic that regardless of any inclination to "save humanity", "help your fellow humans", "rescue kittens", "create the knowledge of civilization", the further you get, the more you will have to deal with politics and admin BS. This is much harder to do with a rainbows and unicorns attitude (<- I used to have that perspective) but fact is that almost everything is ultimately driven by a profit motive ... whether that's more money, more students, more prescriptions, more publications ... and a risk motive ... whether that's staying away from asking the questions that got you interested in the first place in favor of safe tried and trued, CYA recommendations and choices, or principal agent problems ...

Overall, my standard career recommendation is somewhat the opposite [order!] of traditional advice, specifically:
1) Start with a hopefully very very long list of all jobs you can physically or mentally do. (I remove e.g. astronaut because I have an ear issue and pro athlete because I don't have superior genetics for that line of work)
2a) Remove all those which has zero or poor employment or work prospects. (I remove archeologist, actor, and German litt.)
2b) Remove all rock star professions, that is, most people struggle and only a few people succeed. (I remove academic careers.)
3) Remove all those where you don't have the personality/temperament/talents. (I remove anything that involves customer service or helping people with their feelings)
4) Remove all those where you don't have any subject matter interest. (I remove automotive jobs.)

Now pick whatever is left that provides the optimal combo of convenience and opportunity.

Dragline
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Re: what would you do? try to go to med school?

Post by Dragline »

jacob wrote:
Overall, my standard career recommendation is somewhat the opposite [order!] of traditional advice, specifically:
1) Start with a hopefully very very long list of all jobs you can physically or mentally do. (I remove e.g. astronaut because I have an ear issue and pro athlete because I don't have superior genetics for that line of work)
2a) Remove all those which has zero or poor employment or work prospects. (I remove archeologist, actor, and German litt.)
2b) Remove all rock star professions, that is, most people struggle and only a few people succeed. (I remove academic careers.)
3) Remove all those where you don't have the personality/temperament/talents. (I remove anything that involves customer service or helping people with their feelings)
4) Remove all those where you don't have any subject matter interest. (I remove automotive jobs.)

Now pick whatever is left that provides the optimal combo of convenience and opportunity.
The process described above is a great example of decision-making via negativa -- instead of trying to decide what you should be doing, decide what you should NOT be doing. In my view, it usually is a superior methodology and yields practical results that you can actually use and ultimately allow you to do the things you really want to do later on.

Think of how the opposite process might have worked. Jacob really likes archaeology and believes it when somebody says "you should always do what you love and only that", so he spends all he time and money preparing for it. But nobody is advertising for an Indiana Jones, so he ends up working in a library at relatively low pay to pay off his student debts and gets stuck there.

Whereas, he could have worked on becoming FI first while studying archaeology as a hobby in his spare time and then volunteered to work at a dig at his own expense for as long as he wanted.

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Re: what would you do? try to go to med school?

Post by jacob »

"Jacob being 17 years old really likes physics and he was always told to study what he's interested in... so he spends 5 years preparing for that. Despite his B+ average test-taking performance, his A++ MSc thesis leads to getting into grad school, where he proceeds to make about 20kUSD/year. He gets an A++ again for his PhD dissertation showing that while he ain't too remarkable at solving 2 hour textbook problems nor being that impressive at oral exams, he's somewhat of a "great future potential" when it comes to doing actual research and giving seminars, i.e., the shit that actually matters. So he gets hist first short-term (2-3 year) position paying a princely 40k/year. He still "loves his job" but is beginning to realize that he doesn't have the political skills to navigate academia. Also, his expertize is not in a 'hot area" and he has never acquired any awards despite being encouraged to "send his stuff in" because he was only really interested in "furthering the progress of human knowledge" (terribly naive)... or maybe it's just a Danish thing about not trying to stand out. Also, it's becoming clear that the gamesman skills required to succeed is distasteful to him and besides he just crossed FI. He gives it one more shot working for the government for a couple of years but eventually realizes that navigating seven layers of bureaucracy and the lack of advancement available to a foreign national is too much of a cost for being a lifer despite being paid a cushy 65k/year now. He retires permanently from physics(*)."

Yeah, had I had someone like me to advise me when I was 18, I would have done things a lot differently.

(*) Thanks to ERE.

champ0608
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Re: what would you do? try to go to med school?

Post by champ0608 »

I manage a car shop in Sedona, AZ. Most of our clientele are retired rich folks. Lots of insurance and real estate salesmen. A real dull lot. I know two doctors through work. Both are miserable people. Both were pushed into the idea of salary chasing at a young age; one admits he'd really rather be a florist, while the other has never thought he'd do anything else, despite his distaste for his work. I don't get the sense either were ever motivated to help others. I don't think they wanted to play a role in mankind's well being. They simply wanted (because their parent's wanted for them) a high paying job.

Moral of the story...don't be a salary chaser. The goal of ERE is to by all means necessary reduce your need for money. Then you can save a relatively small amount, invest it, live off the dividends, and no longer be forced to do things you don't wish to do.

Seeking out the highest paying job on the market, for the sake of making more money, is very anti-ERE in my opinion. But even if we're not talking about ERE, I still find that some of the world's most miserable people are the ones who were never motivated by anything but money.

Don't be a salary chaser. If you want to help people, and medicine is your calling/gateway to do so...then by all means do so, and enjoy the salary you will have rightly earned. If its about the money, do some soul searching.

Dragline
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Re: what would you do? try to go to med school?

Post by Dragline »

jacob wrote: Yeah, had I had someone like me to advise me when I was 18, I would have done things a lot differently.
Why Boy #1 was required to read ERE before he left for college.

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Re: what would you do? try to go to med school?

Post by FRx »

I'm a doc and I'd say when it comes to going into medicine you sort of know you wanna do it. I never really thought about the pain of going through it. As for it the financial aspect I think the student loans these days for med school are crazy. I finished residency like 10 years ago and I came out with only $150k I think. My experience may have been different but some really dark, dark, dark days getting through but now seeing patients is one of the best things. But "seeing" patients is only like 20% of your time in clinic (I do some urgent care and some family medicine), the rest of it is charting and documenting what you did, what you didn't do, fill out paperwork, work notes, deal with complaints. But that 20% is awesome, like I said. For a take home income of like 100-200k/yr I probably would say it's not worth it. For the 20% of patient care I sadly would say it's still not worth it. Even ED docs are spending minutes with the patient and rest of the time talking to techs to get tests ordered, analyzing tests, figuring out insurances and patient's family preferences to see where the patient can go next (admitted, transferred out, arrange follow up). Now, there are practices that probably will pay less where you get to have a lot more real patient interactions and patients may even be more appreciative but we're talking then take home pay of 60-70k. That's tough with student loans and the years you spent not working, not accumulating savings. And once you're out you sort of have to spend some time "defining yourself" (or as people say finding yourself).

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Re: what would you do? try to go to med school?

Post by Stahlmann »

Interesting problem no. 32312.

From my perspective I'd recommend being really smart in HS (but other than being told by your parents/teachers) and really driven. I've seen "export'' of EE docs to WE and their thought processes/mental models (I don't use this words as pro) are really fascinating.

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Re: what would you do? try to go to med school?

Post by zarathustra »

Confession: I am currently in the medical school application cycle and have one interview invite for the end of this month. Only ~40% of applicants get in, so who knows if I will be successful, but this is what I've secretly been working towards for a few years now.

I already semi-ERE'd many years ago with something like a 7ish% WR. In my journal you can read about the incident that sent me down this path, but ultimately I've ended up in a place where all I want to do is learn all the science of the body and medicine. On its own as a motivation, I could just learn on my own and not pursue the doctorate, but I also want to do the doctoring as well. A lot.

It would've been nice if something like a PA or NP job would be enough for me (because it costs less time and money), but sadly, it is not. There are ego reasons, there are bossypants reasons, but the main reason is the depth of knowledge and higher degree of responsibility that comes with all the training and the job.

I know that this path is not a good financial choice, especially if you are going into debt. I don't necessarily have to go into debt because of my savings, but I will lose most of my investments in the process.

I know that it is a shit-ton of work for a very long time and I will be at the bottom of the totem pole for ~7 years. I truly do not care. I want all the knowledge. Give it to me. I love working for the knowledge!

If I wasn't doing this, I would keep doing what I'm doing now, which is . . . not really focused on making money. My investments grow, I make money here and there, I do what I want. I wouldn't try to get back in my old high-paying career. I wouldn't try to seriously get into any other career.

This is what I want to do with the freedom I earned.

The part that is hardest for me to figure out is how I want to pay for it. If I get in anywhere, I will be asking y'all for help making that decision. It is going to be a very complicated calculation with a lot of unknowns, I think.

Mister Imperceptible
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Re: what would you do? try to go to med school?

Post by Mister Imperceptible »

@zarathustra

If I were you, I would use however much subsidized leverage I could to pay for the education. Student loan rates are will be much more favorable than consumer loan rates, and consumer loans are getting increasingly unobtainable.

However, I am very confident in my investment strategy, and also in my view that the currency will be devalued which will reduce the real burden of the debt. I would not bet on student debt being forgiven but with ever more “progressive policies” this is becoming an increasing possibility.

I would use more student loan debt and liquidate fewer assets depending on your personal level of confidence in your investing ability, and depending on what your view is of the burden of the debt as it relates to the stability of the currency and the appetite of policy makers for forgiveness. Your skills as a doctor should keep up easily with inflation.

PS love your username

shemp
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Re: what would you do? try to go to med school?

Post by shemp »

If you are already financially independent, and want to pursue medicine for its own sake, I'd advise both studying and working outside the USA. Medicine education is a combination of 3 things: theory, which is the same everywhere and can be learned independently; supervised practice, where personal relationships with senior doctors are what matter, and there is no reason to believe USA senior doctors take a greater interest in students than elsewhere or that practice opportunities are better; equipment and supplies, where USA arguably is better, but then learning to improvise has its own advantages.

Medical education in Ukraine is very inexpensive. Ukraine used to offer such education in English for students from Africa. The system is corrupt and its possible to buy degrees, but nothing forces you to take that route. Good teachers everywhere welcome students who really want to learn (though you might still have to pay extra fees under the table for good teaching and use of equipment and supplies, because the official salaries are laughable).

As for practice after education, the 3rd world is begging for doctors who will work for free and provide their own supplies, as you could probably do. So if you are interested in medicine for the work itself, that's the obvious path.

Note that I myself had a difficult entry into this world using almost 60yo technology, and even 3rd world countries like Cuba are at that level by now, and both me and my mother survived. And I had a broken arm and various other mishaps that were fixed with 50yo medical technology. My grandparents managed with no medical technology at all. Modern technology is sometimes a magic bullet, sometimes not.

Contrary to MI's optimism about medicine as a lucrative career, I think the future is less bright. Think of capped salaries as a way of bringing USA medical costs under control.

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Ego
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Re: what would you do? try to go to med school?

Post by Ego »

zarathustra wrote:
Tue Nov 10, 2020 9:42 am
The part that is hardest for me to figure out is how I want to pay for it.
I second Shemp's suggestion. We met some dental students in Cluj, Romania last year. It seemed to me like a very ERE solution to medical/dental school.

https://europe-studies.com/en/compare-t ... versities/

To double check whether the degree will transfer see https://search.wdoms.org/

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