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- Feb 24, 2004
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I thought this might be the best forum to place this,
Really its more food for thought than anything else, and a bit of venting as well.
To all those people that are applying to med school and waiting to get in. Ask yourself, do you have the whole story? Do you REALLY know what you're getting into? Sure people tell you "medicine isn't what it used to be" etc etc.
You think to yourself, sure, I know, whatever, I want in med school, thats my goal.
Speaking as a resident, now done with med school and looking at my career choices, I made a good choice with my specialty, but I think in terms of medicine in general, I'm not so sure:
1. When you're done, you WILL be in debt close to 200,000$, maybe more. When you factor in Interest (which lets face it, not many people tell you this), you're talking more in the neighborhood of 300,000 in total payments. Are you sure you want to be paying this for 10-15 years AFTER residency?
2. To those that think this will make you a lot of money (come on, the thought hadn't crossed your mind that it at least could afford you and your family things?) I've got news for you, It doesn't. TRUE, the average doc will make around 150,000 in salary per year, but lets break this down: Being a doctor puts you in a unique tax bracket, the LOWEST end of the HIGHEST tax bracket, meaning you get taxed A LOT, and you don't end up with much in the end. So, that 150,000 you THOUGHT you had, is really around 105,000. Don't believe me?
http://www.paycheckcity.com/NetPayCalc/netpayCalcResult.asp
Calculate it yourself and see.
3. Now that you've seen how much is lost in taxes, lets break down something else, something that not many people are looking at, your hours worked for the money you make. The AVERAGE Surgeon is working Close to 70 HOURS PER WEEK. Thats AFTER residency. Think about that. Lets say you worked 10 hours a day, from 7am till 5pm EVERY DAY, WITHOUT lunch, you STILL have to work an additional 20 hours ON YOUR WEEKEND to get to the 70 hour average. So, even if you make big time surgeon money, you won't be able to spend it, cause you'll be too busy working in the hospital. Nights, weekends, your family's birthday's, xmas, thanksgiving, say goodbye to it all. (and don't think you'd be able to be any different, these are AVERAGE worked hours, some work more, some work less, but there isn't a surgeon i've heard of that works the magical 40 hours a week)
4. This time for money issue brings another point: If you've got kids, family, a wife/husband, all those hours in the hospital are hours you'll NEVER get back with your family. Period. If an emergent patient comes in who 'needs' to have antibiotics right in the middle of your son/daughter's graduation, too bad, you're the one who's gotta do it.
5. You're not 'practicing medicine' anymore. Don't believe what people say, you just aren't. You're practicing cookbook medicine. Don't know what I mean? well, lets just put it this way, you learn all this stuff in med school to be able to figure out what is wrong with the patient, and how to fix it, and what medications to give. When you get out, you are TOLD by hospital administration (usually social workers, nurses, pharmacists) what medications to give, what to tell the patient, how to write an order, all in prefabricated forms. So, if a patient comes in with chest pain, YOU DO NOT THINK, you just check off the boxes for 'chest pain protocol'. You'd think this would make it easier, but in fact, this brings 10x more paperwork.
6. You're RIDDLED with paperwork. I MEAN COVERED IN IT. Imagine coming in every day, and having to handwrite 1 page on EVERY PATIENT YOU SEE (usually around 12) EVERY SINGLE DAY. On top of that, then you've gotta write 2 pages every time a patient comes in and leaves the hospital (H&P's and Discharge summaries). And remember, none of these papers actually help at all except to make lawyers happy. You will write the same thing every day, again and again and again.....
7. "Midlevels" are taking over! AHHH! Well, I'm sure you've heard at least a LITTLE bit about this. The fact is, Nurses these days can become Nurse Practitioners, which means that they can do pretty much everything (with some small exceptions) that a Family Practice Doctor can do. So, Basically a nurse can come in, make 135-150,000/year, come out with 1/6th the debt as a doctor, NOT go through the brutality of residency, AND make JUST AS MUCH AS A DOCTOR. Lets not forget CRNA's and AA's, which I've seen make as much as 230,000/year!!! Don't believe me? Can't be true?
http://gaswork.com/search/CRNA/Job/All
Check it out yourself. Those are job postings. For Midlevels. Who are being offered more than some doctors will ever make.
Now I know that after reading this people will have rebuttals, and no, its really not all doom and gloom, but I just want to point out the sucky things about medicine that I didn't know about before I applied, and yes, I'm truly happy in the specialty that I have.
Really its more food for thought than anything else, and a bit of venting as well.
To all those people that are applying to med school and waiting to get in. Ask yourself, do you have the whole story? Do you REALLY know what you're getting into? Sure people tell you "medicine isn't what it used to be" etc etc.
You think to yourself, sure, I know, whatever, I want in med school, thats my goal.
Speaking as a resident, now done with med school and looking at my career choices, I made a good choice with my specialty, but I think in terms of medicine in general, I'm not so sure:
1. When you're done, you WILL be in debt close to 200,000$, maybe more. When you factor in Interest (which lets face it, not many people tell you this), you're talking more in the neighborhood of 300,000 in total payments. Are you sure you want to be paying this for 10-15 years AFTER residency?
2. To those that think this will make you a lot of money (come on, the thought hadn't crossed your mind that it at least could afford you and your family things?) I've got news for you, It doesn't. TRUE, the average doc will make around 150,000 in salary per year, but lets break this down: Being a doctor puts you in a unique tax bracket, the LOWEST end of the HIGHEST tax bracket, meaning you get taxed A LOT, and you don't end up with much in the end. So, that 150,000 you THOUGHT you had, is really around 105,000. Don't believe me?
http://www.paycheckcity.com/NetPayCalc/netpayCalcResult.asp
Calculate it yourself and see.
3. Now that you've seen how much is lost in taxes, lets break down something else, something that not many people are looking at, your hours worked for the money you make. The AVERAGE Surgeon is working Close to 70 HOURS PER WEEK. Thats AFTER residency. Think about that. Lets say you worked 10 hours a day, from 7am till 5pm EVERY DAY, WITHOUT lunch, you STILL have to work an additional 20 hours ON YOUR WEEKEND to get to the 70 hour average. So, even if you make big time surgeon money, you won't be able to spend it, cause you'll be too busy working in the hospital. Nights, weekends, your family's birthday's, xmas, thanksgiving, say goodbye to it all. (and don't think you'd be able to be any different, these are AVERAGE worked hours, some work more, some work less, but there isn't a surgeon i've heard of that works the magical 40 hours a week)
4. This time for money issue brings another point: If you've got kids, family, a wife/husband, all those hours in the hospital are hours you'll NEVER get back with your family. Period. If an emergent patient comes in who 'needs' to have antibiotics right in the middle of your son/daughter's graduation, too bad, you're the one who's gotta do it.
5. You're not 'practicing medicine' anymore. Don't believe what people say, you just aren't. You're practicing cookbook medicine. Don't know what I mean? well, lets just put it this way, you learn all this stuff in med school to be able to figure out what is wrong with the patient, and how to fix it, and what medications to give. When you get out, you are TOLD by hospital administration (usually social workers, nurses, pharmacists) what medications to give, what to tell the patient, how to write an order, all in prefabricated forms. So, if a patient comes in with chest pain, YOU DO NOT THINK, you just check off the boxes for 'chest pain protocol'. You'd think this would make it easier, but in fact, this brings 10x more paperwork.
6. You're RIDDLED with paperwork. I MEAN COVERED IN IT. Imagine coming in every day, and having to handwrite 1 page on EVERY PATIENT YOU SEE (usually around 12) EVERY SINGLE DAY. On top of that, then you've gotta write 2 pages every time a patient comes in and leaves the hospital (H&P's and Discharge summaries). And remember, none of these papers actually help at all except to make lawyers happy. You will write the same thing every day, again and again and again.....
7. "Midlevels" are taking over! AHHH! Well, I'm sure you've heard at least a LITTLE bit about this. The fact is, Nurses these days can become Nurse Practitioners, which means that they can do pretty much everything (with some small exceptions) that a Family Practice Doctor can do. So, Basically a nurse can come in, make 135-150,000/year, come out with 1/6th the debt as a doctor, NOT go through the brutality of residency, AND make JUST AS MUCH AS A DOCTOR. Lets not forget CRNA's and AA's, which I've seen make as much as 230,000/year!!! Don't believe me? Can't be true?
http://gaswork.com/search/CRNA/Job/All
Check it out yourself. Those are job postings. For Midlevels. Who are being offered more than some doctors will ever make.
Now I know that after reading this people will have rebuttals, and no, its really not all doom and gloom, but I just want to point out the sucky things about medicine that I didn't know about before I applied, and yes, I'm truly happy in the specialty that I have.