Second (or third) Thoughts

[jmiah717]

Ok, I'm going to try to be succinct here. Just know that I'm working all of this out in my head and I think writing it down is probably helpful to that end.

Brief demographics:
Age: 36
Degree: MSW
License: LCSW - fully credentialed in my state
Marital Status: Married
Job: Govt Job with VA - good pay, good benefits, below average work environment
Other: Own home, wife pregnant (I know anything can happen as that goes but we're hopeful), little to no debt to speak of, some chronic health issues that could make getting through grad school without serious and expensive complications unlikely.

My goal since prior to joining this forum was to return to school and obtain my PhD in clinical psychology to teach, research, and do some clinical work on the side. Those still sound like great things for anyone to try to achieve but recent life events have made me question some things for me personally. Setting aside the fact that I'd have to make my wife and my unborn kid travel around the country with either bad or no insurance for 6-8 years, I'm really starting to wonder if this is even financially worth it at my age.

I figured out the other day that it would take about 5-12 years after I finished my PhD to recoup my income lost over the time I'm in school. And that doesn't even include anything related to retirement lost. It also assumes a pretty steadily high salary throughout that time. I'd be about 46 when I finish school assuming I get in on my first try, which I'm planning for NEXT cycle, not this upcoming cycle. That makes me likely in my mid 50's, when I would hope I'd be slowing down, not ramping up, when I break even. And even that assumes I don't take on any debt while in school in order to live. I certainly understand that sky's the limit in the sense that if I want to work 70 hours a week doing multiple gigs after I graduate I can substantially improve my earning potential. But I can do that now. Sure, my ceiling is lower but the opportunity exists without complicating my life immensely.

At 36 and with the great research opportunity I have right now, this is really my last good shot at a clinical psych PhD. If I walk away from my current research with my mentor that's it, I'm done. I will need to move on and find a way to be okay with never achieving this goal. Clearly, this is not a good financial move. It's not a great move for my marriage and soon-to-be child. It MIGHT be a good move for me personally but even that is suspect at this point. When I break it all down I start to think this might be more about meaning making and false gratification (see chronic illness above). What would you do if you were me? Any thoughts and brutally honest opinions are welcomed.

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[WisNeuro]

This is a hugely personal decision. I'm something of a numbers cruncher, so I'd be looking at whether or not I could conceivably retire at a manageable age.

That being said, the insurance thing is variable. I had great insurance in graduate school, although I know of many others who were not so lucky. And, considering internship and postdoc, if you do those in the VA, you get the same insurance plans as regular employees, so that's something. One big factor is spousal support, does she work, or is she stay at home? If you got a fully funded program in a low-ish cost of living area, may not be too bad. some of us made it out without taking out any loans and worked on the side to make some decent money at the time, relatively speaking. But that is definitely variable by region and program. Of course, I was also single and had no kids at the time, so working the occasional 70-80 hour week to make some good cash wasn't huge drawback.

In the end, I'd be crunching numbers. How much would you have every year to live on, comfortably? If you go this route, what does your retirement look like in your 60's? how much would expenses go up as the kids age? Could you weather a health emergency, etc? I'm somewhat risk averse, so I'd be leaning towards not doing it, but, career satisfaction also plays a big role. Would a change in job setting change anything on the satisfaction side for you?

 

[jmiah717]

This is a hugely personal decision. I'm something of a numbers cruncher, so I'd be looking at whether or not I could conceivably retire at a manageable age.

That being said, the insurance thing is variable. I had great insurance in graduate school, although I know of many others who were not so lucky. And, considering internship and postdoc, if you do those in the VA, you get the same insurance plans as regular employees, so that's something. One big factor is spousal support, does she work, or is she stay at home? If you got a fully funded program in a low-ish cost of living area, may not be too bad. some of us made it out without taking out any loans and worked on the side to make some decent money at the time, relatively speaking. But that is definitely variable by region and program. Of course, I was also single and had no kids at the time, so working the occasional 70-80 hour week to make some good cash wasn't huge drawback.

In the end, I'd be crunching numbers. How much would you have every year to live on, comfortably? If you go this route, what does your retirement look like in your 60's? how much would expenses go up as the kids age? Could you weather a health emergency, etc? I'm somewhat risk averse, so I'd be leaning towards not doing it, but, career satisfaction also plays a big role. Would a change in job setting change anything on the satisfaction side for you?

Well, I'm a bit risk averse too, which is why I've been thinking more about this lately. Job satisfaction is probably the biggest factor but in all reality, I'm likely to end up in a similar job with a similar role, probably in a similar setting. So, really not much would change other than time, age, degree, title, etc. That's why neuro is attractive. It changes the day to day significantly from what I have now and ensures more medical cases. If it wasn't going to take 8+ years, I'd say it would make sense. Or if I was, say 26 and not 36. I REALLY WANT to do this but I'm leaning towards REALLY WANT not being enough to upset the apple cart. Wife works but barely. I imagine after future kid is born, she'll work even less, or at least want to. We're in a position now where she can do that and we'll be okay.

I will be a 30 year federal employee at 60 if I change nothing, sooner if I buy back military time. If it doesn't give me a stroke or MI from dealing with the ethical spider web first, that is. That said, there are ways for me to balance my life better, even in this system, if I am making a go at it long term. I could take a less clinical spot and do some private practice on the side to scratch that itch (I really do like doing SOME therapy) and make some extra money. Definitely a personal choice and I'm not sure where I am with it. Trying to work it out. I appreciate the insight.

 

[Ollie123]

Just a couple minutes, but will second the notion that insurance isn't necessarily bad.

Grad school insurance was decent (would be "expensive" for a family plan, but still nothing compared to commercial insurance). A lot depends on the specifics of the health condition though - not everything is covered in the way that we'd like it to be on every plan (true of employer plans as well). Internship insurance was literally the best insurance I have ever had. Paid zero dollars and everything was free (no co-pays, no anything).

Very personal decision. How is wife's health? How will this impact any sort of LTD insurance? COULD she work (if need be)? And earn a substantive enough salary to live off? Again - not enough specifics to know your health situation (not that I'm encouraging you to post it) but depending on what exactly is going on, these are the questions I'd be asking. If a disability-necessitated "early retirement" is a possibility, that needs to factor in as well since it could affect whether you continue long enough to pay it back. I mean, its a risk for everyone, but depending on the specifics of your health condition it could be a relatively greater risk.

 

[ClinicalABA]

Setting aside the fact that I'd have to make my wife and my unborn kid travel around the country with either bad or no insurance for 6-8 years, I'm really starting to wonder if this is even financially worth it at my age.

umm...Don't "set this aside"! It should be a major consideration in your decision making process. Many people have successfully completed graduate training with young families, but it can't be easy. Your kiddo is going to be between the ages of 1-6 during the process, and may have to move several times (i.e. for school, pre-doc, post-doc/job), impacting her/his social and educational stability. You will be less financially stable, which will impact things like day care, pre-school, and elementary school if non-public school is a potential choice. Many of my current good friends are parents of my kids pre-school and kindergarten classmates, so this will also impact you and your spouse socially. Also, having a new infant/toddler in a place that may be far from existing family and other social suports can be trying. None of this is insurmountable, but I'd rank it at the same level as your other concerns.

 

[deleted343839]

Well, I'm a bit risk averse too, which is why I've been thinking more about this lately. Job satisfaction is probably the biggest factor but in all reality, I'm likely to end up in a similar job with a similar role, probably in a similar setting. So, really not much would change other than time, age, degree, title, etc. That's why neuro is attractive. It changes the day to day significantly from what I have now and ensures more medical cases.

I have to wonder how much of a role burnout is playing for you in this decision. It's really hard to separate "I want to be doing this instead" from "the grass sure looks a lot greener over there." I'm not even sure they are separable. But if your job situation was more favorable, and you had an opportunity to do more of the kinds of things you enjoy, I wonder where you would be in your decision-making process.

My goal since prior to joining this forum was to return to school and obtain my PhD in clinical psychology to teach, research, and do some clinical work on the side.

I should point out that the first item on the list (teaching) is the most poorly compensated, and clinical work is where the money is for most of us. I trust that you could be earning more than you do now, even in a college or uni faculty job (especially if you supplemented your income with clinical work), but if you don't want to spend a lot of your time doing clinical work, make sure that your income projections reflect that and are conservative.

That said, there are ways for me to balance my life better, even in this system, if I am making a go at it long term.

May I suggest that you go ahead and do whatever you can to improve your balance and quality of life, so that even in the best case scenario (you get an offer of admission next cycle), you have as good a "fallback option" as possible?

 

[ellecruz]

To answer your question, if it were me in your position, I would not. There's too much uncertainty. I would at least wait until after baby is born and see how I feel then. I'm not a parent, but all parents I know have stories of how "everything completely changes" after birthing a child. Most parents suddenly become completely selfless and make all decisions with their child's best interest in mind. Of course, that is dragging your decision out longer and you're not getting any younger. But, I think that once you actually meet your child your feelings may change too. I wouldn't want to have regrets about giving up a great VA position with all the benefits, for stressful days and meaningless-seeming assignments & tests and less time with baby during the most critical years.

I also give this advice somewhat based on my own experience. I had a good nyc corporate job, high salary, worked w/ great ppl, but I wanted more meaning in my work. So I left for a masters, worked in low paying research jobs, and have not had a full-time gig since switching industries. I start a PhD program literally in 2 weeks (so I won't have retirement benefits for a long time), but I have actually not been feeling overjoyed or as excited as I thought I would. In hindsight, I think I could have made my old position work and been grateful for the blessings I had. The "meaning" in the research work and seeing patients does not outweigh the fact that I need money, benefits, and ideally save for retirement. Perhaps you're feeling safe and comfortable now, and you're fully cognizant of the difficulties ahead; but it is hard to articulate how much of a real life-altering change it is to drop a good job and become a student again. I couldn't imagine doing it with a pregnant wife.

Best of luck to you in your decision making though! If you haven't, also trying picking the brains of everyone in your network that you can think of.

 

[PsyDGurl]

Just to weigh in on grad school and children- it is HARD. I went back to school to do my MA when my children were 2 & 4 months. My spouse had a good job and became the primary breadwinner. Sleepless nights, sick children, the childcare nightmare and financial pressure was incredibly stressful- not to mention moving school aged children around the country away from family and friends for school and again for residency.

I'm now just finishing residency and have gotten several good job offers making twice what I did before but I gotta wonder if it's all worth it. I love the job but it's been many years of stress and frankly I personally don't think 100k is really worth what I put myself and my family through for the last 6 years.

This is just my opinion looking back but with a young family it's kind of been a nightmare. I feel very lucky that my spouse supported me for all these years as it hasn't been easy.

I'm not saying that this is not the right decision for you- it may be. But think very carefully about all that it will entail and make sure your spouse has it in them to deal with the ups and downs of this process. I wish u the best no matter your decision and congrats on the little one!!


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[Doctor Eliza]

Adjunct teaching may be an option for you now. I have a LISW friend who teaches several courses each year in the social work program at the major university in town. No need to get an additional degree for that goal.

Clinical work you obviously can do now. So that leaves us with research. What do you want to do with research, specifically? Do you want to be a professor? Do you want to work at an academic medical center? How many hours per week do you want to devote to research?

This is your decision. However, if you are asking me what I would do, I would not go back for the PhD. I say this as someone who went to grad school right out of college and was single and childless. Now I have the spouse and child. So, I have a sense of both parts of the equation, but haven't experienced them simultaneously. My grad program was pretty dysfunctional and not supportive, so that colors my perceptions a little too. I also had some health concerns during grad school, and the faculty were horrible to me about accommodations, etc. I would say my quality of life was pretty awful during those grad school years.

Good luck in your decision-making.

 

[deleted343839]

I'm now just finishing residency and have gotten several good job offers making twice what I did before but I gotta wonder if it's all worth it. I love the job but it's been many years of stress and frankly I personally don't think 100k is really worth what I put myself and my family through for the last 6 years.

It is a sacrifice on multiple fronts, but now that you're at the end, it gets much better from here. I hope you feel more at peace in another 6 years!

 

[PsyDr]

... I personally don't think 100k is really worth what I put myself and my family through...
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Protip: multiples of that won't make you happy either.

 

[jmiah717]

I appreciate all of the feedback. Thankfully, I don't have to make any decisions anytime soon. I may wait until after the birth, assuming all goes well, before I make any changes. Some level of burnout is definitely a factor and something I need to take into account. I realized while on vacation last week that I don't necessarily need a major change as much as I need to find a way to improve balance. This really comes down to my day to day at work, which currently consists of therapy all day with many high acuity cases.

Again, I really appreciate the feedback and will take it all into consideration. If I had to say where I'm leaning - right now it's to back out of this process, take some time to enjoy some of the things I haven't been able to, and see where I should go from there. I will have an honest conversation with my very supportive mentor and get her feedback too.

 

[smalltownpsych]

Maybe a change within the field of social work would be better for you. One drawback of social work encroaching into the field of psychotherapy is that many feel a sense of frustration at not making the next step. Social work is about much more than just being a therapist and it could be argued that society is in great need of talented and driven social workers to address some of the systemic problems which face us and our patients. Maybe it would be a wiser investment to push into this arena.

 

[jmiah717]

Maybe a change within the field of social work would be better for you. One drawback of social work encroaching into the field of psychotherapy is that many feel a sense of frustration at not making the next step. Social work is about much more than just being a therapist and it could be argued that society is in great need of talented and driven social workers to address some of the systemic problems which face us and our patients. Maybe it would be a wiser investment to push into this arena.

I've thought a lot about this before. I can't do therapy in this capacity at the VA for the rest of my career. That said, I like therapy, I'm good at it, and I like to think I'm really good at knowing my limitations and constantly being willing to learn.

I think a good future mix might be something less clinical in the VA and PP on the side if I don't end up going to school.


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[WisNeuro]

Just curious, what do you see your ideal work setting/work day with your current credentials, and how do you see that same thing were you to get a PhD and get into neuropsych?

 

[Sendtrees]

You gave so many reasons not to do it, I ended up believing you really want to!

It sounds like the decision point you are at now is the research position (I take this to mean you know what it takes to get into a good, funded PhD program). Why stop or go now? Can you, without losing income now, begin the research work, apply for only excellent programs where you'd really want to go, and see what happens? I can imagine scenarios where a funded PhD with more job flexibility on the other end is what's best for your family.

Having said all that, of course you don't have to get a PhD to have a meaningful life and important work.

 

[jmiah717]

Just curious, what do you see your ideal work setting/work day with your current credentials, and how do you see that same thing were you to get a PhD and get into neuropsych?

Ideal...good question. With my current credentials it would be part of the day/week doing therapy and the other part of the day/week doing something else...more balance I suppose. As for neuropsych, I suppose the idea would be assessment mostly without as much ongoing therapy. Hypothetically, if I had a job where I did maybe two days of nothing but perhaps intake assessments, or something else that was maybe even non clinical, I think it would balance out the therapy days much better. Or if I took a job in a non-clinical setting like the homeless program (just one example), then do some PP work on the side as I've done before. Lots of options. I'm definitely not in any sort of corner or stuck in any real way.

 

[jmiah717]

You gave so many reasons not to do it, I ended up believing you really want to!

It sounds like the decision point you are at now is the research position (I take this to mean you know what it takes to get into a good, funded PhD program). Why stop or go now? Can you, without losing income now, begin the research work, apply for only excellent programs where you'd really want to go, and see what happens? I can imagine scenarios where a funded PhD with more job flexibility on the other end is what's best for your family.

Having said all that, of course you don't have to get a PhD to have a meaningful life and important work.

I'm involved in a research project with a faculty member now at a major university. I could certainly not change that and see how things play out over the next 7 months or so. There's really not much downside to that except for some lost time that I could use to get back into private practice and a few other issues. In the grand scheme of things, I'm not really wasting that much time by continuing the research. I suppose I figured why do that if I end up being sure that I'm going a different direction. But I'm not at that point yet. This is all in the early stages of my thought process.