Hi! I hope someone can help alleviate my fears. I will be pre-med in Janurary, had to take care of some personal issues and just got married so decided not to start this fall. So, anyway, I went to 6 Barnes and Nobles and bought every book on the MCAT and Getting into Med School books. I was reading one of the books on tips for pre-meds and the author was so negative about attending med school, it was the way he wrote, he gave very good ideas about what you need to be a good applicant but he also scared the daylights out of me while reading it. In two of the books I have read so far I have been very scared about the future of medicine because of HMOs, PPOs, etc. One sentence claimed that if the MD had to do it all over again he/she would not have become a doctor. Is that the general consensus of MDs??? I read that getting a job after residency is going to get tough and tough and more competitive. I also read that physician salaries are dropping(which doesn’t bother me much since that is not the reason for my wanting to be an MD, but I would like to know that for all my years of training and the responsibility on my shoulders that I would be compensated accordingly. I’m worried about going through all this training and not getting a job or not making enough to pay back my loans and live comfortably. I also read that after residency most hospitals won’t hire you because you are not able to be board certified until you have experience, but where do you get the experience??? I’m getting the feeling that medicine is a rewarding career from these books. I know that I am going into medicine with altruistic intentions, but I am scared now. Does anyone have an ideas or chatted with a MD/DO to see what they like and dislike? i would love to hear any thoughts. Thanks and take care, Mehgan 
Hi Meghan,
Congrats on your decision to pursue medicine as a career.
Lots of the older docs have become disenchanted with the practice of medicine as sweeping changes have occurred. The previous generations of practicing physicians had a pretty cushy deal: unlimited autonomy, high compensation, and virtual deification by patients and support staff.
Now we have insurance companies placing restrictions on care plans and patient work up, compensations are lower, and the push is for physicians to be part of an overall team approach in patient management, rather than the end-all, be-all of care provision.
Checks and balances on medical spending are an unfortunate necessity in order to continue to work toward provision of quality, equitable healthcare in this country. Headaches are real, but justification of utilization of resources is important, and we will all continue to try to find the balance between providing needed care and avoiding frivolous spending.
Like you, I never was attracted to medicine for the income potential. Basically, if you are smart enough to gain admission to med school, then you are smart enough to pursue most career fields - and the earning potential of physicians pales in comparison to MBAs, some JDs, etc. Better look elsewhere if you're looking to become a millionaire, because it's unlikely to occur in today's medical environment. As a graduating surgeon my compensation package is in the low 200s - which I feel is appropriate compensation for the 13 years of graduate level training I have invested in becoming the highly trained specialist which I am (4 years of college, 4 years of medical school, and 5 years of surgery training).
As to physician respect - my attending surgeons (most in their 50s) report that, during their training, when a physician walked onto the floor of a hospital, all the nurses and ancillary staff had to stand up.
Absurd.
Stories of physician abuses of power are lengendary. There are good data now reinforcing the idea that better outcomes result when people are able to work together and contribute as team members in accomplishing shared goals. Input from ancillary staff reduces medical error and results in better patient care. Respect comes as the natural result of demonstration of your proficiency, capability and compassion, and not from intimidation. These are good changes, but some older docs may find them hard to deal with.
Pursue medicine because you are fascinated and invigorated by both scientific thinking and by working with people. For most of us, medicine is a passion more than a job. I can't imagine doing - or loving as much - anything else.
Best wishes!
Thank you! 
That explanation made me relax and made a lot of sense to me. I as an RN know that teamwork is the best way to provide patient care. Thanks so much for the reply. 
| QUOTE (AstroBloo @ Sep 1 2002, 08:48 AM) |
| Hi! I'm worried about going through all this training and not getting a job or not making enough to pay back my loans and live comfortably. I also read that after residency most hospitals won't hire you because you are not able to be board certified until you have experience, but where do you get the experience??? I'm getting the feeling that medicine is a rewarding career from these books. I know that I am going into medicine with altruistic intentions, but I am scared now. Does anyone have an ideas or chatted with a MD/DO to see what they like and dislike? i would love to hear any thoughts. Thanks and take care, Mehgan
|
Hi there,
There is no way for you to predict the job market this far in advance. Almost everything cycles in medicine. There is a projected shortage of General Surgeons in the next ten years because of the shortage of folks wanting to pursue surgery. Does that make me feel confident about getting a job in surgery? No, but I know that I love to operate and I love taking care of patients. I have a career that I totally love to do and I can't wait to get up each morning. I have a job that I would do even if I didn't get paid. There are plenty of lawyers and physicians out there that hate what they do. They might be making great money but they dread coming to work each day.
I know that you have heard all of this before. Medicine is a sacrifice. Medicine is a long-term goal that will affect you and your family. You are going to be out of the earning situation for a number of years if you pursue medicine. It is very difficult at your point to see nothing except the long road ahead. I can tell you that all of my friends who finished surgical residency within the last five years are board certified and working. Are they millionaires? No but they are very comfortable.
The most unhappy folks are the folks who: 1) Priorities changed during medical school and residency in terms of getting married, having families etc. Generally these folks tend to be much younger. It does take some degree of maturity to know what your really want in life as opposed to your parent's expectations. 2) Had unreasonable expectations as to what a career in medicine entails. When your father and grandfather went through medical school and residency, finances and times were different. Medicine is not the quick ticket into the country club.
Managed care, low physician reimbursment, high medical malpractice insurance premiums, encroachment by mid-level practictioners have all cut into physician practice and physician salaries. But just as managed care has attempted to dictate how a physician will practice, patients have demanded rights also and so the pendulum will swing back to more physician managed care as opposed to administrative managed care. For every disgruntled physician out there, I would say that there are plenty of physicians who love what they are doing in spite of the changes. I know that the folks in my department, General surgery, love what they do. It shows in their interactions with patients and with fellow physicians. They work hard and most take plenty of time to be with their families. All of my attendings are married with children except maybe one. Again, I don't see anyone starving. These folks are academic physicians whose salaries tend to be lower than those in private practice.
Ask questions and read books as a means to obtaining information but for me and most of the folks that I work with on a daily basis, the rewards of medicine far outweight the liabilities. Medicine is difficult and frustrating but again, it's fun too. I don't see too many physicians in the unemployment lines because medicine does give you plenty of options.
Good luck!
Natalie
great post and great advice!
| QUOTE (AstroBloo @ Sep 1 2002, 08:48 AM) |
| In two of the books I have read so far I have been very scared about the future of medicine because of HMOs, PPOs, etc. One sentence claimed that if the MD had to do it all over again he/she would not have become a doctor. Is that the general consensus of MDs??? I read that getting a job after residency is going to get tough and tough and more competitive. I also read that physician salaries are dropping(which doesn't bother me much since that is not the reason for my wanting to be an MD, but I would like to know that for all my years of training and the responsibility on my shoulders that I would be compensated accordingly. I'm worried about going through all this training and not getting a job or not making enough to pay back my loans and live comfortably. I also read that after residency most hospitals won't hire you because you are not able to be board certified until you have experience, but where do you get the experience??? |
Meghan,
I can comment on some of this. Getting a job after residency is competitive, but not impossible if you are willing to look in more than a very narrow geographic area. How competitive it is depends on what you specialize in. Some specialtieswill be in high demand and it will be easy to get a job in those because of high demand (no, I can't guess which ones will be in that situation by the time you would be in that situation -- sorry). As for not being hired because you don't have board certification, that is sometimes true and sometimes not true. In the case of some of the surgical specialties, you can't become board certified until you have done a certain number of cases -- Natalie, can you comment more on this? -- but in many specialties you can take the specialty boards as soon as you finish your residency, and many hospitals will hire you with board eligibility as long as you complete your boards within a couple of years.
Physician earnings are falling. No two ways about that. I can't predict what will happen by the time you would finish residency, but it is going to be harder and harder to earn a really high income as a physician. *But* I highly doubt tthat physicians will end up earning anything less than 100K per year, as almost all physicians manage that, and if that is adequate compensation in your eyes, and will cover your expected loan repayments and lifestyle needs, then I wouldn't worry about that issue any further.