Like many of you I have found this forum to be a light in the darkness. I am a 27 year old male. Currently, I am an RN and have some EMT/medic experience. I knew the RN wasn’t for me when I was about to graduate from nursing school, actually working as one as solidified that for me. I want to study medicine and currently taking the remaining prereqs. I have about 1.5 year left of classes.

The things that I am running into that are discouraging me:

the cost: the cost of prereqs, the prospect of medical school costs, the huge debt loads on top of my debt from RN school. Plus the costs of actually being an MD (malpractice insurance, decreasing reimbursement etc)

Time: I see many docs spending huge amounts of time at work. They look tired and are always grumpy, complaining about insurance.

International work: As a medic I got to work in other countries (no not military). I want to do that again, but I wonder if that will even be a possibility as an MD with having so many loans to pay. International work typically pays nothing or peanuts (but is so much fun). This may seem silly to many of you, I can understand that.

As an RN everyone tells me to be a NP (I don’t want to turn this into a NP vs MD thread) but I don’t know, NP just seems like more of nursing and not the breadth of knowledge and skill learned as an MD. Also, I do not want such limitation.

So how are all of you financing this? Does the debt concern any of you? Anybody having more positive experiences than me? All of these factors are making me consider if it worth it and thus I am seeking some support. Honest answers are appreciated, no need to sugar coat anything for me.


Hello and welcome! Hopefully I can help answer some of your questions, feel free to PM me as well.

Cost: I funded my medical school education through federal loans. I used both the stafford and grad plus loans. I had zero debt left from undergrad. I went to a state school for undergrad and between working and some help from my family was able to not incur any debt. When I look at my loan amount at that I’ll have at graduation, and then the projected payment amount, there is no way I can pay back my loan without being enrolled in an income-based repayment plan during residency. This is particularly important since I have a longer residency. Many of my classmates have educational debt from undergrad, so it has been done.

It’s true that for some aspects of care the reimbursement rates have decreased. They have some adjusted increased for other aspects of care, but as someone that is going into a specialty that fee-for-service is a sensible model, I’m a little concerned about what legislators/administrators/ activists mean when they start talking about getting away from fee-for-service. It’s something that will develop during my training and I’ll just have to see how it shakes out.

Time: Yes, administrative tasks have increased. Some of the meaningful use stuff is dumb. EMRs aren’t really built for patient care, they’re designed for billing so they’re not super intuitive to use. doctors are tired and grumpy because they’re tired and that makes them grumpy. I’m a pretty positive person, but catch me at the end of a 24-36 and I’m irritable.

International work: I suggest doing trips. You can do them on your vacations as a resident. As an attending physician you can organize your practice how you want, some hospitals/institutions will encourage international work, others will not.

NP: This really depends on you. Is the time vs money analysis such that it would make more sense to go NP then MD/DO? Is the practice as an NP vs an MD/DO going to satisfy your goals as a provider? You already have your RN so you are starting down the path to NP. Where do you see yourself practicing? In what specialty? these are questions that you need to answer for yourself. I see NP’s specializing. PA’s have fellowships. There are now so many different ways to be involved in patient care.

I honestly wouldn’t want to be doing anything other then what I am going into training for. That’s the question you need to answer at the end of the day. Is there anything else I’d rather do? Because if there is, do that.

Good Luck to you on your journey!

Thank you, Synchronous. I appreciate your response. You are right, I need to have a candid conversation with myself to determine what I want. Good luck to you.