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  • Prudent Pre-med Weighing Options

    Good Evening WCI,

    This is my first post after discovering the forum last week and I would appreciate advice from the wider community after receiving some feedback from Dr. Dahle. A little about me: I am a 31-year-old with both a BA (2013, Chemistry, 3.27/4.00) and an Ivy League PhD (2018, Chemistry, no GPA at this program). I am currently doing some minor GPA repair by taking some additional college credit classes at the local community college. Professionally, I post-doc'ed for one year at the same Ivy and I currently run clinical trials in a specialty clinic at a major university-affiliated medical center for the past two years.

    The crux of my question is of course finances. I graduated from college debt-free and as a result was able to open an IRA, Roth IRA, and brokerage account in 2014. I continue to max out those contributions every year and also contribute to my 401(k), 403(b), and HSA. Across those accounts and my liquid savings, I have approximately $128k saved. I expect to keep working and taking CC classes to up my GPA for the next couple of years with the MCAT added in there at some point.

    Here is the question: how long should I continue working? My goal would be to graduate medical school net-worth-neutral. Assuming an average loan burden, I would like to start with around $211k in FAFSA-sheltered assets. Dr. Dahle strongly suggested that I get in and start as soon as possible to get to the attending salary fast (makes sense to me).

    What say you all? I appreciate any advice you might be able to share.

    V/r,

    Prudent Pre-med?

  • #2
    If you are going to go to med school, i would start as soon as you can, for a variety of reasons. But I would make sure you really truly want to be a physician before you start.

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    • #3
      Originally posted by Anne View Post
      If you are going to go to med school, i would start as soon as you can, for a variety of reasons. But I would make sure you really truly want to be a physician before you start.
      As the @WCI says, anyone who can be talked out of it, should be!

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      • #4
        I would be hesitant to recommend medicine to those taking the traditional pathway. I don't think I could honestly currently recommend it to those doing a non-traditional pathway.

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        • #5
          The sooner the better, as long as your plan works. Even if you take the MCAT and don't get in, at least you can go on with your life.

          "My goal would be to graduate medical school net-worth-neutral." Not sure if this is realistic. Four years of tuition and living expense combined with a loss of income.
          Rethink that and the residency years. Good luck with that.

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          • #6
            Originally posted by CordMcNally View Post
            I would be hesitant to recommend medicine to those taking the traditional pathway. I don't think I could honestly currently recommend it to those doing a non-traditional pathway.
            I completely agree. The risk:reward is continuing to trend in the wrong direction. It has become even more of a lottery than before. Yes, the highly-paid specialists are doing quite well, maybe better than ever, but the it is a pyramid, and the base of the pyramid, most notably primary care docs, are not doing as well. If you get in later and are stuck at the base of the pyramid, the future prospects seem pretty grim. Everyday on FB I read about a primary care doc or an urgent care doc who has been let go and replaced by an NP or PA.

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            • #7
              If you started medical school now and chose a specialty with the shortest possible residency, you’d be 38 before you became an attending. While wanting to be in a net neutral financial position at graduation is understandable, I wouldn’t prioritize it over an earlier start. If you are certain medicine is for you, start now!

              Nontrads do face some financial obstacles that those going straight out of college avoid, but they have advantages, too (mostly maturity). Your prior experience handling real money (not just beer money) will serve you well, and you’ve already done some significant saving for retirement (and have earned Social Security credits, too). Financially I expect you will be fine. It really comes down to whether or not this is really the right path for you.

              You said nothing in your post about a Significant Other or kids. The presence of one or both can change the calculations, largely because medicine is so demanding of your time during training. If you have a significant other, it’s important that he/she understands this and still supports your goal! Over half of the married couples in my medical school class ended up divorced, and lack of time for the relationship seemed to be the precipitating factor.

              I was a nontrad who started medical school at age 28, with a significantly lower net worth than you have now; at 58, I am financially able to retire should I wish to. It can be done, as long as you have no expectations of living the “rich doctor’s” life immediately (if ever!).

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              • #8
                If it's your calling then do it. If it's for financial reasons- there are easier ways in life to make money.

                If you're getting the GPA up based on some avg GPA posted in US News, then you might be wasting your time and money. I feel like the PhD is the added value to your app, not changing your C in OChem to an A (or whatever brought your GPA down). Some other posters might have a different opinion on this and I'd encourage them to weigh in.

                I'd also looking to move to states with cheaper med schools (like Texas), if physically able to do so.

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                • #9
                  Originally posted by Brains428 View Post
                  If it's your calling then do it. If it's for financial reasons- there are easier ways in life to make money.
                  I have mixed feelings about the calling term. I would be willing to guess that 99% of med school applicants mention medicine being a calling at some point along the way. I would guess that a majority of physicians view it as a job and not a calling. A pre-med applicant has no way of knowing whether it's a calling. I have a hard time calling getting yelled at for not prescribing narcotics or giving work notes for BS complaints or seeing the Monday morning STD check a calling.

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                  • #10
                    Good Morning Everybody,

                    Thank you for all of the comments so far! I see a wide array of thoughts on my situation and I am grateful that you all have taken some time out of your life to share your thoughts on my personal situation. Let me provide additional insights that I didn't originally post:
                    1. No kids, no wife, no girlfriend. Just me, and I intend on keeping it that way. I don't really want to date, get married, or have kids. I like my low-profile existence.
                    2. Regarding VagabondMD's comment of medicine being a lottery: philosophically, I concur to a large degree. I had a minor procedure done recently and the surgeon said that he did his MD at a Texas state school all in for $15k in the late 70's. Borrowed $1k and paid it off as an intern. Certainly not the case anymore.
                    3. @Artemis: I wouldn't delay too much longer beyond 34. I am keenly aware of the fine balance between saving a starting nest egg and the financial demands of waiting versus going. I acknowledge that I am fortunate to have the assets I have; I know one student who loaded in loans for undergrad and is betting on being a dentist to pay those off, and the dental school loans. Pretty long bet, in my opinion...
                    4. @Brains428: My C's were in quantum mechanics, statistics, vector calculus (all taken the same year my old man died, it was a rough year), genetics (I jumped into that class as a freshman, very stupid move in retrospect), and Hispanic Literature (I had no business taking that class). All of these errors are my mistakes, and I get to live with them. I have gotten all A's at the CC (physiology, microbiology, EMT, regular anatomy). I'll be taking gross dissection anatomy summer term. these were courses I didn't take during my BA because I was focusing on organic chemistry (no C's in any other chemistry class, and nearly all A's for my chemistry major). Not only do they raise my AMCAS GPA, but if I didn't get in (or chose not to go), I could use them as prerequisites to go to nursing school as an alternate path.
                    5. Regarding medicine as a "calling": I am a pragmatic guy. During my work running pediatric clinical trials, it has been a pleasure to participate in the care of those children who elected to participate in my studies. As part of my job, I earned my state phlebotomy license and draw the specimens myself in clinic, and like the chemistry lab, I like that physical aspect and manipulation needed to achieve a clinical result. There are elements I am not a fan of (like overbearing CRAs/administrators, the paper charting only to copy it into electronic charts, et cetera). From my perspective, I take the position that it would be a privilege to care for and treat my possible future patients, but at the end of the day medicine (like all jobs) is a means to an end (a living) to satisfy my (few) obligations and other desires.
                    I'll monitor and answer any other questions as they pop up.

                    Not-Traditional Pre-Med

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                    • #11
                      I did the non-traditional path (went back to med school age 30, after a PhD) and it was absolutely the right choice for me. I'm far happier and far richer than I would have been otherwise. I value the former more.

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                      • #12
                        Getting in ASAP is the correct answer. Every year waiting to apply is another year of lost earnings as an attending physician in the future. That’s an opportunity cost of upwards of 400-500k+ per year if you end up in a more lucrative specialty. Idk how much you’re making now but if it’s anything close to that then don’t go to medical school. Another thing to consider is medicine may be very different in 10 years from now, which would be the earliest you could even make an attending salary, so personally I’d try to get in ASAP to make hay while the sun shines.

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                        • #13
                          Sigrid : thank you for your comment! I agree: money is nice, but it's just a tool to allow one to take care of the required business and hopefully have enough to do the fun stuff.
                          @Huggy: I get what you are saying on the opportunity cost, depending upon specialty I might match into. All I want to do is set myself up for success on my first application cycle while having a decent nest egg once I start that I'm not as "poor" as my future peers. And the clinical experience I am getting is really quite excellent, so it was worth the time. No one can predict the future, but I would like to be starting by 34 regardless of my goal of $211k (based on the "average" debt load). My high school chemistry teacher slugged through medical school at 40 and is an emergency physician now, so I take it that there is hope for us old-timers.

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                          • #14
                            Originally posted by CordMcNally View Post

                            I have mixed feelings about the calling term. I would be willing to guess that 99% of med school applicants mention medicine being a calling at some point along the way. I would guess that a majority of physicians view it as a job and not a calling. A pre-med applicant has no way of knowing whether it's a calling. I have a hard time calling getting yelled at for not prescribing narcotics or giving work notes for BS complaints or seeing the Monday morning STD check a calling.
                            I agree with all of this. I'm making a fair attempt at being encouraging. It's a long and challenging road, but lucrative for many of us.

                            Obviously, this site wouldn't be as successful if it weren't for FIRE and many people being so dissatisfied with medicine that they're looking to make the best decisions to get out as fast as possible.

                            A little part of me hopes that the OP, and many other future physicians, are less pragmatic than I am, and may approach medicine with hopes for the better, rather than means to an end. But, you know... I'm a radiologist, so I sold out a long time ago

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                            • #15
                              Originally posted by Brains428 View Post

                              I agree with all of this. I'm making a fair attempt at being encouraging. It's a long and challenging road, but lucrative for many of us.

                              Obviously, this site wouldn't be as successful if it weren't for FIRE and many people being so dissatisfied with medicine that they're looking to make the best decisions to get out as fast as possible.

                              A little part of me hopes that the OP, and many other future physicians, are less pragmatic than I am, and may approach medicine with hopes for the better, rather than means to an end. But, you know... I'm a radiologist, so I sold out a long time ago
                              Unfortunately Brains428, I am an organic chemist, so that makes me a pretty pragmatic (i.e.: you either made the target or you didn't, there's no middle ground). With the way things are nowadays, I would be silly not to consider the pragmatic elements of these types of decisions. I was fortunate that I got paid to do my PhD and have no undergraduate debt, in addition to my current nest egg. May pre-meds and medical students don't have what I have and just go through UG and medical school without even considering these questions. But my goal would be to do medical school, and get out from the underlying financial commitment as rapidly as possible.

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