Prudent Pre-med Weighing Options

[CordMcNally]

[*]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.[/LIST]I'll monitor and answer any other questions as they pop up.

Not-Traditional Pre-Med

Medicine is becoming more and more administrative bloat. Even though you have participated in some clinical trials I don't think you can truly appreciate the amount of BS there is in medicine. You won't understand it in medical school and you won't completely understand it in residency. Medicine currently isn't trending in a great direction. You most likely won't have the autonomy that you want. I'm 34 and my plan is to get in 10 more good years (not too far off the time you'd just be finishing training) and then to significantly cut back or transition completely out of medicine.

[F0017S0]

Medicine is becoming more and more administrative bloat. Even though you have participated in some clinical trials I don't think you can truly appreciate the amount of BS there is in medicine. You won't understand it in medical school and you won't completely understand it in residency. Medicine currently isn't trending in a great direction. You most likely won't have the autonomy that you want. I'm 34 and my plan is to get in 10 more good years (not too far off the time you'd just be finishing training) and then to significantly cut back or transition completely out of medicine.

@CordMcNally: Please excuse me, I didn't mean to equate the practice of medicine with working a clinical trial. Just to say I have exposure to some (but not nearly all of) the challenges of modern medicine. Certainly the practice of medicine has a far greater administrative bloat (at least Big Pharma for the most part abhors bloat so as to ensure their fatter margins by jacking up their prices to fleece the proletariat, but I digress).

[bovie]

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.

Could not agree more. I was in a very similar boat to OP regarding age, finances, working at university running clinical trials, less-than-ideal (in my mind) GPA, basically everything but the PhD. My advice--crush the MCAT, and apply ASAP.

If you do well on that test (but really just do your best), with your extensive work experience in medicine (compared to normal applicant), perceived maturity, and a PhD, nobody will care about your non-4.0 GPA. Seriously. Medical schools love non-traditional applicants.

Right now every month you are taking (paying for?) classes is not only wasting money now, but also wasting money in the future through lost earnings, which WCI and others have noted. The savings and wealth-building from those future earnings will dwarf whatever (comparatively) measly savings you are hoping to put away now on a research salary.

Don't worry about coming out of medical school net worth-neutral. Look at the weekly stories of people around here paying off $250k+ in loans in like two years or less, and make it happen when the time comes. Non-issue.

The real question is, how badly do you want to be a physician? If you are on the fence, as noted above, there are MANY easier ways to make good money. But if you are set on doing something that makes society better as a whole, helps people on an individual level every day, challenges you intellectually, and pays quite well on average, then I would advise you to get that ball rolling ASAP.

Also, how do you get a BA in chemistry?

[bovie]

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.

I definitely wouldn't worry about the net worth-neutral aspect of all of this. You just eliminated the most expensive things in life

[Anne]

Medicine might be the perfect career for you (and i still think medicine can be a great career especially in certain specialties + certain personalities) but the thing that stands out about your post to me is how exact your goal is (211k) like you think you have control over it to the extent that you will end up with an exact amount at Med school matriculation and graduation. You have control over how much you invest and what you invest it in but after that you have to just relax and see what the market does. If the market tanks between Med school application/acceptance and matriculation are you going to say “wait, I didn’t meet my goal, let’s delay another year”. Both medicine and finance are similar in this way—you can do everything right but there are lots of factors out of your control and you have to be able to just roll with it and continue to make good decisions despite outcomes you didn’t want/expect or you are going to get beat down.

[F0017S0]

Could not agree more. I was in a very similar boat to OP regarding age, finances, working at university running clinical trials, less-than-ideal (in my mind) GPA, basically everything but the PhD. My advice--crush the MCAT, and apply ASAP.

If you do well on that test (but really just do your best), with your extensive work experience in medicine (compared to normal applicant), perceived maturity, and a PhD, nobody will care about your non-4.0 GPA. Seriously. Medical schools love non-traditional applicants.

Right now every month you are taking (paying for?) classes is not only wasting money now, but also wasting money in the future through lost earnings, which WCI and others have noted. The savings and wealth-building from those future earnings will dwarf whatever (comparatively) measly savings you are hoping to put away now on a research salary.

Don't worry about coming out of medical school net worth-neutral. Look at the weekly stories of people around here paying off $250k+ in loans in like two years or less, and make it happen when the time comes. Non-issue.

The real question is, how badly do you want to be a physician? If you are on the fence, as noted above, there are MANY easier ways to make good money. But if you are set on doing something that makes society better as a whole, helps people on an individual level every day, challenges you intellectually, and pays quite well on average, then I would advise you to get that ball rolling ASAP.

Also, how do you get a BA in chemistry?

bovie : Thanks for your insights! The classes I have taken are relatively cheap since I'm paying in-state money for the credits. Furthermore, if the absolute worst case were to happen (i.e. get in nowhere or somewhere abysmal), I have completed the prerequisites for PA or NP/RN. I spoke to administrators in some of those programs and they said that the committee would flat out reject me without the classes. So it seemed like a worthwhile pursuit to get them, get A's, and have the benefit of them on my record and boosting my UGPA. MCAT of course is a given, and I'll take a prep class for it. I would like to matriculate no later than 34.

As far as savings: I am getting the picture now about speed versus going into medical school with a perceived "better financial position." It is pretty clear that sooner is better. The (up-front) money issue (debt) is really what has been holding me back.

And to answer how does one get a BA in Chemistry? My undergraduate school (rural small liberal arts college) doesn't award the BS. It is very strange, but that's how they roll. And at least I don't have debt from that BA.

[F0017S0]

Medicine might be the perfect career for you (and i still think medicine can be a great career especially in certain specialties + certain personalities) but the thing that stands out about your post to me is how exact your goal is (211k) like you think you have control over it to the extent that you will end up with an exact amount at Med school matriculation and graduation. You have control over how much you invest and what you invest it in but after that you have to just relax and see what the market does. If the market tanks between Med school application/acceptance and matriculation are you going to say “wait, I didn’t meet my goal, let’s delay another year”. Both medicine and finance are similar in this way—you can do everything right but there are lots of factors out of your control and you have to be able to just roll with it and continue to make good decisions despite outcomes you didn’t want/expect or you are going to get beat down.

Anne: I hear what you are saying! Yes, the 211k is specific, and it is only informed by the "average" debt burden. I take it with a large grain of salt and I don't expect to have total control over the usual fluctuations. I just want to be making the best decisions before taking on such a huge commitment.

[Tim]

Ypu are correct in considering the "average medical school debt" but the other side of the financial equation is the benefit. With your exposure, I would think you have some type of inkling of what type of physician you are considering. The length of residency/fellowship vary widely. I don't think it is wise to choose just based upon medical school. Of course you can't lock in on a path, but the potential payoff has a wide variation. What do you want to do once you have MD? Rhetorical question but it is important.

[billy]

Dont wait a second longer than you need to. The cost of med school is miniscule compared to the years giving up attending salary.
- non trad student, entered expensive med school at 27, took out 240k in loans over 4 years, grew to a max of 309,000 after residency, paid off in 5.5 years as attending. I wish I went in at 24-25 instead. 3 years of the difference between my then job's salary and a normal attendings salary cost me more than my med school cost. Keep all you retirement funds where they are, save up money during this year while applying, and use the money saved (outside of roth and retirement funds) to help minimize your loans. Then do like all of us here and you'll be fine. Dont be penny wise and pound foolish.

[F0017S0]

Tim: I could see myself doing surgery (general or trauma) because I enjoy working with my hands. If I didn't end up in a surgical specialty, radiology/nuclear medicine, cardiology, or something with some real physical or chemical science behind it would be interesting.
billy: That's the message I am receiving: get my rear in gear, nuke the MCAT, nuke the personal statement/interview and get moving.

[Turf Doc]

I agree that the MCAT is the key here. Kill that and you’re a super smart dude with a PhD who has a poor GPA from a long time ago. Do poorly, that GPA starts to look more relevant.

[CordMcNally]

Tim: I could see myself doing surgery (general or trauma) because I enjoy working with my hands. If I didn't end up in a surgical specialty, radiology/nuclear medicine, cardiology, or something with some real physical or chemical science behind it would be interesting.

If you do go down this path (which I wouldn't) I would strongly look at specialties that you wouldn't hate or be physically difficult to do when you're in the 55-60 range since you'll likely still be working at that age given your current age. I would not want to do general surgery or trauma surgery at that age.

[F0017S0]

Turf Doc: Thanks! It kind of boggles the mind that a 3.27 is considered "poor"; but those are the facts I am confronted with and those I get to work with.
CordMcNally: Good advice. I'll have to reevaluate my choices that would allow me the longevity required if/when I head down this path.

[Brains428]

OP- nuc med is generally considered a dying field. That's been said for many years, though. It's actually on the cutting edge when finding newer diagnostic and treatment agents. The issues with widespread use are typically reimbursement, cost, and availability of tracer. THAT, and can surgeons/oncologists continue to do what they normally do (PET/MR/CT follow up) and achieve similar results to the new therapies/diagnostic agents.

But the reputation still remains, and there aren't many people going into nuclear medicine. What does that mean? Lots of job availability in many parts of the country. There is a combined rad/nucs pathway (no one will hire anyone with only nucs experience nowadays... maybe an academic center, but not everyone) that finishes in 5 years with dual certification.
----

Another thought- there are a chunk of non-traditionals who are stuck going the DO route. IF you must do that, go to school at UNTHSC in Fort Worth. They offer in state tuition to Texas residents (13k for the first year, with small increases each year after). They also have affiliate hospitals, so you're not stuck finding your own rotations (the newer private DO schools have a tendency to do this).

The link at the top of this page has an excel sheet for 1st year tuition to all the DO schools for 2020

https://www.aacom.org/reports-programs-initiatives/aacom-reports/tuition-fees-and-financial-aid

I'm a DO. I thought my education was good. It does put you in an uphill battle the second you're looking outside of primary care, though.

[F0017S0]

OP- nuc med is generally considered a dying field. That's been said for many years, though. It's actually on the cutting edge when finding newer diagnostic and treatment agents. The issues with widespread use are typically reimbursement, cost, and availability of tracer. THAT, and can surgeons/oncologists continue to do what they normally do (PET/MR/CT follow up) and achieve similar results to the new therapies/diagnostic agents.

But the reputation still remains, and there aren't many people going into nuclear medicine. What does that mean? Lots of job availability in many parts of the country. There is a combined rad/nucs pathway (no one will hire anyone with only nucs experience nowadays... maybe an academic center, but not everyone) that finishes in 5 years with dual certification.
----

Another thought- there are a chunk of non-traditionals who are stuck going the DO route. IF you must do that, go to school at UNTHSC in Fort Worth. They offer in state tuition to Texas residents (13k for the first year, with small increases each year after). They also have affiliate hospitals, so you're not stuck finding your own rotations (the newer private DO schools have a tendency to do this).

The link at the top of this page has an excel sheet for 1st year tuition to all the DO schools for 2020

https://www.aacom.org/reports-programs-initiatives/aacom-reports/tuition-fees-and-financial-aid

I'm a DO. I thought my education was good. It does put you in an uphill battle the second you're looking outside of primary care, though.

Thanks Brains428! NUCMED is of interest to me particularly due to the ability to use my chemistry background to do research into the synthesis of novel imaging agents. It was a field I wanted to explore in graduate school some, but my PhD adviser had different thoughts: we tried developing a fluorescent probe that would change emission color in the presence of carbapenemase-producing bacteria; it fizzled spectacularly.