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  • #31
    Financially it seems obvious the sooner you can matriculate the better, even if you have to borrow, because your starting physician salary will likely be $100k+ more than your current salary.

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    • #32
      Originally posted by F0017S0 View Post

      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.
      Don't let all these nattering nabobs of negativity poison your well. I love medicine , tolerate the BS just fine, treasure the privilege. Come with a glad heart and find your rainbow.

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      • #33
        Ortho-trauma is 5-6 years residency + 1 year fellowship. You can do it at 60-65, but you will be thinking of retiring. It is competitive and trauma takes a certain temperament to be your sub specialty choice for fellowship. A combination of like and skill but the ability to turnoff the trauma when you leave the hospital. It has been said for the surgical specialties you have to love the OR. If you can be talked out of it, don’t do it. The residency is long and brutal with no moonlighting. I agree with FIREshrink, if that is what you really want to do, go for it but it’s a tough road. At this point, MCATs are the key. Then Step scores and the boards and then .... You get the picture.
        That puts you at 41-42 in your first attending paycheck if you get moving. Food for thought.

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        • #34
          It's pretty clear that right now speed is of the essence so as to not sacrifice too many years of attending salary. As it pertains to specialty choice, that is a tougher consideration between the income generated, time it takes to get to that high income (training years), versus pursuing whatever seems to be of interest to me. I'm curious though to hear from the more senior attendings on the forum: did these considerations ever enter your calculus when you were considering specialty? Or was tuition (relative to today) "affordable" enough that just being a physician would ensure a prosperous career?

          At this juncture, with no significant other, family and kids is a remote probability and frankly undesired. For now I'll keep my savings rate (20%, will raise this year to 25% once the hospital restores the 401(k) match) high, work no longer than summer 2023, and enjoy SoCal SCUBA diving (because now is probably the last time I'll be able to do that for years). I'll set a goal of MCAT in fall/winter and square away my personal statement(s) and apply in 2022, then see where the cards fall.

          And frankly, if no (reputable) school were to take me, then at least I have completed the prerequisites at the local CC to be able to apply to NP/RN and PA. I guess I should count my blessings because getting the science classes (physiology, microbiology, and anatomy) in one academic year at this particular CC is akin to striking gold.

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          • #35
            Originally posted by F0017S0 View Post
            It's pretty clear that right now speed is of the essence so as to not sacrifice too many years of attending salary. As it pertains to specialty choice, that is a tougher consideration between the income generated, time it takes to get to that high income (training years), versus pursuing whatever seems to be of interest to me. I'm curious though to hear from the more senior attendings on the forum: did these considerations ever enter your calculus when you were considering specialty? Or was tuition (relative to today) "affordable" enough that just being a physician would ensure a prosperous career?
            I came out of medical school with what at that time was a boatload of debt, but I chose my specialty based on what I enjoyed most, not on income considerations, and it worked out fine. Unless you have your heart set on living in a very high cost of living area or living an extravagant lifestyle, the odds are you’ll end up fine even if you choose one of the lowest-paying specialities.

            Finances aren’t the chief reason I urge you to apply to medical school as soon as is practical, though; your physical condition is. Hard though it is to believe, at age 31 you are already past your physical prime, and you will be going nowhere but down for the rest of your life. The changes are slow at first, but by age 40 you won’t have any illusions about being young anymore. And as several others have mentioned, some specialties have residencies which are both longer and more physically demanding than others. The later you start, the harder it will be to complete one of those residencies if you fall in love with one of those specialties. Starting ASAP buys you time, and time buys you options.

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            • #36
              Originally posted by F0017S0 View Post
              And frankly, if no (reputable) school were to take me, then at least I have completed the prerequisites at the local CC to be able to apply to NP/RN and PA..
              Going the NP route would also be a terrible decision.

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              • #37
                Originally posted by artemis View Post

                I came out of medical school with what at that time was a boatload of debt, but I chose my specialty based on what I enjoyed most, not on income considerations, and it worked out fine. Unless you have your heart set on living in a very high cost of living area or living an extravagant lifestyle, the odds are you’ll end up fine even if you choose one of the lowest-paying specialities.

                Finances aren’t the chief reason I urge you to apply to medical school as soon as is practical, though; your physical condition is. Hard though it is to believe, at age 31 you are already past your physical prime, and you will be going nowhere but down for the rest of your life. The changes are slow at first, but by age 40 you won’t have any illusions about being young anymore. And as several others have mentioned, some specialties have residencies which are both longer and more physically demanding than others. The later you start, the harder it will be to complete one of those residencies if you fall in love with one of those specialties. Starting ASAP buys you time, and time buys you options.
                I agree with this. On the plus side, you will have a better idea what your body can/can’t handle as you choose a specialty. When I was in med school at age 24/25 I thought staying up all night and working the next day was no big deal. I felt a lot differently by my early 40s. By sheer luck I ultimately chose a field where I don’t have to do that but it could have been different as I didn’t think about these things as a young med student. I’m pretty healthy, don’t have any chronic aches/pains/complaints yet but I need sleep in a way that my younger self did not appreciate.

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                • #38
                  CordMcNally: Why do you think that NP would be a terrible decision? I know a PhD, NP here at my facility who has a pretty good lifestyle as faculty on the medical staff.
                  artemis: What attracted you to pathology? Pathology is another specialty I have considered.
                  Anne: Good points; the later years of my PhD were not as "spry" as the first years, so I can somewhat understand your thoughts there.

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                  • #39
                    My final choice came down to pathology versus general internal medicine, and I chose pathology because I realized that I enjoyed the challenge of making tissue diagnoses more than I enjoyed direct patient interactions. Path felt more “scientific” to me. I was fortunate enough to be able to arrange an elective rotation in pathology (it’s not generally one of the required rotations for medical students, so not many get exposed to it), which confirmed it was the right choice for me. It has one of the longer residency paths (in theory now it’s only 4 years, but in practice no one will hire you unless you do an additional year of surgical pathology fellowship at a minimum, so you are looking at 5-6 years total), but the hours aren’t terrible and the pay is good to excellent. If you think pathology might interest you, do seek out opportunities for exposure to it while in medical school!

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                    • #40
                      Originally posted by F0017S0 View Post
                      CordMcNally: Why do you think that NP would be a terrible decision? I know a PhD, NP here at my facility who has a pretty good lifestyle as faculty on the medical staff.
                      #1 - There's no standardized training and most training that is out there is terrible. You're also usually responsible for your own rotations and that basically means trying to rotate with a friend of a friend who lets you go home at noon and teaches you nothing.
                      #2 - Oversaturation is already becoming a problem with no end in sight. Pretty much anyone that wants to go to NP school gets in. Probably over half of the nurses I know that aren't an NP are either currently in NP school or plan on going. We've got several nurses working in the ED with their NPs because they can't find NP jobs.

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                      • #41
                        artemis: Thank you for sharing! I'll try and arrange a shadow experience with one of the pathology staff here at my institution.
                        CordMcNally: Kind of sounds like the same issue with PhD programs. While I am fortunate to have gone to an Ivy, over-saturation is an issue there as well.

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                        • #42
                          Another finance question just occurred to me as well while reading about the resident waterfall. I currently have (roughly) 50% of my retirement money in Roth accounts and 50% in traditional accounts (across all types IRA, 401(k), 403(b)). I also have a small HSA. Should I be allocating more into the Roth bucket? Would I be served considering converting my traditional holdings into Roth holdings at my low tax bracket?

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                          • #43
                            Originally posted by F0017S0 View Post
                            CordMcNally: Why do you think that NP would be a terrible decision? I know a PhD, NP here at my facility who has a pretty good lifestyle as faculty on the medical staff.
                            On the outside looking in. No idea how the budget and net worth and retirement looks. Spending is typically not a problem for highly educated folks. Some get really really good at it. It's the retirement savings that is the problem. And you will take a hit for years of the accumulation stage (as well as the compounding). It is a mistake to compare yourself to colleagues.

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                            • #44
                              Originally posted by F0017S0 View Post
                              Another finance question just occurred to me as well while reading about the resident waterfall. I currently have (roughly) 50% of my retirement money in Roth accounts and 50% in traditional accounts (across all types IRA, 401(k), 403(b)). I also have a small HSA. Should I be allocating more into the Roth bucket? Would I be served considering converting my traditional holdings into Roth holdings at my low tax bracket?
                              Depends on your current tax bracket also.

                              That being said, the years you are in med school would be a great time to convert some holdings into roth IF allowable (check your 401 and 403 plans) as you will be in the lowest tax bracket (I assume) during med school years 2 and 3. At least convert the traditional IRA to a ROTH IRA so that in the future you can easily backdoor roth. But, I have no idea if this would affect your student loans in any way, so be sure to check up on that.

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                              • #45
                                Originally posted by F0017S0 View Post
                                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.

                                Prudent Pre-med?
                                I will add a few cents to what others have said.

                                I would suggest you apply ASAP. I was also a non traditional med student. I did a PhD first then realized that med students had more fun :-) Writing grants and constant pressure to publish wasn't fun any more. Anyway, started med school around 30 and didn't work till 41.

                                I am pretty confident in saying that you shouldn't consider the 'money/cost' part of med school too hard. I came out with over 350k in student loans plus 100k or so in other debts. 8 years later, I'm approaching 3 million mark with no debt (except home), non-working spouse for over 10 years and a kid.

                                Looking back, I would have gone the med school route right from college. As an older applicant, it was not as easy to sit there and absorb tons of FACTs (which med school basically is. drink from a fire hydrant) and the over night calls. It really is for the youngins. I love science and all the biomedical stuff but I think doing it for a living just wasn't for me. Being a physician is so much more rewarding in all aspects. The stuff I learned from getting a PhD is really more intellectual and personal - nothing that is translatable to finances. But the MD definitely is - it opens doors and opportunities way more than the PhD. I know so much more about the scientific basis, molecular genetics, biochem, 'peer review', and how a particular study may have been done, compared to my MD friends who went the traditional route. But none of that translates into anything practical. Because once you get the MD after your name, everyone pretty much gets paid the same way.

                                Again, if you're already thinking about it this much. Just do it.

                                And I would add that the past decade has been really fun. I haven't worried about money. Pretty much eat out when ever we want and buy most things within reason we want without a budget. Thanks to sites like this (WCI), knowing about finances, I am headed to FI soon.







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