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  • #46
    Tim: Thanks for highlighting those good points.
    billy: I will discuss with my accountant and review my retirement plans.
    STATscans: Good to hear from someone who was in my boat (only differing by a couple of years). The biggest fear of medical school for me has been the prospect of using borrowed money, but I am starting to see that there are strategies that will aid in the retirement of those obligations. My goal is MCAT/statement this year and apply next cycle.

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    • #47
      Originally posted by VagabondMD View Post

      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.
      Yikes...I’m primary care fm, and I’ve actually done quite well during the pandemic. I’ll end up ‘making close to 250k this employment yr ending in 8/2021. That’s working 4 days per wk for the last 8mths, no weekends or nights.
      It’s true primary care is getting overrun by nps/pas. There’s a new health system hiring right now and they told me they will staff each clinic w 2 midlevels, 1doc. So shows you their priorities.
      Scope creep will happen/is happening to other specialties (anesthesia/derm), hope our surgical colleagues are paying attention and can stop the tide before it happens to them(nurse practitioners operating solo in the UK as of last yr I think albeit for minor procedures(not sure how minor)..

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      • #48
        Originally posted by Dontgetthejab View Post

        Yikes...I’m primary care fm, and I’ve actually done quite well during the pandemic. I’ll end up ‘making close to 250k this employment yr ending in 8/2021. That’s working 4 days per wk for the last 8mths, no weekends or nights.
        It’s true primary care is getting overrun by nps/pas. There’s a new health system hiring right now and they told me they will staff each clinic w 2 midlevels, 1doc. So shows you their priorities.
        Scope creep will happen/is happening to other specialties (anesthesia/derm), hope our surgical colleagues are paying attention and can stop the tide before it happens to them(nurse practitioners operating solo in the UK as of last yr I think albeit for minor procedures(not sure how minor)..
        Sounds like there is a lot of competition in the primary care arena...

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        • #49
          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.

          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?
          Interesting thread. I'll go back to the beginning.

          I'd ask... why on earth would you go get an MD now? do you REALLY REALLY want to do patient care? Or are you looking at an MD/PhD physician scientist role where you HAVE to have the MD to lead the department / get the funding you want?

          With a PhD, I'd think you could make a healthy 6 figures from a wide variety of paces in industry today. I'd think going to do an MD (and residency?) means you just gave up 5-9 years of 100k+ salary/year. That's a really steep hole from which to recover. The further you go into business the more upside. Can't you go run clinical trials somewhere?

          Do you want to see patients? Do research? Grow a business?

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          • #50
            Originally posted by adventure View Post

            Interesting thread. I'll go back to the beginning.

            I'd ask... why on earth would you go get an MD now? do you REALLY REALLY want to do patient care? Or are you looking at an MD/PhD physician scientist role where you HAVE to have the MD to lead the department / get the funding you want?

            With a PhD, I'd think you could make a healthy 6 figures from a wide variety of paces in industry today. I'd think going to do an MD (and residency?) means you just gave up 5-9 years of 100k+ salary/year. That's a really steep hole from which to recover. The further you go into business the more upside. Can't you go run clinical trials somewhere?

            Do you want to see patients? Do research? Grow a business?
            adventure: please accept my apologies for not getting back to you! I had meant to reply, got side-tracked, and work has been pretty consuming as we work to get a new, high-impact clinical trial set up at the hospital clinic where I work. To answer your questions:

            1. My adviser in graduate school never published any of my work becasue s/he didn't deem it "high impact enough for [their] liking"; but it was good enough at least for me to defend. As a result, getting a post-doc that would allow me to tap into one of those PhD-only $100k+ jobs (bench pharmaceutical scientist, medical science liaison, pharmaceutical sales et cetera) has never materialized.

            2. In many fields (including conducting clinical trials), I have come to appreciate a bias against hiring PhD's due to the premium the degree carries (I have gone on many interviews with very excited recruiters who return two days later saying "the manager decided to go with someone else"). It happens to everybody, and I try and keep it from getting under my skin and just move on to the next opportunity.

            3. I currently run clinical trials, but the upside isn't as high as I would have thought for mid-career.

            4. I grew up watching M*A*S*H (reruns) and always thought that Hawkeye Pierce was just the coolest TV character. Practicing medicine would be a real privilege and I know I have the intelligence and people skills to eventually become an effective clinician. I could definitely see myself putting in the work to get to a department head position. In my current role, I really do enjoy seeing my patients and to be honest, I get a real charge out of providing them a high quality service and then writing a good, solid note in the paper chart and calling it a day. I find it pretty satisfying...

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            • #51
              OP, it sounds to me as though you know your heart and have made up your mind. Good luck with your medical school application!

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              • #52
                Originally posted by F0017S0 View Post

                adventure:

                4. I grew up watching M*A*S*H (reruns) and always thought that Hawkeye Pierce was just the coolest TV character. Practicing medicine would be a real privilege and I know I have the intelligence and people skills to eventually become an effective clinician. I could definitely see myself putting in the work to get to a department head position. In my current role, I really do enjoy seeing my patients and to be honest, I get a real charge out of providing them a high quality service and then writing a good, solid note in the paper chart and calling it a day. I find it pretty satisfying...
                I feel like this is everyone at the beginning of any job. When they can take their time. Go slowly. Explain things.

                Then boom, Real life: 30 patients with all the administrative meetings/non sense just to make your CEO more $$$. Constantly asked to do more with less. Its like any job i guess, gets old after a while.

                ill bet $100 you cant find 1 attending that says they feel satisfied after writing alot of notes

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                • #53
                  Originally posted by Bdoc View Post

                  I feel like this is everyone at the beginning of any job. When they can take their time. Go slowly. Explain things.

                  Then boom, Real life: 30 patients with all the administrative meetings/non sense just to make your CEO more $$$. Constantly asked to do more with less. Its like any job i guess, gets old after a while.

                  ill bet $100 you cant find 1 attending that says they feel satisfied after writing alot of notes
                  Bdoc: Fair enough. I wouldn't want to do note writing for ever and ever, and you are right that at some point I will develop a real aversion to the practice. I guess for now, this writer embraces writing a quick paragraph or two about the encounters as it compels this neophyte an opportunity to reflect on the care provided to the subject(s). This writer tries to avoid romanticizing the practice of medicine (or clinical trials), but from time to time it makes the practice a little more bearable.

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