Medical Professionals-Would you Counsel Your Kids to Follow Your Career Path?

[Zaphod]

kvpauley wrote:

As a parent and an advisor, I/we see a lot of enabling.  While it exists at some level for all of us, the long-term results usually are not positive.  Perpetual schooling is a common form of enabling that seems to eventually runs its course.  That said, medical school has got to be one of the hardest ways to delay real life!

Separately, and to the point of economic ROI for medical professionals, this info was tweeted over the weekend in the category of “Labor Day Statistics”.  To Dr. Dahle’s point, it is not easy to find a profession that is as financially rewarding as yours.

—-

What are the highest paying jobs in America?  The MyPlan.com website lists the top 300 jobs in term of average salary, and the top of the list is dominated by medical profesedsionals:

Anesthesiologists: $258,100

Surgeons:  $247,520

Oral surgeons: $233,900

Obstetricians and gynecologists: $222,400

Orthodontists: $221,390

Radiologists, Pathologists, Neurologists, Allergists and Immunologists, Urologists, Preventive Medicine Physicians, Ophthalmologists, Hospitalists, Sports Medicine Physicians, Physical Medicine and Rehab Physicians, Nuclear Medicine Physicians and Dermatologists all finish in a tie for sixth ($197,700), and you have to go all the way down to number 22 on the list, to Chief Executives, before you reach a non-medical professional on the list.

Click to expand...

Agree. Although it may lead to a higher likelihood of being unhappy, its a very logical choice and hard to argue with the reasoning. Its just the path is very tough for a seemingly limited factor to have such a big role. Obviously, it shouldnt be the primary and certainly not the only factor, but it definitely can be a main one. You still have to have enough interest to make AND do well enough to be allowed to.

[kvpauley]

As a parent and an advisor, I/we see a lot of enabling.  While it exists at some level for all of us, the long-term results usually are not positive.  Perpetual schooling is a common form of enabling that seems to eventually runs its course.  That said, medical school has got to be one of the hardest ways to delay real life!

Separately, and to the point of economic ROI for medical professionals, this info was tweeted over the weekend in the category of "Labor Day Statistics".  To Dr. Dahle's point, it is not easy to find a profession that is as financially rewarding as yours.

----

What are the highest paying jobs in America?  The MyPlan.com website lists the top 300 jobs in term of average salary, and the top of the list is dominated by medical professionals:

Anesthesiologists: $258,100

Surgeons:  $247,520

Oral surgeons: $233,900

Obstetricians and gynecologists: $222,400

Orthodontists: $221,390

Radiologists, Pathologists, Neurologists, Allergists and Immunologists, Urologists, Preventive Medicine Physicians, Ophthalmologists, Hospitalists, Sports Medicine Physicians, Physical Medicine and Rehab Physicians, Nuclear Medicine Physicians and Dermatologists all finish in a tie for sixth ($197,700), and you have to go all the way down to number 22 on the list, to Chief Executives, before you reach a non-medical professional on the list.

[VagabondMD]

Just last night, I had the discussion at a dinner party with the hosts (very good friends), whose son is a senior in college applying to med school. They know my perspective from previous conversations. I asked if medicine was "his calling", and their reply was that he likes being in school and is not ready (maturity wise) to leave school, join the workforce, etc. So med school is the plan.

I think that this is a terrible approach and told them so (but more gently).

[The White Coat Investor]

squirrel wrote:

Zaphod wrote:

Josh0731 wrote:

The White Coat Investor wrote:

If you can be talked out of medicine, you should be.

Click to expand…

I have to differ and say I’m not a big fan of this sentiment. There is, and will continue to be, a big need for healthcare providers for our growing and aging population.  My suspicion is there aren’t enough people out there for whom medicine is a passionate ‘calling’ to even come close to meeting society’s needs if that were the standard of entry into the workforce.  It’s therefore important that the healthcare industry and medical profession continue to meet people in the middle, adapting to make medicine a desirable career choice in the future.  The biggest example of this is, as recently discussed on the blog, crushing educational costs/debt.

As for the broader question of advice to one’s kids, I would hypothetically discourage my child from going to medical school.  The many reasons are too easy to list: crushing debt, declining and confusing reimbursements, increasing regulatory nonsense, long stressful hours, decreasing intellectual stimulation, physical demands of procedural specialties (a big one, seldom discussed), decreased autonomy/respect from growing administrative bureaucracy, a population of patients who increasingly seem to be almost purposefully wrecking their health through bad lifestyle choices leading to difficult to treat chronic illnesses, etc, etc, etc.  I don’t like that I would want to say, “Go ahead and go to med school, but you’d better chose an E.R.O.D.E. specialty.”, so I would just say I’d recommend against it.  Get ready for the future where medicine is no longer something that our school’s best and brightest want to pursue.

Click to expand…

I think this sentiment is that if talking someone out of medicine works, then they would definitely grind out of it anyway along the path. Medicine is still an obviously great profession income wise. Now with us grumpy codgers telling people to save/invest wildly as opposed to our mentors who suggested we all buy beach houses and ferraris and things will just “work out”….they will be okay. I would definitely make sure they have a financial mindset about it, and choose specialty with a heavy weight on that and length.

The other likely great gig for less everything but most importantly time is a PA. They will probably be taking over primary care with NPs.

Click to expand…

I agree with what I think is the intent of WCI’s comment.  If someone can be talked out of it, they may not have the commitment it takes to get through it.

Click to expand...

Exactly. Long road and if you have this idea that "I should have done law" in the back of your head the whole time, you won't get to the end of it or be happy when you do.

[Allonblack]

Divide the total number of people from your daughter's college by the total enrollment in introductory biology classes multiplied by 2 for 2 semesters. That is the odds of your daughter getting in to medical school. If she is okay with that percentage my advice is don't put yourself in a position where you have to go to medical school to have a career you'd be happy with. So don't be a bio major with no exposure to other fields. Cant comment on being a doctor because I'm still training, but I will say this: be wary of all the advice to become a PA or NP. When you have a field with low barriers to entry and high salaries people will flood into it and eventually salaries and job opportunities will go down. It happened to pharmacy and it's going to happened to mid levels. There are already online NP degrees .

Also as a parting thought, no one crushes it like a successful salesman. Maybe do that.

[kvpauley]

First, sincere thanks to all those that responded.  Your counsel is thoughtful and clearly heartfelt.  I will definitely share this thread with my daughter.

She has volunteered, shadowed and just recently started a job at a pediatric clinic serving very low income families...she LOVES it.

I thought the point about recognizing the down-sides to other professions was valid.  Also the point about work experience.  I started to pursue my Master's degree in Mathematics right out of college, but only was going to receive half the money I needed to live as a stipend, so, I decided to go work full-time for a while instead (I was getting very tired of eating Rice-a-Roni after four years undergrad).  Very grateful I did; when I did go back to school, I studied and approached learning in a very different way than I had previously.

We have a close family and my children have watched me manage a career/business alongside being Mom.  She seems to see the value of that and wants to do the same.  To that end, she has been considering strongly the NP/PA path in the hopes that those careers might offer her more control over her time.  Interestingly, she has received a LOT of pressure from her peers/school to do pre-med (she's a very strong student); the implication being that she's taking the easy way out if she does anything less (eg start with a BSN).  I disagree.  So many of her peers seem to be choosing pre-med by default - as if it's just expected.

At the end of the day, it seems like if you love what you do, it's not really work.  That's not to say there aren't crummy days!  As an advisor, I too have compliance burdens, clients that don't seem to want to help themselves, long days ...BUT, the majority of the time, it's good, I'm helping people live their lives the way they want to, and constantly learning (I really love this part as well).

As stated, I'll let you know in about 15 years how it all worked out!    When they are all about 35 years old and upstanding citizens, I might consider taking a small victory lap, but until then...

 

 

 

[squirrel]

Zaphod wrote:

Josh0731 wrote:

The White Coat Investor wrote:

If you can be talked out of medicine, you should be.

Click to expand…

I have to differ and say I’m not a big fan of this sentiment. There is, and will continue to be, a big need for healthcare providers for our growing and aging population.  My suspicion is there aren’t enough people out there for whom medicine is a passionate ‘calling’ to even come close to meeting society’s needs if that were the standard of entry into the workforce.  It’s therefore important that the healthcare industry and medical profession continue to meet people in the middle, adapting to make medicine a desirable career choice in the future.  The biggest example of this is, as recently discussed on the blog, crushing educational costs/debt.

As for the broader question of advice to one’s kids, I would hypothetically discourage my child from going to medical school.  The many reasons are too easy to list: crushing debt, declining and confusing reimbursements, increasing regulatory nonsense, long stressful hours, decreasing intellectual stimulation, physical demands of procedural specialties (a big one, seldom discussed), decreased autonomy/respect from growing administrative bureaucracy, a population of patients who increasingly seem to be almost purposefully wrecking their health through bad lifestyle choices leading to difficult to treat chronic illnesses, etc, etc, etc.  I don’t like that I would want to say, “Go ahead and go to med school, but you’d better chose an E.R.O.D.E. specialty.”, so I would just say I’d recommend against it.  Get ready for the future where medicine is no longer something that our school’s best and brightest want to pursue.

Click to expand…

I think this sentiment is that if talking someone out of medicine works, then they would definitely grind out of it anyway along the path. Medicine is still an obviously great profession income wise. Now with us grumpy codgers telling people to save/invest wildly as opposed to our mentors who suggested we all buy beach houses and ferraris and things will just “work out”….they will be okay. I would definitely make sure they have a financial mindset about it, and choose specialty with a heavy weight on that and length.

The other likely great gig for less everything but most importantly time is a PA. They will probably be taking over primary care with NPs.

Click to expand...

I agree with what I think is the intent of WCI's comment.  If someone can be talked out of it, they may not have the commitment it takes to get through it.  I was originally pre-med, and talked myself out of it.  I still worked in healthcare for almost a decade, then finally came to the realization I did want to go to med school so went back to school and pushed through it. I am glad I went this route.  I don't think I had what it takes when I was 22 years old.  There is a chance I would not have been able to hack it and stopped halfway, and been in debt with no means to earn to pay it back.  Personally I also felt this made med school and residency easier. I viewed it as a job that required a certain amount of hours and was able to balance life fairly well and build a family at the same time.  I was never one of those studying endlessly into the night spinning my wheels getting stressed out the night before exams.

Despite what some people have expressed in terms of not putting off med school in order to get into higher income earning years earlier, I am a big proponent of people taking time to work in between college and med school. IT seems crazy to me that work experience is required before going into school to be an NP or PA but not for a physician.  It allows a period to save (and therefore borrow less for med school, like I did and came out with very very little debt).  It also provides a time to develop maturity and responsibility of having a boss, answering to other people, etc.  IT also allows a true look into the system (provided one is working in healthcare) and therefore one is choosing medicine with eyes wide open and not some romanticized view of being a doctor.  I have found a lot of immaturity in medicine and I feel part of this is people on the fast track since high school, who may have never had a job or a boss, then are spit out at the top of the medical food chain(meaning as the doctor usually dictating care and giving orders).  I think this leads to people as docs not being emotionally mature, and plays a part in a lot of the unprofessional interactions between doctors as well as docs and other people in the health care field (nurses, techs, LPNs, etc).  I believe this is one of the reasons I come across docs almost every day who seem miserable in their jobs (and I am not talking about docs who have been around a while, Im talking about younger docs and even residents too!).  As we all know, many are saddled with a heavy debt burden, then take on a "doctor's lifestyle" then probably feel stuck and have no other choice but to grind it out and be miserable.  Obviously this has a lot more to with lifestyle choices etc, and not solely going straight through at a younger age.

 

At any rate, I know I am making some huge generalizations, and there are obviously exceptions to what I am talking about but just my two cents.  And to reiterate the whole point, those who choose medicine should be ones who can't easily be talked out of it.

[jhwkr542]

Even with all its flaws, I still think medicine is a good field to go into. People complaining about the nuances of medicine would probably also complain about the nuances of many other fields. I probably wouldn't encourage primary care unless they go to a cheap medical school. That mountain of debt is hard to tackle starting under $150k. As for me, I don't know many other non medical fields I could work in making $200k+ at age 31 in an 8-5 job with the intellectual intrigue that is pathology.

[PhysicianOnFIRE]

My boys are more than a decade away from being college aged, so it's not a decision we'll be facing anytime soon. If we were at that junction, I would try not to interfere too much, and give the most unbiased information I can. Which would be very difficult.

I think I made the right choice in pursuing medicine, and I'm quite happy with where I am today and glad to know all the people I've met along the way. I might have done just as well taking a different path, but it hasn't been so bad that I would try to talk my kids out of it. I would show them a thread like this one, so they could see some differing opinions.

Best,

-PoF

 

 

[akwho]

Think about becoming a doctor mathematically (as you are a finance person).

-> 23% of country has a college diploma (you've got be in the top quartile of education attainment to even get started)

-> My college had 1200 people start in premed, of which 300 graduated with medical school prerequisites done (most transferred to business or other majors)

-> Of the 300, 250 got into medical school (a very good rate, it was an excellent college)

-> Of the 250 approximately 225 will graduate medical school

-> Of the 225 approximately 215 will graduate residency

-> Of the 215 that will graduate residency, slightly less than half will feel happy with their job (most studies estimate ~45%)

= 100 happy, graduated, practicing doctors out of the 1200 who even made it to an excellent college to try in the first place.

 

The odds are stacked against everyone who wants to become a doctor, let alone a happy one.  You give up your nights in college studying much harder than other majors.  You give up your ability to earn income in your 20's, and all your days and nights in medical school mastering the subject material.  There is constant high stakes testing where failures have huge personal consequences.  You work 100 hours a week in residency making enough to afford rent, food, and make your monthly loan payments.  You are sleep deprived, you work is stressful, you fear being named in a lawsuit, you must accept responsibility for lapses in a patient's care no matter who was at fault because it is your job to "double check" everyone else's work.

Despite all the negatives I listed above, I absolutely LOVE my job.  I get to be in a people facing career making a positive difference in many people's life every day. My work is meaningful, technically challenging, and provides great benefits to patients.  I get thanked every day by patients and their families, I get positive encouragement from my family, friends, and community due to the nature of my career.  I'm an intern in a surgical residency, supposedly one of the hardest years of training to be a doctor, and I wouldn't trade it for the world.

My advice to people considering medicine is do it for the right reasons.  Don't do it for the money, if you are smart enough to be a doctor you would make waaay more money way sooner in the top echelons of finance, business and real estate.  Don't do it for the prestige, that wears off quickly and leaves you with nothing.  Don't do it because your parents want you too, they don't have to wake up at 245am to get to work by 330am every day, but you will.  The only way you become a happy doctor is to love people and love taking care of them.

[DoubleMDs]

Do they want to go to medical school? I tell everyone aspiring to that I would recommend against it. If they have interest in anything else, pursue whatever that is. There are many professions you can help people (altruistic), make plenty of money (and a lot earlier) and do it all with a lot less stress, debt, sleepless nights and malpractice liability. The golden years of being a physician are long, long gone.

that being said PAs and NPs do very well at a fraction of the time, cost and effort. If someone is dead set on medicine I would encourage those avenues. Otherwise my advice is virtually always against medicine. And believe it or not, I like what I do, when I'm actually just practicing medicine. But it took too long, is too beuraucratic, cost too much and requires way more then just practicing medicine on a daily basis. Not worth it.

[VagabondMD]

If it is their calling, I would not talk them out if it.

If they are just kicking around ideas of what to do for a living, I would not talk them into it.

My teens are extremely unlikely to pursue a career in medicine.

[YSH]

I wouldn't say I was ever the "best and brightest", tho, I do think I have some grit in me.  I graduated from a public school with a small amount of debt, and I am also someone who didn't have middle/ upper middle class parents who rothed or 529ed anything on my behalf.  Actually, as the youngest child and one that was quite mischievous in my youth, my parents were surprised enough that I got out of undergrad in 4 years. Maybe, key to parenting is to set your expectation low?!?!

I am not in a highly desired specialty, but I do love what I do and do feel fairly (80-85%) appropriately compensated for my skills.  If I were given the chance again, I would still chose medicine.  If my children wanted to go into medicine, I would make sure he/she is fully informed about the pros/cons.  Also, I would enforce the idea that to truly be good and successful at something you have to be willing to put in that time.  There are plenty of people out there who struggles for years before hitting the sweet spot professionally and financially.  We do have a very diverse group of friends (partner not in medicine, which helps), anything from non medical small business owners, artists, investment bankers (like old school residency hours bankers), accountants, phds, to stay at home spouses.  I can say that all professions/ jobs have its pits. Interestingly, sometimes, its our banker friends who complains the most about their work/life/salary satisfactions.

I would most definitely make sure that my child understands cost/benefit ratio, personal finance and the importance of living well below your means.

[GXA]

I would encourage my kids if they are interested.  Our full time ED physicians work 12 shifts a month and get paid pretty well to do it.  Many take a week off every month or two.  We also have three in our group who are part time.

I cannot think of another career with such earning potential and flexibility to work and earn as much or as little as one wants.

Obviously specialty choice plays into this, but the field of medicine is broad enough that one can find an area that works for them and assures a decent work/family balance with a stable income.

[Zaphod]

Josh0731 wrote:

The White Coat Investor wrote:

If you can be talked out of medicine, you should be.

Click to expand…

I have to differ and say I’m not a big fan of this sentiment. There is, and will continue to be, a big need for healthcare providers for our growing and aging population.  My suspicion is there aren’t enough people out there for whom medicine is a passionate ‘calling’ to even come close to meeting society’s needs if that were the standard of entry into the workforce.  It’s therefore important that the healthcare industry and medical profession continue to meet people in the middle, adapting to make medicine a desirable career choice in the future.  The biggest example of this is, as recently discussed on the blog, crushing educational costs/debt.

As for the broader question of advice to one’s kids, I would hypothetically discourage my child from going to medical school.  The many reasons are too easy to list: crushing debt, declining and confusing reimbursements, increasing regulatory nonsense, long stressful hours, decreasing intellectual stimulation, physical demands of procedural specialties (a big one, seldom discussed), decreased autonomy/respect from growing administrative bureaucracy, a population of patients who increasingly seem to be almost purposefully wrecking their health through bad lifestyle choices leading to difficult to treat chronic illnesses, etc, etc, etc.  I don’t like that I would want to say, “Go ahead and go to med school, but you’d better chose an E.R.O.D.E. specialty.”, so I would just say I’d recommend against it.  Get ready for the future where medicine is no longer something that our school’s best and brightest want to pursue.

Click to expand...

I think this sentiment is that if talking someone out of medicine works, then they would definitely grind out of it anyway along the path. Medicine is still an obviously great profession income wise. Now with us grumpy codgers telling people to save/invest wildly as opposed to our mentors who suggested we all buy beach houses and ferraris and things will just "work out"....they will be okay. I would definitely make sure they have a financial mindset about it, and choose specialty with a heavy weight on that and length.

The other likely great gig for less everything but most importantly time is a PA. They will probably be taking over primary care with NPs.