Readers: Health care is nearly 20 percent of our GDP. The surest way to be a full participant in this massive and growing sector of the economy is to get an MD. But it is a substantial commitment for a young person to prepare for, enter, and complete medical school. What is it like day-to-day? To help young people (and old people advising young people) answer this question, I have placed a mole in one of America’s medical schools. I’ll be publishing his diary on a regular basis. Here’s the first installment….
One week to go before entering medical school, Class of 2020, and I am two parts excited, one part anxious: excited about the first cadaver cut in Anatomy 101; anxious about aspiring to heal others, about having another trust me with vulnerabilities. How must I change to uphold the physician’s charge?
Why this book: (1) as a reminder of the enthusiasm with which this long process was entered, (2) in case it is helpful to students considering premed.
Personal background: With the exception of a few years overseas, I grew up in a wealthy American suburb with two well-educated parents and academically successful older siblings. After enjoying an uneventful K-12 in public school, I majored in biomedical engineering (GPA 3.8) at one of America’s better universities, scored 37 on the MCATs, and could have started medical school shortly after graduation in 2015. I spent a year working, however, so that medicine would be an affirmative choice rather than a default. I enjoyed the engineering job, but now that I’ve seen the opportunity cost of not pursuing medicine I won’t have second thoughts after paying tuition bills.
The Whole Book: http://tinyurl.com/MedicalSchool2020
The surest way to be a full participant in this massive and growing sector of the economy is to get an MD.
A close family member graduated undergrad with a BS Biology, didn’t get into medical school, but got into Osteopathic school. After graduating and interning, he got a $110K job with a small NH family practice (1992) that paid off his school loans. After ten years in practice, he got recruited into an assistant medical officer role at a very large health insurance company at $135K. He’s still there, hasn’t touched a patient in fourteen years, and tripled his annual salary! Medicine is a great job if it weren’t for the patients!
Pro-tip for the aspirational: do your MD degree in the Caribbean for a fraction of the cost of US schools. Upon graduation, go into sales of pharmaceuticals / surgical devices – you’ll earn 5-10x over your career vs the stooges who slaved as residents in US hospitals.
Physician assistants make six figures at a fraction of the debt.
Smartest Woman and Billg – There’s an adage in medical school: The bottom 10% will earn the top 10%.
PC – Here in the ER PA’s also have the advantage of not working night shifts, unlike the MD schlubs.
Or you could go to medical school because you actually want to be a doctor and take care of patients.
Ian – That’s why most doctors and nurses go to school. Then doctors (and nurses) realize that most of what they do is not taking care of patients – it’s data entry and form-filling, constantly keeping up with ever-changing rules to get paid by Medicare and Insurance instead of keeping up with best medical practices.
Then the smart/assertive/attractive ones get administrative jobs during banker’s hours to make the above ever-changing rules.
The surest way to be a full participant in this massive and growing sector of the economy is to get an MD.
The surest, maybe, but not the smartest: for that, see “Why you should become a nurse or physicians assistant instead of a doctor: the underrated perils of medical school.”
My doctors have saved my life a good five times by now, and without cataract surgeries I would be blind in both eyes.
Attitudes definitely change between generations. Watching prices for obsolete procedures multiply & insurance ripoffs become mandatory can make one become cynical over 20 years. Surprising after all that evolution, students are still told to write in terms of the physician’s charge, affirmative choices & opportunity costs. The government has said medicine is about making boatloads of money. If you don’t pay up, the insurance company doesn’t take a physician’s charge, they take 2% of your gross income.
The surest way to be a full participant in this massive and growing sector of the economy is to get an MD.
Insurance company CEOs must have salaries that are much higher than doctors. I would advise a bright, young, industrious person to get an MBA at a top 10 business school, get hired at an insurance company and work his way to the top.
Vince: That is great advice for a young person. Would you advise them to plan to run Aetna, Humana, or United Healthcare? I personally would tell young folks to become CEO of Humana because they are headquartered in Louisville, Kentucky, the main UPS hub. They will then get amazingly fast delivery on all kinds of household stuff.
Besides becoming CEO of one of the handful of large health insurance companies, another great career option is choosing to become a leading movie star.
Meanwhile, http://www.bls.gov/ooh/healthcare/physicians-and-surgeons.htm shows that there are approximately 708,300 physicians employed here in the U.S. (plus some additional folks with MDs doing non-physician, but presumably well-paid, jobs?).
I’m excited about the “long game” on this one, as we watch the protagonist describe the romantic and marital (financial) misadventures of his classmates.
How can we be notified of updates to this book?
In Europe, students go to medical school right after high school. That is 4 years of saved tuition and life. If this ever gets implemented in the US, the current doctors will have to compete with cheaper workforce that doesn’t have student debt.
Zoran –
I worked in New Zealand in 2008. Their health care was based on the British system, which included 6 years of medical school after high school (4 yrs postgraduate here), minimum 2 years general internship (0-1 yr here) then about 6-8 more years after to finish residency training to become a ‘consultant’ (known as ‘attending’ here). So, on average it took 10 yrs after medical school to be able to practice unsupervised medicine in the British system. Part of the reason it takes longer is they have more humane work hours (and better pay) as registrars (residents), so it takes longer to learn because they work fewer hours. Also, not all registrars are in a program to become Consultants- I worked with one quite capable medical registrar to have been doing it for 10 years.
So, assuming things haven’t changed too much since then ( the British were starting to require medical students to pay a small amount of tuition)
Then the European system might not work out quite as well as you think in the US.
I don’t know enough about the different health insurance companies to determine which is best, though I’m sure any CEO makes much more than a doctor. Even the people who report to the CEOs probably make a lot more than doctors.
Of course, there more more doctors in America than insurance company executives. On the other hand, there are probably more nurses than doctors.
Vince: “I’m sure any CEO makes much more than a doctor”. Also true of leading Hollywood stars. That’s why I suggested becoming a movie star as an alternative career plan. Another good option is probably joining an NBA team. Those guys make a lot of money and there are way more NBA player jobs than health insurance CEO jobs. So you could advise young people to plan a career with the NBA where they will earn more per year than a typical physician, albeit for fewer years. (I’m assuming that NBA positions are equally available to Americans who identify as male versus female. If not, a change of gender ID should sufficie to become eligible.)
See http://www.forbes.com/sites/kurtbadenhausen/2015/01/23/average-mlb-salary-nearly-double-nfls-but-trails-nba-players/#4ebc9e0c269e for how the average NBA player salary was close to $5 million in the 2013-14 season.