<p>I have a chronic condition that takes me to many doctors. I frequent a teaching hospital. Since one of my children has expressed interest in medicine, I've made it a point to ask every intern and resident I encounter if they are happy with their choice. At first I was just shocked at how negative the responses were. They start with the money woes, what they owe. One explained to me that most young doctors role their med school debt into their first home mortgage. I've also gotten an earful about how competitive certain specialties are, starting with the lucrative ones. Many have had to settle for less than thei first few choices. I've heard about the long hours, endless years before they are full fledged doctors and general unhappiness. I've yet to find one young doctor enthusiastic about the choice. Truly sad.</p>
<p>Keep in mind that internship and residency are miserable times.....I'm hoping the attendings aren't as sour.</p>
<p>Zagat: this sort of general displeasure with the profession is a little worrisome, now that I hear this. But don't you think ALL professions have a lot of complaining and a lot of dissatisfaction, in the early years, especially. A large proportion of teachers leave after the first year and then more within the next five years as well. And I have heard that lawyers have a high degree of wanting to get out of the profession, too. It seems like doctors have to wait to reap the majority of the benefits of their many years of study until after residency.</p>
<p>We have three female doctors in my church and they all seem satisfied and have all made good lives for themselves.</p>
<p>Good question bookiemom. In my own field, management consulting, I think there tends to be high satisfaction for several years and then the problems surface when people marry and have children. I have to say, I was really startled to see young people so dissapointed. Again, your question begs many more.</p>
<p>Just how many people will claim to feel they made the right choice several years out? Is the grass always greener? I must say though, my sister, just 2 years younger who went to med school and married a doctoe (then had 4 kids and stayed home) is more unhappy with her choice than most in business I know.</p>
<p>I think a lot of the unhappiness among residents is due to sleep deprivation. Also, there are so many years of getting into and out of debt before the high salary/lifestyle benefits kick in. And even then, the long hours never end for most doctors.<br>
OTOH, doctors are still respected and admired--people do appreciate the intelligence and hard work it takes to become a doctor. There can be a lot of satisfaction in earning patients' trust and helping them. </p>
<p>Professional/family conflicts are common because this type of work truly uses up a caring doctor--then what is left for the spouse/kids?</p>
<p>There still are good programs where you can agree to serve rural/underserved populations for a length of time to reduce/eliminate med school debt from what I understand.<br>
Like I said, I know of many docs who DO love their jobs as docs, but all agree that there are parts of it which are a challenge, especially dealing with insurers, govt bureaucracies, etc.
One would have to be passionate about whatever they want to do, especially medicine. You can find folks in all professions who love or hate or are indifferent to their jobs. I agree that there can be tremendous job satisfaction in being in a profession you love, especially when you are really helping people--whether medicine, law, or any other field.<br>
OK--I'm off the soapbox again. <grin></grin></p>
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But don't you think ALL professions have a lot of complaining and a lot of dissatisfaction, in the early years, especially. It seems like doctors have to wait to reap the majority of the benefits of their many years of study until after residency
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<p>I think the problem for most MDs are that the rewards are not what they once were. Because of malpractice premiums and the alphabet soup of insurance plans, physicians have seen their incomes decrease while they work harder & harder. For example: a gastroenterologist friend of mine told me his reimbursement for a colonoscopy is 25% of what it once was. Therefore he has to work 4X as hard for the same income. Add to that the mounds of paperwork & phone calls that most MDs need to do to convince insurers that their diagnosis and treatment is correct and you can understand all of the complaining.</p>
<p>EVERY job/profession has parts which are bothersome/difficult/pain in the arse. Yes, physicians who are self-employed (i.e., private practice docs) are seeing a considerable drop in income because reimbursements are only a fraction of what they were even 5 years ago. And specialties are battling to keep each other from being reimbursed for procedures which both do...e.g., the current battle by radiologists to keep cardiologists from being reimbursed for cardiac imaging procedures which both are trained to do. Physicians in 2005 have many options for employment: military, government (local and federal), salaried for practice organizations, academic, salaried employees of groups, or self-employed. Each employment situations has its ups and downs. I strongly sense that only those docs who are dissatisfied are posting here. I can tell you that 99% of the docs that I work with love their jobs and wouldn't do anything else. And we are in what is in the lower paid of the categories of employees (salaried employees of an academic institution with no productivity bonuses). Burned out docs get burned out for more than just economic reasons. Either their interests have changed, their perceived "hassles" outweigh their desires, or they picked the wrong job to begin with. My husband definitely picked the wrong job to begin with (OB). He had the courage to change and is now very happy (still does some minor GYN, mostly pathology, and medical informatics).</p>
<p>Zagat--maybe the docs you know who complain about money first are in this for the wrong reason. We've never had a higher than middleclass lifestyle (our one indulgence which we saved very hard for is college). My H always felt that being a doctor didn't entitle him to live a rich lifestyle any more than anyone else who works hard, which includes teachers, nurses, laborers, etc. </p>
<p>I don't feel too awful for the young docs who roll their loans into their "first mortgages". We didn't own a house till my D was eight (lived in a 4 room apt over a pizzeria till then). For years and years, our loan payments were bigger than our mortgage. We're in the same "starter" house in a lower middle class neighborhood still, and that's just fine. </p>
<p>The docs that we know don't leave over money; they leave over the work conditions insurance/malpractice nightmares, and the abysmal state of healthcare priorities in this country.</p>
<p>I'll take Canada's system any day. I make that choice by looking how the least (least powerful, least rich, etc.) in each country are treated. It would be immoral to me to judge by any other criteria.</p>
<p>Garland, I think this is very difficult. I don't think it's unreasonable for smart people who have busted their butts for many years to expect that money should not be a problem. We're not talking about mansions, but good educations for your kids, a middle class home and a few vacations now and then. What on earth do we work for if we can't hope for simple pleasures? What I have seen as an MBA married to another, is that 2 years of grad school has made us far more comfortable than my sister and husband who had basically 8 years of grad school. Their income goes down every year. At some point iit's fair to say we want a lot for our kids, maybe private school and certainly summer programs. While we don't need to be multimillionaires is it so bad to want to live in a desirable area. Here in CA that costs a lot.</p>
<p>Hey, Northeast Jersey is pretty pricey, too! I understand that.</p>
<p>I wouldn't say it's bad to want certain things. What I don't agree with is for anyone to think they "deserve" them, any more than anyone else. We're all far richer than most of the population of the planet already.</p>
<p>I also don't know that, growing up, kids need so many fancy educational things. I think my kids got most of their education from family dinners, cheap family outings, and loads of reading. They went to what most people here would call a subadequate public school system, never did summer programs, and ended up at some pretty darn good colleges. Because so many life expenses seem connected to education, this made a pretty big difference for us.</p>
<p>The docs I know who are unhappy and/or leaving would be willing to live with less money, and more paperwork. They went into the profession, and made great sacrifices in time and money, because they wanted to help people, and thought that medicine was one of the "purer" ways to do so. The discovery that this has increasingly little to do with the practice of medicine in this country, and that they are increasingly constrained in their capacity to help their patients, is what causes them to leave, or to find medical specialties where they don't have to see patients at all.</p>
<p>Another kid here...</p>
<p>Could anyone say anything about having the military pay for med school? Can they pay for undergrad and med school? </p>
<p>And, most importantly... if a not-so-hypothetical girl absolutely detested every PE class she ever took, and wasn't too keen on unquestioning obedience, would it just be easier to be in debt the rest of her life than to join the Air Force and sweat the debt off?</p>
<p>Thanks so much for the advice on this thread... keep it up; there's an audience!</p>
<p>I can, CleighDrie, firsthand. I was on active duty for 13 yrs and in the reserve for 4 in the Air Force. If you don't like PE and can't follow orders without much question, DON'T go into the military. You WILL be miserable. Take out the loans. You'll get them paid off eventually. </p>
<p>In the military, you may not even get to do the residency of your choice, if there is not a need for that specialty. In this case, the student completes an internship, then serves as a general medical officer or flight surgeon for the duration of your commitment (4 years for med school, 8 to 9 for both med school and undergrad school). Then they let you get out and start your residency as a civilian 4 to 8 years AFTER your friends. If you wish to serve your country and are willing to deploy to Iraq or Afghanistan (you WILL do this if we are still there when you finish med school...all of our colleagues who are still on active duty have had at least 1, and most 2 or 3 tours there), then, by all means, apply for a military scholarship. If not, don't do it.</p>
<p>Hubbell's dad:</p>
<pre><code> With all due respect to quiltguru, let me give you another perspective on military medicine. I went to college on a 4-year ROTC scholarship followed by going to medical school on a 4-year HPSP scholarship and have just finished serving 25 years on active duty, retiring as a full Colonel. I served my career in the Army medical corps-which is larger than the Navy and Air Force medical Corps combined-so there are more opportunities.
First, I have met many physicians who 'signed on the dotted line' because the prospect of incurring a large debt was overwhelming for them, and they did not fully understand that years later, that that debt would actually be quite manageable-once they come to realize that, they regret their decision to have 'volunteered' to join the military-that is unfortunate. However, most military physicians I have met(and in 25 years, I have met thousands), come out of medical school nearly debt free, they then obtain a residency(the GMO route that quiltguru alluded to is the exception, not the rule, in the Army medical corps) and after they complete their residency, they pay back their obligation(usually 4-years)-wherein they become board-certified and obtain several years of great experience-after which, most leave the military and are highly sought after in the private sector-and they are no worse for wear. You can not base any decision on Iraq-as present premeds will not finish training for at least 8 years-and the world will be a different place then today. I agree with quiltguru, that military medicine is not for everyone, but it's not the end of the world either-it was very good to me-and now, today, as a medical school professor-I enjoy that retirement check(I am only 51)-the gift that keeps on giving(for life).
</code></pre>
<p>I know that pretty much all residents work long hours, but after that how feasible is it to work part-time or job share? I know this will vary by specialty - does anyone have more insights into which specialties make this harder or easier? I am very committed to becoming a doctor, but I am not willing to completely give up the idea of being an involved mother and community member.</p>
<p>A very close friend of ours is a pediatrician who is a part-time associate in a suburban practice. She has four kids and is extremely involved with them. OTOH, part-time in medicine is full-time in the real world, as she covers the phones every third or fourth night, and similarly on weekends. Plus similarly taking her turn covering the hospitalized patients.</p>
<p>My guess is she doesn't sleep...;)</p>
<p>At the risk of being flamed!
Jenskate, it is very difficult to predict what medical practice will be like when you would be a full fledged practitioner - say 35 years old, if you went straight through.
Back in the old days, when I was in Med school ;), slightly more than 1/4 of our class was women. I believe that last year's entering class was 50:50. When I started practice, women were not a curiosity anymore, more of a novelty, now they are commonplace. By the time you finish residency, say at about 30, the practicing ratio should be about 60 men:40 women. This will have a profound effect on the way people practice, it already has changed many things. Women, particularly women in the aggregate, demand, and physically have to have more time with their families - I worked up until the day before both of my children were born, but I am in a specialty where I'm not on my feet as much, and I could cut back in the last week without overly burdening my colleagues - but some women have to go on bedrest, others work in specialties where the last couple of weeks of pregnancy have to be worked into leave time.
What has happened is that more men asking for equal leave time in medicine - for one thing it is fair, and the men have seen that you can take time off, and it is OK. The debt load is the same, though, so how do you pay off your debt with a parttime job?
I hope that when the generation behind me is running things (the docs now in their 30s, get to be in their 40s), that it may begin to move toward a system where you actually pay your dues later - many people work shorter hours early, long hours after child bearing years, but I doubt it. Whatever happens, we are moving into uncharted territory - a men's profession becoming a "women's" profession - what happens if the compensation falls so low that the best and brightest don't want to do medicine? You may think that won't happen, but this is a capitalist economy, people can vote with their feet, and one reason American medicine is cutting edge is that many of the brightest people have gone that way for many years - because they were well compensated with personal satisfaction, standing in the community, job security and, yes, money - if that changes, or if the perception of that changes, what happens then? It will be interesting.</p>
<p>Thanks for the insights, both of you.
cangel, when you asked about the debt load, it reminded me of a recent conversation i had with my mother - she asked the same question, and I simply responded, 'no big deal - I'll just marry well.' ha!</p>
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what happens if the compensation falls so low that the best and brightest don't want to do medicine? You may think that won't happen, but this is a capitalist economy, people can vote with their feet, and one reason American medicine is cutting edge is that many of the brightest people have gone that way for many years - because they were well compensated with personal satisfaction, standing in the community, job security and, yes, money - if that changes, or if the perception of that changes, what happens then?
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<p>This is very scary!</p>