Stuck at a crossroads

<p>Hello. I'll just jump into this because I have no earthly idea what a decent preamble would be!</p>

<p>I'm a rising sophomore at a pretty decent public university in the states. I'm here thanks to very generous non-need-based scholarship, so I get my four years at a low, low cost and then it's all for astronomical out-of-state tuition that we frankly cannot comfortably afford. I'm telling you this to explain why I can't afford--literally and figuratively--to spend a lot of time waffling between majors. I'm currently a bio major (pre-health track, as most of us bio majors seem to be:)), and I've been prepping myself for a career in health care for years upon years, though I don't particularly fancy allopathic/osteopathic medical school and have looked into podiatry (DPM) schools instead. I also considered pharmacy for the great pay and high demand but ultimately determined that my interests lie more on the hands-on, direct care side of things, which may be in some ways contributing to this sticking point I'm currently dealing with. Namely, I'm not sure if I want to be a bio major anymore.</p>

<p>I'm not one of those people who were forced into biology/pre-health by overly demanding parents or anything like that. In fact, I absolutely adore certain parts of biology--genetics, neurosciene/neurology, and pathology chief among them. I'm doing research now in biomedical science lab on campus and absolutely love it, though I don't think it's something I would be compelled to do for life. I'm not quite as adoring of chemistry, however, but I guess it and biology are kind of package deal these days. </p>

<p>However, the more and more thought I put in on the subject, the less and less sure I am I want do pre-health. I've set up appointments to shadow some DPMs as soon as I get back home, and I still plan on following through, but the more I read about DPMs, the less sure I am that's what I truly want. First, there's the issue of practice. Most DPMs own their own practices, either alone or in paternships, and that's something I find very unappealing--I don't want to have to deal so directly with the business aspects of medicine. Then there's the debt load, about $160k for school with hefty loans during residency on top of that. I know DPMs make pretty good salaries, but that debt still unnerves me more than a little. Finally, there's the issue of location, and honestly, any job I'm going to take is going have a lot of weight put on location. I don't want to live in London or LA or NYC or any place that any sensible 19 year-old would want to live; no, as silly as it sounds, I want to live in semi-rural Alaska (not big cities but not "bush" Alaska either). There's no place like it, really, and it's been something that's been driving me for a long time. Had an Alaskan college been able to offer anything near what I needed in either academics or scholarships, I'd be there now. In fact, my choice of college was partially driven by the relative probability of making AK connections while I'm here, as I figured the relative probability of meeting Alaskans in Illinois was far lower.. In semi-rural Alaska, people tend not to have a lot of money, and I can't imagine the demands for DPMs would be high.</p>

<p>This brings me to my second point. Lately, I've been looking more and more into social work and liking what I see. I really think it would be a good, versatille degree to have in rural Alaska, as it would allow me to do a wide range of things for people. I like that there are opportunities for work in both counseling and hospital work. That way, even though it's not a "health field" in the traditional sense, it would still allow me to be involved in the medical field and interact with doctors and patients while doing other work as wanted or needed. Also, I really like the relatively short time it would take obtain the MSW: 2 years as opposed to 4 years of schooling and 2-3 years of residency for a DPM. Plus, it helps that the University of Alaska at Anchorage has an MSW program, which would allow me to hopefully make connects for jobs while doing practica and internships.</p>

<p>This is where my actual dilemia comes in; my apologies for the extensive back story-- most MSW programs have something referred to as "Advanced Standing," which allows certain applicants with a Bachelors of Social Work to get their MSW in one year. I realize that MSWs don't make much money at all--one of the few things that relly worries me about the field--and thus, an MSW student can't afford much in the way of debt. On top of that, my parents, knowing me to be the highly ambitious type, agreed if I went to school with costs under a certain amount per year, they would "bank" my education funding and pay out of their current salary for my undergraduate. It's a very generous offer I'm very grateful for, and it means, Lord-willing, that I could potentially come out of undergraduate school with around $25,000-$30,000 to put toward my graduate or professional education. This would probably cover just about one year of MSW school, meaning I would be more or less debt-free from an advanced standing program or have $20,000-$30,000 in debt from a full two year program. I don't particularly relish the thought of paying of $30,000 on a $35,000 salary, and while I don't necessarily need to live in gold and diamonds, I would like to live relatively comfortably if possible, and I think that graduating debt free would be a good step in that direction.</p>

<p>All this leads me to the issue of getting the BSW. I spent almost an entire day going back and forth between course schedules, degree requirements, and school requirements, and came up to the conclusion that it would be nearly impossibe to get a dual BSW/Biology degree in four years, and the only degree that would be even remotely possible would be a sort of hack-eyed, bare minimum Bio degree that is dependent on a lot of "what ifs" and would provided insufficient preparation to apply to any medical programs anyway and would actually make me feel worse about getting a Bio degree if I just did the bare bones of the program. However, I looked into it and fouund it would be very possible for me to get a BSW, a BA in Indigenous Studies (good because that's the population I want to work with), and a minor in Biology so that I could continue to take the courses that I'm really looking forward to and continue my biomedical research) within the next three years if I switched for this upcoming fall. It would also require an overload of credits nearly every semester, which I'm actually pleased with because I feel that otherwise I would really miss the intensity that comes with the hard science and because, due to my school's odd credit fee scheme, would actually mean I would be getting "more" for the same amount of money, as I would be taking more credits.</p>

<p>There are a couple of worries I have with this plan, however. I'm loath to give up the all-bio, all the time nature of my previous program because I really do enjoy biology and because, if I did decide to go the DPM route, this wouldn't give me all the necessary courses. Secondly, and I know this sounds silly, I'm worried about the loss of prestigue. People--including my friends-- are always impressed when I tell them I'm a biology/pre-health major, and I know that a "softer" degree would carry less of that. I don't want people to think I'm lazy, unintelligent, or incapable of doing high level work. I believe that I am, and I intend to do at least some of it in my upper division biology minor credits. My mother would probably be fine with it, as she as always pushed me to go into humanities and "be the writer she never was," but I'm worried about how my father will react. I doubt he'll say anything directly, but I can easily see the engineer in him thinking me a weed-out and failure, or at least as much as one can be with a 3.6+ GPA. I'm seeing an BSW/MSW as a different type of clinical degree than the one I orginally had in mind but as an applied science, "helping" degree nonetheless. If I go that route, I don't fee I'll be abandoning my goals, but rather finding another path to a similar destination. I'm I wrong?</p>

<p>I apologize for the lengthy post, but if anyone has any advice on my situation, or on social work, podiatry, or health care in general, I'd be thrilled. Right now, it feels as though I'm looking at two very good but very different paths, one having more prestige and a much larger salary but also carrying bigger debt and more time, and I need to chose my path in the next few weeks in order to be registered for all the right things, least four year graduation and my "bank" of money become but a pipe dream.</p>

<p>Thank you.</p>

<p>This is a strategy which has been tossed around CC for some time--flip a coin to decide between the two paths and pay close attention to how you feel when you see the result. Honestly, from your post, it seems like you are much more interested in the MSW path. My mother is an MSW who has worked in hospitals and nursing homes as well as doing home visits. It is a mentally and emotionally taxing career but it is fulfilling because you get to see that you are making a difference. </p>

<p>Best of luck in whatever you do!</p>

<p>For what it's worth, my wife is a hospice nurse. About 60% of what she does would normally be considered social work or chaplaincy. She gets paid, I think, a little more in the first year than the MSW attached to her service, and she only has a two-year RN. </p>

<p>Folks with an masters in nursing can basically write their own ticket, with salaries above $80k not at all uncommon.</p>

<p>I agree with Mini--head towards nursing not MSW. Hours and pay for MSWs are not worth it.</p>

<p>I think nursing too. Nurse practitioners are in high demand. Nursing instructors are a vanishing breed. You can go in almost any direction with nursing and get a job anywhere. It's very satisfying work.</p>

<p>I notice you say you want to live in semi-rural Alaska. What careers are there in semi-rural Alaska? Teaching would be one; nursing might be another, especially if you become a nurse practioner and can thus run a small clinic with a visiting doctor. Not enough clients for a podiatrist. </p>

<p>Try reasoning from possible ends (jobs you'd like to do in the places you'd like to do them) to start (what major would that be?) instead of start to end.</p>

<p>As I was reading the OP I was getting NURSING loud and clear.</p>

<p>
[quote]
I'm seeing an BSW/MSW as a different type of clinical degree than the one I orginally had in mind but as an applied science, "helping" degree nonetheless. If I go that route, I don't fee I'll be abandoning my goals, but rather finding another path to a similar destination.

[/quote]
</p>

<p>To try to speak to your specific concerns: perhaps the specific subfield of "clinical social work" would help address your desire to continue in a rigorous discipline: </p>

<p>
[quote]
The practice of Clinical Social Work requires the application of specialized clinical knowledge and advanced clinical skills in the areas of assessment, diagnosis, and treatment of mental, emotional, and behavioral disorders...

[/quote]
</p>

<p>considerably more at:<a href="http://www.dshs.state.tx.us/socialwork/sw_require.pdf%5B/url%5D"&gt;http://www.dshs.state.tx.us/socialwork/sw_require.pdf&lt;/a&gt;&lt;/p>

<p>Also:<a href="http://www.cswf.org/www/info.html%5B/url%5D"&gt;http://www.cswf.org/www/info.html&lt;/a&gt;&lt;/p>

<p>The field of family medical therapy might interest you, though it might constitute too narrow a focus for semi-rural Alaska. For a sample, see:</p>

<p><a href="http://www.psychotherapynetworker.org/index.php?category=magazine&sub_cat=articles&page=1&type=article&id=Crisis%20Land%5B/url%5D"&gt;http://www.psychotherapynetworker.org/index.php?category=magazine&sub_cat=articles&page=1&type=article&id=Crisis%20Land&lt;/a&gt;&lt;/p>

<p>With regard to prestige: when speaking with your parents and friends you could emphasize the clinical and challenging nature of the social work that you are considering (as well as your demanding Bio minor and heavy course load). </p>

<p>You are also concerned that your plan would require you to opt out of being fully prepared for application to a DPM program. Am I right, though, in thinking that you see being a social worker as a better fit for your personality than being a podiatrist?</p>

<p>Lol, podiatry as a personality fit.</p>

<p>Why exactly do you want to work in Alaska? I'm not bashing you, just curious. Have you spent much time there, do you have family connections there? Basically, what I am asking is, do you understand the reality of semi-rural Alaska or are you romanticising the prospect of living there? </p>

<p>Also, is there any way you can put off this decision until after you shadow some DPMs this summer? Don't make this choice in a rush, if you can help it. After this summer, things might be clearer for you - you will hopefully know for sure if you want to be a podiatrist. </p>

<p>In addition, could you not pass on the Indigenous Studies BA and take more bio classes that interest you? While I can see it would be useful for you to have it, if you study for the MSW at Anchorage you will presumably have the opportunity to interact with your target population first-hand anyway.</p>

<p>Mean two-year RN salaries in Alaska are now well over $60k; for BSNs a little bit higher (they often go into different fields where the wages are not necessarily higher, but the working conditions may be better, like school and public health nursing); MSN mean salaries are in the high 70ks. Nurse managers with MSNs can expect significantly more.</p>

<p>Just curious: Would you please be more specific about WHERE in Alaska ( names of towns would be helpful) you see yourself practicing?</p>

<p>Thanks for all the wonderful replies!</p>

<p>To address some points (haven't quite got the hang of the quote thing yet):
-Nursing doesn't particularly interest me; it seems too general, for lack of better word. I like the idea of a DPM degree because podiatry is so medically specific and focuses on areas of interest to me--yes, I'm weird enough to be interested in the foot, I'm afraid. It's hard to explain, really, but I've always just got this feeling from researching nursing and meeting nurses that it just wasn't/isn't what I want to do with my life--the exact opposite gut feeling I get from my experiences with podiatry and, now, social work.</p>

<p>-I got out my spreadsheet and course catalogue and tried fitting in DPM pre-reqs with BSW coursework and was a tad saddened at the result. Like the dual biology and BSW degrees, it is theoretically possible but most likely practically impossible, as it would require taking A&P, which has a 70% failure rate at my school and OChem together on a 20 credit load, which doesn't sound all too doable. Also, it would mean that my sciene gpa would be based on relatively few credits, with chem/ochem and A&P counting a huge portion of the GPA. I'm not saying I can't do well in those courses, as I dearly hope I can, but it worries me, to be honest.</p>

<p>-One of things I really love about social work is that has so many possibilities. My interests lie in clinical work, notably health and LCSW counseling, but I like to know that I would be equipped to handle any number of situations and jobs.</p>

<p>-I could probably fit in a biology minor and BSW with any number of BAs in my school (psychology, indigenous studies, English, environmental stuidies...you name it) and even a few BS degrees. The problem mainly comes up with fitting in the intense lab courses, namely OChem, and I won't really feel comfortable taking OChem on a 19 or 20 load.</p>

<p>-Could I dely my decision? Perhaps but with the first year students registering soon, I'm worried classes I will need might fill up, thus making whatever plan I choose impossible in four years and leaving me in an unpleasent financial situation.</p>

<p>-Do I lean more towards social work? I don't know, to be honest. I love biology, truly, and I love the idea of being medical professional, especially a podiatrist, but at the same time, I'm drawn to the human aspects of social work. I like both options but for very different reasons, and that's what making this such a struggle--I can see good AND bad in both.</p>

<p>-I've never lived in AK, but my family's always been the cold, outdoorsy sort who lived in a big city because, well, that's where one lives with an engineering job. I spent a disproportionate share of my childhood camping, and my family would go to small towns or camp grounds in lieu of going some place big and touristy--we went to Disney World once, looked at each other and pretty much decided we really didn't need to bother with amusement parks anymore. I'm also one of those oddballs who can go out in 20 degrees and be fine with it but who cannot tolerate high temperatures. I know semi-rural AK isn't all cute Inuit children or Coke-drinking polar bears, and I know there will be some problems, but honestly, some cold and rural appeals to me the same way NYC or London appeals to more straight-head folks. </p>

<p>I am looking to get a job, research, or volunteer work up by Sitka for the next summer, so I hope that'll give me some first hand experience in the area.</p>

<p>Again, thank you for all your advice!
Again</p>

<p>crabbylady,
I just saw your post. I don't now yet, exactly, but I'm thinking of the southeast (Sitka and the area around Juneau). However, I also might have the opportunity to spend time in the areas around Nome and possiblly Anchorage, so it may be that something in those regions may grab me as well.</p>

<p>"-Nursing doesn't particularly interest me; it seems too general, for lack of better word."</p>

<p>So much of nursing, especially rural nursing, these days IS social work. Whereas looking up from some folks' bunions....</p>

<p>Well, to each her own.</p>

<p>Totally_lost : I live in Anchorage. I am a retired neo-natal intensive care nurse with a BSN + MPH. My husband is a PHS/IHS physician here. Maybe you should consider an MPH? </p>

<p>I can tell you from personal experience what you don't want to hear - the greatest need in rural/semi-rural America - not just Alaska - is for nurse practictioners and teachers. There is alot of social work involved in public health nursing and the pay is better.</p>

<p>The population of Sitka is approx 9,000 - they have one podiatrist. Perhaps you should contact him regarding an internship. Native health care is a whole different issue.</p>

<p>BTW Sika's history is Russian and Tlingit. The climate is more wet than cold. Remember when you are planning your visit, Sitka and Juneau are only accessible by sea and air - Nome only by air. Also polar bears are circumpolar in the northern hemisphere. They are the top predator of the Arctic marine ecosystem.
.
Alaska is an amazing place to live and work. The population is very diverse. But this is a very expensive place to get in to and get out of. Both of my daughters attend East coast schools - they need 24hrs + for travel time.</p>

<p>One last thing - Visit Nome in mid March when the temp is minus 20 and the wind chill freezes your nose hairs - to celebrate the finish of the Iditarod Trail Sled Dog Race. I am CERTAIN you will find some tired feet in need of attention. </p>

<p>Study what you love.</p>

<p>mini,
To eleborate, I have some physical issues that would make the some of practical aspects of nursing hard for me (i.e., moving patients), so that would probably make it difficult for me to be in that field. I believe these issues could be worked around in podiatry a lot more easily, though I'll have to ask the pod I'm shadowing for specifics.</p>

<p>crabbylady,
Thanks for the info! I've looked into dual MSW/MPH programs a bit, but given the already low salaries plus Alaska's legendary high cost of living, I'm weary of spending more time in grad. school than necessary.</p>

<p>I've heard the market for MSWs rural/semi-rural is pretty good right now, though pay, as always, can be a problem.</p>

<p>Actually, I have a friend from Nome, so I may actually go back with her for spring break one March and experience that for myself!</p>

<p>I think there may be full-tuition scholarships for people going to med school and willing to work in rural, under-represented areas of the country. You should look into that if you're worrried about costs.</p>

<p>bump for any other advice....</p>