<p>I have been following this thread and will sometime write more. </p>
<p>I just want to say that having been in medicine for 30 years, in both practice and working for a hospital, I would say that it is a rather difficult field right now. The reimbursements are low, and one has no power in one's life, as the hospital administrators and insurance companies control your life. I teach medical students and residents daily and most of them have 250,000 in debt, which is crazy.</p>
<p>Many are from immigrant families and this will establish them in US society.</p>
<p>Would I recommend it? A big flat NO. It is not worth it at any price. And the younger doctors who work for the hospital are just as frustrated.</p>
<p>This all depends on which specialization in medicine one wishes to pursue. I know that in the case of the field of laboratory medicine/pathology, it's basically regular working hours with limited, if any, night call, and even though they're not treating patients in terms of a doctor-patient relationship, they're still MD's, and their role is extremely valuable in terms of providing very important information to other physicians.</p>
<p>My--I will say, though you don't have to believe it-- brilliant former MD H is a very, very, happy HS biology teacher. And I think he's using his brain as much, if not more, than he did as a physician.</p>
<p>He says also that if he'd wanted to stay in medicine, he probably would've been better off being a nurse or PA. Doesn't have the ego which needs to be the guy in charge, and would've made more per hour, and had better hours. </p>
<p>There's been a lot of complaint about "discouraging" attitudes here. I'm just describing our lives. If anyone doesn't like it, feel free to skip my posts. Again, he was in primary care. Maybe the take home message is that that is where the conditions are the worst--tell your kids to be specialists. We don't need no stinkin' family docs, anyway, right?</p>
<p>"This all depends on which specialization in medicine one wishes to pursue. I know that in the case of the field of laboratory medicine/pathology, it's basically regular working hours with limited, if any, night call, and even though they're not treating patients in terms of a doctor-patient relationship, they're still MD's, and their role is extremely valuable in terms of providing very important information to other physicians."</p>
<p>I actually have had no problem with working a lot of hours, even long hours and I never minded taking call. Medicine has just has become a tremendous amount of work for the amount of salary and hassle involved now.</p>
<p>Lots of doctors also really do like to see patients, not tissue samples or dead bodies needing autopsies, so you do have to want to give up the patient interaction to go into pathology. This may be a good field for someone with limited social skills.</p>
<p>
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Medicine is becoming a cookbook field. The creative brilliant person will not be PERMITTED to act upon her brilliant ideas. She will be forced to do things the usual way, or else. So her brilliance will be wasted, and her ambitions thwarted.
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<p>totally agree with this, too. My H would probably, though not using the word "brilliant" (only I will :)), felt this. Follow the algorhythms, or else. Unfortunately, that cookbook thinking is starting to infect teaching, too. Maybe, don't go into whatever field he chooses? :(</p>
<p>If you factored in the payments for the $250,000 debt paid over 20 years by a doctor who earns $110,000 per year (what a primary care internist could realistically start at after 3 years of residency) and compare it to someone making $70,000 in another field who has no debt payments, I think the disposable income would be at least the same for the person without the debt. Plus they would start a career many years sooner than the doctor and have the extra time to save and accrue interest.</p>
<p>Wow, this is so topical for me. D1 is finishing her BS physics in May and though she has applied to PhD programs in biophysics (and will probably get 1 or more offers), has informed her real desire to go to Med school. I don't know what to think...as the wife of research physicist, I know how difficult funding in basic science is and the awful compromises a researcher has to make to survive in business/academia. But I keep hearing that the state of medicine today isn't a whole lot better. (OK, maybe job security is better. )</p>
<p>I'm sure she won't end up in primary care or emergency medicine. She's thinking probably radiology or maybe in radiation oncology since she is more interested in imaging techniques than patients. And given her physics training, feels that probably it's a good match. (I know that things can change once she starts in her clinicals..)</p>
<p>D has made an effort to educate herself about the profession. (Done rounds at the local teaching hospital, worked as a paramedic.) But still I'm conflicted about what would be best for her. Her dept advisor has encouraged her to look into the MSTP and there is a state-specific fellowship for MD-PhD she'e eligible for...</p>
<p>But I don't want her to be miserable AND spend the rest of her life in school</p>
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I don't know what to think...as the wife of research physicist, I know how difficult funding in basic science is and the awful compromises a researcher has to make to survive in business/academia. But I keep hearing that the state of medicine today isn't a whole lot better.
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<p>We have a whole testy thread going right now where folks are screaming that we need more science and engineering types and less "Liberal Arts" folks and focus (let's forget that it's Liberal Arts and Sciences. It seems they do.;)). They feel the American Colleges and Universities are not adequately preparing our children for the present, much less the future. And then we have this thread. Jiminy. Raising goats is looking good. Maybe there is a way to combine goats and Ebay.</p>
<p>Unfortunately, pathology and lab medicine is one of the most affected by the changes in medicine. It is largely centralized, very little independent initiative possible by the physicians in that field. Yes, the working conditions can be made reasonable, but this gets back to what sort of person wants that kind of job. An ambitious person would have to be crazy to go into pathology now. Someone whose main concern was regular hours, might be fine.</p>
<p>
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Again, he was in primary care. Maybe the take home message is that that is where the conditions are the worst--tell your kids to be specialists. We don't need no stinkin' family docs, anyway, right?
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<p>This has been the trend for the past few years. US allopathic seniors are going into higher paying specialties while the primary care void is being increasingly filled by IMG's and DO's.</p>
<p>Whoa is me!! Radiation oncologists average about $400k with top salaries about twice that amount. It is weren't for managed healthcare and hospital administrators they could do even better and justify the years of study.</p>
<p>Much of the primary care can be done by "physician extenders", like nurse practitioners. Not clear that there really is much need for primary care physicians. Once people's problems get too complicated for the extenders, they may be better off going to specialists. </p>
<p>Part of the drop off in interest in primary care has been in response to more recent research. A while ago the message to American medicine was that there were too many specialists and too few generalists. This was supposed to lead to over testing, over treatment, high expenses, and not enough primary care or prevention. There were huge pushes to get med students into primary care, fueled by insurers belief that this would cut costs. Then research started coming out showing that for many conditions the treatment offered by specialists was not only better, but cheaper. Now there are people who went into primary care who realize they were sold a bill of goods. </p>
<p>For someone with a BS in physics, headed for medicine, diagnostic radiology is a great field. Definitely will benefit from the background. I don't think the physics is nearly as useful for radiation oncology. They have physicists who do the dose calculations, the MD's role is more in understanding the biology than the physics. They need some general understanding of the radiation properties and effects, but anyone who completes the premed requirements knows enough physics for this. </p>
<p>As a match to a physics background diagnostic radiology is perfect. As a career, it is uncertain. It is rapidly being outsourced, and by the time she finishes training it is possible that most jobs will have moved to Bangalore- unless the pay scales have gotten too high there, and the work is sent somewhere else.</p>
<p>Not to quibble, but figures for radiation oncology are somewhat high for mean, and the "top salaries" are meaningless as a representation of what someone might expect to earn. </p>
<p>Someone brought up computer science earlier. Top range for CS drop outs is networth of $52B.</p>
<p>I suppose the more important bit, for the physics student or anyone one else interested in science and looking at medicine, would be to fully research the career options and figure out if they're comfortable with the level of room for intellectual curiosity and stimulation on the job. </p>
<p>I only say this because most people that have an interest in science want to be in an environment that encourages exploration, experimentation and intellectual challenges and, as several folks have point out, medicine can be a bit of a 'cookbook' science... both because that's the way the field is structured and because of legal and liability issues. </p>
<p>I love watching the TV drama House and of course that show makes it seem like the day-to-day life can be full of all sorts of exciting diagnostics and rogue experiments. However, of course, if anyone like House actually existed in real life they'd be fired, locked up, and facing tens of millions in malpractice suits. I'm not saying I agree with that, but I don't think anyone can really deny that that would be the case.</p>
<p>When you're working with human lives (and have teams of administrators and lawyers watching your every move and ready to pounce if a mistake is made) a physician doesn't have the same amount of freedom to experiment and explore that a normal researcher has and thus the more cookbook approach to issues. A normal, non-clinical, scientific researcher has the intellectual freedom to try all sorts of wacky ideas and experiments with the worst outcome generally being some time or a broken piece of equipment. </p>
<p>Therefore the transition from the freedoms of most scientific research into the highly restricted and regulated clinical environment can be a big shock for some and something the must be prepared for and understand what they're getting into ahead of time.</p>
<p>Just something to think about for a student that has an interest in research... again it's all about personal choices and preferences so as long as someone knows what to expect and makes an informed choice then there's a good chance they'll be happy with their career.</p>
<p>I am not sure how representative this is, but an MD I currently work with worked as a researcher at a top 10 research center for several years and found that he was not able to get the grants and projects he wanted as opposed to the PhDs he was competing against. This was for bench research. He trained in his 40s for a subspecialty and is actually now doing generalist hospitalist work and not really using any of his training. I think he has been unable to reach his potential and has given up. He is happy otherwise with his personal life, which buffers his disappointment.</p>
<p>As to diagnostic radiology, there is no reason that films and Cts need to be read in the US, as it is cheaper to read them overseas. This is the way medicine works now.</p>
<p>nameneeded,
In reference to your quote with reference to pathology "this may be a field for someone with limited social skills", I have to laugh, because in the past 30+ years, I have met many physicians, residents, etc. who specialize in laboratory medicine and nothing can be further from the truth on that point. The pathologist has to be able to have a respoire with not only the laboratory staff but also other members of the hospital faculty, etc., and don't underestimate the value of this specialty. They are the "doctors doctors" - they're the ones who call the shots in terms of a specimen being benign or malignant. There is no room for mistakes. Physicians who pursue this field are most likely at the top of their medical school class.</p>
<p>I know plenty of pathologists. It is a field that was always easy for doctors with limited language skills, such as some of the earlier foreign doctors, as well as those who did not want to "meet the public." It is always easier to interview a dead patient.</p>
<p>Being charming and smiling at colleagues is much different than the daily social skills needed to see 25-35 patients a day in 8 hours and relate to them. </p>
<p>I don't have the residency match statistics for pathology, maybe you do? It never was considered a particularly competitive field like Derm or Plastics.</p>
<p>It's not that path doesn't have a social component. It just doesn't have as much a social component as other specialties. 49% of path residents are graduates of international medical schools. That indicates to me that a) it is not uber-competitive and b) social skills are not as important.</p>
<p>Path is pretty competitive though (comparing it to derm or plastics is unfair).</p>