It’s ridiculously expensive for one thing:
The answer is that we have priced a medical education well beyond the reach of most middle-class students. In 2004, tuition and fees at a public medical school averaged $16,153. Students who attended a private school paid $32,588 according to a 2005 study published in The New England Journal of Medicine.The author, Dr. Gail Morrison, Vice Dean for Education at University of Pennsylvania School of Medicine, tacks on $20,000 to $25,000 a year for living expenses, books and equipment to calculate that the total cost of four years of medical education comes to a heady $140,000 for public schools and $225,000 for private schools. I’d add that, in many American cities, students would be hard-pressed to cover rent, food, clothing, utilities and transportation for $20,000 a year””let alone books and equipment.
With reimbursement pressures at the forefront, any wonder why many of the best and brightest are thinking twice?
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How TRUE!!! To top it all, the AMA artificially regulates the number of students accepted by Medical schools. It is happening now-people travel abroad for treatment and students study abroad to be doctors. What a SHAME.
I have many friends who were equally gifted with intelligence and an ability to work hard, despite wildly varying backgrounds.
All of us began with passions in high school and then college. Those of us who had the most common sense went into finance, where all are happily living a life their parents couldn’t have imagined. Many of my other friends went into law school, with dreams of immigration law and working in NPOs to change life for the communities they came from. A few more settled on health care.
Now my bright, dedicated friends who didn’t choose a career are looking at four years of undergraduate loans, three years of law school loans, and applying to corporate positions instead, because they can’t keep their head above water.
Those of us who went to medical school (my tuition is higher than the average) are forced to make specialty choices based on money, not just inclination. I think I would have liked being an internist. I sincerely doubt that’s where I’ll be — 200k of debt, accumulating interest starting a couple of years ago, will take maybe two decades of my working career, and that’s assuming no family to support. I’d still choose medicine, but that doesn’t mean I forgot basic financial sense along the way.
I did apply to state schools (my top choice), and interviewed at several. They declined, and so I chose a private school because there are only so many years you can defer four years of school and at least three years of low-paid training. I have a theory that all older medical students come from upper middle class or better backgrounds, because how else could you make that choice?
Every time I hear that we should be paid at the same level as our European counterparts, I shiver. I’ll accept that income level happily…when the government forgives my medical school loans and ups resident salaries to more than a retail hourly wage. Give me that, I’d happily accept the compromise.
Of course. It’s not worth the hassle.
You just linked about surgical chatter in the OR in another post just now. The first thing I noticed was this:
“Me, I have my dog, nieces & nephews, and neighbor’s children.”
No kids. It’s not really realistic to have kids as a female surgeon, is it?
Let’s not forget that going the traditional route -> 4 years undergrad -> 4 years med school -> ~4 years residency.
That’s 8 years of student debt piling up thanks to interest, plus you don’t actually start making money until your early thirties. During this time, most of your friends have graduated from school, started procreating, bought cars and started actually living their lives. While you’ve been slaving away in residency.
God help you if you’re not a specialist or didn’t get a free ride to school.
What a crap lifestyle. Money != lifestyle, which is what most people forget when they start talking about “rich doctors”. Things like having children, a meaningful relationship with a partner, and having a life are what comprise lifestyle.
I’ll stick to pharmacy, thanks. I can make more money than you primary care doctors, and there’s a real separation to work and home life.
I think that as business proposition and investment of 225,000 over 4 year into a medical degree is an excellent investment. In that the holder of the degree will generate over a 20 year carrier something on the order 6-8 million dollars in gross income. The student will be in a profit position his or her first year in practice and can pay off the 225,000 over 10 years at below market rates. This is what most business do although they have to pay market rates. They invest and look at the long term.
I think that the “best and brightest” in the US are more inclined to want to make more then the typical family practitioner makes which is 160,000. link to salaries http://mdsalaries.blogspot.com/2005/10/family-physician-salaries.html The specialists are in the 200,000 plus range. While it is true that starting salaries are 20-25% lower in all cases these starting salaries are over 100,000 per year. This does not cover doctors who have their own practice.
As to the term “best and brightest”. Where did the idea that a medical students have to be among the “best and brightest” come from. I bet the AMA public image polishing depart.
There is to my knowledge no minimum intelligence requirement set by American medical schools for entry in to a degree program.The students need only prove that they answered correctly 70-80 percent of the courses test questions.
It’s my prediction that Lipitor will be an irrelevant drug by the time its patent runs out in 2011. The only real place I see for it is with those that have compliance issues who can’t remember to take their simvastatin at bedtime as opposed to in the morning when they presumably take their other pills.
And perhaps for those doctors who wish to play games with QOD dosing. But you don’t see that very often.
We’re seeing a huge shift from Lipitor to generic simvastatin, fueled in large part by form letters by insurance companies to doctors asking them to switch. Perhaps you’ve seen them?
When there are fewer applicants then the exceedingly few spots that the Flexnerites have allowed to exist… then you might have a reason to raise an alarm. Until then, providers will continue to have highest median salaries of all fields of endeavor.
UK GP’s make about 100,000-pounds a year.
What’s the pound running, about two dollars to the pound?
In regard to the calculations above, I graduated in ‘86, and had earned approximately 2,060,000 from that date through the end of 2006. I earn about average for my specialty, some years a tad more, some years a tad less. If I work full-time over the next 20 years, I’ll make slightly over 3 million in my specialty over that time.
I managed to finish med school with modest debt, about 20,000 (about 40,000 in todays dollars), due to sneaking in some part-time work, food and furniture donations from family, and a working spouse for the last couple of years.
It probably works out on paper as worth the 120,000 debt that some were accumulating at the time, but I would not have thought so and would not have done it. For one thing, the motivations for a medical career are many, and one of the stronger ones in my case was the opportunity for geographic and business independece. Debt is slavery and would have limited my options for serveral more years to the point that it simply wouldn’t have been worth it.
I have friends that I went to high school with who are taking retirement from firefighter jobs already and actually live in nicer homes than I do. They never made the money, but becasue the money was secure, they felt free to spend to the limit of their borrowing capacity. Also, their spouses could work while they coordinated their schedule with her for child care–something much more complicated for the spouse of a physician who is on call all or half the time. Financially, they are really much better off at this point. I will “beat” them eventually, but they will meanwhile have had all those years fishing.
Bottom line: the best reason to become a physician is if practicing medicine is what you want to do with your time. With respect to money, we are neither over nor underpaid for what we do, and you can do well in other things if you put just as much into it–maybe much better. Be a doc if you want to do what a doc does, otherwise, do something else.
The cost issue of medical school isn’t the only thing limiting apps. The cost of undergraduate has skyrocketed even more proportionately. Investing 4 years and 180,000 in a premed education just for the chance to apply to med school, and be left with a useless degree if you don’t get in, is an even more quesitonable proposition, especially when for the technically proficient, and engineering degree will offer an immediate high salary.
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