Is Being a Doctor Worth It Financially? Not as Much as You May Think

In this article, I want to explore the question: is being a doctor worth it from a monetary point of view? And if it is worth it, how much is being a doctor worth?

If I ask you to think of a high paying profession, what is one of the most popular answers that come to your mind? Doctor. Physician. Those are very default answers that do not take too much thought.

Before I can supply the answer to “is being a doctor worth it,” I will first explain how I arrive at the conclusion. This way, you can see if my answer if reasonable or not.

Calculating the Value of Being a Doctor

I want to compare exactly how much more money a doctor will make compared to an average college graduate. I want to factor in the cost of medical school tuition, residency, and ultimately salary as a doctor.

My background is in business, more specifically in finance and accounting. So I will be doing some financial calculations, such as net present value (NPV), compounding rates, etc. The calculations could be a bit confusing if you never had exposure to this kind of stuff before.

If you want, you can scroll down to the last paragraph. You can find the answer to “is being a doctor worth it” there.

is being a doctor worth it - no yacht yet

If you are a doctor who recently graduated from medical school, do not expect to own a yacht like this one anytime soon, if ever.

But if you feel like you can follow me, and I’ll try to make it as easy as possible for you to follow me, continue reading.

Making Some Assumptions

So let’s define some of the assumptions I am going to make.

  1. The tuition to go to medical school each year is $30,000. The amount will remain the same each year. In reality, tuition (at least for my school) is increasing at a higher rate than inflation. For 2012 – 2013, tuition will rise 5% to almost $35,000 per year.

  2. An average college graduate will make $40,000 per year for the rest of his or her life. This seems pretty fair. Some college graduates will be working as baristas in Starbucks while other will work as engineers in Boeing.

  3. I estimate the tax rate to be a flat 25% for someone making $40,000 per year. Therefore, the after-tax pay is $30,000. Each year, there is an opportunity cost of $30,000. If you did not go to medical school, you can expect to take home $30,000 each year. So the after-tax amount will be added to the tuition every year. It will also be subtracted from the salary earned as a resident and as a doctor.

  4. The interest rate for the cost of medical school, which consists of tuition and after-tax salary (opportunity cost), is 6.8%, compounded monthly. I based this on the rate of the unsubsidized Stafford loan. There will be no subsidizing of the interest because as of 2012 – 2013, there is no more subsidized Stafford loans.

  5. Salary during residency will be $40,000, the same as an average college graduate. Residency will last for 3 years, the minimal amount of time to complete residency in family medicine.

  6. Salary after residency, as an attending, will be $150,000 per year. That is a fair amount for a family medicine doctor. You can argue that more than half of the people specialize and make more than $150,000. I will counter-argue that people who specialize make more, but their residency is longer. So the cost of medical school will have more time to compound. Without doing any calculations, I will say that the specialty’s higher pay with a longer residency has the same financial benefit as the general medicine’s lower pay with a shorter residency.

  7. I estimate the tax rate to be 33% for someone making $150,000 per year. The higher tax rate is due to the higher salary. So each year, you get to pocket $100,000 as a doctor, after taxes.

Setting Up the Amortization Table

With that being said, here is how the amortization table is set up.

is being a doctor worth it - table 1

Figure 1 – Is Medical School Worth It 1

Row 1 basically represents your four years of medical school. Let’s assume that you will start medical school in July 2012. Your loan and your opportunity cost will begin on 07/01/12. If you take a look at row 1, you will notice that you are taking on 8 semiannual loans. Your yearly cost to attend medical school is $60,000 ($30,000 for the tuition and $30,000 for the after-tax pay opportunity cost). Therefore, your semiannual cost to attend medical school is $30,000. I did not include the cost of living because that is a cost you would be paying regardless if you were in school or not. And I am trying to make this model simple.

Row 2 represents your time in a 3 year residency. You will be making a salary as a resident, but that is the same as the amount you would make with a college degree. Therefore, your salary is canceled out by the opportunity cost.

Row 3 represents your salary as a doctor who is done with residency. Your after-tax pay as a doctor is $100,000. But if you subtract the after-tax amount of $30,000 you would have made without a MD or DO degree, you are left with $70,000. That comes out to $5,833 per month.

Row 4 is just the last payment you would make to complete the cost of a medical school if $5,833 was used to pay down the loan and opportunity cost each month.

Interpreting the Amortization Table

Basically, with my assumptions (which I believe are quite fair), it would take you 13 years to catch up financially to a college graduate who did not go to medical school. So if you started medical school when you are 22 years old, you will finally catch up to your college buddies by the time you are 35 years old.

So for each year after you have caught up to your college buddies, you will be $70,000 ahead, as long as you continue to work. I estimate that you will enjoy about 40 years of excess salary. (You catch up finally at age 35. Since medicine is supposed to be a life-long dedication, you decide to continue working until you are 75, which is roughly the average life expectancy of a person living in the US. That comes out to 40 years, with an excess of $70,000 per year. You weren’t thinking about retiring, were you? What do you think? Is being a doctor worth it now?)

An extra $70,000 per year does not sound too bad right? No, it does not. But what is that worth in today’s money? Basically, I want to know the net present value (NPV) of the excess salary. Let’s assume an interest rate of 5%, compounded monthly. That is the rate of return an average college graduate without financial knowledge should get on his or her investments.

is being a doctor worth it - table 2

Figure 2 – Is Medical School Worth It 2

is being a doctor worth it - table 3

Figure 3 – Is Medical School Worth It 3

If you take a look at “figure 2 – is medical school worth it 2,” you will see that the future value (row 2) of an extra $5,833 per month (or $70,000 / 12 months) is the same as the future value (row 2) in “figure 3 – is medical school worth it 3.” From that future value, you can calculate the net present value (row 1 of “figure 3 – is medical school worth it 3″).

With that being said, the financial benefit of becoming a doctor is $634,922.65, a bit more than half a million dollars.

Is Being a Doctor Worth It Financially? The Answer Is …

The answer is that being a doctor does have financial benefits. But it is not as much as you think. You will be around $600,000 better off compared to the average college graduate. Maybe it is just me but an increase of $600,000 in net worth does not exactly strike me as being rich. And you must take account of the following factors to determine your answer to “is being a doctor worth it”:

  • You will work your butt off. I had more free time when I was working 60 hours a week than right now in medical school (at least for the second year).

  • Your life will revolve around medicine. You will need to take Continuing Medical Education (CME) credits to stay up-to-date.

  • You will re-certify for the boards in your specialty every 7 to 10 years. The examinations will never end.

  • You will work until you are 75 years old. If you work less, your financial benefit will likewise decrease.

On the bright side, since there are so few doctors, especially primary care doctors, you will never be out of a job. At least a medical degree is not like a law degree. You can still get ahead financially with a medical degree. The same cannot be said for a law degree.

So bottom line is the road to wealth and riches is not through medicine, unless you are currently unemployable without a medical degree. Being a doctor won’t make you a millionaire in today’s money. And that $600,000 amount is subject to change too. If you can make more than $40,000 per year straight out of college, your financial return by being a doctor will decrease. If you are bright enough and hard-working enough to get into medical school, you could probably do pretty well in another field too. If tuition increases while doctors’ salaries remain the same, your financial return will decrease. If doctors’ salaries decrease, your financial return will decrease. If you retire early, your financial return will decrease.

Is being a doctor worth it for me? From a monetary point of view, I say, “No.” Why did I pursue medicine? I am hoping that the rewards of working with patients and being able to make a difference for the better would make being a doctor worth it. I’ll let you know my final answer in about 10 years.

So is being a doctor worth it for you? Only you can decide the answer.

This article is part of the Money in Medicine series. Click on the link if you want all the money-making secrets available to doctors.

Comments

  1. Chris Priestly says:

    Thank you so much. I find myself thinking about my future more and more every day. Some days, I feel comfortable, and others, I’m worried. I am a sophomore in undergrad, and I am trying to figure out a plan for my future. I wish it was easier. Easier to provide for your current/future family, easier to fulfill the burning desires in your heart. But I understand that with success, comes hard work, and sacrifice.

    Thank you for taking your time and writing this article. I’m sure it was as helpful to many other people as it was to me.

    • Hey Chris,

      I am very glad this article helped you. It is true that no matter what you do, you will need to work hard and sacrifice to reach success. Even when things are hard, don’t give up. Let me know if you have any questions.

  2. Hey Alex,

    Great article and blog! I agree with everything you said above in your blog. The salary of $150,000 I would say is a bit low, but like you said with extra training and lost income (as a college grad) it should’t throw the scale off that much.

    I’d like to get your thoughts on my story if you don’t mind. I actually started off wanting to be a CRNA. I have a few friends that do it and make great money $150,000+. I thought it wouldn’t be as rigorous as medical school and was a great balance between making great money and having time to do the things I want. Like you, my first love is business. I started my own business doing house cleaning at 18, and still do it to this day. Like you, when I was in nursing school there was zero teaching about money – since at the end of the day it is a business. It bothered me. I asked myself why I was here. It was the money, the job security, the prestige that i’d have of being a medical professional that puts people to sleep. The problem is every day I continued to dislike it more and more. I started to HATE it. There would be people in class that would love this stuff and I’d be force feeding myself it with a solid GPA thankfully of a 3.93. It got to a point in January of this year where I said to myself I can not go on doing this and I dropped out and switched my major to a dual major in accounting and finance.

    I will not lie, I have a few regrets. I have always loved science and business together. I feel as if I was just burnt out and should of given it more time. I feel that in the end it might of been worth it. But I go back and think to myself that in the end, if I do not enjoy what I am doing as a career that there is no amount of money that can make me do that.

    I found your blog because I was thinking of doing the med school route and thinking that nursing school might be way different then med school. The scope of autonomy is sure different. However, I have read your articles and perhaps the experience is not all that different.

    My short term goals are to finish my degree I’ll be 24 – a little mad about this. But I will graduate Suma Cum Laude and be continuing to grow my business. And Gods willing by late 20′s be able to live the monetary and rewarding life style I would have as a CRNA or a doctor.

    Sorry for such a long post. Let me know your thoughts. Take care and God Bless!
    -W

    • Alex Ding says:

      Hey Will,

      Your story mirrors my own in many ways. I am very impressed that you were able to start a house cleaning business on the side. At the very least, it will teach you a bit about business. Would you be willing to talk about that a bit more? As in how you find clients, how you find employees, if it is financially rewarding, etc?

      CRNAs do make good money. And from what I have seen in the hospital, they like their work. They have shift work; they even change shifts during surgery! The nurses have really good unions. You definitely can’t change shifts as a doctor. But the question is: Would you be happy just coasting along for the rest of your life?

      Regarding school, it really sucks. And I totally feel your pain. Some of my classmates lap up school like a fish with water. Personally, I cannot stand it. I have thought about dropping out many times, but it is too late for me. I have already invested six-figures into my education. I might as well just finish it and be a doctor.

      If you regret your decision to drop out, could you go back? How much more training would you need after a nursing degree to become a CRNA? If you do not like nursing school, you will definitely not like medical school. You will be learning the same stuff, but with more details, memorization, and BS.

      If I were you, assuming you are graduating with a bachelor degree, I would not go to medical school. Instead, I would immerse myself in business. And I do not mean textbook, MBA-style business. I mean school-of-hard-knocks business. Grow your cleaning business. Start another business. You will fail, maybe even quite often. Even with your failures, you probably wouldn’t owe six-figures in student loan debt that is nondischargeable in bankruptcy. You would have received an education that is many times more precious than one you can get from medical school. However, each failure will bring you closer and closer to success. You keep doing this for 4 years, you will very likely make a whole lot more than doctors.

      But if you are the type of person who is unable to constantly learn and take risks, then maybe it would be better for you to become a CRNA or doctor. With what I know about you, this path will be very miserable.

      • Hey Alex,
        A lot of what you said makes sense to me. Like you said the CRNA’s do make great money, shift work, etc…Heck I know a few guys who were 26-28 making near $200k with over time. I made so many connections with CRNA’s and networked like crazy, got the grades to get in nursing school…It just got to a point, however, where I just was hating the material and became depressed that I might live a life hating what I do. I know I would have always longed for more to do and get involved in business one day. Yeah, business is very risky, but one good idea and a solid plan of attack could really work out for someone. For me, I look at my 20s as a time to “not screw around” and take the bull by the horns and make something of myself and thats what I plan to do.

        Regarding the cleaning business, it is something that can be quite lucrative actually. I’m happy now because I can finally put in most of my focus into it and other business ideas that I have. Whereas before, I could not give the effort I needed to make it work. In short, it can be very good. I live in an upscale area where most homes are upper middle class. It is not unusual to have someone have their house cleaned every month or every two months and pay $125-$200 for each visit. Translated into a year, that customer can be worth $600-$1,000+ per year. It doesn’t have to stop at interior cleanings, during the summer many clients have pools of which we can clean as well. The two good things about this business are: 1. Residual income – Providing you do good work, you should get paid every month or at least every year from the single customer. 2 – I try to give the best service I can, catering pretty much too all their needs so they stay with me for life. Very rarely will a customer leave you if you show those things. I got customers by initially flyers, but then it turned into a referral thing. For example, I just had a customer who are older individuals recommend me to their daughter of which I got the business. If you think about it though, if you can scale it massively to 500 or a 1,000+ customers, hire out staff reasonably it can really be a home run.

        Regarding the nursing school thing for me, it still is an option on the table. I wouldn’t be able to return until next winter which is when I left. So from now until basically the end of the year I will get a real honest chance and opportunity to try business so to speak.

        By the way, if you have any questions feel free to shoot me an email anytime. I’d love to stay in contact. Here’s my email – saleen1101@gmail.com

        Talk to you later.

  3. I’m a registered nurse and coming from a family of doctors, I was influenced to pursue medicine by the very first day I got to handle a patient. My 2 uncles are both physicians, an orthopedic surgeon and a family medicine doctor. However, they would not advise me as they know that it is not worth the stress, but yes with the money.
    When I was a junior nursing student, me and my friends would always practice writing a doctor’s orders in our little notes during clinicals. I am a Filipino who had just migrated here in Manitoba, Canada last year. And getting into university here is not a piece of cake. Although it may take time, I feel that this is my calling. But for now, I’ll stick with my designation RN as I contemplate deciding which path to take. Thank you for your very good post.

  4. I am an physcian who graduated med school in 1988. Medical school is a long painful slog. Residency is better because you work in your preferred specialty, but the hours are long. After training, the hours are better than they were, but still longer than for most of your non medical peers. The stress of being responsible for another human being’s life and health, time away from your family, and increasing adminstrative burdens WEAR YOU DOWN. If you become a physician, it is likely you will start to burn out around age 50.

    And yet, physician incomes keep falling. Physicians are increasingly undervalued by society.

    Is medical school worth it? From a financial standpoint, no. You should go to medical school only if you are 110% committed to being a physician for non renumerative reasons….or if you are masochistic.

  5. Michael says:

    Thank you so much for the effort you have put into this website. I’ve found it very enlightening. I’ve been accepted into a DO program and May 15 (tomorrow) is the deadline for my matriculation. I still haven’t made a decision…

    • Alex Ding says:

      Hey Michael,

      Congrats on getting accepted. But now, you have a very hard decision to make. Personally, if I was in your shoes, I would not know what to do as well. Let me know what you have decided.

  6. Cynthia says:

    Well, as a mid career gen X physician also disadvantaged by my female gender (being a mom) I can say with absolute confidence that gong into medicine was a terrible decision. I am not willing to work incessantly and neglect my family. What has not been factored in above are some things I would not expect and non-practicing clinician to understand. Unfunded mandates by government such as electronic medical records and EMTALA (the Emergency Treatment and Active Labor Act, look it up). Salaries are down, when I first started as a board certified internist I made 93,000 a year. 2 decades ago the same doc would have made close to 200,000. The so called Job Security or “you will never be unemployed is a false statement. I have friends who trained with me who took off a few years too be at home with their children, and now they are not able to find a job because they have been “out of medicine too long”. In addition, with the shortage of physicians likely to expand, the work hours horrors will only worsen. For your own well being if you have a chance to get out do it sooner rather than later.

    • Alex Ding says:

      Hey Cynthia,

      Thanks for bringing up EMR and EMTALA, but I don’t think they would affect a doctor directly. Maybe indirectly.

      I am surprised that a board-certified internist makes only $93,000. I know that hospitalists in the NE (which pays doctors lower than any part of the US) makes about $200,000.

      But I do understand your point about job security and the increasing demands on doctors. As I reflect back, I realized that medicine is probably not as financially rewarding as I would have hoped.

      Changing the certification from life-long to every 7-10 years sure didn’t help any.

  7. Chris Knapp says:

    I’m 29 years old and have spent my post college career in finance and private equity. I’ve never really found either field to be personally rewarding and have recently been considering going back to med school. I would need to take the required prerequisites before applying. Does anyone have any insight as to whether or not I am too old to make such a dramatic career change? Also, is medicine as personally rewarding as it seems or is it a grind much like many other high paying professions?

    • Alex Ding says:

      Hey Chris,

      You have pretty much the same background I do, except that you are a bit older before deciding to go to medical school.

      To answer your question, you should NOT go to medical school if you are looking for a personally rewarding job. Knowing the things I know now, I would not go.

      For most people, becoming a doctor means working for someone else. Over the years, government and other third-parties have gotten more and more say over what doctors can do and cannot do. Third parties with no knowledge of providing medical care will dictate what you can and cannot do. They will dictate how much you get paid. Doctors’ autonomy is severely restricted.

      A US doctor is the MOST regulated profession in the world.

      It may be nice to help people, but I doubt doctors can even help themselves. With the yearly increase in tuition, declining reimbursements (and salaries), malpractice lawsuits and insurance, extended residencies and fellowships, requirements for certifications, there is just too many things you have to juggle to keep afloat. I predict that many more doctors will go bankrupt. Already, there are doctors leaving the profession because of dissatisfaction and inability to make ends meet.

      For you, you are going to be set back financially. You will have to take the prerequisites. If you are like most people and attend a post-bac pre-med program, you’ll probably pay $30,000. Then there’s the opportunity cost of whatever your salary is. The program is for two years. It is very like that only by attempting to get into medical school (without a guarantee to get in), you are already down over $120,000 (if you include the opportunity cost of a mere $30,000 annual salary).

      Then there is medical school, which I have explained in this post.

      The ones who find medicine personally rewarding are those who really love their job, in spite of all the crap they have to deal with. I would bet that at least 75% of the current doctors are dissatisfied.

      If you are a yes-man, and ready to jump through any hoops placed before you like a trained monkey, you’ll like it. If you value independence and higher thinking, you’ll hate it.

      But if you really want to go back to school to escape your work, I would caution against going to school. But if you really must go to school, choose medical school over law school or business school. At least there is some kind of ROI, although it quite small.

      • Well, I’ve been debating between law, medicine and teacher’s college. i am 30 years old and do have admission from a law school in the UK, admission from a teacher’s college in Canada, and interview from a D.O. school in USA, all lined up! in terms of law being a bad choice, different people have different opinion. I mean worse comes to worse if I do not get hired in any law firm I would open my own office and get clients. real state lawyers charge a minimum of $1300 for each transaction, and even one personal injury case would bring around $15,000! so in reality I would not need many clients to make money. With medicine my biggest concern is surviving and graduating! I went to pharmacy school, and failing one year after another I decided to quit! still like your opinion. what would you do if you were in my position? lets not forget that the pharmacy school I went to, was one of the highly ranked ones in Canada and insanely difficult school!

        • Hey Marla,

          It seems like you have a lot of options available. I don’t know what I would do in your situation.

          If you failed pharmacy school, do you think you can make it through medical school?

          On the other hand, many lawyers are under-employed … if they are employed at all.

          Starting your own business is a wildcard. You can do well or not, but if you go the business route, do you really need to go to a professional school? In some US states, you can take the bar exam without having a law degree. It may pay off to look into which states and how to study for the bar exam. Once you pass, you can legally practice law and open your own firm — without spending the years and money in school.

          The only way to make a decision is to ask yourself, “What do you love to do?”

  8. Its not just the US…Australia, UK, anywhere…and its also not just medicine…most professions are now heading to the duldrums. Medicine in particular though, entails taking huge risks financially and emotionally everytime you take on treating a patient and if you subscribe to the risk and return equation, the returns are well below par.
    Im an anaesthetist, I make over $500K/year and I think that’s still a poultry sum considering the risks involved in the job. Keep in mind that the average business might run a net margin of 5%, then a turnover of $10M would give you the same income and the business would have a value of $4M based on NI multiples. Whereas, a clinician making even $1M annually is worthless at the end of their career.
    In summary, medicine is now a complete and utter waste of time….it ruins your family life, you personal life, and if you wanted an average life….you can have one with much less risk and headaches.

    • Alex Ding says:

      Hey Alfred,

      Thanks for your insight.

      I totally agree with your point. If I had to do this all over again, I would not be a doctor. I’ll focus on building up a business instead.

      Medicine requires so much dedication and time that it does ruin relationships and your personal health. Sure, the salary is higher than average but the quality of life is lower.

  9. Thank you all for the analysis on the financial value of medical school. I was offered the opportunity to attend a 7 year med program after high school. I believe it would have been financially rewarding as I would likely have been a highly paid specialist. However, I was not interested in medicine and instead attended Harvard on a scholarship.

    After Harvard I was offered careers in finance, consulting, and tech. All of them pay as well as the average salary of a doctor without any further education or investment. However, I felt that all of these careers were a sell-out and did not fit with my goals in life to improve society and pursue creative interests. Instead I became a private consultant to non-profits and government agencies in the tech space.

    Was this a good financial decision? Probably not. My net worth reached a peak of $1 million in my early 30′s but dropped to $600k by my late 30′s due to real estate investments. My income is $150k, less than any doctor, consultant, or i-banker. I have friends in those careers who are millionaires. My dentist buddy pulls in $300k per year.

    However, I work 40 hrs/week and take most Fridays off. I have 7 weeks of vacation per year and telework a couple days a week from the comfort of home. I’ve had time to write a novel, perform as a stand-up comic, and travel the world.

    Most importantly I have not compromised on my ideals. In fact I can say I’ve learned more about health than my friends who did go to medical school and focus on medicine, an industry far removed from health and well-being. The doctors I know are deeply dissatisfied with the state of their industry but powerless to improve it. Some of them have considered quitting to become tech entrepreneurs.

    On the other hand, they have the prestige of being doctors and they do earn more money. A *lot* more money. So it’s a real trade-off. Plus, doctors never go out of business, and the competition is limited, whereas IT is exposed to global competitive pressures.

    If I could do it over again perhaps I’d have looked for a medical program that fit with my worldview instead of rejecting the industry as a whole, although I frankly doubt i would have lasted the 7 – 10 years of my life it would demand. IT has been an easier, if less lucrative, path, and it also offers the opportunity to “change the world” if your app is a success.

    Bottom line is that the world is changing rapidly and it’s very hard to plot the future as we once could. Medicine could be socialized and salaries equalized with other professions. Or not. Tech industry could die, or re-inflate. It’s good to keep an eye on the numbers, but most important is to be true to your own self.

    • Alex Ding says:

      Hey dude,

      You know, after college, I was one of those people that wanted to work on Wall Street. But after reading Where Are the Customers’ Yachts, I did not feel that doing so would contribute to the good of society.

      $150K is a respectable salary. It is in the range of a primary doctor’s salary. The thing is that it seems like your quality of life is superb. I doubt most doctors have time to do what you did — writing a novel, traveling the world. You don’t have to deal with insurance companies and the mountain of paperwork either.

      I really thing you are over-estimating the amount doctors make. Sure, a specialist can make $400K (most doctors won’t be making that kind of money), but that is after 8 years of schooling (if you include college), and another 5 – 8 years of training (with minimal salary). You were fortunate you had a full ride, but most doctors don’t. These days, colleges can cost $50,000 per year. So if a freshman wants to borrow her way through college and medical school, she will have over $400K in student loan. Compound that at 6.8% per year for 8 years while she is training, and she will have over $700K in debt. I wonder if she can every pay off her loan, especially if she wants to buy a house and start a family.

      I agree that choosing your profession, whether IT or medicine or whatever, cannot be based on finances — especially if you are going to work or someone else. Salary can change anytime, especially if it is dependent upon a third-party payer system.. I constantly talk to my classmate about a hypothetical scenario where someone chooses a specialty she hates for the high pay. But if the pay decreases, she is deep crap. Not only will she hate her work, there will be minimal financial reward. Therefore, choose a specialty that you will like, not because of how much it pays.

  10. Over the past few weeks, I’ve been doing some soul searching after facing rejections from medical schools. For years, I convinced myself that the benefits of being a physician will far outweigh the drawbacks. But I’m beginning to realize that my personal priorities and desires may not be suitable for the lifestyle as a doctor. Yes, the money you make as a doctor is fantastic and the lives you save will definitely bring gratification, but I would feel guilty knowing that I have neglected my family and pushed aside my desires (and knowing my work ethic, medicine will consume my life). I’ve been offered a job to fill a position in a healthcare administration team, where there is potential to make a difference in people’s lives. I couldn’t decide if I’m just feeling the burnout and apply to med school again or take this job opportunity to start over.

    I stumbled upon this blog post as I was perusing the internet to reach a decision (great article, by the way) and after reading the comments, I’m starting to get a sense of perspective. All things considered, sounds like medicine may not be the right option.

  11. so basically, if im looking for med school to give me a financial boost in the long term, im wrong? i am going to get the exact opposite? what if i wanted to be an anesthesiologist? would it still not be worth it, from a strictly monetary prospective?

    • It’ll give you a financial boost. It won’t be as much as you may think. And you’ll definitely have to work for it. It is a gamble too, because what happens if you spend all that money and time and fail to become a doctor?

      If your job currently pays you even $50,000 / year and it is stable, medical school is not worth it.

  12. Great article, I just realized that doctors don’t make as much as people thought, but may make more that other people. I have a decent job and pay but always feel that I don’t have enough money to survive even if I don’t have lavish activities. I always see people happy with their livings even though they earn less money, how do they manage to survive?

    • There are two possibilities:

      - they spend less (rent rather than buy, used rather than new, no student loans)
      - they go into debt

      It is tough out there, especially for people who are in the middle class. Hang in there!

  13. Hey guys,

    I just came across this blog and I find it rather comforting. I’m a first year med student and am having serious doubts about continuing my medical education. The only thing keeping me in the program is the shame I would cause my family should I drop out. These doubts began several months before school started, but as I brought up the concerns to my family, they told me I have to at least give it a year, otherwise maybe I will regret it forever. That said, I dont feel like I would regret dropping out. I didnt enter medical school for the right reasons….I wanted to go to medical school for the prestige, respect, money. I think the reason I pursued medicine in the first place was because it was the biggest challenge I could strive for. Most of my life I had been a horrible student, an underachiever that lived in a realm of mediocrity….so when college started I sought my sights on the highest challenge I could find, which was medical school. I just feel like my heart is not in medicine, I don’t feel any sort of calling to help people and I am not willing to give up the aspects of my life I value most (family/fiance) to become successful in a field I do not enjoy.
    I feel like I am falling apart. I am at a fork in the road with everyone telling me to go one way, while my heart tells me to go the other. Med school has taken its toll on me psychologically…I cannot sleep anymore due to the stress of not knowing what to do. I spend the time I should be studying surfing the internet for people in my situation. My plan B at this point is to take a LOA and try and pursue an MBA in finance, I have always wanted to work in investment banking of some sort, yet I have a BS in biology with no business experience.
    I really hope there are some words of wisdom some of you could give me. I know many of you will say its only your first semester so you dont really know what its like to be in the field, but I am already 26 years old, I spent a couple years after graduating working in the medical field, directly along side doctors. I dont know why I never made this decision earlier, when I wasnt already 40k in debt from 1st year loans. Thank you.

    James

    • Hey James,

      Thanks for your candor.

      There really is no right or wrong reason to go into medical school. You wanted to go for the prestige, respect, and money … Well, you may get prestige and respect. But the money is highly debatable.

      Why is your heart telling you to get out? And can you endure through another 3 years of it? Medical school won’t get better, especially if you don’t really like the subject.

      Why do you want to get an MBA? These days, lots of people with MBAs still have trouble finding jobs (unless the degree is from a very prestigious school.) It may get you an entry-level job. Or if you really bust your butt during school and get internships, you can get a mid-level job.

      Personally, I feel that schools are a waste of time and money. But if you had to pick a school and get the most bang for your buck, it would be medical school.

      My interpretation is that you don’t really know what you love in life. You certainly want prestige, respect, and money. But who doesn’t?

      Would you be happy working 80 – 100 hours a week in the finance world? You may be pulling bank but you may not have time to spend the money. Would you love working on Excel all day, creating financial models? Giving presentations, stressing out to make deadlines, etc?

      If I were you, I would take a leave of absence. Don’t jump into school though. Get internships and work for free (so you can break into the field). Experience > school. Maybe you can get a mentor. Read about finance. Learning financial modeling through an online course (which is so much cheaper than a MBA).

      Or better yet … travel to a different country. Maybe teach English. (And hit on foreign women.)

      Start you own company.

      Interview people you look up to and see what path they took in life.

      Basically, find what you love. Because the prestige, respect, and money comes from being a master of a valuable skill, not what degree you have. You won’t get that from a MBA. You’ll get that as a doctor (because you can save lives) but you’ll endure through so much bs on the way to get there.

      So what I did is that every single free time I have, I learn how to sell and how to market. (No matter which field you go into, the most valuable person is the one who brings in the money.) Heck, be a sales person. Drug reps make decent money.

      If I was starting all over again, I would ditch school, travel, and build companies.

      If you want, I can recommend some books for you to read. It’ll get your mind into focus and give you a general strategy on how to excel in life.

      • Hey Alex,

        Thanks for the response. I can honestly say my heart was never in medicine. I remember as a kid growing up I’d look up to my grandfather who was a doctor, and I saw the comfortable life they had and thought to myself, “hey, i’ll take that”. Prior to starting school, the prestige/money/respect seemed like legitimate reasons to become a doctor. But the truth of the matter is, I dont feel that I care enough about people or the field enough to put up wt all the crap that is ahead of me just to work 85 hour weeks and make a salary that is poultry compared to my training and debt load. I’ve come to the realization that money isnt everything. I would rather make 75k and be happy, than make 175k and dread waking up in the morning. These are concerns I have had for a long time now. However, I am trying to address them and make the right decision before I get buried too deep in debt and am obligated to trudge forward with medical school.

        I suppose my major problem is that I don’t have a great fall back plan if I were to drop out. I have a degree in biology, which is basically useless career-wise, and I have no experience in the business field. I feel like I would do good in the business field. I know it is a hard market to break into with no experience but I am giving it strong consideration. Alex, did you go to medical school? If so, did you have these thoughts and what did you do?

        • Yeah, I went to medical school. I am currently in my last year.

          I constantly think about what you’re thinking about now. My doubt crept up during the second year. But I just kept going at it.

          There really isn’t a right or wrong answer. If you’re that miserable, leave. You only got a year in, so it is not too bad. But if your goal is to help people in the business field, it may be better to start your own business. Kind of like Ben & Jerry’s or The Body Shop. I doubt Wall St. is there to help others, but rather to help themselves.

          If I was in your shoes, I would take a leave of absence. You will have one year to try out all the different things out there. And if after one year, you want to go back to medical school, you can.

          • Thanks alex,

            I think I will most likely take an LOA and get help. Quick question for you though. If you knew then what you know now, would you still have gone through with medical school?

          • If I knew then what I know now, I would not have gone.

  14. Interesting read.

    I did not read all of the replays and comments so forgive me if this is redundant.

    I believe your assumption about “specialists” is quite far off. (I also think that your 150 number for physicians as a whole is more representative of a physician early in their career but I admit I don’t really know)

    I can only speak from my experience.

    I am a physician 3 years out from residency. My particular specialization (Ophthalmology) took only one more year of residency to complete then say a GP or family medicine doc (4 years instead of 3). Radiologist and Dermatologist also follow a similar path.

    As a specialist you make a bit more money starting out in general (I started out at 200k my first year for example). Where your argument misses a bit is when you become a mid-career or “busy” specialist. For example as my surgical volume has grown over the past few years my salary has more then doubled. I have 2 friends from medical school (both specialists) who have followed a very similar compensation paths.

    I usually don’t respond to things on message boards and I am not writing this to brag about my compensation. I guess I hear so many negative things about a career in medicine these days (stress, burn out, poorly compensated etc…) that I felt a need to comment. I can say with out hesitation that going to medical was one of the best decisions I ever made. It has payed out in spades both in terms of work satisfaction and financial compensation.

    • Hey Ken,

      Thanks for adding perspective to the discussion.

      It is true that a specialist makes more than the $150,000 I used as salary. Your examples (Ophthalmology, Dermatology, and Radiology) are pretty much the cream of the crop specialties that most medical students will not go into.

      I was comparing average doctor to average college graduate.

      Think about it. Since you were so bright to get into medical school and to get into a coveted specialty, don’t you think you could have just as much outside of medicine … sooner?

      In addition, I don’t really know how stable any doctor’s salary is, especially if he has to depend on a third-party for reimbursements. The ophthalmologist I rotated with was telling me about the good ol’ days where medicine was more enjoyable (without all the legal hassle) and reimbursed more. I know for radiology, the salary and job prospects are getting worse and worse.

      Can specialists make just as much 10 years later? 20 years later? I’m not sure.

      I think for you, it worked out. First, you are happy at work (which I think is the most important). Second, you’re doing well for yourself.

      • All valid points and I realize that my situation may not represent the majority of doctors.

        To answer your question regarding pursuing another career outside of medicine and making more money… Perhaps. But I can not think of a single undergraduate degree that can essentially guarantee one a certain minimum level of compensation like medicine can. Not to mention the potential upside if you are motivated to build a healthy practice.

        At my practice for example all physicians work 32 hours. This makes my actual compensation-per-hour-worked quite a bit higher then the average college grad (about 10x!). Could one accomplish this with a 4 year degree and the added time to grow their compensation? Maybe. But it would be tough and the down side risk would be very high.

        There are of course more entrepreneurial endeavors that could result in better compensation (owning a business/ starting a hedge fund etc etc) but they carry high failure risk and I would argue doing this requires more “guts” then raw intelligence. So as a far as being payed for your time its hard to beat medicine.

        As far as future compensation for physicians… Who knows and your point is a valid one. Our senior partner is always saying that since the mid 90s everyone has been saying doctors will be making nothing in 5 years and yet most of us appear to be doing alright 2 decades later. I think we are all working harder/seeing more patients to keep revenue up but at some point you can’t stretch things any further. Time will tell I guess!

        • Hey Ken,

          You’re certainly right about the guaranteed compensation. I think every medical student expects to make low six-figures, at the very least.

          You work hours are certainly pretty nice. I can’t deny that I’m a bit envious.

          Starting your own business is risky. I agree with what you said. But if you put in the amount of time you studied in medical school and the amount of money you spent in tuition to learn about business (especially marketing and sales) and to set up your own gig, I think you’ll have a pretty good shot of doing well. And if you fail, you can discharge the business debt in bankruptcy. You can’t do that with student loans.

          But overall, medicine is good if you a guaranteed lifestyle and income. But the increase in tuition and lowered reimbursements may put a dent on that for the next generation of doctors.

  15. Appreciate the food for thought. I’m currently a high school senior and am weighing my options of a good degree to pursue. I also am interested in both sciences and business and found this article helpful. Thanks!

  16. Hello Alex

    I believe there are some things that are missing in your analysis. These days physicians are having an incredible flexibility in job options. The main job description of physician may be clinical care, but others may chose to use their MD degrees to gain jobs in the pharmaceutical industry, consulting, court experts, administration in hospitals, teaching, etc. Physicians have a range of salaries and lifestyles. Also, there is a growing number of physician entrepreneurs who are using their medical knowledge to create novel community clinics and become CEO of hospitals across the country. Those physicians with the business knowledge are a growing.

    Also, let me give you an example which might change your perspective slightly on specialties and lifestyle. Currently a Internal Medicine Hospitalist makes an average of $230,000 if he works during the day and more than $300,000 if he works night shift. They do 1-3 years of internal medicine residency training. But here is the things that might surprise you. Hospitalist work 12 hour shifts 7 days straight “on” and 7 days they are COMPLETELY “off” and when I mean completely, it is! No beeper, no page! So just imagine working 6 months of the year, 168 hours a month (42 hours a week) for that salary? You are making 1,370 dollars an hour AND you have time off half the year!!!! To do whatever you want! And you can use that free week to do whatever you please…..hell you could get a second job if you want!! So its not as clear cut as you presented it here, it may vary depending on the specialty and there is still a way to have quality of life.

    Additionally, there are a number of programs that repay your debt from medical school if you decide to practice in certain specialties/underserved populations. MDs are respected because of the undying commitment to caring for others which should be the main reason to be in medical school. I am currently a medical student, I used to be an MD/PhD student and I found out that doing a PhD is definitely a waste a time and much less return on investment based on financial outcome and job liberty….it actually limits you. I have plans to become a medical entrepreneur and want to start my own business in medical care for elderly with dementia. There is a great opportunity to do good and to also make some money….it takes inventiveness and thinking out of the box!! So anybody who is passionate about service should not be deterred from pursuing medicine!!! And if you feel dissatisfied afterwards, you can ALWAYS use the M.D. to do a career switch to a non-clinical patient care job, and you will definitely be valued!

    • Hey Frank,

      Thanks for the detailed comment.

      I agree that doctors can use their degrees and branch out from clinical care. But it won’t be as easy as you may think. Most non-clinical jobs will require a pay cut in the beginning.

      So for those who become CEOs and entrepreneurs, they’ll make a whole lot of money. Yes. But then again, you don’t need to become a doctor to do that. I know the CEO of my local hospital is definitely not a doctor.

      For the doctors who deviate from non-clinical care and go into something more lucrative, they could have done the same thing … without the 4 years of medical school, 3+ years in residency, and six-figures in debt.

      I was actually thinking about becoming a hospitalist, just because the 7 days off sounds so tempting. If a hospitalist makes $200,000 – $300,000 a year … that is more like $100 – 200 / hr (not $1,370 / hr). Still, the salary is respectable.

      If you want to make more money as a doctor by doing clinical medicine, go somewhere that needs you so much, they’ll be willing to pay an arm and a leg for you. It probably won’t be close to any metropolitan area though.

  17. Hey Alex,

    I am currently an engineer making a decent entry-level salary (80k). I have college and grad school loans that are already in the 6 figures. I was a bio major/premed student in college and then decided to pursue engineering after I graduated because I was still uncertain about medical school and also thought I liked it or it was cool (still think its cool but maybe just not for me?). I know my callling is to be a doctor, but I am already 26 and my parents are not very financially sound; it also makes it more difficult that I’m female because I have to think about potentially having a kid during residency?!). I applied to medical school in secret and have gotten an acceptance. However, I realized that my family is my biggest priority and even if I dont mind being in debt, I have to think about how to support them.

    I am currently looking into different career path that would fulfill my life desire to help people without getting into any more debt so that I can start helping out my family. I was thinking of staying with my company and having them pay for my next educational endeavor if necessary for a different career path. Then again, I don’t want to be 50 and realize I should’ve pursued my passion, because at the moment and for pretty much my entire life, I really could not see myself happy with any other career..

    What suggestions do you have for me?

    Thanks!

    • Alex Ding says:

      Hey Sandra,

      First, congratulations on getting in medical school.

      Now to your main concern: should you follow your passion and get into more debt or should you support your family and lose out on doing what you love?

      I really do not have a good answer. I will warn you that medicine is a perilous journey. How did you conclude that medicine is your passion? Because it would really suck if it wasn’t, especially the amount of sacrifice you will make to become a doctor.

      You’re also wise to realize that pursuing medicine may not be so great if you want a family of your own. It’s very hard to find the time to date, marry, have children, and spend time with your children.

      Personally, I am biased against medicine. I am going through the training now and it really sucked the joy of medicine out of me. But I’m not going to tell you to forget your dreams. What I will advise is to confirm that is really your passion. Did you volunteer in the hospital? Did you get to work beside doctors? Did you work the hours doctors work? Are you ok waking up in the middle of the night, to take on an emergency? Because most likely, when you’re a doctor, you’ll work in a hospital and under its system.

      Helping people is so broad. Why become a doctor and not a nurse? Or why not a physician assistant?

      I can’t answer the question for you. Only you can answer the question. But from a rough estimate of talking to my classmates, 50% of medical students wished they never went to medical school. But now it is too late for them.

  18. Hey, I read your blog and I think it’s great. The crap you have to deal with sounds exactly like how I was in nursing school. I made it to my second clinical and simply could not put up with it anymore. I wanted to be a CRNA in the end, but after shadowing a few I realized it was definitely something I wouldn’t want to do for my whole life. I enjoyed medicine and the science behind it, but not so much the physical application of putting in catheters or standing over someone for 8 hours a day while they sleep. I thought about switching to pre-med but realized that as a physician I may have more autonomy than a nurse, but I would still be doing things that I would not enjoy. Anyways, I have always had a love of business like you. I switched majors and will be graduating with an accounting degree. I plan on getting my CPA and going to law school (full tuition scholarship or I don’t go). My end goal is to open my own tax, accounting, law practice, and just branch out from there getting investors together to buy franchises, being a venture capitalist, etc… the possibilities are endless. Money is important to me and I hope and am willing to work hard so I at least can achieve a doctor salary. There is a little bit of me that thinks it would have been cool to be a doctor, but when I read the reality of what you wrote out here it re-affirms it’s just not right for me. Anways, good luck to you and screw the system like you said. Concierge medicine might be a great option and money maker for you. You’re a bright business mind full of none-business minds. Take advantage of that.

    • Alex Ding says:

      Hey Mark,

      You’re right. The possibilities are endless. And if you get good enough at tax, you will always have a job. Everyone would want to pay as little tax as possible.

      If you open your own firm, or make partner in another firm, there is no reason you should not pull in a doctor’s salary (or even more).

      And thanks for your well-wishes. I am very, very excited for the future — once I get past residency that is. Ugh …

  19. Rose_tabbu says:

    Hi Alex,

    I m 29, f, from India. It’s 4.57 AM right now in India but couldn’t sleep. So I went on to search the question of my life….went through the whole article and replies mentioned in this blog.

    From the moment I could remember my first thought of this world……I wanted to become a doctor. I went to Ukraine to pursue MBBS as in India couldn’t get free seat and also because i already wasted my 3 years in preparation for entrance in India and didn’t wanted to waste more so I went to join in. By that time my elder sis was already pursuing MBBS in Russia. So I went Ukraine completed my 2 years, all of sudden my Dad passed away. Unfortunately I came back to India due to financial crisis. From nowhere I could get help to continue as there was some financial n property issue. Mean time my elder sis completed her studies as it was a fixed amount for her already. In my case it wasn’t there.
    So after coming back in 2008 I completed my graduation n anyhow managed to get into some jobs. After many years my property issue has been sorted. So here’s the trauma….Nobody supported me to pursue MBBS after I left but I always I knew deep down that one day ll come I ll complete my studies. But I don’t see any supporter. From 2006 I ve totally cut down my friend circle as I couldn’t face them. But they all are doing well in their lives. So looking at my sister and friends I cry every night n even days were there where I totally was about to commit suicide coz it was d only dream I had. After coming back I felt all time like a dead person just passing the days of life. I know it may sou d crazy to u but I haven’t spoken to anyone yet. So please tell me what should I do? I have money with me now but my family tells me about the age factor n getting married n having kids. I m girl always thought of doing something great in the society. I wanted to have marked a name as well n wanted to b so successful professionally. But if I m going to do what’s others are asking to do may b I ll spend my whole life in trauma. But in India society stand first but not a women. I feel caged. I wanna become a legend in this world so that people could remember me. Since medicine is my first love I don’t know what to do now……..In india I m already over aged to get admission in medical college, n after doing medical studies from abroad I ve to appear for registration exam MCI in india which is very tough but I ve confidence in me. So what do u suggest……I ve my experience in weddings and events….but it’s not all respective job. Business was never my interest…So never liked doing anything related to finance or anything. ….so please do advise me on my complicated life…..

    • Alex Ding says:

      Hey Rose,

      Wow, your life sounds really complicated. The question of you focusing on marriage and changing careers vs focusing on medicine and remaining single is a heavy decision. I cannot tell you what to do.

      What do you want more? Doing what you like in life or having a family? It will be very hard for you to have both in the world of medicine.

      Sorry, I cannot be more of a help.

      • Rose_tabbu says:

        Hi Alex,

        Thanks for replying.

        I wanna say something to all…..

        If u believe in the institution of serving humanity through medicine then only think of becoming a Doctor…..
        Otherwise reality is all about what is in this blog.

        I respect and salute to all those people who have become doctors. As they have achieved what I wanted deadly. So I can’t explain you how does it feel when you couldn’t become a doctor.

        Best of luck to all my beloved Doctors….
        You are the true heroes of this world. …
        Love you all….
        I wish for everything you all wished….

        Bye…

        Regards
        Rose.

  20. Dear all…
    Im surprised and a little sad reading this blog…the doctors need to help a people and put attention not to damage the relationships with wifes or husbands, childrens… I dont know what you will say if you will know that average salary of doctors in Italy is about 2500 USD / mounth – so about 30.000 USD a year…or that in Bieloruss the doctors salary is about 200 USD / mounth – about 2400 USD year….less than a salary of saleswomen with a 260 USD / mounth – about 3120 USD…Beeing doctor it is not beeing a business men..no? Or something is wrong with USA society? so many mediocrity in this world! Regards from Italy…

  21. Rose_tabbu says:

    Hi Alex,

    I don’t know but I want to this share with you.

    Today I have got diagnosed with Bladder cancer.

    Life is funny…..isn’t it?

    • Alex Ding says:

      Hi Rose,

      Sorry to hear that.

      Remember that there is always hope. Nothing in medicine is set in stone. Take one day at a time and enjoy the present.

  22. Very interesting blog. I’m 29, from the UK. I have a PhD and seem to have been an eternal student, but I have enjoyed a nice lifestyle and really got to know my friends and family and spend time with them. I have worked for a few years in a good university and although it isn’t challenging, it is alright…but only pays about $60,000. I escaped research so am not in that postdoc trap. I wasn’t too studious at school or mindful of well-paying careers so I’m always envious of those with much higher salaries at my age and wondered how it happened, I never had that drive, although I do now. For several years I have wanted to go to medical school, and I have an offer for one from this September. My dilemma is that actually although I have a dull job, it is reasonably secure, not stressful and in a nicer environment than most. I did the maths and studying medicine would not really pay back (lost earnings, cost of medical school, pay as a doctor vs. current role) for about 20 years. I want to do medicine for the challenge and non-financial rewards, but am not silly enough to jump at it blind, without considering my future (for example get on the property ladder now or spend savings on medschool!). Also the litigation, poor state of out NHS, lack of autonomy…So I don’t know what to so, I’ve come to the realisation that medicine, though it is a calling of mine and I would regret not doing it, would not pay me back and may actually swallow my life, something my very average job doesn’t. But then maybe life is too short not to take risks? It’s very hard to know what to do and any thoughts would be great. What I don’t know is if I just like the idea of medicine and would love the course but find reality of life as a doctor to be much like some of the dissatisfied people here.

    • Alex Ding says:

      Hey Alex (great name btw),

      I totally feel your pain about being the eternal student.

      It seems like you are in quite a predicament. Do you stay where you are and be comfortable and safe? Or do you take the risk and work your butt off for a bit more money and status?

      I don’t know how much medical school is in England, but in the US, it is crazy expensive. So you cannot just give it a try and expect to come out of it financially unscathed.

      My only advice is to go into medicine if that is what you really want to do. As you are already aware, the money is not THAT much better when you look at the situation as a whole. In the end, no matter if you become a doctor or not, whatever you do will become just another job … if you are not passionate about it.

      If I had to do everything all over again, I would not have gone to medical school. Instead, I would have dived headfirst into building businesses. But that is because I like creating something new and is self-motivated to accomplish it.

      So bottom line … do you love medicine? Do you love being in the bottom of the totem pole for quite a while? Are you willing to take huge financial risks for payoffs decades down the road? Do you want status? Do you want job security? If you answered “yes,” to most of the questions, then maybe you should become a doctor.

  23. Hey Alex,

    I’ve had my mind set on going to medical school for a while now. I’ll be turning 26 next month and was wondering if it is still worth pursuing a medical degree (not only financially but with recent changes to how Dr’s are reimbursed, and increase patient load due to the affordable care act, etc) . I’ve recently switched my mindset to pursing a degree as a physician assistant due to the length of schooling, similar scope of work (covering roughly 85% of what physician’s can do to my understanding), and a fraction of the debt. Don’t get me wrong, I love medicine, but I also have other interests as well (like starting a business as well or real estate much like you mentioned.) Also, is it true that PA’s tend to work less hours as well?(i understand they also get paid less than physicians but it seems the debt to income ratio is better).

    • Alex Ding says:

      Hey Tony,

      It is true that PA’s work less hours, especially when PA’s don’t have to do residency.

      If I had to choose between medical school or PA school, I would choose the latter in a heartbeat.

      Good luck.

  24. Hi again Alex,
    I’m also in this same boat, and have decided to pursue PA school with the hopes of having a strong career without too much personal heartache. However, I’m wondering how you feel about what you’ve encountered with PA’s vs. physicians in the realm of work life balance, knowledge, prestige, etc.? Any personal anecdotes you might be willing to share?

    Thanks!

    • Alex Ding says:

      Hey Luke,

      Good to hear from you again. Knowing what I know now, if I had to choose between being a PA or doctor, I would choose being a PA in a heartbeat. Right now I am in residency and there is no such thing as work-life balance. It is just work. 80 hours of it every week.

      Being a doctor is more prestigious, but you’ll make pretty good money as a PA … without the residency. And knowledge wise, it is person dependent. A PA who reads every day will know more than a doctor that doesn’t.

      So I was talking to my co-intern. And she shared how jealous she was of her PA friends, whom after 3 years of school and no residency are getting job offers in the six-figures. While she (and I) make half the pay with twice the hours of work.

      And if you decide not to do a residency as a doctor, good luck finding a job. As a PA, all you have to do is finish school (3 years). As a doctor, you have to finish school and finish residency (at least 7 years).

      • Alright so I left this blog a while back and randomly decided to look at it again. I have to chime in here.

        Alex seems like a great guy and is really trying to help everyone with this blog. However, he is a resident – not a practicing physician (I don’t mean this in a condescending way btw). Residency is frankly horrible. Residency in no way reflects being a practicing physician. When I was finishing my intern year, working obscene hours, I too wondered if this was the life for me. You are in your late 20s (at the very least), working like a dog, usually in an academic center where the sickest of the sick come, making pennies. It’s bad.

        It’s not for everyone. It’s challenging. It’s not easy to become a doctor. You will be pushed hard along the way.

        I am now 3 years out from residency. I am working 4 days a week with evey Friday off. I help people every single day and love it. That is why I went into medicine. And it doesnt hurt that I make over a half million a year in salary – if you are motivated and good you can excel in medicine like anything else. Getting your MD is not a guarantee that you will be successful or make money. You have to earn it like everyone else. Residency/ med school is just the beginning.

        I’m reading this wondering why the heck anyone would want to be a PA if they could be a physician? You are a physicians ASSISTANT. Of course it takes less time. And costs less to get the degree etc… Because you aren’t a physician. You will never be treated like one and you will never be compensated like one. You will never have the same respect. If that’s your thing – then go for it. I’m not saying this is a bad degree. But you are not an MD.

        I’m a private practice doc that works with and knows many docs. Evey doc I know is doing quite well. I have no idea what the future holds. From a financial stand point medicine will never be better than it is today (and it was better in the past) but it’s still a wonderful profession for many reasons.

        • Alex Ding says:

          Hey Ken,

          Good to hear from you. Your story is quite motivating, but how many doctors can make $500,000? How many doctors can become ophthalmologists?

          And when you say:

          “From a financial stand point medicine will never be better than it is today (and it was better in the past) …”

          It sounds like you can go through all this sacrifice and ordeals, and still not get a guaranteed payoff. That sounds awfully lot like gambling to me. If medicine is going down the drain financially, being a PA involves a lot less risk.

          There is one thing for certain though. For the length of your training, medicine will consume your life. For at least 7 years after college, you will have less sleep, less free time, and less money. If you just want to breath, eat, and sleep medicine … while living in relative poverty compared to other healthcare providers, go for it and become a doctor.

          But if you want a balanced life (one that is not consumed by work), do something else. Nurses and PAs don’t have residencies and can still practice medicine. Dentists, pharmacists, and optometrists don’t need to do residencies and can still practice their craft. But for some strange reason, a doctor — who has received more education than most — can’t practice, unless he spends a few years in indentured servitude residency. (And you will feel like an indentured servant for the length of your training.)

          And since a doctor is seen as the top of the hierarchy (although the real top dogs are administrators, government regulators, insurance companies), you’ll get hit with a lawsuit more often and for a higher penalty than nurses and PAs. And that is also because lawyers like to go after those with some assets to take. So all your toils could potentially be all for nothing.

          If you like gambling, try Atlantic City. At least you’ll be treated like royalty in the process.

  25. Alex,

    I don’t mean any disrespect but your conclusion is a bit specious. Your calculation is really saying that the difference between a doctor and a college graduate is: it is as if the physician was handed 600k today and invested it all over the next 40 some years while the college graduate did not, that’s how much more money the doctor would make in a lifetime. That number you calculated near 9mil, that is how much more the doctor can make. It is not worth 600k more. The present value is irrelevant in comparing these two since taking 600k today to invest is not an option…

    Furthermore it’s important to note that making 30k a year is nothing, and even the cheapest of cheap lifestyles in a normal city would leave the college graduate with VERY little to invest and accumulate wealth… Given your own calculations, being a physician would be worth literally millions more over a career.

    The only way the present value would matter would be if there were an option to take 600k to invest vs embarking on a medical career. In that instance both routes would lead you to the 9mil surplus. It does NOT mean that being a physician will only increase your wealth over the college graduate by 600k over your career.

    I have a business degree too and am currently in med school. I’m not trying to sound disrespectful at all, I just think your conclusion is misleading people who don’t understand your calculations…

    • Alex Ding says:

      Hey Chris,

      Future value and present value are very relevant. How else will you compare the return on investments? How else will you compare the loans you spend today to the money you will earn in the future. Money today is worth more than money in the future and that must be factored into the equation.

      $600,000 today is worth as much as a few million decades down the road. So yes, doctors over their careers make millions of dollars, if they choose to work until old age. But millions of dollars in the future is not worth as much as people may think.

      • Alex,

        You wrote ” You will be around $600,000 better off compared to the average college graduate. Maybe it is just me but an increase of $600,000 in net worth does not exactly strike me as being rich.”

        That is inaccurate. You will be millions better off. 600k would be the money you need to invest successfully for 40 years to make what a doctor makes over a career. It is not the difference in net worth of the doctor vs a college grad…

        Essentially the college grad would need a 600k portfolio that pays out in 40 years, which would be worth millions…

        The reason I say its irrelevant is because MOST people don’t have 600k to invest today to make millions as an alternative to medicine. Sure, if you were offered a 700k portfolio instead of med school TODAY that would pay out more than a career in medicine… But I assume that isn’t a common choice to have to make….

        To further illustrate how your net wealth will not be only 600k more… Imagine every year the doctor makes 70k more than the grad he buys a condo. So at the end of his forty year career (which is your number) he has 40 condos he’s renting. Is that really worth only 600k in wealth more?

        The present value is based on the idea that that money will be invested and that’s why less is worth more if you can use it now… But the money isn’t there after college in this situation, so you’re just working backwards to find the capital you would have needed to make the same money as a doctor… Again, I stress, the career is worth millions not 600k. Your conclusion is confused.

        • Alex Ding says:

          Your argument is similar to saying that the $1 bill in your wallet is not worth $1. It is really worth $10. Frankly, that is more confusing and more misleading.

          • You are saying that a career worth millions is only worth 600k in your pocket today, even though that money isn’t there to have… I’m not sure what’s confusing you. 600k present value does not mean that’s how much more wealth you will have…

            And as for a dollar today being worth ten, that is literally what the whole concept of present value vs future value is, and that is the central premise of your conclusion…

          • Alex Ding says:

            “600k present value does not mean that’s how much more wealth you will have …”

            It does mean that $600,000 is how much more wealth you will have by being a doctor rather than an average worker, measured in today’s money. If you want to say you’re worth millions some time far away in the future, go ahead. But millions in the future is not worth millions today.

            If your business school was any good, you should have learned that valuing investments is based on intrinsic value — future value and perpetuity translated to the present value.

    • Hi Alex,

      I appreciate your site and all the perspectives you bring to light. I currently just finished my BSC and am 25 years old. I have the grades and work ethic to go to med school and do well. I just don’t know if that is the best thing for me in terms of pay off, opportunity cost, and the lifestyle I want.

      The thing is I have little work experience and not many business skills. I spent the years after high school partying and trying to do well in my undergrad. I recently discovered that the road to true wealth and financial independence is through business, real estate and stocks. I don’t know why but I’ve basically been asleep and thought that after working my ass off and becoming a doctor I will be rich, but learning more I realize that isn’t necessarily the case.

      Its not all about the money, I do like helping people but there are so many ways you can help others while making better money and have a better lifestyle. Basically, I’ve been thinking about becoming a real estate agent instead of going to med school. I’ll probably suck as a real estate agent because I have never had a sales job but I could use my first few years as a real estate agent as an education while I am being paid. I can learn marketing, selling, and business skills. I can also become extremely knowledgeable about real estate and investing. In other words I will work extremely hard (70 hours a week) at real estate and developing skills. After being a real estate agent for a few years, I could start a business.

      I know there are tons of real estate agents out there, but not very many work as hard as med students/doctors and not many are as driven. The competition is crazy but not much different from medicine. I don’t know how I could start a business right now, I’ve just been a student for my entire life, not too much real world experience so don’t have many ideas. I think being a real estate agent would give me a valuable education and skills.

      Real estate agents don’t have a good reputation and I will be a disappointment to family and friends who know me for getting straight As. But I just want to make the best decision for my future and life. Let me know your thoughts on this.

      Thanks

      • Alex Ding says:

        Hey Zack,

        I’m going to give you a tip that pretty much all doctors would agree with:

        Go into medicine if there is nothing else you would rather do. The cost of becoming a doctor is way to high. Medicine will consume your life.

        If you want to go into real estate, go into real estate. Will you fail? Maybe. But even if you get into debt and fail, you can still pick yourself back up. And you’ll learn a whole ton about business and sales, which you can use in any field. You can start again and have a higher chance of success.

        At least your business debt will be dischargable in bankruptcy. Not so with student loans.

  26. Hi Alex,
    I graduated from high school with an associates degree, and could graduate in two years with an economics degree, but I can’t decide if I’d rather be a physician. The main reasons I have for becoming a physician are monetary stability, power, prestige, and of course helping others. I would like to have a life outside of my job, but while also making enough money to “live”. What would you suggest?
    Thanks

    • Hey Nathan,

      Being a physician will allow you to have more money, more stability, and more prestige. I don’t know if a doctor has more power and more ability to help people.

      You will have to get into medical school, endure through maybe a decade of training, get into debt, and work your butt off even when you’re out of school. Will you have a life outside of your job? Maybe, if you try hard enough. But it’s very possible your work will become your life.

      Is it worth it? Only can you say for yourself. I would choose something else, just as entrepreneurship. If you keep plugging away, you’ll get it eventually. You’re still young.

  27. L. Barsoom says:

    If I knew 15 yrs ago what I know now, I would definitely took different path. Qulaity of life is below zero. You have no time for yourself, Family or your kids. Your life is full with work , reading CME and attending CME.
    Risk of the profession is very high:
    every one comes after you with complaints: Patients, The college, The Tax man, Lawyers. It never ends.
    I forgot to have a good night sleep . Wish I knew this before.

    • Thanks for sharing. Lots of doctors feel the way you do.

      • Thanks for your opinions, my main hangup is not knowing what else there is(in terms of profession) that allows you to have the financial stability that a physician enjoys? Any ideas would be appreciated!

        • Hey Nathan,

          If you want a stable job, try to get a job with the government. Those are generally very stable. Medicine is stable as well. So nurses, pharmacists, physician assistants, and doctors have relative financial stability. And there is always the military.

  28. Hi,
    I’m a MBBS doctor from Asia and i always wanted to get into a residency program in US.But towards the end of medical school, i started getting tired of working so hard, and it seems i still have a long way got go if i want to practice in US, as prospects of matching are getting grimmer for Non US IMGs every year, with people not entering even with high USMLE scores and observerships. I am thinking of a degree in public health (Mph)now, but it pays less than a medical career.So, is it worth it to put 6-8 years of hard work into a becoming a physician or should i jump ships and enter into public health.I’m really confused.Can you tell me of any other job( in healthcare, health care management,) that will provide financial stability?

    • Hi Suprada,

      You’re right. You still have a long way to go if you want to practice medicine in the US. It will be harder for you just because your are not a US graduate. If you have really good scores and some money, you can apply broadly. But it will be tiring and expensive. Personally, in your situation, I would do something else.

      If you want a stable job, try to get work with the government. So MPH is a possibility. Medicine is also financially stable. Maybe you can go into nursing or physician assistant, because those don’t require residency. But it will require time and money.

      And in my opinion, the safest way is to have your own business. It will be hard in the beginning but will pay off in the end.

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