While I know there are financial pros and cons to taking gap years, my bigger concern for me is that I would like to have children. I worry that adding 2 or 3 years to my training makes infertility more likely.
On my other thread people suggested that the solution to this is to have kids in medical school or residency. But I have trouble imagining working the hours of residency and not missing my child, so finishing training as quickly as possible and then having kids seems like a better plan.
I’m not sure I understand this.
Obviously, there is a huge variation in how long different medical specialties take to train for. But unless you’re arguing that undergraduate school choice would determine the specialty I go into, I’d still finish any of them faster from School A than from School B with gap years.
So, if I go to school A and pursue family medicine, then I would probably be 28, whereas if I did School B and 2 gap years, I’d be 31.
On the other hand, if I did school A and became a pediatric neurosurgeon, I might be 33-35 when I finished. Whereas if I went to school B, and did two gap years, I might be 36 - 38.
Of course I realize that different medical schools, and paths to get there, might change my mind about what I want to do, or change my odds at getting the specialties I want the most. But predicting that seems impossible. So, while specialty selection is obvious a factor in the age at which I finish training, and how many years are left in my career at that point, it seems separate from the factor of how old I am if/when I start residency, and if a goal is to finish residency younger than choosing the faster path seems logical.
I think that not having scores on MCAT to stress about, or worrying that you’re taking the right classes, or doing the right activities sounds less stressful. I know I will still need to take certain classes, and get clinical and service hours, but it seems like they give you guidance on what to choose etc . . .
My point was that there are so many variables that go into “how old will I be once I start practicing medicine” that the time compression of the combined program, or no gap year, or no “I have to take another year to get more shadowing experience or retake the MCAT’s because my scores aren’t high enough”, that it’s not really part of any equation right now.
Saving a year is really not that significant over the course of your entire career. Going into a specialty you aren’t interested in because the training is shorter is not a decision any of the attendings you’ll be working with during your rotations would encourage.
Not a way to pick an undergrad college IMHO.
School A for the win.
First though, I’ll say - many who think they love a school find out they don’t. So it’s hard to totally predict on those you think you love - or don’t love.
But if you have $400K, you are saying a guarantee at the med school - and it’s $460K total - so $60K in debt?
Except - your $400K today can easily earn $20K - so $20K a year or even conservatively $20K the first, then $15K, then $10K, etc. - so you’ll cover more than you think.
And even if you earned not a penny, I’d surmise under $100K for a doctor is still good.
Then there’s the other thing - the likelihood that you’ll change off med school anyway.
So if you have $400K and undergrad is $140K, I think you’re in a position to choose School A if that’s what you desire.
But you need to have your money work for you - so $400K will be more than $400K in a year, two, three, etc.
And believe me…should you get to medical school, you will be taking test after test after test, and high stakes ones at that…the whole time you are in medical school.
Even in BS MD programs, you will need to “take the right classes”, but perhaps those are ore chosen for you.
I don’t think the amount of debt you are talking about is an unreasonable amount. $140,000 is far less than many, if not most, medical school grads have in debt.
I’m confused on $140K in debt.
OP is saying school is $140K + $320K = $460K.
OP has $400K to spend - and frankly, if they invest in CDs or Federal Bonds, it’s more than that - sans any risk.
So their max debt, if costs hold, would be $60K and less if they invest.
I think $140K is the delta of school A (costs $140K) to B (full ride) - but not debt.
Assuming costs hold seems optimistic. Shouldn’t we assume inflation?
I feel like it’s important to note that without a state school option, $80K per year is a little less expensive compared to many medical schools. So, $140K is the difference between the two undergrad costs, but without knowing what medical school I’d go to after School B, it’s hard to know the actual cost difference.
It’s not my money. My parents are good with money, obviously, so I trust they’ll invest it correctly.
Here is how I imagine it. I know there is a list of coursework that is required to even apply to medical school, that I would need to take at either School A or School B. But I feel like at School B, I would be asking whether I should take extra classes, etc . . . to be more competitive. Whereas at School A, I wouldn’t have that worry.
Similarly, at both I’d need to do service and clinical hours, but at School A, I could probably ask “do these opportunitiesI found meet the requirement?” and then choose, whereas at School B, I might be wondering which one is better, what if I choose the wrong one?
And yes I know I’d be skipping one of many tests. The MCAT is not a reason why I’d choose School A, but it’s still nice to be able to skip it.
I’m just going with the #s quoted. I rarely suggest the higher #. Yes there’s inflation but investing the $400k and then each year will either keep pace with it or grow or fall behind on the margins.
Even if $60k becomes $100k - with med school assurance, it’s a win. If they don’t go med school - they still have $260k or with serious inflation - north of $200k left.
But it’s important their money is put to work in risk free investments while it waits.
I’m sure you could handle the MCAT if necessary, but it is also true that in part because people don’t really know what score they will need, they typically put a lot of time into prep. Which is fine, but if you are doing that at the same time as taking a full load of college classes AND doing a lot of experience stuff on breaks, that can be a lot. So this is in fact one of many reasons people are often taking gap years.
And as discussed above, in some sense being able to avoid a gap year for that sort of reason could actually have a monetary value. And, you know, maybe you would enjoy college a bit more too.
Again, maybe no one of these things is enough to justify the additional cost (although that would still be personal), but the combination of factors does seem to add up to a lot more to consider.
I would choose school A. Not all BSMD programs have no MCAT requirement, but putting that aside, having a more or less certain path (and potentially one or two fewer gap years) is, IMO, worth the relatively small chunk of your attending salary.
Also, make sure you learn how to use Anki and other study skills (e.g. memory palaces: Basics - Memory Techniques and Memory Palaces for Students | How to Use a Memory Palace to Learn — Mullen Memory ) during undergrad, so you don’t need to both learn how to learn and learn medicine at the same time during medical school.
I believe the student who is starting medical school after, say, two gap years would be more likely to choose the quicker, less appealing specialty due to fears of lost earning potential than the student who is able to start medical school immediately after undergrad.
I would love to see data on this…I mean most students take 1-2 gap years currently (average matriculating age is 24), because they aren’t competitive enough for med school without getting more clinical/patient serving experience. These data support doing a BSMD/DO program provided it’s right for the student.
Not according to my doctor kid, and her doctor friends. Everyone she knows chose their specialty based on their interest. They did not choose something less appealing…for any reason. Being a doctor is hard enough…you want to be doing something that is most appealing, not less appealing.
Or because they are doing something else during that 1-2 years…maybe Peace Corps, or Americorps.
For sure, but still activities that are making their future med school app stronger/more competitive.
There is absolutely no data to suggest this is happening.
The only data available suggests that it only once a student is 30 years old or older when starting med school is there any shift in specialty preference toward fields with shorter training periods (mostly primary care) and better work-life balance with predictable hours**. But the shift to primary care is not that huge: 50% of older than 30 med students go into primary vs 40% of younger than 30 med students.
** specialties with the most predictable hours = dermatology, occupational medicine, PM&R, outpatient psychiatry, pathology, public health, allergy, plastic surgery
The primary driver of specialty choice seem to be: personal preference, board scores and financial ROI.
Pediatrics routinely fails to fill all its residency slots and not coincidentally is the lowest paying of all medical specialties.
Just to be clear, I am not planning on choosing a medical specialty based on the length of the training. I do think that if I go to School B, and need to take gap years, if I then choose a specialty with longer training and higher pay, I will wish I had chosen School A and finished earlier. On the other hand if I go to School A and decide I want family medicine or pediatrics, I might really regret having any debt at all.
I think part of my problem is that I don’t really understand the finance piece. Let’s say I graduate medical school with $100K in debt, which seems like a high estimate. How does that debt impact my life during residency? Do I start paying it off then? Or wait till I finish training? If I wait till the end of training, how much will it be by then? How much would the payments be, and how would those payments be on a typical doctor’s salary?