We have a family member who has just completed the 3rd year of med school. He is definitely stressed, studies all the time but loves it. Sets a goal and is very driven to reach that goal: being an orthopedic surgeon. I was very surprised to learn about the competitive nature of grades, board scores, etc in this world. He swears that if he wanted to be a primary care doc, it would be far less competitive and so much less stressful for the student. I don’t mean competition among his classmates but among other med students nationwide who are interested in the more competitive residencies. At the end of the day, he says the competition is with himself.
It’s not a life for most of us. …you must get good grades in h.s. and knock the SAT out of the park to get into a good college, then you must have exceptional grades in college and knock the MCAT out of the park to get into med school–any med school, not to mention a ‘good’ one! Then, you have to study all the time in med school, do research on the side that impresses the pros so you can get a project published. You need to always–and I do mean always–get top-notch grades while studying constantly for the uber-important Board exams. Seriously, if you don’t hit a home-run on the Step One Board exam (there’s a definite cut-off score), you can forget the specialty you dreamt of all those years and there’s no taking it a second time–truly once and done. You have to always be on top of your game for your rotations because the residents and attendings will be able to make or break you when it comes to residency selection. Residency selection is really out of your hands, btw. You apply to hundreds of residency programs, hopefully interview at twenty or thirty, rank your top ten and hope somebody likes you. On that magic day in March, called Match Day, you open the envelop and find out where {If at all } you will be spending the next five years (primary care is only four years) of your life. You find out a few days before Match Day if you didn’t match anywhere. Imagine, all that work and you match nowhere…You either scramble to find something open in another specialty or you find a research job to tide you over and try again next year.
I asked him what would happen if he just hit a triple instead of a home run on the Board exam. He says there isn’t much wiggle room when it comes to minimum scores acceptable for certain specialties. The saddest thing: there are more med school grads than there are residency slots, so some will do all that med school work and NOT have a residency slot! Craziness!
Oh and he will have close to $300K in debt before he starts his residency! He’s fortunate to not have undergrad debt but his med school and living expenses in a big city are over the top. At least he will earn a paycheck for residency ($50,000 or so) and won’t have to incur more debt. So the pressure is truly on for him to get his high-paying specialty so, as a minimum, he can get out of debt at some point in his life!!
Good luck to the OP. Health care is a noble profession and I’m so glad there are people out there who will subject themselves to this kind of stress so we can have the world-class health care we enjoy in this country. It’s not for me!
With regard to medical school graduates to residency spots ratio – there were ~ 17k seniors of US MD schools in 2014 and ~25k residency spots. There are more applicants than spots because foreign graduates and DO graduates are applying to residencies as well and they’re typically less competitive than the “US seniors.” There are enough spots of US MD students. There were only more US MD applicants than spots in six of the most competitive specialties of 21 availabale specialties.
Applicants for podiatry residencies DO outnumber openings, which creates a LOT of stress and anxiety for the students. We have a relative who worked VERY hard so that she wouldn’t be one of the unfortunate ones who didn’t get a placement. She ended up getting her 1st choice, as did her BF. They are both living in SF and very happy, tho extremely busy. He’s just starting his internship, followed by residency in pathology and she in podiatry. Podiatrists start with their college degree, then have 4 years of podiatry school and 3 years of residency.
Respiratory therapy is a 2-year program at many CCs, but many get a BS as well, just so they have opportunities to advance or take promotions and other jobs when they are available.
I doubt the typical medical student applies to 100’s of residency programs. There are a few very popular- hence competitive- specialties that students may be applying “everywhere” for but not all specialties are like that.
Most medical students will not have to have studied that hard to get good grades in HS or even college- they will be the serious students who study more than most but will have the ability to handle a heavier workload than most. Medical school is a ton of learning- nothing that hard to understand but so much material in the allotted time. Again, unless they are competing for the specialties that are most popular relative to the number of available spots they don’t need to stress out unduly. Different personalities sort themselves out into different types of medicine. Not everyone in medical school is uber competitive. In fact, many medical schools are pass/fail for grades- no need to rank everyone as all need to learn enough. Remember- even the last in the medical school class will become “Doctor”.
Re differences between physicians and nurses giving anesthetics. One is a physician, the other a nurse- consider the training for each. Physicians look at patient care from a diagnostic and treatment aspect while nurses from a nursing care viewpoint. I knew one CRNA who considered anesthesia to be nursing because of the hands on care but that is seeing only the tip of the iceberg. I know for the oral anesthesia boards ( one of several specialties that has oral as well as written boards, btw not required by law to be board certified to practice any specialty, but must have a vallid medical license) we had to make all medical determinations as if we were the internist, cardiologist, pediatrician, obstetrician etc- deciding which tests to order et al. In the real world you get the consult if you do not feel the patient may be ready for surgery medically speaking. Anesthesiologists, like all other specialists, are physicians first. Good surgeons remember this when they plan an operation- the patient comes for their presurgical anesthesia visit with all sorts of concerns based on their health already addressed. Technically all CRNA’s are physician supervised (although state laws have been changing over the years)- ideally by an anesthesiologist or otherwise by the surgeon. Also- any orders written by CRNA’s likely are also approved by a physician while the anesthesiologist can contradict what the surgeon has ordered for preop meds, and add tests. This is an “off the cuff” description- not meant to be the researched, definitive answer. The CRNA governing association disagrees with the Anesthesiologist’s (ASA- American Society of Anesthesiologists) on several things.
<<<
I would go to one of my state universities, and not the “most elite”. High GPA always trumps prestige of undergrad school when it comes to med school admissions. MCAT scores are really important, too. Find the med school section of this web site to see what is involved and how difficult it can be.
<<<
@toledo I agree. That was the strategy my son had.
I see so many premeds get tripped up by:
going to a prestigious school (or really any school) where their stats are middle quartiles.
loading up with too many hard classes the first semester/first year.
adding second majors or choosing a very difficult major because they think the SOM Adcoms will be impressed.
There are some aspects of the med school app process that can seem counter-intuitive. You don’t get a break for having a lower GPA from a top school. You don’t get a break for having a lower GPA for majoring in engineering. You don’t get a break for having a lower GPA because you added a second major or some minors.
Traditional applicants have to get thru those initial filters. Those are typically ones that don’t involve human eyes. GPAs tend to be a first-line filter for traditional applicants. That’s why we’ll see top school applicants with a 3.5 GPA get NO interviews. Their apps likely didn’t make it thru the first filter.
The life after med school is even more challenging in terms of long grueling hours. Is 14 hours a day very common for PGY-1, the first year in residency?
The self-study time in the month or two before STEP-1 could be 11-13 hours everyday also. (Maybe those students who could manage to score 42 in the old MCAT test could study only 10-11 hours a day.) This assumes that these students aim for those competitive specialties.
Re: "That’s why we’ll see top school applicants with a 3.5 GPA get NO interviews. "
With such a “low” GPA, it is could be a hit or miss for med school admission from any school.
How much do MDs make during their residency? This is what I have found this morning. The pay is almost the same independent of the specialty. It is only after, say, 4 years in med school and 5 years in residency, their income starts to increase significantly, and the compensations become quite different between different specialties. (due to a more grueling training, and/or a longer training - thus a higher level of indebtedness.)
“Average residency salaries increased from $51,000 in the first year after medical school to over $60,000 after the fifth year. According to a recent commentary in the New England Journal of Medicine, when adjusted for inflation, resident compensation has not changed in 40 years.[2]”
Residency is part of the training process- just because they’re getting paid it doesn’t equate with being out in the real world. The first year of residency/internship year is likely the hardest of all. Someone with current knowledge could report on the requirements for paying back loans- ie whether they come due as money is being made or whether residents still have student status. I remember starting to pay mine while others did not.
I do not see where residents should be making any more, adjusted for inflation et al, than in the past. Along with providing needed services there is a lot of learning still going on. It is hard to justify residents making a lot of money when those costs would need to be passed on to someone. I do not understand how CEOs of hospitals, insurances companies, pharmaceutical companies et al can make such giant salaries. Their added value to their product certainly is not there. Check how much is paid to nonmedical management of health care- it is huge. Our society would do well to restructure its priorities for business people and entertainers, including athletes, making huge amounts. One does NOT go into medicine to make money- when you consider the time and expenses compared to the money earned it does not pay well. You have to like what you do. The same reason some are academicians instead of out making a profit from their skills.
Again, you do not become a physician for the money. There are so many intangibles. The hours many women work mean the money spent becoming a physician do not get reimbursed as well as they could be with being a PA per the article. However- the knowledge gained is something else, the autonomy, and so many other intellectual factors are different. I could never settle for not being in charge or having a lesser knowledge base- all those hours of basic sciences behind the skills mean being able to change things and not be trained to do something.
To relate to the OP’s question. It isn’t just the actual patient care method/type but all of the unseen beneath that tip of the iceberg that differentiates various professions. Even among nursing degrees you see where some may wonder- why go through the bother of being an RN when LPNs seem to do so much of the same daily work- the professional judgments made are usually not noticed but are there. One nurse once joked about being a “Low Paid Nurse” instead of being a Real Nurse". What you choose depends not only on the daily routine but on the background knowledge you desire. Following established routines is one thing, but knowing the theory behind those allows one to alter them to best help the individual patient.
@mcat2 , when I read your information and casually mentioned the present-day first-year resident salary to my H, he responded with a “Wow, that’s a lot of money!” His 1989 first-year residency salary was approx $16,000, which according to this website translates to $30,684 when adjusted for inflation.
But, honestly, if money is the primary goal, there are other ways. Going to med school for 4 years + 5 years of residency + 1-3 years of post-residency training makes many a new practicing physician 32-34 years old.
@wis75 and @AttorneyMom, Thanks for sharing your experiences and insights.
Many residents need to live in a high COL area. I happen to know several residents who end up in Boston (MGH, etc.) The rent alone is $2000 a month for a studio in a nice location. His family can afford it though.
There are some residency placements that offer free rent on apartments that are on the hospital campus. I don’t know if the income is then lower. My niece’s husband is one that had such a residency. There were 10-15 two bedroom apartments across the parking lot from the hospital just for the residents. The residents and spouses helped each other out with childcare, etc and it was a real community.
I heard there are beds in the hospital which are reserved for the residents. Med school students are not allowed to use them. They do not work the med school students as hard as the residents, I think. However, med school students may still complain they had to be working much harder than typical UG students. One CCer here once posted that those UG students really do not know what it means by “studying hard”. Maybe PGY-1 may say something similar to med school students.
No, I wouldn’t say new physicians will have the same attitude towards those behind them in the pipeline as medical students do towards typical college students. The high level of difficulty in the 1st year of medical school is in part due to change and this is echoed in the first year as a resident. Whole new role with increased responsibilities and typically a whole new hospital system to master.
Most HS students do not study as hard as the top students who go on to college and even in college most students do not study as hard as those who go on to graduate or professional schools.
However, in medical school everyone has the same goal of learning as much as possible- some come with better innate abilities and/or background knowledge (even the crème de la crème has its crème de la crème). Despite how competent senior medical students become by June there is still a difference in what is expected and responsibilities for MDs- new learning curve (yet again). For a physician there are three such times- as a new medical student, second year you know how things work at your school for basic sciences, then the first full time clinical rotations where you again know nothing about how things work followed by the final year where you know how the system goes. Then the whole new role as a physician (finally). The rest of the years may be challenging time wise but you know how the system works by then.
Compare it to getting your first job as a professional. You learn not only the company/job routines but insurance plans, retirement plans, vacations… all things you can apply to any future job.
} you will be spending the next five years (primary care is only four years) of your life. You find out a few days before Match Day if you didn’t match anywhere. Imagine, all that work and you match nowhere…You either scramble to find something open in another specialty or you find a research job to tide you over and try again next year.