Great opinion piece about the societal coats of encouraging students to do gap or glide years before applying to medical school
By James Allen, MD
Professor Emeritus of Internal Medicine at the Ohio State University
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Interesting article.
One thing I didn’t see mentioned (or I missed it when I read). Some students actually decide to pursue medical school applications after undergrad. IOW, they were not premed in undergrad and might not have taken all of the required courses for medical school applicants. This can take a year or two, or more, depending on how many courses a student needs to take.
And really…physicians can contribute to their retirement accounts to the max…and have the income to do so. Honestly, I don’t know one retired physician who has financial issues. And yes, some did different things after undergrad before applying to medical school. So working less years in total doesn’t seem to be an issue.
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This seems like the critical premise to the argument in the article:
There is no reason to think that physicians who take gap years will retire at an older age than other physicians, thus every gap year will shorten a physician’s working years by 1 year.
I would not necessarily be inclined to make assumptions either way. Like, I definitely would not assert I know they will all work to an older age as physicians, but I am not at all sure they will all work to the same age. I actually suspect this would get even more complicated if you really tried to model it, as of course not all people who go to med school actually work as physicians, or not their whole careers, and I am not confident that taking gap years would not interact with those variables as well.
Like this is just speculation, but is it possible that gap years marginally reduce the number of people who rush into med school, end up not liking the profession, and end up not being physicians for long or at all? I don’t know, but it could be, right?
That said, even assuming this is true–if there is a shortage of physicians, isn’t the real answer that we need to be producing [edit: and retaining! see below] more physicians? I get that is a complex subject, but to me, complaining about the speculative marginal effect of gap years seems to really be dodging that central issue.
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Exactly. From my observation, doctors who are retiring now are doing so because their autonomy has eroded significantly given the buyouts/corporate ownership of their practices, insane amounts of paperwork for lower insurance payments, and a lot of administrative hassles. It has nothing to do with their age. My mom’s geriatrician retired at 85-- if he’d taken a gap year way back then, it certainly didn’t impact his longevity as a solo practitioner at all.
My friends who are taking early retirement are doing so because the ratio has now flipped- they are still working 18 hour days, but the majority of those hours are now non-patient hours. We’re worried about an extra year when our health care system is driving experienced providers out of the profession? We’re losing an entire decade of patient care due to frustration with the system!
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Well, if I was working 80+ hours as a surgeon, I’d never have time to spend all that money. That makes for a GREAT retirement 
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glad to see you back
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I know a couple of doctors who worked until they were 70, and then retired. However, both appeared to be in very good shape at 70 and very much able to work. How much this was motivated by finances versus just liking the work I am not sure.
In terms of retirement planning, to me it is not clear that taking a gap between undergrad and medical school should hurt at all. Presumably the student will be working in those gap years, and could contribute to an IRA during that time.
If a parent can afford to do so, then I think that it is a good idea to help your child contribute to an IRA early, for example if they are taking a gap between a bachelor’s degree and graduate school. Even relatively modest contributions to retirement funds, if made early, can make a big difference 40 or 50 years later when retirement age comes around, or 60 years later when someone has been retired for a while.
I think that this is possible. Our daughter who got a DVM took a gap, and a big reason for the gap was to make sure that she really wanted to take this path. She did know a few (very few, but not zero) students who dropped out part way through the DVM because they decided that they just did not want to do it. Taking a gap and figuring this out before you start to me seems like a far better approach.
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I agree with all of this. Plus applicants who have taken a gap year(s) have higher acceptance rates than those right out of undergrad, so that would have to modeled in too. Those coming right out of undergrad and even those with only one year of gap experience might never even make it to becoming a physician because they aren’t successful in their apps, so they just move on to a different job/career. Tricky to model all of these factors that have been mentioned, but it’s certainly possible.
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I know college grads who took gap years for that exact reason. They needed more time to shadow, speak with physicians, and decide if this was the right career.
The sibling of a young coworker went straight to medical school, hated it, dropped out, and decided to go to culinary school.
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I have one young physician who took more than one gap year and is on-track to retire very comfortably at 50.
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I have a friend who took a gap year between undergrad and med school (already accepted) to earn and save some money for the latter. Decided that the money-earning work was very interesting and chose to go to grad school for that rather than med school.
With that said, I have 2 friends who left medicine for other fields in their early 30s.
It is often difficult if you’ve been in single-minded pursuit of something to realize there are other things out there.
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Interesting thoughts about individual pros and cons and some great anecdotes. However, in the absence of data, I’m inclined to believe his expertise. His bio states, “My primary missions as medical director were to align the clinical resources of the hospital with the clinical needs of the community, to provide a venue for community medicine training for our students and residents, and to do it all in a financial viable way.”
Hmmm…the author assumes that medical education loans are “low cost.” This will no longer be true starting 2026, when federal student loans get capped at $50K/year for professional students with a lifetime cap of $200,000 (including any federal student loans taken during undergrad). This means that med students will be taking higher cost/more expensive unsecured private loans to finance their medical education. Current interest rates for those are running anywhere from 10% to over 35%.
For students who do not come from wealthy families, this means they either need to go into substantial debt, possibly unsustainable debt, in order to pay for med school or they need to work to put away a cushion to help minimize the amount of loans they need to take out.
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Everything @blossom has said is spot on. One more year on my lease. We are not renewing. We are talking to large VC groups and small individuals. We are a small mom and pop medical office that actually talks to you and gets to know you. The current doctors want to make a small fortune. Not work for it. Work 9-5. Sure not everyone but there is a paradigm shift.
So we always had a two person (my wife and I) practice but working one person’s hour’s per se. We both wanted to be with our kids when they were growing up. We paid down over $350,000 students loans (thanks house equity 
) many moons ago.
I didn’t read the article but read your comments. Sorry, taking a year off means nothing about future income. Kinda a stupid premise. We employ lots of premed student’s. They all seem to take a year off these day’s. It seems to be their normal.
There is also a push to retire early. That comes with good financial planning and not buying the newest Mercedes or living in the best area right away. I see some medical residents driving nicer car’s then their attendings.
My saving grace is I know how to use technology like Ambient listening to get my charts done pretty much by the time I leave the treatment room. (I lecture and a medical consultant for an AI company).
But older doctors aren’t going to want to adapt. I have known many doctor’s that couldn’t make it in medicine. They are doing something else now. Not all doctors are rich and will do well in retirement.
I just had this conversation with another doctor on my way home. I said “It’s hard enough being a good doctor. I can’t imagine how hard it is being a bad one?”
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A year or 2 or 5 is not going to make an appreciable difference in overall earnings or the shortage of physicians. Agree with many of the points above. I am a mid-career physician in academics in a low-paying specialty located in the Northeast where physician salaries on average are lower in relation to the high cost of living. I have no idea when I will retire. I am burnt out, but even on my worst days, I cannot imagine not seeing patients or teaching residents/students because this is now who I am. Most of my colleagues retire in their 70s, not because they don’t have the money to retire, but because they are doctors and they like their work even in this difficult health care climate. I cannot complain, I am comfortable. However, this is not a career path for someone trying to be super calculated about return on investment. I personally think medicine is a stupid career choice for someone who is just thinking about money, even for high-paying specialties. There are easier ways to land on this salary without all the delayed gratification of so much schooling, stress, liability, and money (to pay for schooling and the delayed earnings/retirement). I am fortunate I finally paid off the last of my student loans (2 years before my kid starts college) and am very comfortable, but I don’t do this for the money. I don’t say all of this to discourage people, I actually encourage kids to choose this, but people need to go into eyes wide open, which brings me back to the original post and gap years. I know no one who took gap years and did nothing. People applying to medical school are driven. They are working and generally doing some sort of medical or service related job. They are saving money for the upcoming lean years. I took one year. As a first gen, low income student, gap year was not in my vocab but medicine was not on my radar until mid college so my timing was off by a year. I am so glad I did. It is hard to be so young when you start seeing patients in medical school. Having some maturity and life experience is beneficial. I see those skills in the students and residents I teach who have done something else before med school. And additionally, this time can help confirm (or not) that they really want to take this path. Better to learn that before sinking more time and money in. It is an easy path to feel stuck in pretty quick because it can feel hard to quit once you jump through so many hoops. It is good to get off the train and soul search a bit. Also nice to live a more normal life for a bit in your 20s! When things were tough in med school or residency, I would often think about my job that year (along with other jobs I held) and know that I could have maybe done it for 5 years max and then I would have been bored.
Sorry for long post, some of it a little off topic. I am sure others may have different experiences, but this is how I see gap years and medical training in general.
And physician shortages will only get worse with the current state of health care. To attribute any of the current physician shortage on a year or 2 that bright, dedicated people take off to work in their early 20s, feels a bit like victim-blaming.
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