If You Could See Medicine Through My Eyes: Resident Perspective

Thank you Wall Street Physician for your contribution to this project. This is exactly what I had in mind when the idea came to me and you did not disappoint.

It is nice to see how every generation views medicine and to get it from a resident’s perspective was especially informative. I am glad to see that you feel a medical career is still worth it. Gives hope that there will still be a promising future for young docs

Life is more than money. No question most of medicine is moving to shift work to facilitate work/life balance. Maybe this will produce a healthy happier generation of docs.

The work life balance changes may be the most important of all those you mentioned. I’ll be curious to see if these shifts in priority are protective against personal catastrophe going forward.

You are precisely on point that the buffer of a high income won’t be what it was for prior generations, but neither will the expectations that medicine comes above all other priorities.

That might mean more children know their physician parents, fewer failed relationships, and more connection to other human beings.

Those trade offs may be expensive, but consider that they might also be priceless.

Great post, and brilliant idea for a series!

First, and foremost, I just wanted to say thanks for all the helpful information and the hard work you do for this website. I wish I had found it sooner as it would have definitely prevented me from making some simple financial mistakes.

I am a current PGY-3 in psychiatry which has notoriously been one of the more “lifestyle friendly” of the medical specialties. My co-residents, and I, are all a pretty happy bunch as far as job satisfaction go, compensation, work life balance, and job security going forward. The one thing that seems to demoralize many of the newer residents I meet is student loan debt. Some residents I have met graduated with >400K in student loans.

At that rate some are accruing multiple thousands of dollars in interest per month! My loans are more manageable ~200K and, to steal from Dave Ramsey, I plan to be “gazelle intense” when paying them off once I land my first post residency job. This gives me hope towards a soon to be debt free future, but it does seem that at a certain point (once loans near half a million dollars) it might not be worth it go into medicine from a purely financial standpoint.

I’m very glad to see such optimism and excitement about joining the profession. A lot of the financial independence writing (including my own) in the physician blogosphere is either neutral about medicine or somewhat down on it.

You are of course right, there is so much that this profession can offer people and to be able to do it with a good work/life balance is even better. I think this might be one of the most influential and important effect us millennials are having on the profession.

I think it’s all still worth it. Compared to the alternatives, medicine can offer a reliable, lucrative (relatively speaking) paycheck pretty much anywhere in the country. A financially astute individual can live a very comfortable lifestyle, raise a family (with a stay-at-home spouse even) and be FI by age 50.

Although you might not have gathered it from my post’s perspective, I echo Kpeds’ sentiments – it’s heartening to see someone’s optimism for the future of medicine.

It is precisely this attitude that makes me hopeful we’ll be able to turn things around in the future. As more and more of us who value work/life balance enter the workplace, the medical system will have to respond in kind. As we’ve had to be more financially savvy, we will also no longer be beholden to jobs that don’t serve us and will be a lot more mobile to make better career choices.

In the meantime, appreciating the privilege we have as physicians is the right approach. The trust that people give us to walk with them in their darkest and happiest times is something we should never take for granted.

Thank you for sharing your perspective!

I loved everything about this collaborative series. It’s interesting to see what everyone thinks of each other’s generations. You are right about medicine still being worthwhile and financially rewarding. Physicians can still graduate med school in 2018 and still become financially independent before traditional retirement age. They just need to go in with a plan and not step on too many landmines along the way.

Thanks for being part of this creative concept.

I actually work for a university and I routinely see physicians with loan of $200-300k. It is very scary. And you are absolutely right about training being long. I have seen residencies go on for 7 years! The debt is accumulating interest like nobody’s business. It is a shame that doctors have to spend hundreds of thousands of dollars. I have seen situations where people were able to work as physicians as well. Which is awful. And its not just doctors. Lawyers too are ponying up a pretty penny to get thru school. One guy did an interview and said it debt had ballooned to over $100k even while paying over the last 20 years! He said he expected them to attach that student loan bill to his coffin! There has to be a better way.

Thanks for the post.

Miriam

If you think about the cost of medical education, really the first 2 years of basic science is where the university costs are. The last 2 clinical years are spent in the hospital and the instruction is given by attendings on the medical school staff who are rarely paid anything; so the costs from the university for educating the last 2 years are minimal. Also many of the Universities require that the tuition checks go first to the university and it divvies up what it wants to the medical school. (ie Wayne State University). Also have you noticed haw many new medical schools have sprung up? They are easy money for their sponsoring university. ie Central Michigan Universsity, Western Michigan University, Oakland University. I think medical education has become a racket with all the new schools and all the new testing that is deemed required these days.

Working with kids is my passion and I absolutely love helping children regain health. I love seeing families care for their children and I love interacting with them and being there for them in the darkest moments. Being a pediatrician is one of the most emotionally rewarding careers and in that regard a career in medicine is totally worth it.

However, being a pediatrician also comes with the downside that our pay is at the lowest among all physicians. It is difficult to swallow a pill of $400k of loans (from medical school and interest) and then knowing that right out of residency many other NPs and PAs in other medical fields are making more than me with significantly less training. (This is not a post bashing on PAs. My wife is a PA and I think it’s an amazing profession).

Many of the graduating residents I know from last year had starting salaries <125k in their first year of employment with no moving cost help and no signing bonus. From an economical standpoint, it doesn’t make sense for general pediatricians to spend such an immense amount of money on their training. If you are trying to pay your loans off in 5 years you’re essentially living off 65-70k/year because your loan payments are so high.

Don’t get me wrong, I love my work and I wouldn’t trade it for anything! But financially speaking, a career in primary care with costs of education and salary potential just doesn’t make sense.

As a multigenerational doctor I was infused with the understanding that your identity is your profession.

My father would go to the hospital before I went to school and returned many nights after I went to bed. Some nights even my mother would not see him due to working oncall.

In my surgical clerkship ( q2 ) I asked why not just break up the work into shifts. The response was continuity of care. What is best for the patient.

I follow that today. My patients come before everything ( good or bad that is how I was raised / educated )

I am also very interested to see how the new medical approach to doctors having a 9-5 job pans out.

I’m my humble opinion we as the leaders in the medical community desire the high salaries to justify all the sacrifices we had and continue to make.

But the article this week showing no quality difference in care between MD, NP, and PA helps put on of the few last nails in the coffin for being an MD. Why go through all the crap for an MD when there us no additional respect, very little additional money, and ALL of the liability????

Just an FYI that Internal Medicine residency is not 2 years and has not been so in our lifetimes.

I watched the slow decline of our profession over nearly 30 years in practice. I am saddened to see doctors giving it all up so easily, with a whine and a whimper now and then, but with not a shred of resistance to the pack of parasites who have nearly sucked the life out of us. Litigious patients and their amoral lawyers, the lawyers who make a living defending us, insurance companies, prior authorization agents, consumer advocates, “consultants” of every stripe…the list is endless.

This author tries to put a happy face on an undeniably grim situation: “There are so many reasons why medicine is an awesome career. It is a tremendous privilege to care for patients, and most patients are grateful for what we do.” This attitude accounts for much of our misery. Those who prey on us, those who siphon off large portions of the value that we and we alone create, depend on us to be driven by this asceticism. But it has reached the point of pathology, of masochism. It is human nature to not respect people who don’t respect themselves.

Doctors have the awful power of life and death over the public. A moment’s reflection will confirm the truth of that simple statement. Why on earth don’t we act like it?

It’s not about the money. The reason I told my son not to pursue a career in medicine was due to ever increasing regulations from insurance companies and the government and the fact that physicians no longer run medicine. The government, hospitals, administrators and nurses control medicine and they are the least qualified to do so. I enjoy taking care of patients but hate the inane bureauracracy in which I have to work.

You can’t be serious? I’m 39. Of course it’s NOT worth being a doctor. A teacher that starts work at 22 with a Pension makes more over their life than a GI doctor. Why torture yourself for 13+ years for that? Forget it. I’d never do it again. No chance.

Medicine is no longer worth it and I will argue it is because of ourselves. Name me another job that has such high liability per ratio of monetary reward? “Taking care of patients” is actually the biggest fallacy all of us tell ourselves while the business of medicine is leaving physicians in the last place. This is the reason physician reimbursements are low. Physicians are killing the future of medicine by delegating the business of medicine to hospital administrators, or other third parties, while believing we should concentrate on just patient care. This is the reason we have hospital administrators making regulation and rules for physicians in the first place (we make money for the hospitals, assume nearly all risk).

The day physicians win is when every one of us puts value to our time, and when we start charging per hour rates for everything we do. We will never be able to do so when physicians keep on giving away their time for free for the name of patient care. Name me a car mechanic that stays late to fix your car in the name of being a better mechanic? Name me a lawyer that stays late and doesn’t charge per hour rates? Physicians keep on drinking the falsehood of doing everything for free because its good patient care. I would argue, you are the problem of medicine, in that you are de-valuing physician’s time.

In America, all post graduate degrees are investments. You are choosing to go further in your studies in an attempt to gain more, whether it be money, power, prestige, security, or even just knowledge. This investment has three direct costs attributed to it. The first is the wages lost while in school based upon the completion of a 4 year degree. The second is lost retirement planning. Lifetime retirement accrual begins some 10 years later and is often underfunded in those choosing medicine. That is why you see many doctors working in their 80s. The third is the direct cost of education combined with cost of living and the accrual of interest. Therefore the accrued cost (lifetime) of a medical education can easily exceed a million dollars.

Once you have committed to this investment you then face a lifetime of risky behavior requiring additional insurance (another cost), night and weekend work, increasing public scrutiny of your work product and devaluation of your investment as those with lesser eduction are elevated to being your practice peer.

It is implicit in “Choosing wisely”, one is putting passion aside. Consider carefully the cost of pursuing your passion so you won’t regret the decision later.

From a financial perspective and QOL perspective, medical school is 100% not worth it for many physicians. That’s obvious. However, for the independently wealthy or those with little school debt, it can be worth it. The debt to income ratio is the most critical factor.

As an alumnus of the NYU School of Medicine (NYUSOM), I’m proud to see my alma mater be a leader in reducing the financial burden faced by most graudates of U.S. medical schools. NYUSOM announced in August that effective immediately, all current and future medical students will pay $0 in tuition. This action will come close to eliminating the onerous expense of a medical education for NYUSOM graduates.

As far as the answer to the question, “Does it still pay to go to Medical School?”, I hope today’s current and potentially future medical students have more altruistic than materialistic motivations to become physicians. There are many potential career paths for physicians other than a lucrative practice that may prove far more emotionally gratifying although less remuniterave. Over the course of a many-decade career, the physician should consider which career path is least likely to conclude in burn-out, dysfunctional family relationships, etc .

I’ve been a physician for 16 years and this is the SAME argument made when I first started in 1998…the exact same. The PA, NP debate is only slightly different because of the advent of NP online diploma mills. But come on guys, relax…

Med School worth it? Financially, no. Rationality aside I found myself surrounded by zealots and fanboys my first year of med school. After a couple of clinical years the bloom was coming off of the rose. A poll taken for 4th year students showed that over 1/2 regretted coming to medical school. So why keep going? An MD outside of medicine is functionally worthless. Four years of college, four years of med school with many 100 hour weeks are good for bragging rights but not for making a living or paying down school debt.

I stayed in because with all of its warts medicine allowed me to hang a shingle and make a living anywhere I cared to go. That is basically no longer possible, but at the time it was still true. No PhD mire to navigate. No bank officers to pitch to. No board of directors to woo.

But today an MD costs a lot more and is worth a lot less. Self-employment is almost gone and return on investment is marginal at best. I cringe every time a young person approaches me and says that they want to go to medical school. Over half want to be dermatologists. Lots of money, good hours and if someone gets sick send them to a doctor who bothers with such nasty little details. They don’t understand how fragile such revenue streams are. Look at ophthalmology. They are making a fraction of what they did in the 80s. Same thing will eventually happen to derm and already has around the edges. No lifetime security there.

But I will say what I told my own children — If not being a doctor will leave a hole in your soul, by all means go to med school. It is easier to get in now than ever. If you can be a complete person doing something else then please follow that path. I respect both journeys fully.

I would guess NYU med school is financially worth it, if you can get in. If you do well financially and save for college for you kid, the undergraduate school will cost you 100K per year though.

Unclear where some of your data comes from. There is no way for one year of school to cost $100k +. Medicine residencies have been 3 yrs. for at least the last 25 yrs., and radiology has always been 1+3 yrs. Debt is skyrocketing and now there is a race to offer no loans or no cost (NYU). Lots of change coming in the next 5 yrs.

It’s absolutely still worth it to go to medical school! If you love it.

Is it “worth it” to become a concert level musician who makes nowhere near what a physician would make, but lives an incredible life and experiences joy each time they play?

Medicine is like anything. Forget about the past images of wealthy doctors playing golf without a care in the world and stop feeling sorry that we live in a different time. There certainly is a price to pay for the training, but it’s still very easy to do well financially in medicine if you make intelligent choices, just as you would have to when navigating any field.

I’m a reconstructive surgeon in academics, and every single day I get to do incredible things that change people’s lives. I enjoy every minute of seeing my patients and sharing unique, privileged experiences with wonderful people in the operating room. Wouldn’t trade it for the world. And wouldn’t trade it for a private practice where I was hustling to make more and more money by putting in as many breast implants as possible.

It doesn’t hurt that in academics, you have no overhead and qualify for public service loan forgiveness.

Do anything because you love it, and it becomes worthwhile.

We talk so much about how bad medicine is, and how much it costs to get your degree, the obstacles to practice, and the lack of income commensurate to our abilities and workload. These are very important issues that need to be addressed as medicine has changed over the years. The fundamental question that each of us must ask of ourselves – are we happy as doctors? With all of the trials and tribulations that we experience – would you really want to do something else? For me medicine offers a never ending challenge that I enjoy. Each patient presents with as a puzzle with a few clues – symptoms, a rash, fever, changes in blood chemistries, etc. And I never tire of the challenge – and my reward is knowing I have made a diagnosis (hopefully in a timely fashion) that can help or save my patient’s life. Putting together all of the clues, and using the knowledge that you have stored up combined with some information that you just read about in a journal to come to a conclusion that is correct – that makes my career choice worthwhile. Would you really be happy as a mindless automaton spitting out canned responses to a boss who cares nothing about your opinion. Can you imagine going from endless meetings with other cubicle rats to repeatedly discuss mundane matters in the hope that one day everyone will agree on a plan of action that satisfies the company. Never discount the freedom that we enjoy as doctors – to make what we want of our lives. Do you want to live near a beach or in the mountains, in a small town or a big city – all choices are open. I started my career before medicine as a chemist specializing in the science of polymers and dyes (yawn). I realized that I would be forever relegated to the few areas where my expertise could be employed. I would never be able to set my own schedule, never be able to be my own boss, and never have control over my life. Medicine is a constant challenge that you can put into practice in so many different ways. It isn’t a daily grind – it is a unique opportunity that few people ever get.

We as a profession need to address many of the issues that are destroying the younger doctor or potential medical student. The cost for a degree now is outrageous and (I believe) results from medical schools turning into profit centers for their universities. My tuition (in 1978 my first year) was $285 per semester. You read that correctly. I went to a state supported school and graduated with a small amount of debt that was reasonable and relatively easy to pay off over the next few years. My first year of residency paid a little over $12,000. I cannot imagine the stress of several hundred thousand dollars debt hanging over me as I start a career. It is the equivalent of buying a half million dollar home on graduation day. No bank would ever loan money for that purchase based on the expected income of the doctor starting residency. Fiscally, how can these schools justify these huge sums? The cost to educate a new doctor simply cannot be that much. And if it is, then the payment system post graduation needs a huge revision to balance this out.

I chose the direction I wanted my life to go. Medicine allowed me to do so. Absolutely it is a career worth pursuing. Changes need to be made regarding the cost of this career. No career should be based on how much money you can make, and the choice of medicine should not come with such a huge financial burden that all of your subsequent choices are directed toward making enough money to pay off the debt. That is a recipe for unhappiness.

Thanks for the opportunity to express my thoughts.

I’ll try to keep this short – but that’s going to be hard. I’m 62 years old, have run my own specialty clinic. I have written articles to empower patients and at the same time I have written articles for medical colleagues to point out not only the serious direction medicine has taken but the need to fight it. Believe me, I have a passion for helping and am usually very upbeat and outgoing. I love to teach – from patients and would-be medical students. So, I do feel some reluctance to spill the beans. But – here’s the truth: I hate to disappoint but the realities are that those of us in the know are not just worried but are also disgusted with the ongoing desecration of the profession of medicine. No, it’s not worth it anymore from the standpoint of the provider. (Of course, patients would disagree.) I appreciate the young and fresh ideals of young docs/students in this blog. However, young docs and residents expressing such optimism clearly have not lived in the profession long enough to know what’s going to happen to them. The bottom line is that docs are being increasingly forced to become lackeys in a system that is broken. I realize that young docs are full of energy and optimism. Believe me, I was there once as well! But, when I see the struggle with never ending exams, Maintenance of Certifications, constant, daily interference by the powerful insurance companies who daily frustrate my clinic’s attempts to order tests and prescribe even basic medications (ie I cannot “be a doctor’) and to be able to simply prescribe meds for my patients, the threats of very real audits by insurances, my colleagues in academic institutions outraged by the paperwork and need to play time-wasting “Mother May I?” with the insurances in each of their areas so they can order badly needed meds and/or drugs for their patients (but then get turned down so patients CAN’T ACCESS THE TREATMENT YOU LEARNED IN TRAINING WAS THE CORRECT COURSE OF ACTION), and see the number of docs joining large organizations because their small clinics are overburdened and they can’t keep up with admin burdens (but then tell me they regret their loss of autonomy)…the list is much longer……while one’s free time due to administrative headaches dries up and one’s family suffers, then it is very clear that medicine is not worth it. To now look back at issues like harsh and exhaustive residency programs – I say with disappointment that the same complaints years ago haven’t changed!!! Attempts were made but it’s only getting worse. I totally agree that things “have to change” but, look, they have “had to change” for over 40 years but haven’t. And listening to my colleagues – even those in retirement age, it is clear that they are burned out. (NOTE: There is a 50% burn out rate across most specialties.) So – unless the truth be told nothing is going to get better. And, yes, HORRIBLY – the medical profession continues to have the HIGHEST rate of suicide of all professions. I recommend more people pay attention to the new documentary on medical student, resident and full-fledged physician suicides: “Do No Harm.” VERY sobering. If I didn’t love people I would not have made the many sacrifices to keep trying and plugging along with the same optimism as many of you are feeling. However, in the context of not only administrative but also financial burdens – which are HUGE – and personal and family burdens which are equally huge, despite tremendous altruistic intentions and beliefs, if people are blindly throwing out the exclamation: “It’s worth it!” well, this is doing a disservice to well-meaning new recruits. This will not help those recruits. You have to identify problems in order to change them plus you have to dig into the various sources of those areas where organizations or companies currently PROFIT/benefit from this unfortunately broken and deteriorating system in which profits spread like cancer. Unfortunately, this is a David vs Goliath situation. However, compared to the biblical story, David has shrunken while the Goliaths are cloning themselves. Remember – if I didn’t care so much about what’s happening, I wouldn’t have taken the time to write this. Sometimes the truth just has to be told.

Future for MD’s is for “gentleman” docs with well-protected assets, the few that don’t care about getting financial rewards for climbing over many obstacles, and those that target narrow areas of proficiency that allow them to opt out of the usual straight jacket imposed by the current system. Anyone else that wants to write prescriptions would be much better served by going the NP route and learning on the job at a salary way above any resident. You have the creds to get into a good medical school, you likely can be paid to get your NP!

I always have found medicine fascinating and a being a physician a privilege. Yes, things change; I recall hearing “older docs” complain about this very thing when I was a med student in the late 1970s (“Medicine just isn’t like it used to be”). At the risk of sounding Pollyanna-ish, everything in life changes, and the key for me has been finding a niche that works, taking the good with the bad, and taking good care of those entrusted to you.

Most of theae comments are delusional and ridiculous. Medicine is a business. Period. Physicians need to onow their value and leverage the beat deals that they can get. Medical school costs 100k per year now. Physicians need to get paid to make it worthwhile. Uninsured patients in the ED, medicare patients, obamacare managed medicaid…. These patients do not generate suffixient revenue to make it wirth one’s while. If you are going to spend 400k on your medical esucation, spend your beat years in residency, only to have to deal with crappy insurance/medicare… it will not be worth it.

I am also a radiologist. I resent that the author says “Yes”, after giving all of the reasons that you shouldn’t go in to medicine. I have three grown up kids, and told them all not to go into medicine, even though 2 would have probably done well. You didn’t even mention that almost all college students now have to do a gap year before they can get into medical school. Your reason to go into medicine is to take care of patients. What about the insurance companies and medicare telling you that you can’t do this, that, etc.? What about the lack of tort reform, so that you have to cover your butt? I have always been top in what I’ve done, and should have just gone into business, where if you totally screw up, they give you a golden parachute to go away, and you retire young and rich. That never happens in medicine. Too much money to get into the game. Too much time, and not enough return for all of that work. I’ve only ever met one other person who has done more schooling for their career than almost every doctor. The bang is not worth the buck. Sorry.

There is a major and growing disconnect between the cost and the payback for becoming and being a physician in the US. Cost is measured in $ and years of your life you cannot get back. Payback is measured in professional satisfaction (declining as autonomy falls and algorithmic medicine grows) and compensation. I guess it is good that young physicians are optimistic about the future, otherwise we would have none. But I suspect as they approach middle age and find that workload is ever growing even as compensation is not, they will question their career choice, though 25 years too late. Personally, I have worked 27 successful years full time as an anesthesiologist, and have seen no meaningful change in my income over that time, although I find I work harder and harder to earn it. Though I enjoy the work, I find my college classmates who chose other careers have more to show for their years of hard work than I have.

Practicing medicine with a medical degree will once again be enjoyable when the reduced earning potential is appropriately matched with a reduced cost. The personal cost in lost years can only be balanced by the personal satisfaction that we find in learning, gaining skills and healing.

Two words define why the practice of medicine as we knew it has died and why I believe a career in medicine isnt worth it: corporatization and deprofessionalization. We are no longer physicians, healers, doctors who are valued and respected, we are now providers and many of us work for corporations. Gone are the days when you could hang a shingle and practice real medicine. Many of us are forced to spin our wheels faster and faster to maintain our salary, spending less and less time on patient care and more time attending to the ever increasing rules, regulations, certifications and electronic medical record keeping with diminishing control and all of the liability.

Its not about a return on an investment or how much money we can make, its about complete and total lack of respect and we have only ourselves to blame for letting the government, administrators, and insurance companies eat our lunch while we say “please sir, may I have some more?”

The answer is no, I wouldnt ever recommend anyone, including my own children go to medical school. Why would I recommend that anyone train for multiple years, incur tremendous debt, have their innocent idealism crushed and endure years of frustration only to burn out while trying their very best to care for their patients and not get sued in the process.

The current system will have to die a painful death before it is resurrected in a functional way and new age Physicians will have to lead the way. Sorry but this is the horrible truth.

Compare Medicine to other professions. A Restaurateur takes out $100,000 for a business with a 50% failure rate, same with many other retailers, service providers, manufacturers, etc. While the margin for financial error in medicine is less than it used to be (per the article), normal diligence and good practice more or less guarantees financial success in the long run.

Not quite sure where all the negativity is coming from. As a physician, you can now have good life balance as you choose to work part time or full time, you can pretty much decide to live where you like, rural, suburban or big city, as jobs are plentiful. And the income is still in the upper levels of all professions. new lawschool grads often make < $100K and are quite plentiful, with fewer job opportunities. Business school grads are a dime a dozen. Teachers have many of the same psychosocial issues to deal with as we do, with much less financial reimbursement. And many other professions, ie psycholgists, social workers need advanced degrees to be able to practice their profession. So over, physicians really don't have it so bad. Yes, things have changed a lot over the past 40 yrs, and will continue to do so. But it still has much professional and financial rewards. If it is your dream, go for it.

To answer the question, “Is it worth it?”, I would answer, “It depends on the cost.” The cost of attending medical school is different for almost everyone. On one end of the cost spectrum is an early 20’s recent college grad with no student loans and a full ride scholarship to cover tuition and living expenses. On the other end of the cost spectrum is someone with pre-existing 6 figure debt who will incur an additional $200-$300k of marginal interest rate debt, miss out on potential alternative income for at least 7 years, and most importantly, enroll in a lifestyle that is extremely jealous of competing interests. For a privileged minority, the cost of attending medical school is definitely worth it.

Relative to other physicians with whom I’m acquainted, I have a very good work-life balance. In spite of my ability to find a “diamond in the rough” type of position, I have counseled all 4 of my children not to pursue careers in medicine. My primary reason for this is the time commitment involved. If my children said that medicine was, to use colloquial christian jargon, their “true calling,” then I would feel at peace with their decision. However, to enter into medical school with multiple competing outside interests is a setup for problems in my opinion. Ask me how I know…

Let’s say a brand new student today plans to pursue family practice. Let’s then assume that student’s debt from medical school plus living expenses will amount to $200,000.00 (a reasonable and not uncommon estimate at today’s tuition rates). After a 4 year residency period during which those loans will be in forbearance, at today’s interest rates that debt burden will balloon to $300,000.00. Then, again theoretically, let’s say that student is offered a job for $150,000.00/year out of residency (not an unreasonable assumption based on MGMA data). That’s $12,500/mo, after taxes about $9000 (depending on which state he/she resides in, could even be less than that depending on state income tax rates). About $2000/month will go toward the loan payment (which if the new doctor uses the entire 30 year period to pay off, will have a total cost of around $600,000).

Altogether, after figuring in taxes and loan payments, that equates to a take-home pay of $84K a year after factoring in taxes and student loan payments. There is not a single soul in their right mind who would ever endure the mental, physical, emotional and financial sacrifices, not to mention the time investment, required to go to medical school for that kind of paltry return. You could do better as a tenured teacher, plus get a fat pension and free healthcare for life when you retire at 55- neither of which you will get after a career in medicine (unless you work for the VA).

And of course, all of that assumes that physician incomes will remain stable at their current levels or increase going forward adjusted for inflation. Let’s just say I do not think that is a safe assumption, at all. If we ever get anything resembling national “single payer”, I expect average physician incomes across the board will take a nosedive from their current levels, making medicine an even worse investment for future physicians.

Anyone planning on a career in medicine today should go into it fully aware that the federal government is capable of completely pulling the rug out from underneath this profession at any time with the stroke of a pen, and that is likely to happen sooner rather than later considering the current political climate.

The current cost of a medical education is astronomical, few available loans at reasonable rates, most post graduate positions now are limited as to what they pay since most work is now available to be done by less expensive PA, Nurse practitioners and other ancillaries. Use of EHR causes unduly stress on physicians and patient physician relationship and government as well as third party payers tell you what you can charge all of this under the stress of liable and lawsuits . So I must really reconsider the question is Medical practice worth it certainly under the guise of helping humanity , but who will help the caring physician. Most other countries offer free or relatively low cost for medical education with little or no fear of legal actions hence the lesser burn out rate. Think Bernie Sanders will come to our rescue? I guess the traditional private practice is on the road to extinction .

Definition of Practicing Medicine in 2018:
Document and then document some more to maximize billing, minimize risk of litigation, and in the process if you help a patient or two, that’s the added bonus.
If you are in academics or you’re owned by an institution, that definition still applies. It simply gets transferred from you as the practicing physician to the institution that has hired you.

No

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I want to testify about Dark Web blank atm cards which can withdraw money from any atm machines around the world. I was very poor before and have no job. I saw so many testimony about how Dark Web Cyber hackers send them the atm blank card and use it to collect money in any atm machine and become rich. {DARKWEBONLINEHACKERS@GMAIL.COM} I email them also and they sent me the blank atm card. I have use it to get 500,000 dollars. withdraw the maximum of 5,000 USD daily. Dark Web is giving out the card just to help the poor. Hack and take money directly from any atm machine vault with the use of atm programmed card which runs in automatic mode.

You can also contact them for the service below

* Western Union/MoneyGram Transfer

* Bank Transfer

* PayPal / Skrill Transfer

* Crypto Mining

* CashApp Transfer

* Bitcoin Loans

* Recover Stolen/Missing Crypto/Funds/Assets

Email: darkwebonlinehackers@gmail.com

Text & Call or WhatsApp: +18033921735

Website: https://darkwebonlinehackers.com

My name is Tom Peacock from USA, I want to say thank you to Dr Emu for the good thing he has done for me, Though am not sure if this is the best forum to show my joy and happiness for what he has done for me but i can’t hide my happiness and my joy so i have to share it with people, my marriage got crashed about two years ago and i tried all i could within my power but to no avail. I saw a post and testimonial about the good things Dr Emu has been doing so I decided to give it a try. though he is always a busy man but when he responded back to my email, he gave me 48 hours for my marriage to be restored really just like he said my marriage was restored since then I am happy and i am living happily i am so grateful to Dr Emu you can always email him here: {emutemple@gmail. com} or WhatsApp: {+2347012841542}

HOPEFULLY THIS REVIEW WILL SAVE SOMEONE OUT THERE!!!

Am here to testify about the handwork of A Great Verified Hacker ( Mr Morris Gray )Who helped me recover back my lost funds from the hands of scammers who Ripped me off my money and made me helpless, I could not afford to pay my bills after the whole incident, But a friend of mine helped me out by given me the contact info of trusted Recovery Expert, his email: Morris gray 830 @ gmail . com contact him or chat him up on (+1- /607-69 )8-0239 ) and he will help you recover your lost funds If you have been a victim of any binary/ cryptocurrency or online scam, Mobile spy, Mobile Hack contact this Trusted and Verified hacker, He is highly recommendable and was efficient in getting my lost funds back, 11btc of my lost funds was refunded back with his help, He is the Best in Hacking jobs, contact him ( MORRIS GRAY 830 AT) GMAIL (DOT) COM.

THE ONLY TRUSTED AND GUARANTEED RECOVERY EXPERT TODAY (MR MORRIS GRAY)

Please everyone should be careful and stop being deceived by all these brokers and account managers, they scammed me over $279,000 of my investment capital, they kept on requesting for extra funds before a withdrawal request can be accepted and processed, in the end, I lost all my money. All efforts to reach out to their customer support desk had declined, I found it very hard to move on. God so kind I followed a broadcast that teaches on how scammed victims can recover their fund, I contacted MORRISGRAY830@GMAIL. COM , the email provided for consultation, I got feedback after some hours and I was asked to provide all legal details concerning my investment, I did exactly what they instructed me to do without delay, to my greatest surprise I was able to recover my money back including my profit which my capital generated. I said I will not hold this to myself but share it to the public so that all scammed victims can get their funds back. Contact; MORRISGRAY830@GMAIL,COM…

TRACE AND RECOVER YOUR LOST CRYPTO THROUGH ULTIMATE HACKER JERRY.

Learn more;Web http://www.ultimateshackjerry.com

Last year I stumbled across a cryptocurrency platform Advertisement online and I felt compelled to watch them since I had little knowledge of how profitable cryptocurrency is. I was immediately intrigued by it and decided to invest with the investment firm., on my first trial, I deposited $113,000 to the platform.My profit had accumulated so quickly after 48hrs that I became more interested and decided to add $215,100 to my initial investment.on attaining my profit target I requested for withdrawals. This company then began asking for more funds to activate my withdrawals.This made me suspicious, so I decided to consult a Crypto Expert. I came across Ultimate Hacker Jerry who advised me that I had been scammed but was also an Expert in Crypto Recovery Services. This expert Ultimate Hacker Jerry was able to recover all my Crypto a total of $328,100.I must recommend this erpert to any Scam victim that has been defrauded and have your Crypto recovered back by Ultimate Hacker Jerry.

CONTACT;Mail Ultimatehackerjerry@seznam. cz \
Whatsapp +1(520)282-7151.

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Regards

HOW I FINALLY RECOVERED MY LOST CRYPTO: I lost all my crypto to a fake investment scam to someone I met online. I started searching for help legally to recover my funds, and I came across a lot of Testimonies about HACKER STEVE. I contacted him, providing the necessary information and it took him and his team of experts about 36 hours to locate and help recover my stolen funds. I am so relieved and the best part was, the scammer was located and arrested by local authorities in his region. I hope this helps as many out there who are victims. I strongly recommend Steve professional services for assistance with swift and efficient recovery (Crypto, Credit card, Forex, NFT, etc) on Gmail: Hackersteve911@gmail.com | https://hackersteve.great-site.net/

BE SMART AND BECOME RICH IN LESS THAN 3DAYS….It all depends on how fast 
you can be to get the new PROGRAMMED blank ATM card that is capable of
hacking into any ATM machine,anywhere in the world. I got to know about 
this BLANK ATM CARD when I was searching for job online about a month 
ago..It has really changed my life for good and now I can say I’m rich and 
I can never be poor again. The least money I get in a day with it is about 
$50,000.(fifty thousand USD) Every now and then I keeping pumping money 
into my account. Though is illegal,there is no risk of being caught 
,because it has been programmed in such a way that it is not traceable,it 
also has a technique that makes it impossible for the CCTVs to detect 
you..For details on how to get yours today, email the hackers on : (
atmmachinehackers1@gmail.com < Tell your 
loved once too, and start to live large. That's the simple testimony of how 
my life changed for good…Love you all .

RETRIEVE STOLEN/SCAMMED BITCOIN

I had the unfortunate experience of falling victim to fake airdrop scam, which resulted in the loss of Bitcoin worth USD 28,500. I was devastated and felt utterly helpless as I had no idea how to recover my funds or who to turn to for help. That was until I stumbled upon Crypto Pandemic Hunter.

From the moment I shared my case, their team was incredibly responsive and empathetic. They quickly understood the urgency of my situation and took immediate action. They were transparent about their process and kept me informed every step of the way, which significantly kept me at ease through out the whole process.

The Crypto Pandemic Hunter team equipped with top-notch software and a deep understanding of the blockchain, set on a quest to retrieve my lost Bitcoin. Their expert analysts and retrieval agents through chain analysis were able to trace the stolen funds, navigating the intricacies of transactions with a high level of precision. Despite the complex nature of the theft and the vastness of the digital assets universe, they managed to track down most of the stolen Bitcoin initiate reversal through assets freezing.

Their dedication to customer service was evident in their regular updates and willingness to explain every step of their strategy in a way that was easy for me to understand. After several weeks of tireless work, Crypto Pandemic Hunter successfully retrieved a substantial portion of my lost Bitcoin. The feeling of relief and joy after seeing my bitcoin back in my wallet was nothing short of incredible.

I cannot recommend Crypto Pandemic Hunter enough. If you or someone you know has fallen victim to cyber theft involving cryptocurrency, do not hesitate to reach out to them. They are the best, and their commitment to helping people like me is nothing short of commendable.

To anyone who finds themselves in a similar situation, please don’t lose hope. Contact Crypto Pandemic Hunter at cryptopandemichunter@consultant.com for retrieval of your digital assets.