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(The New York Times)   Medical schools weigh the benefits of a three year program. New doctors may actually have a chance at paying off their tuition before they retire   (well.blogs.nytimes.com) divider line 22
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930 clicks; posted to Geek » on 26 Oct 2013 at 11:14 AM (38 weeks ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



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2013-10-26 11:18:44 AM
I don't know if this experience is typical, but my ex-girlfriend was (is) a doctor, and based on the salary she was promised upon completion of her residency, she could have paid off her tuition in a single year if she'd wanted to - and still lived a pretty lavish lifestyle compared to mine. And she wasn't going into a specialty well-known for being especially lucrative.
 
2013-10-26 11:30:18 AM
axeeugene:
the salary she was promised upon completion of her residency

There's a key word here, I feel.
 
2013-10-26 11:33:00 AM
Please Log In

Thanks Obama
 
2013-10-26 11:52:27 AM

oryx: Please Log In


Just google the headline for any NYTimes article.
 
2013-10-26 12:04:23 PM

axeeugene: I don't know if this experience is typical, but my ex-girlfriend was (is) a doctor, and based on the salary she was promised upon completion of her residency, she could have paid off her tuition in a single year if she'd wanted to - and still lived a pretty lavish lifestyle compared to mine. And she wasn't going into a specialty well-known for being especially lucrative.


People say doctors get paid too much.  But if salaries started to fall, tuition would need to come down too or nobody would go through the trouble.

Family med (a pretty low paying specialty) is about 180K if you want to work 40 hours a week in a saturated area.  If you want to work 50hours per week in an in-demand area, you will make closer to 300k.
 
2013-10-26 12:06:44 PM

Bacontastesgood: oryx: Please Log In

Just google the headline for any NYTimes article.


How about this instead:

1.  Read interesting article on NYTimes.  Consider submitting.
2.  Reconsider.
3.  Google same article and find it not behind failwall.
4.  Submit alternate link instead.
 
2013-10-26 12:07:29 PM

Bacontastesgood: oryx: Please Log In

Just google the headline for any NYTimes article.


Oh and the login wall doesn't even show you the headline.
 
2013-10-26 12:13:08 PM

brandent: Bacontastesgood: oryx: Please Log In

Just google the headline for any NYTimes article.

Oh and the login wall doesn't even show you the headline.


Yeah, you have to dig it out of the url

http://well.blogs.nytimes.com/2013/10/24/should-medical-school-last- ju st-3-years/?_r=0
 
2013-10-26 12:47:33 PM
BigLuca:
People say doctors get paid too much.  But if salaries started to fall, tuition would need to come down too or nobody would go through the trouble.

Family med (a pretty low paying specialty) is about 180K if you want to work 40 hours a week in a saturated area.  If you want to work 50hours per week in an in-demand area, you will make closer to 300k.


Personally I don't have a problem with doctors being paid well. They're highly skilled specialists whose decisions are often life-and-death. I can't think of a better reason to be compensated handsomely. It's only the hand-wringing of the headline I was responding to.

In my ex's case, the situation was as you describe above - she was offered $300K a year because she was working in an under-served geographic area. But more than that, she was even offered a $1500 retainer as a signing bonus - every month, for a full year before she was to start work in her new job, she got half what I gross in a month at my job *just for signing a contract* .

It's a good gig if you can get it...and dedicate 6-8 years of your life to it. More power to them, I suppose.

/What's that Alec Baldwin said?
//Who do you think they're praying to?
///I AM God.
 
2013-10-26 12:48:47 PM
It's a difficult choice.

As it is right now, the first two years of med school are purely classroom education. Anatomy, biochemistry, psychiatry, neurology, pathology and physiology. The next two are clinical. Internal medicine, family medicine, surgery, OB, neuro, psych, pediatrics, electives. Fourth year is all electives. Between the two is USMLE Step 1, then Step 2 in the third year and Step 3 after fourth year.

The difficult part is what to cut. The clinical courses used to be 12 or 6 weeks. Now they're 10 and 5. Cut out the electives and you'd have people picking a specialty they theoretically had never taken in med school. Shaving them down to, say, 8 and 4? 50 weeks becomes 40, but even that only knocks out 10 weeks. They're too short as is in some cases- psych is barely long enough at five weeks to actually learn the bits you need.

Trim down the first two years, and we've another problem. Biochemistry is 11 weeks at most schools. Anatomy is 16. All of neuro and psych is 12. Where do you trim?

Even if you cut out all the breaks, there's not a year's worth. You get 2 months after first year, a month after second, and two weeks after third.

I'm not a fan. Simply don't see how it can be done. I have over 300 thousand in loan debt, and shaving a year from that would be great, but if anything I'd stretch med school to five years. There's just so much material to cover.
 
2013-10-26 01:06:18 PM
Well once you start practicing you forget all the random stuff you learned that doesn't pertain to you.  Does a cardiologist really need to know that about all the different maneuvers for removing a baby with shoulder dystocia?  Does an ophthalmologist need more than a cursory knowledge of what goes on in psych? They could probably cut most rotations in half because most of the time you're just doing biatch work and not really learning anything. The real point of the core rotations is to let you know if you go well with the biatchiness of patients/culture/work hours of that particular specialty.
 
2013-10-26 01:13:36 PM

Bacontastesgood: oryx: Please Log In

Just google the headline for any NYTimes article.


Same behavior as for Wall Street Journal. .. yet fark bans those links.
 
2013-10-26 02:52:06 PM
axeeugene:
In my ex's case, the situation was as you describe above - she was offered $300K a year because she was working in an under-served geographic area. But more than that, she was even offered a $1500 retainer as a signing bonus - every month, for a full year before she was to start work in her new job, she got half what I gross in a month at my job *just for signing a contract* .

It's a good gig if you can get it...and dedicate 6-8 years of your life to it. More power to them, I suppose.

/What's that Alec Baldwin said?
//Who do you think they're praying to?
///I AM God.


Was she going into family med?  I saw an ad a couple weeks ago for a family med job that paid 180k per year.  It was 3 shifts per month of 48 hours. Weird.

Oh, and Malice is awesome.
 
2013-10-26 02:57:26 PM

zelachang: Well once you start practicing you forget all the random stuff you learned that doesn't pertain to you.  Does a cardiologist really need to know that about all the different maneuvers for removing a baby with shoulder dystocia?  Does an ophthalmologist need more than a cursory knowledge of what goes on in psych? They could probably cut most rotations in half because most of the time you're just doing biatch work and not really learning anything. The real point of the core rotations is to let you know if you go well with the biatchiness of patients/culture/work hours of that particular specialty.


You learn that stuff well though.  If you ever need to wake someone up at 0430 to ask them if they farted last night, I'm your man.  I got that shiat DOWN.
 
2013-10-26 03:36:36 PM
If they're going to change medical school, they really need to start focusing on relating to patients and having a decent bedside manner.  I've had doctors who were complete dicks, and had one basically tell me I was probably going to die...but they'd have to wait for the tests to come in.  (Obviously she was wrong.)  Some also treat their patients like crap because they have a superiority complex and figure everyone else is below them.  I love it when the topic comes to "so, what do you do for a living?" because they're trying to waste time or they're filling out a paper and don't want an awkward silence and I say "I'm a lawyer."  The change in attitude is amazing.  I'm not sure if it's the fact that it shows them I'm also educated...or it's just fear of a lawsuit if something goes wrong.  Either way, that level of respect shouldn't just be shown to certain people.
 
2013-10-26 06:26:25 PM

EmmaLou: Some also treat their patients like crap because they have a superiority complex and figure everyone else is below them.


Many also treat medical professionals who aren't doctors (RNs, LPNs, etc) as beneath them. For example, I had several medical checks done by a nurse. The doctor came by later and insisted on redoing all the tests. Her actual words were, "Well, she's just a nurse," accompanied by an eye roll.

Guess what? The nurse's observation from the medical checks were 100% correct.
 
2013-10-26 08:17:52 PM

axeeugene: Personally I don't have a problem with doctors being paid well. They're highly skilled specialists whose decisions are often life-and-death. I can't think of a better reason to be compensated handsomely.

Baahahahahaha, yeah.  Okay.  Here's a gem I heard from the medical students a while ago "Why do we have to learn all this genetics stuff???"  I know a lot of people that get picked by the school to be personal tutors for med students... none of them are impressed.  Here's the thing - every med student the school kicks out makes the school look worse.  If they can get them to pass their exams and shove them out the door, they will.

Sword and Shield: They're too short as is in some cases- psych is barely long enough at five weeks to actually learn the bits you need.

Agreed.  A while back I had a resident come to me and ask me to explain what a "p-value" is for research and why they need to do clinical trials of investigational new drugs at different doses instead of just a really strong dose to see if there's an effect.  Dose/response/toxicity is intro-level stuff that his school just never taught him.  I'm not saying there are no good doctors, but when I sit in to grand rounds with neurology residents and they ask questions that show that they don't know what cranial nerves are... well I just think med schools are failing to prepare enough GOOD doctors.

zelachang: Well once you start practicing you forget all the random stuff you learned that doesn't pertain to you.

Which is why I went in to research instead of customer service.  I'd rather not waste time learning things that I won't use.  Also, I'm not good with people.

EmmaLou: I'm not sure if it's the fact that it shows them I'm also educated...or it's just fear of a lawsuit if something goes wrong. Either way, that level of respect shouldn't just be shown to certain people.

Many (BUT by no means all) of them come from high class families and they honestly think they're better than everybody else.  I heard one student angry that his reviewer wrote that the kid feels like he's entitled to be a surgeon just because his father is a surgeon.  He admitted it was true, but was just angry that somebody wrote it on his evaluation.  You better prove that you're somebody important if you want somebody like that to treat you like a human.  I've dealt with it too, I just happen to know the same people as them, which I sometimes lead with just to make the visits go by easier.
 
2013-10-26 10:23:31 PM

ThatGuyOverThere: Many (BUT by no means all) of them come from high class families


Which is actually one of the problems with med school these days. It used to be med school students came from the whole spectrum of socio-ecnomic backgrounds, but now it skews heavily towards the top. That's not a good thing.

ThatGuyOverThere: why they need to do clinical trials of investigational new drugs at different doses instead of just a really strong dose to see if there's an effect. Dose/response/toxicity is intro-level stuff that his school just never taught him. I'm not


WTF? I've never gone to med school, didn't study pharmacology, bio-chem or anything like that, and even I know why they test new drugs at different doses and why the initial trials are for toxicity and such, efficacy comes later.
 
2013-10-26 10:44:11 PM

BigLuca: axeeugene: I don't know if this experience is typical, but my ex-girlfriend was (is) a doctor, and based on the salary she was promised upon completion of her residency, she could have paid off her tuition in a single year if she'd wanted to - and still lived a pretty lavish lifestyle compared to mine. And she wasn't going into a specialty well-known for being especially lucrative.

People say doctors get paid too much.  But if salaries started to fall, tuition would need to come down too or nobody would go through the trouble.

Family med (a pretty low paying specialty) is about 180K if you want to work 40 hours a week in a saturated area.  If you want to work 50hours per week in an in-demand area, you will make closer to 300k.


No way, even anesthesiologist jobs in the Chicago area aren't paying that much. Where are you getting your stats?
 
2013-10-27 01:45:27 AM

brandent: How about this instead:

1.  Read interesting article on NYTimes.  Consider submitting.
2.  Reconsider.
3.  Google same article and find it not behind failwall.
4.  Submit alternate link instead.


I'm not the submitter.  My advice was more for if you find yourself wanting to read an article there in general.  They still give 10 free/month I think and then want you to pay.
 
2013-10-27 10:50:24 AM

rga184: BigLuca: axeeugene: I don't know if this experience is typical, but my ex-girlfriend was (is) a doctor, and based on the salary she was promised upon completion of her residency, she could have paid off her tuition in a single year if she'd wanted to - and still lived a pretty lavish lifestyle compared to mine. And she wasn't going into a specialty well-known for being especially lucrative.

People say doctors get paid too much.  But if salaries started to fall, tuition would need to come down too or nobody would go through the trouble.

Family med (a pretty low paying specialty) is about 180K if you want to work 40 hours a week in a saturated area.  If you want to work 50hours per week in an in-demand area, you will make closer to 300k.

No way, even anesthesiologist jobs in the Chicago area aren't paying that much. Where are you getting your stats?


The best resource for general, specialty and region specific stats is MGMA Physician Compensation Survey.  It is hard to find for free but there is the one from 2010 floating around the internet.  That being said, Chicago is exactly were you DONT want to be to maximize your salary.  Even going 2-3 hours north to Milwaukee will net you an extra 20%.  Basically, stay away from anywhere that sounds like a decent place to live: Boston, SF, New York, etc. Think rural South Dakota, rural Wyoming, I heard some OB residents talking about a job posting in Albany, Georgia for 850K .. over twice the national average.  I've gotten my specific job information from a variety of sources, mostly word of mouth - friends or preceptors that I have talked to or medical placement website (although you have to take what they advertise with a grain of salt).  AAFP puts out interesting family med postings.  One family medicine preceptor I had in Olympia Fields, IL works about 50 hours, both clinic and nursing home, and makes around 300K, another worked in South Chicago, clinic only, and made about 270K.  If you are just graduating though, to make that money you need to be rural, and per diem probably.  I have many friends that took jobs right after graduating and made 250-300K in South Dakota, Alaska, and Nevada.

If you are in anesthesiology the regional differences are even more pronounced.  The MGMA survey lists the median job in the North East at 320K, but in the South (Texas area) it's 500K. So just depends how much you want to sacrifice to pay off those student loans.
 
2013-10-27 08:19:30 PM
BigLuca: So just depends how much you want to sacrifice to pay off those student loans.

Exactly. In my ex's case it wasn't a matter of sacrifice, though, since she wanted to practice close to home (western ND) in the first place. Frankly, I always thought it sounded like a good system. Rural people need good docs, too, and it's pretty obvious the "upper class" people referenced above would rather live in urban areas, so screw 'em. They can choose any two: an upper crust job, a classy place to live, a huge salary.

Myself...? I'd like a good bit more money for what I do...but I'd still much rather be able to drink a whole bottle of wine on a random Sunday night at will than have the privilege of making $150-300K and never be able to do so. A guy has to sacrifice *somewhere*!
 
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