I have been on the fence for the past two years after completing my undergrad about entering medicine. Last week I attended an interview to enter the faculty at my local university.

Reading this thread has helped immensely in my decision to, or not to, enter medicine. I especially enjoyed the numerous comparisons to tradespeople or even restaurant workers. It seems as though the question, in a financial sense, is to live now and then in retirement or to live from ~30-55 and still have a somewhat difficult time retiring at that age. Of course job security and the respect given from society is not factored.

Even though reading this thread has helped, it has not made my decision. There is still a strong urge to enter into the world of small business as an entrepreneur where the earning potential is without ceiling but the risk is inheritably similar. I see this an option leading towards an easier/earlier retirement and similar financial success given equal dedication.

This is more a personal comment possibly to hear myself type, but feel free to comment on anything I have said.

I just finished residency/fellowship as a surgical subspecialist and I can tell you that incomes and overheads are all over the map. I pay 20% as a flat overhead rate working out of a hospital. I currently bill about 70k per month so my after expense income is about 650k. That being said, there are some docs in the same specialty in my city making 200k after expenses. Others make much more.

This would have sounded great to me 13 years ago when I finished high school but I can say with certainty that I would NEVER do it again. There are very few things in life as draining as a surgical residency. There were times I really thought I would have an intracranial bleed the next time my pager went off after being up for 40+ hours at a running pace with people literally dying in front of me.

There are many things about my job that give me great satisfaction but I can’t say that giving up my 20’s and developing a personality disorder as a result were worth it! I really hope my kids decide on a different career path.

Now, I have heard of a few programs where after residency, I can go up North and work for a few years and they’ll help me pay off my debt. Does anyone know how much they can help me pay off? I will be getting 10000$ from my family to start off for my bachelors and the rest of the money is for me to find…

American doctors don’t do squat for the “nonspecific” illnesses just like I put in my first post. Most of what we go to the doctor for is nonspecific.

Most of us don’t and won’t need a heart transplant.

Greed pays a significant part in the profitable preventive medicine industry in this country, but I think there are some other contributing factors. Transplants, cancer cures, etc., are the glory work. I am not sure all of the factors going on here. Yeah, the drug industry promotes its chemicals. Yes, people do get cancer, and yes, the medical profession has made progress in treating cancer.

The average US doctor can’t function without a blood pressure cuff.
But if you have an illness with symptoms, it’s all in your head.

Try and get a mole or a wart remove, and see how far you’ll get. But you can get heart surgery. They’ll saw through your chest bones and plunge their hands intro your heart.

Look at the obstetrical industry, when lots of babies come into the world without advanced degreed birth attendants throughout the world.

It seems like there is a desire to control people through American medicine, but not a desire to treat illness.
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Physicians salaries are much too high in the US, especially since the US is not training doctors to treat nonspecific illnesses with symptoms.

Some of the non-greedy ones seem to be doing quite well, living in comfy homes without too much excess.

I too like what I read in The Millionaire Next Door. Many millionaires actually live in homes worth about $100,000 instead of $500,000. Just because a doctor is a doctor does not mean the doc needs to live in a $500,000 home and send the kids to the costliest private school. Doctors do need reliable cars to get to their jobs, so some costly reliable car expense is justified.

I got really ripped off in the 1980’s, which I consider the heyday of fee for service. None of my local doctors would accept insurance assignment or bill me. So I’d have to pop down $75 to $125 at first on a credit card and wait for reimbursement.

Then in the early 1990’s along came managed care with the copayments. First time that happened to me, I only had a $5 copayment. Okay, so it went up to $10, $15, or $25 later.

But when the patient is only paying a small copayment, doctors can and will order every test they can and sock it to the insurance company.

If you have to go from one doctor to another, like from a GP to a specialist, it’s easy to see who is not greedy. Greedy doctors order tests at each visit. The nongreedy docs request the tests from the referring doctor and only redo them if questionable.

Every job is stressful. Doctors aren’t the only ones under pressure. As for their life saving pressures, well, I’ve repeatedly walked away with untreated illnesses from quacks who didn’t want to do anything other than preventive medicine: play with the blood pressure cuff, test cholesterol, and screen for cancer.

These doctors quake at the sight of a sick person. Then I end up having to pay and pay till I find a doctor who can treat a sick person. That’s one reason for high health care costs.

The high student debt for graduating doctors is a relatively new phenomenon, corresponding to the inception of student loans. I don’t want to hear any whining on the student loans. Payment amounts can be adjusted according to income.

Medical doctors went to school on the buy now, pay later plan. But, when they are delivering services in their offices, they want you to pay them immediately. They usually take copayments now because the insurance industry forced them into that.

But they know the insurance company will pay them for their services, in less than 30 days. If you don’t have insurance, you are expected to pop out a large amount of money right then and there. When I work a regular job, I expect my employer to pay me within one or two weeks after the completion of a pay period, not immediately every hour of the day.

Now I’m on Medicare and most of them do accept Medicare assignments. My Medicare payments, which I check on my statements, tend to be less than I paid for services in the 1980’s in the old days of fee for service. So I assume Medicare is close to the real cost of health care.

Doctors lose money on Medicaid, but not on Medicare.

When one of the Bushes was president, thet prez would pop off about the old days when doctors treated patients free one day a week, but now couldn’t do that because of malpractice fears. Duh??? They don’t do it now cause they know they can bilk someone else for money and let the indigents flood the emergency rooms.

I say, pay the doctors in produce and livestock, like in the old days

If you’re truly passionate about becoming a Dr., don’t get too scared by your age. I’m 33, in the middle of my 2nd degree and I’m getting ready for an interview at Dalhousie next month. I applied last year with no luck and will apply once more next year if I don’t get in before I give up…but only because there is only so much you can do to change how you look on paper in the selection process…not because of my age. I have a Biology degree and am doing a degree in Public Health right now. I love my current program and would HIGHLY recommend that you look into this it. It’s not demanding and is very interesting. The job market is strong in Canada now and doesn’t seem like it will slow down. It is similar to medicine in that there are many different areas to become an expert and you can have a direct impact on the quality of life within a community. It’s almost like being a Dr to a population instead of an individual. I know that if I don’t get into Med school, I will be happy having a career in Public Health and will be able to support my family and enjoy a comfortable lifestyle.

My two cents on this topic, I do believe Doctor’s compensations are unfair when you take an engineering standpoint. There have been many times when I have visited a GP clinic with my tummy aching only to find out that most of the diagnosis process was first based on history (doctors knoweldge) and then on medical technologies (engineered developed technologies) ie, Ultrasounds, MRI’s and all the other fancy gadgets that are used by the medical field. When it came to the former ie, doctor compentency there have been only a handful of doctors who have takent he sincere interest to determine what was wrong with the patient and using the knoweldge they gained in medical were able to diagnosis 9 out of 10 times the excat cause of a particular aliment (this is what I call experience) perhaps the same applies to engineers or any other professional folks.

The rest of the GP’s relied on two approaches, one was to carry out the basis tests (cbc, alk phs, etc) and wait for a hematologist or pathologist or radiologist’s knoweldge of what was wrong with a person. Not to mention in the meantime the patient was suffering his or her share of pain till a firm diagnosis could be estabilished. The other approach viz a viz reffering to a Specalisit when it was beyond the scope of the GP, again this takes quite a long time in some parts of Canada. Finally, the patient visits the specialist who more than experience relies (atleast in the present era on sophisticated techology to diagnose a particular disease, typically CAT’s, PETs, MRI for disease as varied as cancers.

Then it comes to the actual skill ie, when specialisits perform surgeries and other physical procedures. This I believe can truly be attributed to a skill that a specailisit doctor should have would have learned during his Medical school and practice (ie experience).

So to me, all the years of medical schooling and all the high pay becomes pretty meaningless when the entire diagnosis rests on techonologies developed by engineers who are not compensated as much as doctors especially GPs. As far as responsiblities go, there are only a few GPs who are willing to take on responsiblities about making accurate diagnosis or taking calcuated risks in making headway in alievating patient suffering. Most of them shy away from the legalities involved and refer the patients to specialists again. So I do not really comprehened the talk about high medical insruances (which don’t really get used up much atleast not in canada) cause the GP either prescribes tylenol or suggests a wait and watch approach.

I still try to imagine a world of Doctors minus all the fancy gadgets, ie PET , MRI, scans, or for that matter even X-rays (result of experiements in particle physics) but the compentation, ie Doc vs engineers, Doc vs physicists, doc vs any other professions in North America still seem to ellude me cause it defines my logic.

I do not believe that Doctors salaries could be lowered (certainly not increase) . They have put a lot of time in school memorizing tons of stuff and paying highly to the school. However, the profession and the salary should reassess and realign itself with the real world.

Personally I do not really understand how all the time, money and energy spent in medical school translates to better healthcare. It ulimately boils down to a business, a business of making and generating money.

This post is not ment to undermine doctors (atleast not all doctors) in anyway, but just a way to see if all the compensation (high or low based on different opinions) is really worth the service we as patients or consumers get overall from the canadian health care system.

Blindly chasing graduate work in sciences is not the answer for all schools. Some schools (talking Canada and Ontario specifically) do not put much, if any, emphasis on graduate work. U of T does have a separate Grad pool of applicants, so it CAN help there. My wife does did graduate work, published high impact, and was respected in her sciences degree which is actually under the Fac of Med. I recall researching at the time Uni. Western Ont and McMasters and it didn’t seem that Grad work helped.

In a good/bad way, there are not enough medicine spots because our healthcare system is government controlled and a monopoly which is also kept reined in by the Royal College, CMA, OMA and other organizations in a union like way to protect their jobs, pay and lifestyle. It’s bad because we don’t have a free market in choosing/getting good doctors, on our terms, with good service and essentially are takers. It’s good for me and my family because my family will benefit through my wife has a stable, high paying, high demand job with little outside competition because of the regulations..

Although this goes against what you preach, you might consider countries that have reciprocal agreements (think Australia, maybe Ireland as Ontario is accepting Int. Med Grad (IMG)) and there are several in my wife’s residency.

I also have a good friend who is in the caribbean for med school right now. He doesn’t go to class – that’s right – he told me he sits on a beach and watches the lectures on his laptop that his teacher puts up online. You really want this lazy ass to come back here and practice medicine on YOU or your loved ones, when he barely attended his classes??

Foreign degrees are NOT the same as here, and doctors who can’t speak English properly are not the answer either. Tell me how a doctor who can’t speak properly is supposed to explain a complex procedure or something to you. It won’t work. We need to find a way to keep the Canadians in Canada.

Thank you so much for your info, I thank you for taking the time to post back to me. I guess medicine has a wider range of choices(specialties) than i imagined…i just wanted to get some comments on how the lifestyle for someone who has to put in that much commitment is like, i mean it’s 15 years of my life so i wanted to know what i was getting into… but i guess like NS MedS said, i should focus on short-term goals rather than long-term since it will be at least ten years before i have to decide my specialty and my choices could fluctuate a lot.

on a side note strap- i currently live in Florida and I’m a resident(since I’ve lived longer than 8 years here) and also a U.S citizen now, so my opportunities are even better since they are opening a medical school here in 2010-2012 next to UCF University of Central Florida(right next door to my house).

http://www.med.ucf.edu/

Againg thank you Strap~~~~~~

So, if you get that one spot say of UofT, it is a 6 year residency to be a cardiac surgeon. Or become a General surgeon first (5yrs) and then do a 3 yr. cardiac surgery add-on. Then to do Congenital Heart surgery, you definitely need to apply and get a fellowship (2yrs), meanwhile a PhD is strongly encouraged…
http://www.surg.med.utoronto.ca/card/programs.html

Most likely, to become what you want to become will take (college) 4+ (medschool) 4+ (residency) 6+ (fellowship) 1-2 +Phd (done half-concurrently) 3 = 18 years. It will take you probably until you are 35-36 to become what a Congenital Cardiac Heart surgeon… that is if you get into medschool on your first try and don’t take time off for kids, transfer and take a few months off here and there. 30% of the class at UofT medschool already have masters degrees in medical biophysics, immunology, and have published papers before medschool. My wife know many people who won’t become full 5 yr. specialists before 35-36. Yes, it’s true.. then you have 15 years to work until 50 when you want to slow down.

Family medicine is a good option now a days b/c you can do it in 2 years and then add a year of ER, anesthetics, or low risk OB. Plus, you can have your own business/clinic, be affiliated with a hospital, get supported by family health networks, and be flexible. It’s a great time to be in Family Med b/c the demand is huge and healthcare is slowly privatizing. Family Docs can make $300-$400 pretty easily now a days too..

hehe i guess hands down if i were to be testing who had more medical knowledge you would win( since i have none, clap clap to you ), but that’s not what I’m trying to get across…in fact completely the opposite. I’m posting here because I’ve read every single comment on this page, since this topic interested me, then i commented on what i thought about the whole thing, which was that yeah doctors do deserve to be well compensated for their work,and then i added a little more, which, me not knowing a lot about what the hell im talking about made me look like an idiot hehe…. though i may not know much i do look at it that way, the whole melody and tune thing i mean….it sounds stupid and probably i said it to sound corny or movie-like but yeah i have watched some operations being done mainly from this website:

http://www.orlive.com/index.cfm

http://www.orlive.com/umm/videos/tecab-totally-endoscopic-coronary-artery-bypass?cmpid=active_redirect

and my overall philosophy i guess you could call it is that everything has to be done in a certain procedure or else things might not run smoothly or maybe not work at all( kind of like how you have to put your clothes on first before your shoes, it just doesn’t work right the other way around) hence my little melody-tune concept(sorry if i didn’t get my point across right, i mean…. i like your over all post, but it just seemed like you were mocking me instead of doing anything else). As far as surgery never being life-threatening…………………..

To be more specific on what i have been currently looking into, it is a sub-specialty called Congenital Cardiac Surgery, and me being only 18 and just recently going on this rode(i haven’t really even began to be on my way to becoming an m.d, but I’m becoming more and more interested and passionate about it, so that’s a start for me) i was looking for some INSIGHT from any surgeons here already practicing or doing their residency, thats all NS MedS.

Anyhow, that’s just my opinion as a second-year med student interested in surgery. I’m pretty sure of that route (if not the specialty), but it’s still possible that I might change my mind during clerkship. It’s good to be thinking seriously about your future career, but I’ve little doubt that your thoughts will change over time – not least the fact that actually making that choice *within* medicine is 8-10 years away. That’s a long time.

We do know one ER doc who started in cardiac surgery but switched out b/c of the lifestyle. One thing, you are quite young and most likely once you get into med school and are exposed to all the different disciplines you will have more of an idea. Even med students/residents don’t know until the last year and even try and switch during residency so I don’t know how you really can know you would want cardiac surgery at this early of a stage.

One thing to say about cardiac surgery is that it’s a low growth or even dying area… a lot of the cardiac problems now a days can be handled by interventional cardiologists (get in through internal medicine) through stents and balloons and stuff like that. Also, there aren’t many jobs out there for cardiac surgeries as there are only 10 cardiac surgeons at TGH in Toronto and so if you want to work outside of the big city there isn’t much work. So, be aware of jobs… for example with nephrologists, we know one who has started who masters b/c of no jobs and of her resident class of 5, only two got jobs and the others are doing Phd, masters and fellowships… So after 8-10 years of schooling, to get into big, downtown specialties they often make you do more work.. anyway, I hope some of this is helpful.