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Happpy

Any family med docs regret switching careers as a non trad?

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I’m considering leaving my career and applying to medical school with the intent of becoming a GP in BC. 

My current career is sedentary and bureaucratic and caps out around 90k/year. I get tons of vacation and work 35 hrs/week. I’m in my late twenties and female so also taking into account that I may start a family while in med school or residency  


I’m considering medicine because I would like to help people and make a direct impact in peoples’ lives, but also partly because of the additional potential income and goals I have that are not readily attainable in BC without a significant income. I’d like to be a GP in a rural setting in BC. 
 

My question is whether anyone else here has switched from an established and growing career to start off in family medicine, and if they have any lessons learned or regrets they would share? I don’t want to put my partner through this switch, if I’m biting off way more than is worth chewing. Any insights? Obviously my own situation is unique, but I’d love to hear from non trads that practice family med in BC. 

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I can't answer the questions you posed but getting into medical school is extremely competitive in Canada. Some people have planned this for years to never get in or get in after applying many times. Have you written the MCAT? Do you have a high GPA - or do you need to do an additional degree to raise it up? Do you have a strong EC record? Do you interview well? Etc. It also takes 1 year from application to starting medical school in an application cycle. These are all important questions to consider. Also, the vast majority of applicants apply 2 or 3 (sometimes more) times before getting. Once you are in, you have to also add another 4 years of medical school and 2 years of residency if you want to do FM. If you change your mind and want to do literally any other field in medicine that's another 3-4+ years. 

 

So, realistically you are looking at 10 years from today to become a family doctor assuming you get in.  

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Would you be able to elaborate further on your goals that require a significant income (e.g. buy a 1M cottage home) and the potential timeline you would like to reach it by (e.g. At age 40)? While for most people I would counsel them on the merits of doing the job out of interest, I think in your case there seems to be a component that may be determined fairly accurately through financial modelling. As a non-trad myself the math doesn't always work out if you have earlier life goals. I think for many people you do come out ahead in medicine but it is often at the tail end of your career rather than the midpoint where you could be equivalent (although you have mentioned your career caps out at 90K so perhaps not for you).

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I'm sure there have been those that have regrets, but its super specific to individual situations. That being said, the trend I have seen is that those who started later on after a different career seem to be more satisfied, as they don't have the "what-if" or grass is greener thoughts that those who went to med school straight out of undergrad do. I think it's important you actually talk to and if possible see what the day to day of a rural GP is, and make sure you have an accurate read of what life is like, both the ups and the downs. If you've maxed out your current career and you are unsatisfied, and if that life still appeals to you, then you can consider it.

That being said, if you have a family or are otherwise limited to where you can apply, it might make only sense from a cost-benefit if you're already a good candidate and don't need to go back to undergrad etc.

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I'm going to agree with an above poster and say it would be helpful to have an idea of what these financial goals are, so you can get more specific advice. The opportunity cost of pursuing and entering medicine is high, assuming you're starting from scratch, and that doesn't include a lot of other factors too. If you start a young family, it is a priority that will definitely decrease the number of hours you are able to study and work, and that shouldn't be underestimated.

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From those I've met, they generally they enjoy family medicine more than their old careers which they left because they were unhappy or unfulfilled in the first place. As for financial goals, you should do the math and think about your net worth if you continued your current path versus pursuing family medicine. Figure out the point where you would earn more in medicine than staying at your current position by adding up the opportunity cost (i.e. lost income), educational cost (e.g. tuition, travel), and interest accrued on your debt, then figure out when your differential income will lead to a greater net worth. Usually the costs are much greater than people think.

Example below for the first 6 years:

Educational costs = (Medical school mandatory fees over next 4 years x 4) + 15k for elective/interviews/random mandatory crap. UBC's website quotes it at around 22k/yr. 22k * 4 + 15k = 103k

Opportunity cost = (Average income over your next 6 years at your current job)  - (average income of resident for 2 years). If we assume you'd average 70k/yr over the next 6 years, then it would be 70k * 6 - 60k * 2 = 300k

Interest accrued will vary a lot, depending on your rates on how aggressively you can keep it down and if you have any savings you can use. Let's assume you accrue 20k of interest during those 6 years (assuming you aren't using savings or paying it off aggressively).

In this example your total cost would be ~420k by pursuing medicine. Below is how long it'd take to catch up in net worth given this total cost.

Example for looking at the differential incomes:

As an attending lets say you're working hard and gross 220k/yr on average. You mentioned the cap in your previous income was 90k/yr. The difference in your gross income would be 130k/yr. To catch up to your previously calculated total costs of ~420k, it would take you about 4-5 years. Meaning that it would take in total 10-11 years minimum to catch up in net worth.

In reality it is even less favourable to pursue medicine, since we used 'gross' income instead of net income, assumed you get in right away without needing anything at all, ignored the pension/benefits that you have now, and presumed you do not extend residency/take mat leave as staff. Overall in this example it would probably take closer to 12-15 years to catch up in net worth by pursuing medicine.

Of course if your goal is property, having a bigger income = bigger mortgage, which is obviously very helpful. In medicine there is also always the option of working yourself to death for more money as well.

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Thanks for those helpful perspectives! 
 

I’ve always had a dream of owning property... 5+ acres with a set up for horses/hobby farm. Don’t need anything fancy and I really don’t think I’ll feel content until I’ve achieved this goal and I’d like to reach it ASAP.  Currently living in the Lower Mainland, this would run me $1.2 million plus. I keep a close eye on the real estate market elsewhere, and even outside of the Lower Mainland in the more desirable areas of the province such as outside of Kelowna or Victoria/Nanaimo, properties without the infrastructure are $700-800k ish. In more rural/remote areas such as the Cariboo, I could find something like this for a much more affordable price of course. 
 

My partner and I have been shopping around and looking at potentially purchasing our first home in the Fraser Valley, and we’ve come to the conclusion that with our current incomes, we could afford something around 500k or up to 700k IF it has a rental suite. I currently make about $71k salary and he makes about $95k. My job is transferable to our other offices around BC, including some very rural areas. My partner is in the trades and he could work virtually anywhere, however we would most likely take a significant pay cut. 
 

After looking at some homes and doing the math, it became very obvious that living where we do now, we will not be able to afford my dream property for at least 5-10 years. We could move to a more rural area and be able to afford potentially right away, but my partner is very hesitant to move currently. We would also be giving up some of the nice weather and proximity to family that we have now.  Putting aside other reasons for career and focusing solely on income, it seems to me that the options are to stay in my current career and move outside of the Fraser Valley or pursue a higher paying career such as medicine if I want to achieve my goal of property.
 

I do plan on having further conversations with my partner about moving, as medical school would most likely involved 1 or two moves anyways. If we can move more rural sooner, then it seems like my current career could meet my financial needs just fine. However, we do enjoy living in the Fraser Valley and if we had the option of staying here, we would love that. 
 

In terms of other reasons to switch careers, I do think there is a big element of ‘what if’... I was very into sciences in high school and had always considered medicine, but didn’t have the self confidence when I was younger to think I could do it. I now am in a very office based, bureaucratic environment where I work very closely with stakeholders and other organizations to find solutions to issues. I am sincerely interested and passionate about my current field, and I am somewhat content with my job. I do get very generous vacation time, a pension, and every other Friday off. We do plan on starting a family in the next 2-4 years, and doing that during med school/residency may mean I don’t get the mat leave benefits I would get if I was employed. 
 

However, I wish my job was more active, technical/tactile, and I deal with a lot of regulation/enforcement which doesn’t leave you with many warm fuzzy feelings of helping. Medicine attracts me as personally and professionally I have interacted with people who have not been able to have their health care needs met and I would like to directly help them access care (why I think FM is a good fit). I love learning, love solving problems and putting pieces together, and I’ve realized that I do have great communication skills. 
 

I plan on writing the MCAT this fall and may apply this cycle or next.. not really sure. I have a GPA of 87% and tons of work experience with rural and indigenous communities, which I think gives me a decent shot at UBC. 

 

I am very open to hearing thoughts on whether a career switch would be worth it! I kind of anticipate that the responses will be “move rural now, and if you can’t, then perhaps consider med school”. Really appreciate the feedback. 

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14 hours ago, 1D7 said:

 

Of course if your goal is property, having a bigger income = bigger mortgage, which is obviously very helpful. In medicine there is also always the option of working yourself to death for more money as well.

Just wanted to comment directly on this — the goal is property and having a larger mortgage as well as being able to afford life things as well... vacations etc. 
 

My current employment very much has a cap and I have no real opportunity to work OT to make more money. I make $71k annually, and this will increase by steps for several years and 2% annually once I reach the top step. I wish I had more opportunity to grow financially in my current job by picking up shifts, but I would have to start some kind of side gig if I wanted to boost my income. 

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21 minutes ago, Happpy said:

After looking at some homes and doing the math, it became very obvious that living where we do now, we will not be able to afford my dream property for at least 5-10 years. We could move to a more rural area and be able to afford potentially right away, but my partner is very hesitant to move currently. We would also be giving up some of the nice weather and proximity to family that we have now.

If you choose to pursue medicine, you are looking at 7+ years before reaching a high income. 1 year For the application cycle (at minimum, assuming you apply this September, for the class of 2025 && are lucky enough to get in on your first try), 4 years of medical school, 2 years of residency for FM. You also said you’d like to start a family, and I imagine you’d want to take leave, which would add even more to this timeline. I don’t think medicine will help you achieve your goal sooner at all.

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Forget the admissions process just for a second.

Even if you got in today:  You'll stop getting a salary from your current job ($71-80k X  6 years, plus whatever your partner needs to take time off to look after kids), plus you'll owe around $150k of tuition when it's all said and done = ~$580k as a conservative estimate. That's not including costs of moving if you have to move or if your partner is unemployed as a result of the move.

If your dream is to own property, I don't see how being a rural doc allows you to attain that sooner PLUS have the time to enjoy it.

i mean it’s fine if you want to be a rural doc and help people, do what you have to do. But if you just want the property and you and your partner have the freedom to move now, just do the math yourself.

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Yeah...I agree the math doesn't really add up here. Even if you do FM, be prepared for delayed gratification, including income-wise. I don't know how strong this 'what if' feeling is and sometimes you can't rationalize yourself out of that stuff, so I'll just speak on the financial goals:

12 hours ago, Happpy said:

My current employment very much has a cap and I have no real opportunity to work OT to make more money. I make $71k annually, and this will increase by steps for several years and 2% annually once I reach the top step. I wish I had more opportunity to grow financially in my current job by picking up shifts, but I would have to start some kind of side gig if I wanted to boost my income. 

So pick up a side gig. You were vague about your role, but is it possible to start some kind of consulting side hustle with your current skills? Move up into a managerial role? If not with your current skills, then do a masters part-time in 4-5 years while working full-time?  You'll be investing lots of time outside of your FT work to get your application ready, then in med school and residency it'll be like a 1.25-1.5+ FTE time commitment-wise, with more stress than your current job. If you invested ALL that extra time on a side gig, you could potentially make more money without investing the ~420K that 1D7 calculated and without losing your pension.

Also, if your partner is in the trades, then he should have no problem picking up a side gig to increase your joint income?

Also, I've heard some grumblings from BC family docs about how they are significantly underpaid compared to other provinces. Maybe someone who knows the system better than I can comment more on the income potential of a rural BC doc.

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To build upon the analysis above. The quality of life you have now (hours wise) may not be attainable for a while until you finish your training. You mentioned a pension? Is it a defined benefit pension? You may want to calculate out the true value of that as it may not be insignificant. Small issue but don't forget the issue of tax brackets. Making less money over a longer period of time generally means you keep more of it than making a high income and being in a higher bracket. There are always ways to mitigate that like incorporation but broadly that's a consideration you want to have as well.

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Thanks for all the helpful feedback! 
 

I’m a bit confused over the math and how staying in my current role I’d be able to afford a property in the Fraser Valley within the same time frames. 
 

An acreage out here runs about $1.3 milllion, give or take. With a minimum down payment of 20%, you need about $289k cash to purchase the property and at current interest rates, a mortgage would be $4500/month, not including other housing expenses (more like $5000/month). 
 

Say in our current roles, our household income peaks at $200k annually. After taxes (assuming 30% taken off), the monthly take home is about $11,500. Based on this, about 43% of our income would be spent on housing, which isn’t outrageous, but higher than the 30% affordable benchmark CMHC uses. There is also the question of how long it would take to save up the cash needed (or equity in a starter home). I see us reaching this point in 5-10 years after buying a starter home first. 
 

From what I understand, if my partner kept his same role and I made about $250k after overhead as a GP, our household income would become $360k or $21k monthly after taxes. Of course, this would be 6 years after beginning med school, about the same time I envisioning our salaries peaking in our current roles. Our monthly income would essentially double, a mortgage would be that much more affordable, but the question of cash for the down payment remains. I would have to pay off a LoC - how much are typical monthly loan payments? 
 

I suppose we could buy a small place while I am in med school and use my LoC towards a piece of the monthly payments and then have build up equity when I graduate (do people do this? We have a down payment already).

Am I off here? Obviously there is debt associated with going to medical school, but it seems to me like the 6 years of opportunity cost is very quickly repaid with a much higher monthly income. 

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10 hours ago, Happpy said:

Thanks for all the helpful feedback! 
 

I’m a bit confused over the math and how staying in my current role I’d be able to afford a property in the Fraser Valley within the same time frames. 
 

An acreage out here runs about $1.3 milllion, give or take. With a minimum down payment of 20%, you need about $289k cash to purchase the property and at current interest rates, a mortgage would be $4500/month, not including other housing expenses (more like $5000/month). 
 

Say in our current roles, our household income peaks at $200k annually. After taxes (assuming 30% taken off), the monthly take home is about $11,500. Based on this, about 43% of our income would be spent on housing, which isn’t outrageous, but higher than the 30% affordable benchmark CMHC uses. There is also the question of how long it would take to save up the cash needed (or equity in a starter home). I see us reaching this point in 5-10 years after buying a starter home first. 
 

From what I understand, if my partner kept his same role and I made about $250k after overhead as a GP, our household income would become $360k or $21k monthly after taxes. Of course, this would be 6 years after beginning med school, about the same time I envisioning our salaries peaking in our current roles. Our monthly income would essentially double, a mortgage would be that much more affordable, but the question of cash for the down payment remains. I would have to pay off a LoC - how much are typical monthly loan payments? 
 

I suppose we could buy a small place while I am in med school and use my LoC towards a piece of the monthly payments and then have build up equity when I graduate (do people do this? We have a down payment already).

Am I off here? Obviously there is debt associated with going to medical school, but it seems to me like the 6 years of opportunity cost is very quickly repaid with a much higher monthly income. 

As a physician (specialist) who fairly recently started practice, I would really put some consideration into whether or not this the route you want to go.  I worked for a couple of years prior to medical school, more because I didn't know what I wanted to do after my undergrad.  I don't regret my medical training, and would do it again, but it's was a significant sacrifice.  I'm not sure I would have opted for this path looking through the lens that you have somewhat described.  While I can't speak to your personal situation, it's not uncommon that people find that medical training prevents them from having the family life they want or spending as much time with their kids as they would like to (often this becomes more of an issue than people realize once they have kids).  You may also find that if you combine a physician professional life and having kids that you really don't have any time to enjoy the property you dreamed about or don't have the energy to actually maintain it.  If increasing your family income to be able to afford property is a really important thing to you and your partner, give some serious consideration to how this could potentially be done with your current skill sets before kids come into the picture.

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11 hours ago, Happpy said:

Thanks for all the helpful feedback! 
 

I’m a bit confused over the math and how staying in my current role I’d be able to afford a property in the Fraser Valley within the same time frames. 
 

An acreage out here runs about $1.3 milllion, give or take. With a minimum down payment of 20%, you need about $289k cash to purchase the property and at current interest rates, a mortgage would be $4500/month, not including other housing expenses (more like $5000/month). 
 

Say in our current roles, our household income peaks at $200k annually. After taxes (assuming 30% taken off), the monthly take home is about $11,500. Based on this, about 43% of our income would be spent on housing, which isn’t outrageous, but higher than the 30% affordable benchmark CMHC uses. There is also the question of how long it would take to save up the cash needed (or equity in a starter home). I see us reaching this point in 5-10 years after buying a starter home first. 
 

From what I understand, if my partner kept his same role and I made about $250k after overhead as a GP, our household income would become $360k or $21k monthly after taxes. Of course, this would be 6 years after beginning med school, about the same time I envisioning our salaries peaking in our current roles. Our monthly income would essentially double, a mortgage would be that much more affordable, but the question of cash for the down payment remains. I would have to pay off a LoC - how much are typical monthly loan payments? 
 

I suppose we could buy a small place while I am in med school and use my LoC towards a piece of the monthly payments and then have build up equity when I graduate (do people do this? We have a down payment already).

Am I off here? Obviously there is debt associated with going to medical school, but it seems to me like the 6 years of opportunity cost is very quickly repaid with a much higher monthly income. 

 

Don't take this the wrong way. I don't think we're trying to dissuade you from pursuing your dream to become a rural doc.

Simply pointing out that your financial goal is attainable by keeping on the current path.

Refer to @1D7 post above for how long it takes to break even.

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I would argue that for OP's situation, medicine is probably the best way of making a 150k+ income. With that being said however, it is a road with a lot of sacrifices and I actually don't think the benefits of medicine will pay off for OP for at least 15 years compared to if she stayed at her current job and during at least 10 of those years your life will be more challenging. 

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Super, thanks for all your perspectives. I’m obviously taking a critical look at this potential path and this is really helpful. 
 

On the topic of work-life balance, for those that work as a GP, do you find your work stressful? How many hrs/week do you work? I’m anticipating that I would join an established practice and would most likely focus only on family med/walk ins, rather than doing any hospital or Ob/gyn work. My hope is that I would do that kind of work 4 days a week, work 32ish hrs, and still make a great living and have time for fun and family. Is taking vacation difficult as a GP? I understand that you need to find another physician to cover you if you’re away for long periods of time? 
 

For comparison, for my current employer I can take every other Friday off, start with 4 weeks vacation (up to 7 weeks after 25 years), and have a 35 hr work week. We are currently WFH with covid, and I am hoping in the future they will become even more flexible. 

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10 hours ago, Happpy said:

Super, thanks for all your perspectives. I’m obviously taking a critical look at this potential path and this is really helpful. 
 

On the topic of work-life balance, for those that work as a GP, do you find your work stressful? How many hrs/week do you work? I’m anticipating that I would join an established practice and would most likely focus only on family med/walk ins, rather than doing any hospital or Ob/gyn work. My hope is that I would do that kind of work 4 days a week, work 32ish hrs, and still make a great living and have time for fun and family. Is taking vacation difficult as a GP? I understand that you need to find another physician to cover you if you’re away for long periods of time? 
 

For comparison, for my current employer I can take every other Friday off, start with 4 weeks vacation (up to 7 weeks after 25 years), and have a 35 hr work week. We are currently WFH with covid, and I am hoping in the future they will become even more flexible. 

I think therein lies the problem with your plan. If you go into Rural (and I mean rural like...5 acre horse ranches within 5-10 km of your work place), you need to enjoy doing hospital work and possibly cover ER, in-patients, long term care, take overnight call. Otherwise, who else is going to do it? There is almost no chance you can do 4 days a week AND still make a great living. If you do four days a week you're likely looking at <200k after overhead. You'll beg on both knees to find a locum to cover for you if you're away long periods of time. There is literally no incentive for your colleagues to cover you because they're likely overworked themselves.

In most rural places like the ones I've described, you're likely looking at 60 hours per week, in my honest opinion. Typically 8AM rounds at hospital, 9-5PM clinic, 5-6PM hospital, and then possible overnight coverage. Weekends: round on hospital patients, round on long term care, possibly overnight coverage or ER coverage.

 

If you're looking at Victoria/ Nanaimo, I don't know the real estate situation there, but I suppose you can get away with doing only clinic work. However, their walk in clinics are shutting down in spades due to poor remuneration. Meanwhile patients there have a huge waitlist problem and cannot find a family doctor.

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On 7/28/2020 at 11:27 AM, Happpy said:

Thanks for all the helpful feedback! 
 

I’m a bit confused over the math and how staying in my current role I’d be able to afford a property in the Fraser Valley within the same time frames. 
 

An acreage out here runs about $1.3 milllion, give or take. With a minimum down payment of 20%, you need about $289k cash to purchase the property and at current interest rates, a mortgage would be $4500/month, not including other housing expenses (more like $5000/month). 
 

Say in our current roles, our household income peaks at $200k annually. After taxes (assuming 30% taken off), the monthly take home is about $11,500. Based on this, about 43% of our income would be spent on housing, which isn’t outrageous, but higher than the 30% affordable benchmark CMHC uses. There is also the question of how long it would take to save up the cash needed (or equity in a starter home). I see us reaching this point in 5-10 years after buying a starter home first. 
 

From what I understand, if my partner kept his same role and I made about $250k after overhead as a GP, our household income would become $360k or $21k monthly after taxes. Of course, this would be 6 years after beginning med school, about the same time I envisioning our salaries peaking in our current roles. Our monthly income would essentially double, a mortgage would be that much more affordable, but the question of cash for the down payment remains. I would have to pay off a LoC - how much are typical monthly loan payments? 
 

I suppose we could buy a small place while I am in med school and use my LoC towards a piece of the monthly payments and then have build up equity when I graduate (do people do this? We have a down payment already).

Am I off here? Obviously there is debt associated with going to medical school, but it seems to me like the 6 years of opportunity cost is very quickly repaid with a much higher monthly income. 

A bit off topic; but how did you calculate 21k after taxes monthly?  Just wanted to see the calculation.  Based on my calculations it would be less than 20k on that income; well below; probably like 17-18k.

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I'm going to be starting as an MS1 this year and I have had 2 careers prior to medicine as a healthcare professional and then in the public service. You implied bureaucratic so I'm guessing you may be involved in the government somehow? If so, I ran some numbers and with my career in the public service, if I lived to average life expectancy in Canada, then I would be losing out on at least $500k in lifetime earnings if I became a family physician with a gross income (after overhead) of about $200k because physicians don't get a pension. So yeah, medicine isn't always the golden goose egg that society thinks that it is. That being said, I knew I wouldn't be fulfilled with my current job and needed to make this career move or regret it forever. There is nothing quite like the feeling of helping someone get through pain that even their most intimate friends/family may not bear witness to.

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2 hours ago, windsormd1 said:

A bit off topic; but how did you calculate 21k after taxes monthly?  Just wanted to see the calculation.  Based on my calculations it would be less than 20k on that income; well below; probably like 17-18k.

@windsormd1 I'm assuming it is because spouse pays taxes according to his own personal tax bracket on the 95k part of the household income. Still not totally 21k/ month, but roughly there.

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