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Giving Up A Really Good Job For Med


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Im seeing a bunch of highly educated professionals in here who are looking to give it all up to go to medical school. I am also an educated professional with an earning capacity of 80k+, full pension, benefits, sick time and paid vacation. Does anyone here worry about the opportunity cost of going into med? I'm eligible for a lucrative, union negotiated, government pension at the age of 54 and if I go into med there will be none of that for sure. But having said all that, I'm nowhere near as passionate about what I do as I am for medicine. I truly love it, but like a marriage, it takes more than love to make something work. I'm really weighing the pros and cons here of going into med, and I'm so torn. Anyone have any advice?

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Not all applicants make it. Persistence with high motivation is required. On the one hand, you want to live with no regrets and on the other hand, you would be taking a big risk with the downside of no medical school and having lost a good income and future.

 

Only you can make that decision. Certainly, you need to assess your realistic chances based upon your GPA & background. Then, there is the MCAT and how you likely will do. Depending upon your GPA, you may need a second degree.

 

The starting point for me would be to make a realistic assessment of your chances given your present stats, and then, if improvement is needed, how long will it take to attain the required improvement, will you be financially sustainable during this period. Assuming you are or will be competitive, remember that on average, it takes 3 times for an acceptance (obviously less time for some and more time for others).

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Im seeing a bunch of highly educated professionals in here who are looking to give it all up to go to medical school. I am also an educated professional with an earning capacity of 80k+, full pension, benefits, sick time and paid vacation. Does anyone here worry about the opportunity cost of going into med? I'm eligible for a lucrative, union negotiated, government pension at the age of 54 and if I go into med there will be none of that for sure. But having said all that, I'm nowhere near as passionate about what I do as I am for medicine. I truly love it, but like a marriage, it takes more than love to make something work. I'm really weighing the pros and cons here of going into med, and I'm so torn. Anyone have any advice?

 

Well I'm sure medicine will pay it off somehow. I mean the average salary of physicians is something close to 200k isn't it?

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Well I'm sure medicine will pay it off somehow. I mean the average salary of physicians is something close to 200k isn't it?

If i stayed in my position yes, it would very much pay off. But something else I have the opportunity to do is my NP. It's significantly faster and less expensive than med school. I would keep all my pension, sick time, vacation increase increments, and seniority. As well I would start off about 112k (not including the aforementioned sick time, vacation, and pension). But in the end, it's still not medicine.

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Let me tell you about opportunity cost...This year I will finally make more than I did in 2002.  :rolleyes:

 

I have a spreadsheet titled "Medical School - Breakeven" which shows I will be in a net positive financial position somewhere around 2018 or 2019 (for a process that started in 2003).

 

You will giving up a pretty cushy situation, with no financial payback for a decade or more.  I have no specific advice for you, other than it's good that you're thinking about these things.

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Let me tell you about opportunity cost...This year I will finally make more than I did in 2002.  :rolleyes:

 

I have a spreadsheet titled "Medical School - Breakeven" which shows I will be in a net positive financial position somewhere around 2018 or 2019 (for a process that started in 2003).

 

You will giving up a pretty cushy situation, with no financial payback for a decade or more.  I have no specific advice for you, other than it's good that you're thinking about these things.

I know it's good I'm thinking about these things, but obsessing about them the way I am can't be good lol. It actually boils down to NP vs MD. I can do my NP without giving up anything except 20k of tution and 6 months of pay because I need to take unpaid leave to do my clinicals (which overall is peanuts considering what I would have to give up for med).

 

Could you possibly send me a template of that spreadsheet? I'd like to see what my own numbers look like on there.

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If i stayed in my position yes, it would very much pay off. But something else I have the opportunity to do is my NP. It's significantly faster and less expensive than med school. I would keep all my pension, sick time, vacation increase increments, and seniority. As well I would start off about 112k (not including the aforementioned sick time, vacation, and pension). But in the end, it's still not medicine.

 

That is definitely true, I find the role of a doctor is significantly different from a NP. How come you would keep your pension, sick time etc? Isn't NP a full time course?

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That is definitely true, I find the role of a doctor is significantly different from a NP. How come you would keep your pension, sick time etc? Isn't NP a full time course?

You are right, NP is significantly different than physician. The scope difference is huge, which is why I'm so interested in going all the way with med school. The NP course isn't full time. I could do it part time over 2 years. The theory courses are online, and the 6 months of clinical would be done on unpaid educational leave. I wouldn't accrue pension, seniority, or sick time during my leave, but I would still be a permanent employee so I wouldn't lose it either.

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Faced much the same dilemma when considering medicine. Ultimately, I decided on medicine because of the breath of opportunities. In my previous career, there were ways I could advance, but I could really only go in one direction at a time and I wouldn't have much control over how quickly I could pursue those pathways. The one nice thing about being a physician is the ability to tailor your practice and your career with what can be a very unique mix of activities. It's not completely in your hands, but certainly more so than in other fields.

 

However, I was not nearly as far along in that career as you are right now. In addition, in the time between applying to medicine and getting in, my career advanced further than I expected it would, so the actual decision to pursue medicine came at a time when I wasn't giving up much. There were also some personal factors which made going into medicine a beneficial move (unique situation, feel free to PM for details). Having the NP route as an option is also something I did not have. While being an NP is not quite the same as being a physician, they have quite a bit of flexibility as well - there are NPs in clinical practice, research, administration - you name it. In all honesty, if an equivalent to being an NP existed in my field, I would have considered that above medicine.

 

Financially, being a physician likely pays off in the end. But it's short term loss for long term gain and even then difference probably isn't huge unless you pursue a very lucrative field. It's a tough balance without a good answer, so consider what your life goals are outside of your career and how the medicine pathway might help or hurt those. After all, money's just a means to an end.

 

Lastly, while there are a lot of great things about being a physician that don't exist in other careers (including NP), there are a lot of not-so-great things about being a physician that don't exist in other careers (including NP). You probably see those pros and cons on a regular basis - make sure to consider them all when deciding whether or not to pursue medicine.

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NPs are always increasing in scope and breadth.ive met some NPs whom are very autonomous and indistinguishable from FM docs. I'd look into the situation in the U.S., and see if you can self rationalize that to Canada(in small pockets), as it is very likely especially due to health care dollars being less effective over time.

 

If NP is a viable option, it may be something really really worth considering. Unless you absolutely want to do something super specialized in medicine, that you can't get out of NP.

 

Why not still pursue the NP, while getting your ducks in a row for medicine? Further training can't hurt and may be beneficial as well in your med apps. It may take some time before you are fully ready to apply and ultimately be admitted to medicine.

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NPs are always increasing in scope and breadth.ive met some NPs whom are very autonomous and indistinguishable from FM docs. I'd look into the situation in the U.S., and see if you can self rationalize that to Canada(in small pockets), as it is very likely especially due to health care dollars being less effective over time.

If NP is a viable option, it may be something really really worth considering. Unless you absolutely want to do something super specialized in medicine, that you can't get out of NP.

Why not still pursue the NP, while getting your ducks in a row for medicine? Further training can't hurt and may be beneficial as well in your med apps. It may take some time before you are fully ready to apply and ultimately be admitted to medicine.

Where I work, NPs have an excellent scope and function very similarly to GPs. That's something that attracts me to the NP route. But at my age and circumstances, I couldn't possibly justify going to medical school after completing my NP. And no, I'm not interested in doing something specialized at all. NP or MD, I want to be in primary care. So at the end of this post, it appears as if I'm leaning towards NP. But at the end of the next I might be leaning towards MD. So indecisive lol

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For strictly figuring out the financial side of it, I think the question is, how much money will you make in your lifetime on one route vs. the other.

 

Let's say if you went the NP route you could start next year (and let's say you will be 30). You would be making say $80K as a nurse for the 2 years while studying part time, then nothing for 6 months to do your clinical rotations. I'm going to give you an extra 6 months for studying just in case, and to make my math easier. So now you have made $160K betweeen ages 30-33.

Now, as an NP, you are making say $120K a year (I'm just going to bump your $112K starting salary to $120K and keep it static, which is underestimating your NP income over your lifetime). Let's say you retire at age 55. From age 33-55, you make $120K/year over 22 years, that's $2.64 million. Now, let's say your pension is $50K a year and you live to 85. That's $50K a year x 30 years is $1.5 million. Add that to the $160K you made becoming an NP, and the $2.64 million you made as an NP, and you have an estimated lifetime income of $4.3 million.

Let's say it takes 2 extra years to get started on an MD. So you will make the same $160K from 30-32. Then from ages 32-35 you make nothing, taking the optimistic assumption that you get into a 3 year program. Then from ages 35-37 you made about $50K/year as a resident so $100. So from ages 30 to 37 in this scenario, you make $260K. 

Now let's say you are still only working until 55, to keep the comparisons accurate. Let's say you make $300K/year over those  18 years, that's 5.4 million. Add on the $260K you made before that, and you are at $5.66 million. 

So when you look at it that way, medicine is not working out to be significantly more lucrative when you are earning $4.3 million in your lifetime as an NP compared to $5.66 million in your lifetime as an MD. 
 

I didn't include tuition, but that would knock the MD number down as well. 

These numbers are a total over-simplification, but what I am saying is this is how I would calculate it. It's almost impossible to compare the two accurately when you include all the details. 

From a strictly financial perspective, it seems like the NP route is almost as good as the MD route, unless you choose to work a lot of long hours as an MD or to work longer. This is entirely possible because 55 is really young and you might want to work an extra 10 years or more!

I would say that the low-risk and extra security of the NP route would lean me in that direction. 

Also, I made up half these numbers, so you would need to adjust them for your situation, maybe you will come to a completely different result. :P

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For strictly figuring out the financial side of it, I think the question is, how much money will you make in your lifetime on one route vs. the other.

 

Let's say if you went the NP route you could start next year (and let's say you will be 30). You would be making say $80K as a nurse for the 2 years while studying part time, then nothing for 6 months to do your clinical rotations. I'm going to give you an extra 6 months for studying just in case, and to make my math easier. So now you have made $160K betweeen ages 30-33.

Now, as an NP, you are making say $120K a year (I'm just going to bump your $112K starting salary to $120K and keep it static, which is underestimating your NP income over your lifetime). Let's say you retire at age 55. From age 33-55, you make $120K/year over 22 years, that's $2.64 million. Now, let's say your pension is $50K a year and you live to 85. That's $50K a year x 30 years is $1.5 million. Add that to the $160K you made becoming an NP, and the $2.64 million you made as an NP, and you have an estimated lifetime income of $4.3 million.

Let's say it takes 2 extra years to get started on an MD. So you will make the same $160K from 30-32. Then from ages 32-35 you make nothing, taking the optimistic assumption that you get into a 3 year program. Then from ages 35-37 you made about $50K/year as a resident so $100. So from ages 30 to 37 in this scenario, you make $260K. 

Now let's say you are still only working until 55, to keep the comparisons accurate. Let's say you make $300K/year over those  18 years, that's 5.4 million. Add on the $260K you made before that, and you are at $5.66 million. 

So when you look at it that way, medicine is not working out to be significantly more lucrative when you are earning $4.3 million in your lifetime as an NP compared to $5.66 million in your lifetime as an MD. 

 

I didn't include tuition, but that would knock the MD number down as well. 

These numbers are a total over-simplification, but what I am saying is this is how I would calculate it. It's almost impossible to compare the two accurately when you include all the details. 

From a strictly financial perspective, it seems like the NP route is almost as good as the MD route, unless you choose to work a lot of long hours as an MD or to work longer. This is entirely possible because 55 is really young and you might want to work an extra 10 years or more!

I would say that the low-risk and extra security of the NP route would lean me in that direction. 

Also, I made up half these numbers, so you would need to adjust them for your situation, maybe you will come to a completely different result. :P

 

These numbers are pretty good, except that I'm already 32, and I'm eligible to retire at 54, and the opportunity cost I'm lost income for going to medical school would be 80k x 4 years = 320k. Plus 40k in tuition as opposed to 16k for the NP.As well, for my day to day income, I need to consider that if I wanted a months paid vacation, I would have to decrease my income to save in order to pay myself for the time off work. There is also sick time, so I would have to either take from my net income savings for an emergency fund or some type of disability insurance. Another thing to consider is that GPs work more than 40h a week. NPs (in the context which we are discussing) only work 40h a week. If as an NP I wanted to pick up weekend or evening shifts above and beyond my regular M-F work, I could make much more money and be significantly closer to a GP income. The calculations I did were from a slightly different perspective than yours, but I think reached the same conclusion. In the grand scheme of things, the financial benefit of doing my MD instead of my NP is not particularly significant.

 

But then, there is the scope and the opportunity to work in a medical model instead of a nursing model. This to me is huge, and much more difficult to calculate. The NP route is faster and easier, but I think overall would be less rewarding. The MD route is long, and from what I have heard from many medical students, very painful. This is going to take more time and thought.

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Hmm...in your situation it's really hard to ignore the upsides of going the NP route.

I agree-especially given how much they are increasing in prevalence lately. I feel like the job market is stronger in more geographic locations than some areas of med at the moment   

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Honestly, if medicine is what you want to practice, you will likely not be satisfied with anything else. Believe me, I've tried!

 

I quit my $100K+ job, started a new degree and have just been accepted to medicine. It's been quite a journey. However....I am fortunate to have the support of my husband who earns a good salary, which makes all the difference.

 

FYI - I am considerably older than you too ;)

 

Feel free to PM me if I can help in any way.

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I agree-especially given how much they are increasing in prevalence lately. I feel like the job market is stronger in more geographic locations than some areas of med at the moment

 

It really is. If I wanted to so anything other than primary care, I think med would be winning at the moment. But the time, financial, and stress cost of going to medical school is really starting to push me towards the NP route.

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I think that your situation is unique in that you have a pension that you would be giving up. 

It's not all that comparable to other professionals giving up a good-paying career with no pension. 

The security and peace of mind that you get from having your retirement figured out, and from having a union there to protect you if you are ever unable to work from an illness or accident or something, that's huge. 

Doctors are among a small group of people who can easily purchase those things for themselves, so you would be fine. But giving up what you already have and dealing with the stress and uncertainty of med school costs and no income for so many years is a lot to sacrifice when you already have that stuff figured out and invested in. Especially because your potential day to day role as an NP who is only interested in primary care anyways, is so similar (and NPs can practise independently within their scope, that's huge). 
 

In my work as a lawyer, I have seen people who have been extremely successful in business, making millions of dollars, but then having some bad luck and losing it all. Security is an awesome thing to have, and not something to give up without a really really good reason. 

At the end of the day, it's your decision though. If you want to talk it out a bit, feel free to PM me :)

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It really is. If I wanted to so anything other than primary care, I think med would be winning at the moment. But the time, financial, and stress cost of going to medical school is really starting to push me towards the NP route.

Especially in Ontario with the cuts they just announced-it's crazy to think that there might not be flexibilty for jobs in family medicine. I guess how much you would rather do specialist vs GP is the thing to really consider

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There is a big opportunity cost, but one thing that you and others have realized is that work is about more than just making money. From a simple personal satisfaction point of view, having the opportunity to practice two professions in a single lifetime would be a huge upside to switching to medicine, provided you have already accumulated enough resources to make it through the next 6-8 years.

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There is a big opportunity cost, but one thing that you and others have realized is that work is about more than just making money. From a simple personal satisfaction point of view, having the opportunity to practice two professions in a single lifetime would be a huge upside to switching to medicine, provided you have already accumulated enough resources to make it through the next 6-8 years.

 

BTJJ hit the nail on the head here. If I get into med, I'll also be giving up a six figure income with a pension. I'll be honest. It does scare me sometimes. 

 

Life is relatively short though and I'd rather work in a fulfilling career and be able to say "I'm glad I took a risk and did that." rather than "I wish I would have done that." 

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