I've always dreamed of leaving behind Silicon Valley and pursuing emergency medicine. I need to stay the course for a while to ensure my college approaching kids are taken care of but stories like this are inspiring reminders that age doesn't have to be a factor when I finally decide to make the move.
Make sure you get a good perspective from a trusted friend in the medical community before making any big moves (if you haven't already). For the uninitiated, it's the furthest thing from a low-stress job. For some people, the passion outweighs the stress. But despite knowing countless people in medicine, I can only think of one that still professes to love her job - the rest were burned out long before covid.
As a counterpoint, nearly everyone in my family in medicine still loves it. My parents are surgeons in their sixties who don’t need to work any more. My uncles and aunts are GPs, radiologists, and anesthesiologists. My cousins are GPs, nurses, and anesthesiologists. So that’s a spectrum from 21-65 and almost all of them enjoy their jobs. The things that really bother them are poor administrators etc. They’ll quit jobs over that, but not out of burnout.
I think it’s easy for this to be a fulfilling career if you’re the kind of person who doesn’t get early filtered out.
Interesting. I've heard not great things about physician job satisfaction in the last few years, mostly centering around more time spent with billing/paperwork and less with patients.
They’re not all in the US. Spread over the US, Canada, UK, and the UAE. But anecdotally there are more complaints from North American family about paperwork. Obviously I see NA family more, living here now, so that’s not really a surprise.
All of those roles are rather low stress (aside from RN which can vary wildly depending on your dept/floor). The high churn/burnout roles are in critical type care from my experience being married to a nurse. Many docs go without sleep. Either they are on call in the middle of the night and on weekends or they are on 48 hour shifts. Its crazy they are allowed to do that let alone it being the norm.
Past the edit window, but I didn't notice that autocorrect changed "pay" to "party" (which works just well enough in that sentence to be confusing, I'm sure)
I had a colleague that was in his late 30's or early 40's at a large tech firm that applied to medical school and became a doctor. It was a long and hard road for sure. I ran into him years later in a Trader Joes in San Francisco and from what I gathered he had had his share of road bumps, but he was well on his way.
The salaries look nice when they're windowed to a single year. Career earnings, it's good but not that great compared to tech - especially when you consider the hours and stress.
* 4 years of med school - $0 income - $40k+ of tuition
* 3+ years of residency, minimum (4+ for most fields, even more for surgery) - $60k/year
------
If my wife had gone straight into tech, we'd have been better off financially until our 50's. 30 years is a long, long time to break even.
> Career earnings, it's good but not that great compared to tech
We are in a strange time when software engineer salaries can even be comparable to those of doctors. Rest assured that sooner or later tech workers will be middle-class schlubs like pretty much every other type of engineer.
The idea that doctors need to make huge amounts of money compared to almost everyone else is very American. Here in Poland, doctors up until very recently were paid not much more than the country's average wage. Now it's more diversified, especially with short-term contract positions paying much more than that - but regular jobs at a hospital still don't pay more than 3x the national average.
In the UK you have no debt but salaries for the first ten years generally don't go over 50k per year which makes living in a major city and having children unsustainable
Missing interest - unless you really want to fuck yourself in the short term. 160k of tuition costs more like $300k with the standard payment play. Good luck if you have undergrad debt. Could easily add $500k more to your debt load.
> 80k x 4 = 320k lost wages.
Try a number closer to $400k. Also a good portion of MD's take a gap year for research either during med school or before residency. Potentially adds a year.
> 30k x 3 Delta wages.
3 years is for family medicine, most other specialities are 4 years - so add a year. Surgery is more like 8 years.
This wage delta is more on the order of $80k to $100k+ per year. I have friends who are closer to $150k+ per year wage gap compared to their MD spouses.
For my wife and I this number will be $400k.
$300k + $400k + $400k = $1.1m+ difference.
> You said 30 years. I'm counting 2.
You're counting two because you're only looking at salary and not the salary difference. I'm counting 15 at minimum on a pure salary income.
My wife is also working 80/hours week. I'm working 40. It will take into our 50's before my wife makes more on a per hour basis than I do. If I worked 80 hours per week, my wife would never catch up.
If you are smart enough and tough enough to go through med school and become a doctor you can easily earn $300k-$500k per year in tech, with much less stress.
There’s some interest in there as well which adds up over 7+ years. Plus how much his wife makes depends on her specialty and the potential salary in tech is also wide. You can make $400+k at a large tech company faster than a doctor can even begin practicing.
Granted this is word of mouth from several years ago amongst new grads looking for jobs in NYC and Boston, some in SF, who were looking to stay in academic centers. I would say that's the worst case scenario. (there's a huge line of aspiring NIH PI's who are willing to work for peanuts for UCSF, Mass General, etc. The NIH training grants who are supposed to compensate for "75% time" are $98k/year...so do the math for the full 100%...).
For the Medscape study, I would say it's good to see the numbers are better in the private practice world, nationwide. But - most MD's will be presumably internal medicine and you'd have to look at the breakdown. The low end jobs in primary care, public health, etc start at $200k, and most folks who aren't surgeons or ophalmologists or dermatologists are in the low-mid $200's. That's assuming you graduate from residency in your late 20's or early 30's w/ the $350-500k in debt or whatever it is these days, unless you took the National Health Services or DoD scholarships, whereupon you then owe them 4-8 years of your life...
If you're going into medicine for the money you are making a huge mistake. The front-side effort, commitment and cost is massive, and depending on your field it make impact important aspects of your life for as long as you practice. There are way easier ways to make money.
One example: do a comparatively easier 4-yr undergrad in business and start with a bank straight out of school (they scoop up lots of new grads willing to move around). In the same ~15 years you can move into a senior position in finance or M&A and make comparable money. It's not easy or guaranteed but IMO easier...
Medicine is the single most reliable path to the upper-middle class in America. Sure the other things you described are possible but honestly unlikely unless you have an Ivy League undergrad.
It's a ten-year commitment, roughly, to become a practicing ER doc. And in today's industry, you'll spend the overwhelming majority of your time doing documentation on shit that should've been seen by a PCP, not an emergency department. And definitely not treating emergencies. You'll be lucky if you see one or two a day in a major ED; in smaller ED's, even one a week is optimistic.
If you want to jump in with eyes wide open, more power to you. Most days, I can't tell you whether I regret my move or not.
Depends where you work - I work at St Joe’s in Stockton, and it’s not unusual to incubate 5 or 6 patients in a shift, though one or two is more usual. Get in touch if you’re looking to work in a super underserved community, with ridiculously high acuity!
That said, most ED’s are not like that, and an awful lot of emergency medicine is ‘just’ careful assessment and reassurance, so I’d agree that if you don’t like the process of seeing and helping high and low acuity patients, it’s a bad career choice.
If anyone wants to chat about the pro’s and con’s of EM and career changing, happy to chat, contact info in profile
This fellow went to a 3 year med school that doesn’t care too much about your prerequisites as long as you have a degree. It’s 3 because they don’t really do summers off.
Although he did a full 5yr EM residency, in Canada you can work EM with a 2 year FP residency and another year as an FP specializing in EM.
The tech industry saved many lives during this pandemic. Compliance with social distancing standards would be way lower if people had nothing to do at home but watch TV. Even social media is showing its bright side. People are using it in more positive ways, connecting with each other and largely sharing quality information regarding Coronavirus. Life would have come to a halt without modern internet technology, almost warranting a calendar pause until the pandemic passes.
That being said, there's a lot of variability in the social value of tech industry jobs. At risk of being pedantic - you can net society more social good if you transition to a higher social value job within the same industry. It takes many years to become a doctor, and many people compete for that career so you wouldn't expand the supply of medical labor. Moreover, medical industry cronyism plays a part in bankrupting America with little to show for it. You should do what you want ultimately. I've just seen some people self-flagellate when they're actually doing really good things for society.
Agreed. I think there's plenty of space to make a difference in tech. I don't think it's automatic in any way (i.e. making a positive social impact) -- I think the choices of every CEO and every worker matter. Facebook and/or Google could turn the industry in completely different directions (e.g. more centered in providing culture, growth and genuine interaction) if there was the will. The extent to which they're glorified ad-machines is a choice.
And outside of that (i.e. big tech) there's plenty to invent and contribute in countless ways. Medical equipment, niche technology products, innovative and useful consumer technologies, the warriors we don't hear about improving industrial processes and everyday stuff, etc.
I have younger friends looking to enter the game industry. I tell them: make sure you don't land somewhere that makes you start hating what you loved just so you can tell yourself you make games (having addiction-machine mobile games in mind). Better work anywhere else and wait for the opportunity to do it right, I believe.
Selling your soul is always a choice... and it's not an easily replaceable good.
There is burnout across medicine and various other verticals that Technologists hope to retire into. I do think there needs to be a support network to help modern knowledge workers recognize the dignity and value of their labor. Some of the possible exercises could include practicing empathy during the work day, learning to explore where their labor helps the world, and recognizing the things about the systems around us that we cannot change.
Working on public policy is a worthwhile (and uphill) fight for sure. But it lacks imagination to suggest that impact at scale isn't possible in tech (examples: robust low cost medtech for non G7 economies, same for finance in those markets, support systems for large scale NGO efforts, access to justice efforts, etc. etc.). Clearly these opportunities exist, but they may be under resourced relative to lucrative tech options.
With that said, here is my example: Medicare For All would save us $450 billion, and avoid 68k preventable deaths, every single year. I find it a stretch to suggest that ambitious goals such as that "lack imagination". Such impact is simply not obtainable with tech or NGOs alone. Even Bill Gates has needed roughly $50 billion to drive forward his foundation's humanitarian efforts (but admittedly, is very efficient, with estimates of having saved ~122 million lives through their work).
I don't think this is a counterexample, and the imagination lacked wasn't in the scope of what can be done in policy work, but in the scope of what can be done in tech.
To stay with your examples, some of the Gate's foundation efforts have largely been tech efforts, some haven't. Some of the things I mentioned off-the-top have potential to reach 10s to 100s of millions of people. MFA is a big $ number partially because the US healthcare system is expensive and inefficient, so that draws focus on $ saved ... other efforts may focus on lives impacted at much lower $ impacts.
Most public policy work isn't as big as MFA either.
I'm not saying policy work isn't important or impactful. I'm rejecting the idea that you (generic 'you') can't have similar effect in technology to what you might be able to achieve in policy; especially the idea that this is so clearly true that the "right" thing to do is quit technology to go into policy. Even assuming you can be as effective in policy work as you are in tech work, which isn't a given.
You're welcome. I think it's a really interesting question in general: where do I want to spend my working time, and to what end? I've spent quite a bit of time thinking on it for my own case, and trying to find technical areas where I hope to be able to find an impact. It was the majority reason I left academic work (not that I am saying that can't be impactful).
Making companies that matter work more efficiently is meaningful progress. I've never had the thought that what I do isn't making a difference for the next generation.
It doesn't matter what you do, there will be days you wish you had a different job.
How do you think a doctor feels when he sees some fat patient going into the donut shop (or all you can eat buffet) after he told them to go on a diet and lose weight. (is this worse than the person who dies of bad genes caused heart attack despite talking their medications, exercising and eating well - another thing doctors see)
While my grandfather was in the hospital years ago, the patient in the room next door was recovering from a quadruple heart bypass. He didn't like the hospital food so his family brought him cheeseburgers from the fast food restaurant down the street.
absolutely. Or even less exotic: they probably won't make a (sexy) TV show about IT in a hospital but if you've ever been to one there are massive opportunities to make a huge, meaningful change
There's scope within tech. I recently moved to the NHS as a software engineer and it's amazing the amount of low hanging fruit there is. The main issues are politics and the fragmentation of existing tech but if you're an engineer with good people skills and the ability to deal with lots of system integrations you can have a lot of meaningful impact.
I tried this. I didn't get into medical school but it is doable.
I enrolled in a premedical postbaccalaureate program, and over the course of two years of night classes finished all of the prerequisites required by most allopathic medical schools. I worked by butt off to finish with a 4.0 GPA and place in the 96th percentile on the MCAT (good enough to not be ruled out because of my MCAT score). I also volunteered at a memory care hospice on weekends during this period and ended up with 100 hours of clinical experience. I had some additional clinical exposure working on medical device projects as an engineering student.
I applied to 27 schools and was invited for two interviews. Of those two, I was waitlisted by one and rejected by the other. I didn't end up clearing the waitlist. So what went wrong? I can't say for certain, but I suspect these were contributing factors:
* My undergraduate engineering school GPA was 3.3 and my graduate school engineering GPA was 3.4. These are reasonable by engineering school standards but borderline for medical school.
* I only had 100 clinical hours. Many applicants have hundreds or even thousands of hours of clinical experience when they apply. I was 31 when I started the postbac program and decided to keep my full time job in order to save up money. The opportunity cost of each hour of clinical experience was higher at this age compared to a typical undergrad. In hindsight I should have at least devoted my weekends to gaining clinical experience the moment I decided to go this route.
* One of my recommendation letter writers was late. My application wasn't processed until all recommendation letters were in. I wasn't eligible for consideration until later admissions rounds.
* I didn't stand out. To be clear this isn't a requirement, but schools like to build a diverse and interesting class, so standing out in some way can be helpful. I struggle to decide if this was something beyond my control or if it represents a personal failure.
To return to my initial point, it is doable. In an alternate universe in which my recommendation letters made it in earlier, or I slept better before the MCAT and got an extra point, perhaps I would have been invited for one or two more interviews. If the interview -> admission invite conversion rate is 20%, that boosts the odds of admission from 36% to 59%. (I haven't ruled out applying again, but I would need to enroll in classes for at least another year in order to get new faculty recommendation letters. Unfortunately it isn't safe to volunteer at the hospice right now due to COVID-19).
Can corroborate. Schools care about GPA too much even in the face of work experience (most doctors on admission committees have never had another job..) + MCAT score. Median GPA is 5% of the grading in the US News research rankings and that matters a ton to the schools. Went from software to med school, now in my second year (4 since software). 3.67 GPA (bioinformatics)/ 3.55 BioChemMathPhysics GPA with 100th percentile MCAT. ~140 hrs clinical experience when I applied. 20 applications, 6 interviews, 4 waitlists (to rejection), 1 immediate post-interview rejection (screw you too NYU), 1 acceptance.
If you read about this CEO and are thinking about making the switch be very realistic with your chances, particularly about your GPA like parent post said. Without a 3.7+ you're going to have a tough time, and there's no guarantee that you won't spend 2+ years and get rejected. You'll have to overperform on the MCAT. Expect bias against your work experience (only software really). Whenever I said I used to be a software engineer you could see the light leave some of the interviewers eyes... Though if you're FAANG or another name-brand company I wouldn't expect the same.
Have got to say though software/data skills have been super useful for research projects, which are the fun part of medical school vs the absolute grind of pounding facts in.
Wow. That story didn’t end like I thought it would. How depressing. I hope you get into med school because it really sounds like you deserve it. There is just so much unnecessary grind and friction in this country.
Your stats are pretty impressive. I'm surprised you didn't get into an MD program especially considering that you did the postbac. I'm sure you would've gotten into DO school though.
I've thought about doing this myself. I'm curious, what made you want to switch (from software engineering I'm assuming?) to medicine?
Thanks for sharing the story. I am curios if you applied both for MD and OD schools? Anecdotally, I heard opinion, that OD is more tolerant to people, who choose medical field as a second career or older applicants.
I've entertained very similar ideas myself. It's one of those things I often revisit -- wondering if I had made the right career choice. I love being an engineer and have been very lucky in being financially rewarded for doing something that I love. But whenever a startup I'm at fails or I feel my career is at a standstill, the things that's given me joy during those times are the times I've spent helping others outside of my career. I think it's because acts of kindness and generosity are meaningful in and of themselves whereas a career in engineering might make sense in the end or maybe not.
A good friend of mine actually had a great career in software but decided that to become a nurse in the time he has left on earth. He and his wife both decided to go to nursing school and were definitely the oldest students. They are both now nurses and seem very happy.
I’m a resident in Australia.
11 years at university (took some side tracks), $70k in debt for the whole time, now gone, and we are paid between $70-110k a year as interns.
Although our training pathways are longer because we are required to do 2 generalist years
Yes, I second the opinion that the costs the schedule issues etc are a US problem..
I think one could study at much lower cost in China, Russia, Eastern and Central Europe. They have now courses in English, and have become the new hub for medical education.
> I think one could study at much lower cost in China, Russia, Eastern and Central Europe. They have now courses in English, and have become the new hub for medical education.
Cost is cheaper, yes. Quality varies a lot across the country. Some countries are doing better than others. But medical degree is still not easily convertible, so if you study outside the US, but practice here, it's not simple. Language is not the main issue, different approaches, different standards, etc.
