5 ms·

Exactly! Medical training in the US is unnecessarily long. The med students don't need 4 years of undergrad studies on top of another 4 years of med school. In

Exactly! Medical training in the US is unnecessarily long. The med students don't need 4 years of undergrad studies on top of another 4 years of med school. In my home country, 5 years of med school and 2 years of residency is sufficient to train a competent generic physicians (not brain surgeon). Physicians from my country, when they came over to the US to be trained in the residency programs here, found that the medical exams and residency training to be not that difficult (it is extremely difficult to get into one because they are foreigners, but once they get in, almost every one of them become multi-millionaires by their 40s). My gf externed at a hospital just outside of LA in California. The attending physician there earn ~300K/year for a total of 14 days of work per month. She met two physicians (both from my country again), who work at two hospitals near that area as attendings; they go to one hospital for one week; then work at another the week after; and the cycle repeats. Each of them makes easily >$500K/year (one of them said so to my gf). Despite majority of Americans are led to believe by doctors, born and trained in the US, that they are the most hardworking folks out there doing 70-hours/week shifts, it is simply an exaggeration. Sure there are some outlier residency programs that made its first or second year residents work maybe 60-hours/week, but 70 to 80-hours? I know so many former and current residents in a the biggest metro area in the US (and another one who just finished her residency at JHU), and asked them about their working hours. NONE of them had to work that much. The average for first year residents is ~50 hours. Then it drops off to normal 40-hours/week starting second year and third years.

pixelmonkey 7y ago
Spouse of young doctor here. I have worked in tech for two decades. During that time, my spouse did 12 years of post-secondary pre-med and medical training. Undergrad, postbacc, med school, and residency; she is now in a fellowship. You said (paraphrasing): “despite majority of Americans being led to believe doctors are doing 70-hour shifts per week, it is simply an exaggeration.” First, most Americans don’t believe it. Second, my wife worked 60-100 hours per week for her entire 4-year residency. That included month-long stretches on nights doing 6pm-6am shifts, 6 days per week. That included more 24-hour (or, even 28-hour) shifts than I could count. I know the hours precisely because I worked from home the entire time for my tech startup job, and we lived a 5 minute walk from the hospital. It’s a top academic hospital. I once attended a wedding where all her med school friends were guests, all in their 3rd and 4th year of residency. Polled them about work hours. All similar. Group of 7 or 8 residents at programs all across the US, mostly top programs. Some exceptions in residencies like geriatrics and pediatrics, but any surgical or specialty residency is brutal. The happiest resident had recently quit medicine altogether — to go into tech. They work that hard whilst earning essentially sub-minimum-wage. The contrast couldn’t be greater vs tech. My company employs over 50 people, mostly college educated, and it is not even remotely comparable. Residents get paid less than our lowest paid staff, and work twice the hours, with higher stakes, a higher emotional toll, and worse working conditions. And it just gets more unequal from there. She is now in fellowship and the hours are slightly better. But she is now in a more urban area with a longer commute, higher taxes, higher cost of living, and debt hanging over her. As a fellow, she only makes marginally more money for her 13th and 14th years of post-secondary training. This week she worked approx 55 hours so far (if you don’t count the 4 hours of “journal club”, also required), and will need to commute an hour by car on her Sunday morning to round on a single patient — part of her unscheduled, but required, call. If she becomes a multi-millionaire in her 40s, as you suggest is inevitable, I will be pleasantly surprised — but considering fellowship, for her, ends at age 37, I think it unlikely. First, she has to pay down over $300k of student debt, since none of the journey was paid by her parents. Then she has to earn for awhile, and make up a little for lost time, since she doesn’t have decades of savings behind her, living right at the breakeven mark for cost of living for so many years. And even if it does happen, I’ll think it a justified renumeration for her countless sleepless and low-paid nights saving lives in her 30s, not to mention the opportunity cost (and real cost) of educational years. After all, should we expect the personal sacrifice of one’s 20s and 30s have no reward at all? Doctors should be paid much more, sleep much more, and they should suffer much less ire from people like you. As someone with two decades in tech and first-hand, concurrent experience of the contrast, I feel that much more now than ever. Some earlier comments: https://news.ycombinator.com/item?id=20437414 https://news.ycombinator.com/item?id=20437414 https://news.ycombinator.com/item?id=15182632 https://news.ycombinator.com/item?id=15182632
- rb808 7y ago
  I think you're agreeing. The 10+ years of doctor training is too much, too long and too expensive. But I think you're double counting the residential years as medical training as well as an underpaid job. Yes I agree software developers are currently overpaid as well.
  - pixelmonkey 7y ago
    "Yes I agree software developers are currently overpaid as well." This reminds me of an old Romanian joke a family friend once told me, translating to English. Two pig farmers, one Romanian and one Bulgarian, live across from each other along the countries' border. A genie magically arrives on the Bulgarian side and says to the farmer, "I can grant you any wish in the world." The humble Bulgarian farmer thinks on it for awhile and says, "I wish for 10 beautiful and healthy pigs, so that my farm may thrive for the coming years." The genie grants the wish and the pigs appear. The genie flies over to the Romanian side. He says to the Romanian farmer, "I can grant you any wish in the world." The Romanian farmer thinks pensively for a little while, and then it comes to him. He points to the Bulgarian side and says, "Kill his pigs."

pixelmonkey 7y ago

Spouse of young doctor here. I have worked in tech for two decades. During that time, my spouse did 12 years of post-secondary pre-med and medical training. Undergrad, postbacc, med school, and residency; she is now in a fellowship. You said (paraphrasing): “despite majority of Americans being led to believe doctors are doing 70-hour shifts per week, it is simply an exaggeration.” First, most Americans don’t believe it. Second, my wife worked 60-100 hours per week for her entire 4-year residency. That included month-long stretches on nights doing 6pm-6am shifts, 6 days per week. That included more 24-hour (or, even 28-hour) shifts than I could count. I know the hours precisely because I worked from home the entire time for my tech startup job, and we lived a 5 minute walk from the hospital. It’s a top academic hospital. I once attended a wedding where all her med school friends were guests, all in their 3rd and 4th year of residency. Polled them about work hours. All similar. Group of 7 or 8 residents at programs all across the US, mostly top programs. Some exceptions in residencies like geriatrics and pediatrics, but any surgical or specialty residency is brutal. The happiest resident had recently quit medicine altogether — to go into tech. They work that hard whilst earning essentially sub-minimum-wage. The contrast couldn’t be greater vs tech. My company employs over 50 people, mostly college educated, and it is not even remotely comparable. Residents get paid less than our lowest paid staff, and work twice the hours, with higher stakes, a higher emotional toll, and worse working conditions. And it just gets more unequal from there. She is now in fellowship and the hours are slightly better. But she is now in a more urban area with a longer commute, higher taxes, higher cost of living, and debt hanging over her. As a fellow, she only makes marginally more money for her 13th and 14th years of post-secondary training. This week she worked approx 55 hours so far (if you don’t count the 4 hours of “journal club”, also required), and will need to commute an hour by car on her Sunday morning to round on a single patient — part of her unscheduled, but required, call. If she becomes a multi-millionaire in her 40s, as you suggest is inevitable, I will be pleasantly surprised — but considering fellowship, for her, ends at age 37, I think it unlikely. First, she has to pay down over $300k of student debt, since none of the journey was paid by her parents. Then she has to earn for awhile, and make up a little for lost time, since she doesn’t have decades of savings behind her, living right at the breakeven mark for cost of living for so many years. And even if it does happen, I’ll think it a justified renumeration for her countless sleepless and low-paid nights saving lives in her 30s, not to mention the opportunity cost (and real cost) of educational years. After all, should we expect the personal sacrifice of one’s 20s and 30s have no reward at all? Doctors should be paid much more, sleep much more, and they should suffer much less ire from people like you. As someone with two decades in tech and first-hand, concurrent experience of the contrast, I feel that much more now than ever. Some earlier comments: https://news.ycombinator.com/item?id=20437414 https://news.ycombinator.com/item?id=20437414 https://news.ycombinator.com/item?id=15182632 https://news.ycombinator.com/item?id=15182632

rb808 7y ago
I think you're agreeing. The 10+ years of doctor training is too much, too long and too expensive. But I think you're double counting the residential years as medical training as well as an underpaid job. Yes I agree software developers are currently overpaid as well.
- pixelmonkey 7y ago
  "Yes I agree software developers are currently overpaid as well." This reminds me of an old Romanian joke a family friend once told me, translating to English. Two pig farmers, one Romanian and one Bulgarian, live across from each other along the countries' border. A genie magically arrives on the Bulgarian side and says to the farmer, "I can grant you any wish in the world." The humble Bulgarian farmer thinks on it for awhile and says, "I wish for 10 beautiful and healthy pigs, so that my farm may thrive for the coming years." The genie grants the wish and the pigs appear. The genie flies over to the Romanian side. He says to the Romanian farmer, "I can grant you any wish in the world." The Romanian farmer thinks pensively for a little while, and then it comes to him. He points to the Bulgarian side and says, "Kill his pigs."