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New resident physician in the U.S. here. I actually really enjoy my job now but absolutely hated medical school. Would I do it again? Probably not even though I

New resident physician in the U.S. here. I actually really enjoy my job now but absolutely hated medical school. Would I do it again? Probably not even though I’m happy now. Four years of misery during my twenties was not worth it. And the stress of $250,000+ of student loans is ever present. And unless you’re at the top of your class at every stage of training, you have little control over where you end up geographically which is really bad when you have relationships to maintain. Long distance for several years sucks a ton. So I’d only recommend going to medical school if you’re a top student who can get scholarships (so you don’t have much debt) and so you have some control over where you go (because you’ll be competitive for most programs). But even so, I went to a top Med school which was my first choice and I still ended up hating it. You’ll never know what program/city you’ll like until you try it but once you start it’s very difficult to change Med schools or residency programs in general.

pmiller2 7y ago
I sort of understand why it’s difficult to switch residences, but why is it difficult to switch schools?
- tmh79 7y ago
  very few transfer spots open, and the schools tend to have different curriculum programs (generally the same courses, but taught with varying focuses).
- outlace 7y ago
  It’s difficult to switch residencies because each residency program has a fixed number of positions per training year which is largely funded by the government. And almost all positions are filled by the end of match so the only way you can switch is if someone leaves their position for some reason and they happen to be at the same training level as you. Medical schools admit a variable number of students each year although they aim to have a specific number. It’s difficult to switch medical schools because Med school curricula are very different from program to program. And also there’s just no standard mechanism for switching, you’d just have to schmooze some of the higher up administrators. Med schools don’t really get any advantage by taking in transfers unless they had a mass exodus of students and needed the money. So there’s little incentive for administrators to even bother with transfers. In residency you want all your positions filled so you can keep the funding and have enough staffing so if a position opens you want to fill it ASAP.
- SkyPuncher 7y ago
  My wife's school had 5k applicants for 108 spots. Schools can be ultra selective in who they accepts and are allergic to people they think won't graduate from their school. Not finishing a degree at one school suggests you're more likely to not finish it at the next school. Why would schools take that risk when they can choose from 4,999 other applicants instead.
wallace_f 7y ago
Once in med school, how Meritocratic vs Subjective or Political is the road to top student status?
- vonseel 7y ago
  From my understanding (2 doctors immediate family and several others extended fam), it can be quite political. Desirable specialties are competitive, whether for lifestyle (dermatology, radiology, etc.) or prestige/interest (things like pediatric surgery). Once you get into a specialty, the work does not stop, as there are usually progressive tiers of training and additional programs. You might do first 4 years residency in Dallas, then receive your next placement in Chicago for 2-3 years. These would be great locations, for most, from what I gather. Most aren’t so lucky. IIRC the surgery fellowship (8 years after graduating undergrad, 4 years after med school graduation) application process gives a list of 10 cities (hospitals) which the intern is interviewing and applying for. They are allowed to rank their top three cities from this list, but there is no guarantee. They will travel to all ten cities and interview at all the programs. Medicine is great for someone who wants to be in training until they are mid 30s - and that’s assuming you go directly to med school from undergrad.
- tmh79 7y ago
  My wife recently graduated from a top med school. Her experience was that it was probably 80% "meritocratic" (long hours, grinding it out, being there when someone needs help) and 20% "political" (knowing the right people in the department, knowing what research projects will be good to join and what projects are dogs). To be the top student, you need to know the material well and be productive at research and be a good service provider (good manners, thoughtful, empathetic, etc). The good news is that departments generally give very good opportunities and mentorship to anyone student who shows an aptitude for grinding. Basically, to be in the top 1/5 of the class is all about getting in your reps, and the things that separate the members of the top 1/5 of the class is who they know, who knows them, and the impact and scope of the projects and procedures they were trusted with.
- outlace 7y ago
  The pre-clinical years (usually the first two years, but many schools are condensing this phase into 1 or 1.5 years) are very meritocratic in that your standing depends on mostly multiple choice tests. And then you take the first medical licensing exam called Step 1 which largely determines your competitiveness for residency programs. The clinical years where you are actually working in the hospital in various fields is less objective as you are judged based on the subjective feedback evaluations of the residents and attending physicians. However, you are mostly rated on how much you know, how confident you are and your social skills. So if you did really well in the pre clinical years and are not socially inept then you’ll probably get good evaluations. But it’s a marathon. It’s an unbelievable amount of information you have to memorize and in the beginning it’s hard to stay motivated when you can’t see it’s direct relevance. So overall I’d say it’s fairly meritocratic. If you can memorize things well and are social then you’ll do well barring any exceptional circumstances.

pmiller2 7y ago

I sort of understand why it’s difficult to switch residences, but why is it difficult to switch schools?

tmh79 7y ago
very few transfer spots open, and the schools tend to have different curriculum programs (generally the same courses, but taught with varying focuses).
outlace 7y ago
It’s difficult to switch residencies because each residency program has a fixed number of positions per training year which is largely funded by the government. And almost all positions are filled by the end of match so the only way you can switch is if someone leaves their position for some reason and they happen to be at the same training level as you. Medical schools admit a variable number of students each year although they aim to have a specific number. It’s difficult to switch medical schools because Med school curricula are very different from program to program. And also there’s just no standard mechanism for switching, you’d just have to schmooze some of the higher up administrators. Med schools don’t really get any advantage by taking in transfers unless they had a mass exodus of students and needed the money. So there’s little incentive for administrators to even bother with transfers. In residency you want all your positions filled so you can keep the funding and have enough staffing so if a position opens you want to fill it ASAP.
SkyPuncher 7y ago
My wife's school had 5k applicants for 108 spots. Schools can be ultra selective in who they accepts and are allergic to people they think won't graduate from their school. Not finishing a degree at one school suggests you're more likely to not finish it at the next school. Why would schools take that risk when they can choose from 4,999 other applicants instead.

wallace_f 7y ago

Once in med school, how Meritocratic vs Subjective or Political is the road to top student status?

vonseel 7y ago
From my understanding (2 doctors immediate family and several others extended fam), it can be quite political. Desirable specialties are competitive, whether for lifestyle (dermatology, radiology, etc.) or prestige/interest (things like pediatric surgery). Once you get into a specialty, the work does not stop, as there are usually progressive tiers of training and additional programs. You might do first 4 years residency in Dallas, then receive your next placement in Chicago for 2-3 years. These would be great locations, for most, from what I gather. Most aren’t so lucky. IIRC the surgery fellowship (8 years after graduating undergrad, 4 years after med school graduation) application process gives a list of 10 cities (hospitals) which the intern is interviewing and applying for. They are allowed to rank their top three cities from this list, but there is no guarantee. They will travel to all ten cities and interview at all the programs. Medicine is great for someone who wants to be in training until they are mid 30s - and that’s assuming you go directly to med school from undergrad.
tmh79 7y ago
My wife recently graduated from a top med school. Her experience was that it was probably 80% "meritocratic" (long hours, grinding it out, being there when someone needs help) and 20% "political" (knowing the right people in the department, knowing what research projects will be good to join and what projects are dogs). To be the top student, you need to know the material well and be productive at research and be a good service provider (good manners, thoughtful, empathetic, etc). The good news is that departments generally give very good opportunities and mentorship to anyone student who shows an aptitude for grinding. Basically, to be in the top 1/5 of the class is all about getting in your reps, and the things that separate the members of the top 1/5 of the class is who they know, who knows them, and the impact and scope of the projects and procedures they were trusted with.
outlace 7y ago
The pre-clinical years (usually the first two years, but many schools are condensing this phase into 1 or 1.5 years) are very meritocratic in that your standing depends on mostly multiple choice tests. And then you take the first medical licensing exam called Step 1 which largely determines your competitiveness for residency programs. The clinical years where you are actually working in the hospital in various fields is less objective as you are judged based on the subjective feedback evaluations of the residents and attending physicians. However, you are mostly rated on how much you know, how confident you are and your social skills. So if you did really well in the pre clinical years and are not socially inept then you’ll probably get good evaluations. But it’s a marathon. It’s an unbelievable amount of information you have to memorize and in the beginning it’s hard to stay motivated when you can’t see it’s direct relevance. So overall I’d say it’s fairly meritocratic. If you can memorize things well and are social then you’ll do well barring any exceptional circumstances.