I am currently in college working on a nursing degree. My childhood passion to become a doctor or surgeon has suddenly been resparked. It feels like I was meant to be one. The only reason I am going for nursing is because I thought I had no chance due to my apalling grades. Now that my ADHD has been under control, I am on a roll and will probably have a high GPA at some point. I feel like anything is possible at this point. I will be finishing my pre reqs soon and it seems like I’ve gotten too far to just make a u turn at this point.
Convince me to either become a doctor or settle for nursing. What are the advantages or disadvantages to either path? Either way, I’m sure I’ll at least like my job.
Are you married? Do you intend to get married? Your spouse will have to make a crap ton of sacrifices for your career. From following you around the country as you complete your training, to having to deal with all the times your work gets in the way of your marriage, your spouse will have to deal with a lot of the fallout of your career choice. I’m devoted to my wife, but I don’t know how many times I’ve been this close to saying “Fuck it” and walking out the door.
The impact on your loved ones varies by the specialty you choose, the type of practice you go into, etc. So if you are, or intend to be, in a committed relationship, talk to some married doctors or their spouses about how they make it work.
I want to become a nurse because my mother is one and I have spent much time in hospital, so there is a lot of exposure. I have always been fascinated with the medical field and the human body and enjoy the thought of helping people and making their days. My chosen field at this point is labor and delivery. I want to become a doctor for the same reasons, but in this case I would be more involved with learning about the human body and in treating patients. I like the mystery of making a diagnosis. Surgery also is so fascinating.
I’ve never actually thought about NP. I will look into that. I would have yo forget about surgery though.
I am not currently married nor in a relationship. I do plan on at least being in a committed relationship at some point. The specialties that interest me the most are orthopedic surgery, ER, and trauma.
I should add my younger sister is currently premed and on the path to becoming a pediatrician.
A career in nursing is not “settling” at all … unless it is not what you want to be doing.
Consider debt load and the “opportunity cost” involved in going the MD route. Medical school runs roughly $50K plus a year for tuition alone and the residency years are indentured servitude, not real income. Going an NP/PA route gets you earning with much less debt much much earlier. Opportunities for bright NPs and PAs abound in areas from primary care to specialties. Yes including surgical specialties and nurse anesthetists.
Your past “appalling grades” never go away. Two years of straight As can dilute them but they still impact your total GPA. One C in a science class is able to be overcome with As from there on and kick-ass MCATs plus maybe something else about you that makes you special but if you have two … it is tough. Not impossible but an uphill climb. Most med schools average admitted total GPA is round 3.6 to 3.7 (plus minus depending on the school, some average 3.5, some 3.9) and not too different for science GPA. Of course less kick ass MCAT requires higher and more slightly less.
I am a physician (pediatrician) who absolutely loves what I do and I recognize that I have some “power” in the system that I would not have as an NP or PA. And my annual income is greater than an NP or PAs. But given that you are asking, I am not sure that return on the investment is so hot compared to the PA/NP route, especially since the process includes a certain calculated risk regarding getting into medical school as well. If I was a bright undergrad today I am not so sure what I would be choosing. That debt load is pause-worthy. Your sister will be servicing her debt for years after someone who goes the NP/PA route is netting a decent income.
Some specialties require just a residency; some require a residency and a fellowship. For both residency and fellowship, you will probably have to go through a “match” process, where you interview with the programs you’re interested in, you rank them, they rank you, and you are matched to one of them by a selection process you don’t control. At least it was this way 10-15 tears ago. I think it’s still the case. The upshot is that you go on all these interviews, then one day you get a letter telling you where you “matched”. Congrats! That’s where you’re going to live for the next 3-5 years, like it or not. You had family where you were? Your spouse was up for promotion? That’s a damn shame. You want to do a residency, right?
Also consider that, once you’re done with training and ready to join a practice, you may have to sign a non compete agreement. So, you decide you’re going to work for the greatest phrenology practice in Peoria because that’s where your family is. You sign a non-compete agreement saying that if you leave the practice, you can’t practice phrenology within 50 miles for two years after you leave. (This is more common in some specialties than others). You find out you hate the job because the head phrenologist is a jerk. Now what? If you want to leave, you either have to get a lawyer and fight the non-compete, or you have to find another town to practice in. Your family is in Peoria? Your parents are elderly? Your kids are in school? Your spouse is trying to build a career there? Yeah, that sucks.
Or, maybe there’s no non-compete, but there are just not that many phrenology practices around. You want to leave, but the other practice in town isn’t looking for a new doc, and the closest one that is, is two states away. You have employment for life, as long as you don’t care where you live.
I don’t mean to be all gloomy. There are a lot of great things about being a doctor. You get to help people, and of course the pay can be very good. Just make sure you give a lot of thought to the impact on your family life.
I cannot give a cite, but I recall back as an undergrad we read about one study that showed the ratio of mental illness among med students increased with each year. The researchers were unable to decide if that meant the sane students dropped out over time or med school drove you insane. Really.
How are you with responsibility? I mean, life and death responsibility? Are you best in the front of the team, making split second decisions and giving clear instructions to those around you? Or are you a great team member who can understand unclear instructions, get fast clarification, determine if they’re safe and sane, and then carry them out, while at the same time noticing new things happening that need to be communicated to the primary decision maker?
I became a nurse because I’m not comfortable with being the head of the team. I’m great with teamwork, and I’m very good at thinking on my feet and I’m a leader within my agency, but I want there to be someone else I can call and go, “meep? What do I do now?”
Plus, medical diagnosis has never been my strong point. Nursing diagnoses make a lot more sense to me. I don’t particularly care whether a patient has bronchitis or asthma…I care that they’re not getting enough oxygen to their tissues, and I know how to fix that, no matter what you want to call it.
If you truly consider being a nurse “settling,” then you should not be a nurse. That doesn’t mean you should be a doctor, though.
Not reading any of the other responses, but if you have a British accent, I would say you should become a doctor, just so you can introduce yourself to patients by saying, “I’m the doctor.”
I think the people you should be asking are practicing doctors. Even in my limited experience I know plenty that feel trapped in their career choice. The Washington Post recently had Why doctors quit. It contains this tidbit
There are plenty of similar articles. So you should get plenty of opinions from people who are doing the job. It’s the advice Daniel Gilbert would offer if you read Stumbling on Happiness.
Almost took the words out of my mouth. It takes a lot of self-motivation to become something like a doctor or a nurse. If a person can’t find the motivation inside themselves, it’s unlikely that external motivation is going to help short of somebody picking up the bill for the education. Even then it’s going to take a lot of drive and self-motivation to go through all the training.
Yep. My physician anxiously awaits retirement due to the changes that have taken place in his profession. He also thinks things will continue to worsen in the short term.
I’ll echo some of the other comments that if you are well along to becoming and RN, then you should do some serious research and consideration into becoming a nurse practitioner or physicians assistant. Probably a NP after you get your RN. Many medical practices are now hiring lots of NPs and PAs, who do much the same work as the physicians, but have the docs to fall back on with questions. I have a friend who is a nurse anesthetist. She works in the OR and makes pretty darn good money. Lots of paths to choose from, but you need to decide which one is calling you and how motivated you are.
Retro-Phrenology might require a separate fellowship, so… not sure.
I didn’t read the linked article, but my wife also probably spends more time banging away at the Electronic Medical Record system than she does talking to patients. She works at a big university, and she has to deal with a lot of other administrative crap as well. Then, there is the time she spends fighting with insurance companies to get her services covered. The part of her job that she actually trained for (making people better) is probably a minority of her day.
No doubt the nature of the medicine is changing extremely rapidly and some physicians’ responses to that have been “Get off my lawn!”
It is a tough business right now. Income is for most flat or decreasing and the effort required to stay flat is increasing. The docs who are trying to hang on to the small independent practice model are often struggling as more and more compensation is tied to being part of a much larger group that is able to hit various targets that measure the quality and value of the healthcare delivered across populations of covered lives. This requires coordination of care, teamwork across the spectrums (primary care to specialty and back, outpatient to inpatient and out again, physicians and other providers in the trenches working with those who promulgate the guidelines and protocols and “owning” rather than resenting them …) Given that WhyNot’s take that the choice of medicine has often made by those who want to be the deciders is likely pretty much accurate, the fact that delivering medicine now is much more a team sport across the board and one in which few individual physicians get to be the sole quarterback of the team, makes some grousing inevitable. Having to understand about population health? Being concerned about how we structure health care delivery and organize ourselves to achieve better group outcomes and accepting that we may sometimes be the wide receiver on teams that rely on a running game? So sad. Of course physicians have always groused about how much better it was in the good old days, those halcyon days … oh how we miss Joseph and his amusing dreams …
Don’t become a doctor expecting to be the captain of your own ship in today’s world. Do worry and consider how you will manage to service your debt load, especially in the early years. While the malaise of practicing physicians is far overstated in media NPs reportedly have very high career satisfaction, possibly higher than MDs.
Again, great job, can’t imagine being as happy doing anything else, doubt I’d be as good at anything else, thrilled to be part of recreating how medicine is delivered actually, but really seriously consider the costs, both direct and indirect, both monetary and otherwise, and only do it if you are sure those costs are worth it to you and your goals.