I need medical career advice.

I know there are a whole bunch of medically experienced Dopers, and I’d really like some input.

I did well in high school and got accepted to a prestigious all-women’s college (including getting into their special intern-with-a-professor work-study program). I also did a Telluride Association summer program, if that means anything to anybody. More recently, I took pre-med physics at the University of Washington and got something like a 3.6 cumulative (while working more than full time).

It sort of came to me a couple of years ago while working in a completely unrelated job that I should be a doctor. It really seemed like a bolt from above, almost. So when I got laid off from that, I looked for jobs in the medical field.

Currently, I work as a phlebotomist in a local hospital and I totally love what I do. I really like working with patients, and I really like the hospital atmosphere.

I am planning to go back to school in the near future to do something in the medical field. The thing is that I left college after two years, and don’t have my bachelor’s degree, and while I was in college I took no science courses.

I came in thinking I wanted to be an MD, and I haven’t totally given that up. However, I’m starting to question my abilities to make it through internship/residency. I’m a 28 year old female and I live near my parents but not with them. I’m self supporting financially. I have a semi-long term relationship that I can’t count on for emotional support through this time; I’ve never been married and I have no children. I am unsure whether I want children.

I’m starting to consider whether I’d rather look into either being a Physician’s Assistant or a Nurse Practitioner, but my stubborn streak says to go for the MD, since that was the original idea. (I’ve got nothing but respect for RNs, PAs, and NPs; I’ve seen them in action.)

I know that realistically I’ve got about three years of undergrad left (because I do have to work while going to school) and right now I’m planning to take the general prerequisites for either medical or nursing school and kind of see how I fare from there.

I’d like to hear from Dopers in the medical fields (especially female MDs or those who are close to them) and find out what they think about my particular situation. I can’t really talk to the interns/residents at work; they’re very busy, and I also feel uncomfortable talking to them because they’re all men my age or younger.

I know this was long. Thanks in advance.

(And mods, I hope I’m in the right forum. I’m looking for some [NS] humble opinions.)

The Army has a PA program. Have you considered that route?

Free training and certification
Free on the job experience
College credits for the training
Free housing
Free food
GI Bill to continue your education when you get out.

You’d have to join the Army

I’ve considered joining the Navy (my dad’s service in Vietnam). I haven’t looked into it much, but he’s told me that based on some unfortunate past incidents in my life I would not be accepted as a recruit. (I can’t donate blood either. I don’t like to get much more specific on the internet, but the reasons are related.)

You don’t list where you live, but you don’t need to be in the military to attend a physician’s assistant program. It’s usually a master’s degree, so you’d need to finish your bachelor’s first.

You might also think about a nursing degree. Some states (Pennsylvania being one of them) have special financial aid programs for people getting a bachelor’s in nursing, and you can always go on to be a nurse practitioner.

Just a couple of thoughts/suggestions.


All the interns are men? That’s weird, 70% of my class is female (I’m a medical student in Ireland, with less than a year until I qualify).

What specifically worries you about becoming a doctor?
The hours, the stress, the amount of time until you graduate, your age, financial issues, whether the course will be too difficult?

I wouldn’t worry about your age or gender, I went into our 6 year course straight from school, but there is 42 year old mother of 2 and a 36 year old father of 3 in my class. We also have 2 qualified pharmacists, 1 qualified nurse and 4 qualified dentists (who want to be maxillo-facial surgeons). There isn’t a problem coming in late, as long as you’re prepared to put in the work.

Use whatever pull and contacts you have in the hospital where you work to help you with your options. In Medicine, like in most professions knowing the right people can open doors and smooth your path.

Aim high (whatever “high” means for you), at least that way you’ll always be able to say that you gave it a shot, rather than spending your life wondering abou missed opportunities.

If you really want to be a practitioner, go for the MD. US med school classes are over 50% female these days, and feature a lot of “experienced students” who are a lot older than you are now.

PA and NP are good career choices too, but I think it would be frustrating as hell to be a competent PA or NP stuck with having to take direction from a less-than-able MD.

Residency is tough, but not the hell it used to be (back when I was a resident, of course :smiley: )

Just my two cents, take what you can use and discard the rest.

I’m a female MD, out in the real world for 6 years now.

Most medical school classes here in Canada are at least 50% women, and have some mature students. In terms of workload, internship & residency (while not a picnic) are generally not as difficult as people think they are, and certainly not as nuts as they used to be, given the rules that have been put in place to protect trainees. Depending on what field of medicine you think you would be interested in working in down the line, the residency can be long and arduous (think neurosurgery) or short and tolerable (think family practise).

In terms of whether to go for the nurse practitioner /physician assistant vs. MD, I think you need to consider if you are the kind of person who likes to help take care of someone but not be ultimately responsible for their care, or if you like “being the boss” despite the stresses involved. Also, physicians often go into medicine because they want to help patients and enjoy patient contact, and are disappointed to find out that they get to spend less time with patients than (for example) nurses do: we tend to see the patient, order whatever tests and treatment needs doing, but nurses and therapists deliver a lot of the actual care. On the other hand, physicians get more respect than other health care professionals from patients and their families, which can be frustrating for good nurses, physician assistants, etc (not to mention we typically get paid more, as well).

You may want to ask any nurse practitioners or physician assistants you know if they regret not going for the MD degree and what they see as the differences between their job and that of the MD, and see what you learn from their answers. MDs generally like what they do but complain about the bureaucracy, paperwork, etc.

Hope this helps.

Thanks for the advice.

Yes. All of it.

Eh, that’s probably not entirely accurate. I’m thinking more of the residents, and it seems the ones I come in most contact with are the surgery residents, who are almost all male. I know there are quite a few women in the local med school.

Those are very good points to think about. Thanks.

In terms how you’d fit demographically with medical students - this past years entering class at the University of Washington was 57% female and ages ranged from 21-37. Part of your post seems to imply a worry that you’re too old to start thinking about medical school now. As other people have said, you’re not. You would be on the older end of the spectrum but not likely the oldest in the class. If deciding whether to go for a PA or an MD, I’d look at how long you’re willing to spend in school, not how old you’ll be when you graduate.

Financially, unless you’re independently weathy or have some willing to pay your bills, going to medical school requires going into debt. Fortunately student loans are pretty easy to get and the average doctor’s salary allows you to pay them off.

As far as the hours, I have no idea about where you’ll work. It averages about 75 hours a week here (but the EU Working Time Directive is coming into place over the next few years, which will reduce hours to 48 per week).

I have friends who were working 14 hour shifts every other day (and every other weekend, and every third night) for 3 month blocks, but everyone copes. It’s not like ER, you have time to put your feet up or sit and take a break in the lounge, especially at night (hell, you might even get to sleep!). Even in surgery, you have time between cases while they put the patients under anaesthetic and prep the theatre.

As for the stress, at least here, because you spend so much time with your classmates, you form a really tightknit circle of friends who are all going through the same thing. There’s always someone to offer tea and sympathy and a shoulder to cry on, even if you don’t have a SO or family.

I don’t know if it matters that we’re not marked on a curve, it helps to form solid relationships with your classmates when you’re not constantly in competition with them. However, if you’re with the same bunch of people for 10 hours a day 5 days a week you’ll get pretty close even if you are competing for marks.

Although academic requirements for medicine are high, that’s more a product of supply and demand for college places than because you’re actually required to be that smart. You have to be able to pull disparate pieces of information together to make a diagnosis and management plan which makes sense, but you don’t need to know EVERYTHING- that’s what libraries, textbooks, the internet and senior colleagues are for.

Talk to an independent financial advisor about your finances. Yes, you’ll be in debt, but you’ll be able to pay it off and still have enough to be comfortable-unless you want to live like a rock star within 5 years of graduating you should be ok. Plus, doctors get things like 100% mortgages (well, they do here, I can’t imagine it would be different for you).

Have you looked into studying in the EU? I’m surprised irishgirl didn’t mention it, but Ireland is reputed to be an excellent place to study. I have been looking at doing something similar myself and I heard about the Atlantic Bridge Program. The six year program is no longer than you will spend finishing your undergraduate degree and attending a US medical school. The expenses don’t seem to be much higher than the most of US schools I looked at and lower than some.
I have also found that Charles University in Prague, a highly-regarded school, has an English-language medical school. There are many other English-language medical schools in Europe and the British Isles.
Getting an offshore medical degree doesn’t just mean cut-rate schools with soft admission standards in the Caribbean.

After reading my post again, I see that the second sentence should end something more like “Ireland is reputed to be an excellent place for Americans and Canadians to study.”

There is a tradition of scholarship in Ireland that rivals that of any other country.

Since sewalk brought it up…

We do have several North American medical students in Ireland. Most of them in Dublin, either at Trinity (my school) UCD (University College Dublin) or RCSI (Royal College of Surgeons Ireland). All of these schools have excellent international reputations, and our North American graduates don’t have problems getting the jobs they want. Johns Hopkins has a medical school in Bologna, Italy that is well thought of too, if you fancy a warmer climate!

Trinity has links with Columbia and Boston, and several of our students spend their electives in the US. As many Irish graduates spend some of their professional life abroad, there are also several senior Irish physicians in the US who will look kindly on students from the Irish universisites (we call them the “Irish mafia”).

About half of my class have taken/will take the USMLEs Part 1 and 2, in order to ensure they’re all set should they wish to work in the USA or Canada at some later date.

It’s not actually a 6 year course any more, it’s a now a 5 year course here, but since most graduate entrants were able to skip the first (basic science) year anyway it doesn’t alter much.

IIRC the fees are about 25,000 euro a year. This does NOT include living expenses, and Dublin is NOT a cheap city to live in, but it still works out cheaper than the more expensive American schools. Most people only travel home at Xmas and for the summer (as I said you can do electives in North America), but if you can face extended periods away from your family you would save more money.

One of the benefits of graduating from an EU medical school is that your degree is accepted by all of the member states…meaning you’re qualified to work all over Europe, should you choose to do so. Some choose to do their internship in Ireland or the UK, others go home straight after graduation.

The study methods and way of examining here are different, and some North Americans find it hard to adjust. For example, as I said earlier, there is no grading curve, so if you get 50%, you get 50%. Also, question spotting and preparing set answers isn’t possible, as the lecturers can (and do) ask ANYTHING on the course…even if it was a throw-away comment at the end of a lecture attended by 3 people. Exams are either practical OSCEs or a mixtue of MCQs (with negative marking) and essays.

This system favours the Irish method of studying (pulling an all-nighter before the exam and trying to cram in a vague knowledge of everything) far more than the North American one (intensive study sessions, study groups, learning set answers to set questions etc).

I’m telling you this just to warn you that the North Americans often feel a little short-changed, as they tend to get similar results to their Irish classmates, even though they’ve probably studied more. We tend to hope for the best and waffle and bullsh*t our way through, they tend to panic if the questions don’t fit into one of the set boxes they’ve studied. It’s not a better system or a worse system, it’s just a different one to the one you might be used to.

Anyway, I’ll not bore you to much more with info you may not even be interested in.

Sorry, no. That’s the School of Advanced International Studies. http://www.jhubc.it/

The Hop only turns out Med School graduates in Baltimore.

At least that’s what their web site tells me.

Sorry, crossed wires during a trip to Bologna. I was sure they said medical students, but i must have remembered wrongly.

Thanks again for all the input. I didn’t mean to abandon my thread, but I don’t have internet access at work and I’ve been pretty busy the past few days.

I have never considered studying in the EU, but it sounds interesting. (I espeically like the part about waffling and bullsh*tting.) :smiley:

I’m comforted that none of the MDs/students have come in saying, “For God’s sake no! Don’t do it!”

I like school; I always have. The idea of being in school for that long doesn’t bother me.

I’ve still got at least three years before I have to decide (due to the aforementioned need to finish the prereqs) and lots of things could change in that time.

Could you explain that for me?

At least half of my med school class (which graduated in 2002) was made up of people who were not on the typical college-straight-to-med-school track. I’d say it’s true of almost 3/4 of them if you include a fifth year of undergrad.

I think I’d be frustrated as an NP or a PA, knowing that there were things I couldn’t do, and that I’d always be answering to some doctor, and that I’d never make as much money as I would as an MD. At the same time, though, I think an NP or PA would have a far easier time having a life outside work. Doctors are now far more accepting of other doctors who make their family (as in, their kids) a priority, thought some old-timers even still grumble about that. But there’s still a lot of looking down on doctors who take anything else seriously, and I’m starting to resent that a bit. No one will think less of an NP or PA who only wants to work at it 40-50 hours a week, but if a doc wants to limit his hours like that–and to take on a job and a patient load that allows it–his devotion is questioned.

The most important attribute in medical education is perseverence, aka stubbornness. There is so much crap that will make you wonder why the hell you do it, and you’ve got to make it through those times. There are also times that remind you of why you do it, but sometimes they can be a little far between, and you’ve got to stick it out until the end.

OSCE-objective, structured, clinical exam.
Basically a room separated by screens into separate booths. In each booth is a task.You rotate from one booth to the next when a bell rings.

In one there might be an X-ray for you to interpret, in the next a piece of equipment to identify, in another an actor playing a patient and you have to ask them questions and make a differential diagnosis or treatment plan. You might have to demonstrate a clinical skill, like intubation or suturing- on a model, not a real person!

Each station is usually 5-10 mins and there are usually about 10-15 of them. The exam is supposed to test your clinical knowledge, practical skills and communication skills. You may well get marked for the WAY you ask the “patient” questions, rather than getting the right answers from them. Being polite, sensitive and aware of any underlying issues might be worth more marks than getting the “correct” diagnosis.

The multiple choice questions are usually true/false. If you answer wrongly either 0.5 of a mark or 1 mark will be deducted, while 1 mark is awarded for each correct answer. You start with zero, so it’s best not to guess, since the pass mark is 50%.

Essay questions are exactly that.
You’ll have between 30-45mins to answer something like “Discuss the pathology, aetiology and treatment of kidney tumous in the adult” or “What is medical Negligence?” or “Discuss the management of hypertension”. There are usually 3-4 essays per paper (depending on subject), there may or may not be an MCQ section first. Our written exams usually last between 2 and 3 hours.

Our final exams (the ones just before you graduate) are the old fashioned style of practical exam. A long case and a short case for surgery, medicine and paediatrics, a long case only for Ob/Gyn.

For the long case you are presented with a patient, this time a real one, whom you will never have seen before, and on whom you are given no information. You have no access to their charts.

You have 45mins alone with them in which time you much get a full history and perform an examination. For paediatrics the parents are present, and you’re expected to get most of the history from them. Then an examiner comes in, you present your history, examine the patient again in front of them, present a differential diagnosis and an appropriate management plan. You then answer any questions the examiner chooses to ask.

For the short case it’s the same set up, but a simpler case, you’re given some information on the patient, and only perform a short examination. The short cases take 20 mins.

All our exams have a 50% pass mark, 60% is second class honours and over 70% is a first class honours. To give you a rough guide, about 5% of a class will fail any exam, 75% pass, 15% get 2nd honours and 5% get first class honours. Some exams are harder (more fails), some easier (more honours).

If you fail an exam outright you have re-sits in September. Borderline fails (45-49%) and honours (57-59%, 67-69%) students have a viva voce exam, where you’re asked questions by two or more examiners. Most people have their marks put up.

If you fail the re-sits, you probably have to re-sit the year (even if you only fail one subject). Usually one or two people fail each year (most pass their re-sits), and either repeat or drop-out (but this is out of a class of 130).

40% of our class is International-usually Malaysian, North American, Norwegian and Botswanan. Plus we have some English and some Northern Irish students. In my year we also have Kuwaitis, Japanese, Australians, South Africans, Mozambiquans, Indians and Pakistanis. It’s a nice mix of cultures, and we all tend to get on very well with each other. I have no idea how that compares to North American schools, but I like it.

http://www.tcd.ie/ is my university website, you can click on the links to the Health Science faculty and school of Physic (Medicine) if you’re interested.

Ding! There’s the dilemma. I really like the idea of being in charge (scary as that can be - and believe me, I’ve watched the faces of the interns as they make decisions). A few months ago I got to pretend to start a central line on a dummy at the UW Med School. I turned to the doctor helping me (head of the ER) and said, “That…was sooo cool.” I loved it (he also got quite a kick out of it, apparently). I think that the way my head works, I pretty much have to be an MD. But as a woman, it’s hard to understand that that means that a) I might not be able to have biological children; or b) I’ll have to have them during a time when I can’t pay as much attention to them as I’d like.

Career breaks, flexi-time and job sharing are options.
The profession IS changing, but if women give in and accept the status quo, it’s not going to change as much as it needs to.

Two of our female Consultant (Senior Attending) Obstetricians (traditionally one of the most stressful and demanding specialties) job-share. One works Mon-Wed, the other Thu-Sat and they take turns working Sundays and share their overtime and night duty. It actually works very well.