This opens a rather large can of worms in the United States. About 40–50% of physicians will tell you that we would never choose medicine again. Let me explain why. - The pay/reimbursement/employment has changed over the last 10 years. Now we are reimbursed less than the previous generation of doctors. This may not seem like it is important, however, I graduated from a state medical school with $284,000 in student loans (I payed in-state tuition). With interest accrued through residency and fellowship my total is now $615,000 and my monthly payments are over $5000. Yes, physicians are well paid. However, we have not been able to save money during medical school (4 years) or residency (2–6 years) or fellowship (1–3 years). This means we do not start a nest egg or 401K until we start to practice. For me, I was in my mid 30s when that finally happened (I graduated med school in 2011). You will only make $48,000-$60, 000 during your residency and only about $62,000 in fellowship. You will likely not be able to pay off all of your interest during this time, so you will be in the same boat as most of us are, unless your family was able to pay for your medical school. (Note: I had no debt from undergrad or graduate school. This is *all* from medical school.) - Training is hard. This is true no matter what specialty you go into. The 80 hour work week is an average over 4 weeks. This means you may be working 100 hours one week and 50 the next. For us, we never went under 80 but often saw over 100 hours per week. When we report our hours honestly we were told that we were inefficient and it must be our fault it took us that long to get our work done. The longer you are in a program the more worn out you get. By our second year we all were prescribing antidepressants to each other. By the end of my 4th year I was in full blown burnout. I finished without ever letting on. Medicine values sucking it up, resilience, and toughness. You will not be allowed sick days and, if you are, you will not take them because even if your attending begrudgingly agrees to let you off , your co-residents will be angry because they have to pick up your extra work. This goes for dental appointments, doctor's appointments, and other self-maintenance things. You will eat, sleep and breathe your specialty during training. No one cares if you are burnt out, tired, depressed, failing as a spouse, trying to have a baby, caring for a baby, etc. All of these things are considered to be your fault, or your choices, so you deal with them. Some people don’t make it through training. You need a good attending as a mentor. Find one. - You aren’t going to be able to go to just any city/metro area and find a position. When I was looking there was only one position in my home state and none closer than 2 hours drive from my family. You must be prepared to move where you are needed. This sounds obvious but I don’t think that most of us think about this when we start residency or medical school. - When you get your first attending job you will be better off financially, but you must remember point 1 and save much of your earnings to be able to catch up to your peers. I work my surgery job and have a side hustle as well, but I want to be extra comfy and am a few years older than the typical grad. Some random things that you encounter: No one respects you as a resident, either. Women, you will still be the nurse. Even when you introduce yourself as “Doctor” and have it in giant neon letters on your coat. Even when you tell them that you did the operation that saved their life. You will get to know everyone at the hospital. Everyone. Be nice and use these relationships to learn and network. RNs taught me much of my critical care knowledge. They catch changes in the patients before you do (they spend more time with them) and they make or break your call nights. Use the other residents in other programs to help. I mean this in the sense that if you have a question that doesn't really deserve a consult, call your fellow residents and ask what they think. The network you build will really help you out even after you graduate. You will be surprised at your reactions to a patient dying. Depending on a situation your reaction will change. You may even feel that you have become callous. No worries, as physicians we compartmentalize the deaths to be able to move on with our day. There will be that one that will break your heart. Lock yourself in the bathroom or call room and cry. Then straighten your scrubs and go back to work. There is no crying is surgery. I am assuming this applies to medicine in general. You come out of residency a different person than when you started. Surgery changed my personality. It isn’t a bad thing, per se, but you will need to “find yourself” again when you become an attending. I didn’t even know what hobbies I liked after I finished training. It is definitely a journey. Source
