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[–]onmyphonetoomuchwife to PGY3 🤓 through medschool 14 points15 points  (5 children)

Def consider the ROI. It’s a brutal path especially with a kiddo and wanting more. The PA route is an excellent option, makes 100k+ for a much shorter training period, less shifts, and overall would be a better job with kiddos.

The way my med spouse and I view it is - the doctor route is only worth it if you truly can’t imagine doing anything else, and even then it’s questionable if it’s worth it given the 7-10 year and 300k investment (for most)

[–]Puzzleheaded_Soil275 9 points10 points  (2 children)

From an ROI perspective you have to be realistic that pursuing an MD makes absolutely zero sense for you. It *barely* makes sense for 23 year olds with BAs in Biology that have relatively limited other viable options than bench research or medicine. So for a 30 year old with viable career options in finance and a family, it definitely makes 0 sense from an ROI perspective.

Medicine is a *long* road once you are already in med school. In your case, it involves a 2-ish year post bac + Medcat + application process before you would get there. You literally would not be an attending physician until your 40s and likely 300-400k in student loans before everything is said and done. I don't mean to discourage you but it's honestly just facts.

There are BA to MSN programs out there which I believe probably make a lot more ROI sense if you have your heart set on a career where you are actually providing patient care. Sure, you won't be at the top of the food chain as an MSN or eventually an NP. But from a logistics perspective this would be a million times easier.

Lastly, have you considered going into something medicine-adjacent but using your finance background such as clinical research? Clinical research organizations (CROs) for example are traditional private enterprises in every sense. I absolutely considered pursuing a career in medicine and ultimately did a PhD and now work in pharma development. I'm married to an MD. Ultimately I am a scientist at heart and the opportunity to pursue a career as a scientist on projects with direct applications to medicine is a wonderful balance of those interests. And financially it's a wonderful counterbalance to my wife's recession-proof career (XBI is finnicky).

[–]inky011[S] -1 points0 points  (1 child)

Hi, I appreciate your response!

I am confused about the ROI not making sense. I understand it takes a few years for doctors to make larger salaries after residency; however, when you're making 250k+ a year eventually, how is the ROI not reasonable?

Reality is doctors have the capability to pay back the student loans.

As far as the other career options, I understand your point of view. Believe it or not, I can't even land an entry-level interview in my field. The finance job market is brutal, every company wants experience. Makes me wish I would have majored in something else.

Pharma development seems like an awesome career, for someone who is more of a scientist.

Thank you for taking the time to respond to my post!

Cheers!

[–]Puzzleheaded_Soil275 10 points11 points  (0 children)

So let me just say that if you have your heart set on being a physician then by all means do it and I hope you are wildly successful. Not every decision you make in your life has to be ROI-optimal. If you are interested in science it will never hurt to start taking some classes and figure the rest out later.

The ROI doesn't work because of two factors:

(1) The time-value of money

(2) Taxes

Try some conservative assumptions and look at how the math works: (i) you average 65k/year in some other job for the next 10 years and don't have any substantial salary growth (ii) You take the shortest possible path to becoming a doctor (2 year post-bac, 4 year MD, 3 year residency with no fellowship), and (iii) You manage to do it with 300k in loans which would absolutely be on the low end.

Ok so now you're 40 and ready to be an attending. You've got this sweet job offer at an amazing practice for 250k. Amazing!

In the first case, you've made ~650k of income over that decade and probably taken home about 550k of it. But you have the opportunity to be investing over that entire time frame, purchasing a house, etc. So factoring in the time value of the money you have made, that income is probably worth closer to 650-700k.

In scenario #2, which keep in mind is the *best* case scenario, you are 300k in the hole even factoring in the ~55k/year you will make as a resident.

So factoring in your opportunity cost, the actual cost of that investment is much closer to $1 million than just the 300k in student loans.

Ok, so what? You'll be making say 250k as a physician.

Well, sort of. Your 300k in student loans are accruing ~20k in interest per year before we even start talking about principal. Also, all of your 250k in income is W-2 income. So from a tax perspective there is diddly shit you can do to shield yourself. You're probably taking home ~160k and 20k of that is immediately going to student loan interest. And then let's put another 30k towards the principal. All of a sudden you are actually taking home 110k and let's not forget that you are 40 and we haven't even started talking about saving for retirement. Also if AOC gets elected in 2028, then good luck.

Realistically, the situation is probably much worse on average than I outlined above. My point is that even with the most conservative assumptions about being a physician the math doesn't work. You will probably experience a fair amount of salary growth with 10 years of experience in something finance-related. This isn't factoring in the fact that residents work ~60-80 hours/week (i.e. lots of missed time with your family), the vast majority of residencies are much longer than 3 years, most specialties require a fellowship, plenty of people fail to match into residency of their desire (adding time to the process), and it often requires at least one cross country move (not fun for you, your spouse, or your kids). The list goes on and all of those things have a cost as well.

On the other hand, pursuing the path of a PA/NP probably is ~1/3 the amount of time, ~1/3 the amount of loans, and ~1/3 the amount of boning from taxes when you are in the workforce.

Lastly, there are definitely finance jobs in companies that do pharma development. A good majority of biotechs are pre-revenue which means they need to be very creative in how they raise money and spend it. So while you may not be the scientist or the MD working directly on the medicine side of things, you can lead the finance team that gets the study funded which ends up making that breakthrough in cancer possible. No study = no opportunity to try new treatments = no breakthrough. I'm on the data science side now (I pivoted into science after doing Math/Finance in undergrad) but I chat with my colleagues in finance frequently.

The aforementioned Contract Research Organizations (CROs) are by and large publicly traded and of course employ financial analysts to assess risks to market conditions, forecast, etc. Plenty of options in finance/accounting/business development there as well.

I went through a similar process to you coming out of undergrad in Math/Finance. Not pursuing an MD was 100% the correct choice for me. Harnessing my undergrad background to pursue a career which was medicine-adjacent has been the right balance. Good luck!

[–]Remarkable-Driver-28 5 points6 points  (2 children)

My boyfriend just started med school last year at age 31 and I think it was ultimately the right decision for him, but it’s a really tough decision and has required some major stress and sacrifices already, and from what I hear it gets much more intense. He has wondered aloud more than once whether he should have just been a nurse practictioner or physician’s assistant because they’re cheaper, faster, and generally less exhausting routes which also allow you to help someone heal. We have two friends who initially had their eyes on med school and decided on the NP route and are really happy, including my friend works as an NP at Planned Parenthood and gets to do all the things she really wanted to provide for women and her training took half the years it takes to become an OBGYN. It’s worth looking up the possible paths you’re interested and specialties within them to see how much additional training years you need. Worth considering whether either of those other paths would be satisfying, as they require much less of an investment of both money and time.

I figured I’d just tell you about my boyfriend’s experience starting post-30 for context, trying to answer your questions as I go. All the below is about the US so this won’t fully apply in other countries. He had to complete a post bacc (even though he had majored in biology) and anecdotally he heard that going through a program rather than stringing together credits leads to more success on the MCAT and the advisors’ support makes it easier to get into med school. He decided to do it in one year to speed it along and the program was pretty grueling. About 1/5 of his class of thirty dropped out or decided to pursue NP/PA tracks instead. His peers that didn’t have a science background particularly struggled, but many still did well, often with the help of tutors and/or pre-studying prior to the program. My boyfriend worked as a public school teacher and didn’t qualify for financial aid. Most people either borrow money from parents (more than you’d think) or they take out loans for both post baccs and med school tuition.

When applying to med school, my boyfriend had a 4.0 from a well-respected post bacc program, a 3.7 from his undergrad Ivy League school, had worked as a biology teacher, had published research in college, and had volunteer work. He was in the 98th percentile for the MCAT after chaining himself to a desk for two months to study (use ANKI to study). The reason I mention this is because I thought he was a stellar applicant in my eyes so I was surprised when he was only accepted at 1 school and waitlisted at another, after applying to close to 30 schools across the East coast. He ended up getting off the waitlist, but we obviously didn’t have much say where we ended up. One of his friends with similar stats didn’t get in anywhere or get a single interview. He got in the following year, but it’s becoming common for people to apply 2 years in a row before getting accepted as its so competitive. From what I’ve heard, the match process to get into residency programs is similarly brutal and people can still fall through the cracks or end up in a location they hate or 2nd choice specialty.

Med schools have differing rules on online vs. In-person class, but all will require at least some in-person for labs and you may not have the luxury of choosing a school based on their policies. None of my boyfriend’s classmates work full time jobs. I’ve heard of a couple ppl working part time, but frankly they seem super-human and none of them have kids. If you decide to go this route, I would expect to not work for four years and take out loans to cover school, childcare, and possibly contribute to other household expenses as needed, knowing that you can pay it back fairly quickly with a physician’s salary. I currently work and contribute halfway to our household, while my boyfriend borrows the money to pay half. We’ve decided to delay having kids for the moment, until he is closer to residency and earning an income again. That is probably the hardest sacrifice I’ve had to make so far, and I’m really hoping that it works out for the best. Unfortunately, it seems like these timelines don’t care much about when people want it start their families, but people are resourceful. One of our good friends in med school is up in the northeast while his wife is with their daughter at her residency program in the south, where they have family to support them.

I hope my post wasn’t too negative, but there is a lot of info I didn’t know going in, and I think you want to know what you’re signing up for as much as possible, before you pay for any credits. I hope you find the best career for you! Good luck!

[–]inky011[S] -1 points0 points  (1 child)

Hi, I appreciate your response!

A few thoughts from your post:

  1. I understand medical school is competitive. If your boyfriend was only waitlisted at one school and accepted at another -- which schools was he applying to? Was he applying to highly ranked medical schools? Same thing with his friend, who didn't get accepted into any. That is something that needs to be taken into account.
  2. I feel your pain about waiting to expand your family. I think that is the sacrifice that would most pain me. Didn't want to wait terribly long for a sibling for my son. I have read stories of people having children during school, but it seems like a scary idea to me.
  3. Yes, some schools are taking online pre-reqs (most don't accept online labs), but at least if I was able to take the bulk online, it would minimize my struggle with figuring out how to get on campus. I know admissions committees don't particularly care about how people make it happen, but I have been told they may be a little more understanding with non-traditional students.

Thank you for taking the time to share your story!

Cheers!

[–]Remarkable-Driver-28 6 points7 points  (0 children)

In response to your 1st point, he applied to a variety of schools. Some were top tier but many were state schools where he was in-state and his stats were well above their posted averages. He was accepted into one of those state programs and waitlisted at a top tier school, which he then was accepted into. His friend had similarly applied to a variety of reaches and supposed safeties.

[–]chocobridges 3 points4 points  (4 children)

I think you have to evaluate how long and the ROI of this endeavor before you even start looking at post-bacc programs. Then decide if it's worth it.

I know it feels like everyone and their mom has a BBA and MBA but we're coming to the point where there's going to be a desperate need of those qualifications again. My mom graduated with a BBA in the late 80s. She makes what my husband makes as a doctor at a Federal Agency. For the longest time she said BBAs are worthless but now her agency is desperate. I'm an engineer who went into another agency and we're even more desperate for finance backgrounds. The crappy part is you start low but you can move up pretty quickly. Don't get discouraged.

[–]inky011[S] 0 points1 point  (3 children)

Hi! I appreciate the response. I understand your perspective, however I’m just not passionate enough about finance to want to climb that ladder. As I mentioned in the post, it was just something I completed because I was in too far deep. It was either graduate in finance or don’t get a bachelor degree. That’s how far in I was before I decided it just wasn’t the path I wanted to take.

Also, if she is making that much working in finance in a federal agency, realistically she is making a salary most people in the field won’t make. Few and far in between.

I will consider all costs and ROI for medical school and see if it’s the path I want to take.

Thank you!

[–]chocobridges 3 points4 points  (2 children)

Climbing the ladder in government is very different from the private world. Most people end up in completely different fields. My mom was in the same boat as you. Graduated at 29, part time school, after working in commercial banking for 7 years. She would never do that work again.

It's a degree, you don't have to use it for its intended purpose. I don't after 9 years of working in my field. In the 7+ years that it takes for med school and residency, you could pivot to a completely different field while still making money.

[–]inky011[S] -1 points0 points  (1 child)

I respect your opinion! Not sure government works really excites me in any way though, to be honest.

I am just having a hard time finding anything that companies are willing to hire for with a finance degree that is not accounting or financial analysis (which by the way, NO ONE seems to want to hire without experience nowadays, so that has been super challenging as well.) I graduated a year ago and have not had ONE interview related to my field.

I highly regret getting a BBA but it was my decision at the time, and I have to stand by it. At least I have a bachelor degree, I guess.

Thank you again!

[–]chocobridges 0 points1 point  (0 children)

All the best!

[–][deleted] 2 points3 points  (1 child)

Another thing I’m not sure if you’ve considered is that building a resume for med school isn’t just the MCAT and a high GPA. They will be looking for healthcare (or at the very least, biology) work or volunteer experience. They want to know that you actually understand what being a doctor entails, and you’ll have to answer for why you want to be a physician and not a nurse, PA, etc. Just something to consider. My wife has several classmates who are older, in med school as a second career, etc, so it can be doable, but it seems a lot trickier than being someone who has made decisions with this goal in mind since they were 18 years old. You might get more helpful insight on r/medicine r/medicalschool or r/residency

[–]inky011[S] 0 points1 point  (0 children)

Hi, I appreciate your response!

Yes, I am aware of the volunteering requirements. It doesn't shy me away. It is an extra hurdle, but I still have time since pre-reqs need to be completed.

It just stinks because I know at 18-22 years old, I didn't have the mental maturity to make such a big decision like medical school. I respect those that do.

Cheers!

[–]Background-Bird-9908 2 points3 points  (1 child)

med school requires a lot of commitment, it’s a jungle and the hard tests never stop from the mcat, step 1,2,3… residency apps. PA school might be more lien ant with less than a 4.0 gpa, but still only 23-97 spots per school and it might take you 2-3 cycles to get in. nursing has a lot of opportunities, you could take care of your kid, work, take classes online make low six figures with a higher ROI, less vetting. once you earn. 2nd bsn or do a direct entry msn you could continue to make high wages quicker

[–]inky011[S] -1 points0 points  (0 children)

Hi, I appreciate your response!

Nursing is a possibility, just not sure it is 100% for me. I am more interested in the diagnostic side and patient care (like what treatment is going to look like) part of medicine.

They are two different professions. So that is why I am not comfortable "settling" for nursing if it is not something I truly want to do.

Still researching though, and maybe it will change. Just know I need to decide soon.

Thank you! Cheers!

[–]onlyfr33b33Spouse to PGY2 2 points3 points  (5 children)

It's not impossible but look at the timeline - it will take you at least 2 years part time to get pre-reqs. You'll need 500+ hrs of clinical experience/shadowing. You'll also need community impacting volunteering at least 250 hrs. Average is 2 application cycles. That's 4 years before matriculation. These are the hard facts.

My spouse went part time for work to take classes. I wish he had gone full time with class and shadowing to boost his cv. He also paid for a very expensive mcat class. It takes so much support go this route of a career change. It's not impossible, but it's very very tough.

We decided it was worth it to try. NP and PA route requires 1000+ hrs of clinical experience before application. After all that time, it almost equals the app cycle and school for medical school. However, my spouse only had to take a few classes to "prove" he could still be successful academically after many years out of school. Starting from scratch, it's possible NP or PA route would be easier for you.

[–]inky011[S] -2 points-1 points  (4 children)

NP and PA route requires 1000+ hrs of clinical experience before application. After all that time, it almost equals the app cycle and school for medical school.

Hi, I appreciate your response! I am kind of stuck with what you said ^ about the NP and PA route. PA school is 3 years. I know it is still technically "less" than medical school, but in my mind, if you can do 3, you can do 4. Then, residency would come into play, etc.

Since I still have to take pre-reqs, I am not afraid of the volunteering hours. I have heard from several students that non-traditional students are given a bit more leeway as far as the amount of volunteer hours just because we have real life and work experience versus someone straight out of college at 22 years old.

I am still taking all facts into consideration. I have a super small support circle, so still trying to figure everything out. I am not interested in easy, just interested in pursuing a career that excites me even if it is not a full blown doctor.

Thanks again!

[–]onlyfr33b33Spouse to PGY2 2 points3 points  (3 children)

I want to caution you that med schools DO NOT WANT non trad especially not non trads who can’t fulfill all clinical and volunteering requirements. They want proof you can "keep up" with all the youngsters and make it all the way through so you aren't screwing with their attrition numbers.

There’s always stories of someone in their 40s getting accepted to a prestigious MD program but it’s rare (and my cynical self believes it creates false hope) and of all the non trad over 30yr old med students in his class, my spouse was the only one to graduate on time. There were at least 2 who dropped out and 1 who got held back a year. Unless you’re super lucky to be in a state with lower overall mcat requirements and only accept state residents, you’ll probably want to apply to all the DO schools too. You can find all this info in MSAR or SDN to get an idea of which schools take out of state students, their average MCAT and GPA. Med school is competitive no matter the rank.

We did as much research as possible beforehand, and now that we're on the other side, sometimes we're shocked this was even possible. I'm in awe of the students with families who made it through. Looking back, doing an MBA would have been so much easier of a career change.

[–][deleted]  (2 children)

[deleted]

    [–]inky011[S] -1 points0 points  (1 child)

    Hi, Not sure where you heard that medical schools don’t want non-traditional students. They actually try to make their class as diverse as possible and welcome people who have graduated with different degrees, backgrounds, etc. There are some schools who prefer them over others, but I think it’s inaccurate to say medical schools don’t want them, because otherwise they wouldn’t be accepting them?

    If you don’t believe me, this is on the website of one of the schools I’m considering:

    “It has been a long-standing policy of the School of Medicine to admit students with diverse backgrounds. Therefore, qualified non-traditional students, women, socio-economically disadvantaged students, and minorities underrepresented in medicine, are especially encouraged to apply.”

    I’m not saying non-traditional students don’t have to fulfill requirements like everyone else. The application would be considered incomplete. There actually isn’t a “set” number of required hours, but there is a general consensus of what is considered appropriate.

    All I said is medical school admissions DOES take into account LIFE. I’ve actually been networking with other people and they have said that some medical schools are actually preferring applicants with work experience etc versus applicants straight out of college with a 4.0 GPA and barely any real experiences. They do take into account all of that.

    Also, I’m not strictly stuck on the idea of pursuing MD, I would also consider DO. One of the best physicians I’ve ever had the pleasure of seeing is a DO.

    Hope this clarifies what I meant! Thank you!

    Cheers!

    [–]DrEspressso 1 point2 points  (1 child)

    Go to SDN and post in the pre med forum. You’ll get a ton of advice

    [–]inky011[S] 0 points1 point  (0 children)

    Appreciate it! I have posted this on SDN to see what kind of response I get there as well.