This is a question I get asked a lot, from both my friends and colleagues. In fact, I ask myself this question a lot as well. The expanded question is:

If you could do it over again, would you be a doctor again?

This is somewhat of a loaded question because, when asked by another physician, it somewhat infers that they probably would not. I think some of my colleagues are seeking validation of their own decision, or perhaps trying to see if I would have the same reasoning as them.

The answer to the question is:

It depends.

Many of you would say that is a cop-out answer and that I need to give you the real answer. I will give you my real (meaning long-winded) answer, but trust me, the “it depends” answer itself is not a cop-out. I have spend an inordinate amount of time wrestling with this question. In addition, my wife and I have discussed it at length during med school, residency, fellowship, and even as attendings many, many times.

At its very core, being a physician provides a reasonable salary and reasonable job security. Yes, I said reasonable. Not high salary and not great job security. Just reasonable. Physicians were paid very well for many, many years. However, I think that their overall pay has gone down when you take into account inflation, increasing amount of hours worked, ever-increasing amount of debt, and the significant opportunity cost of both residency and fellowship,

This is not a sob story that physicians don’t make enough money. We do fine.

I am just saying that when you account for the above factors, the $200k a doctor makes after finishing training SHOULD mostly go toward their huge loans and maxing their 401k/403b and, if available, a 457. It is very stressful to start your first attending job with $300k (~$200k loans + accrued interest) of debt weighing you down and $0 in your retirement account. However, I would say that this is probably the norm for most doctors coming out nowadays.

If you had asked me this question as a resident or fellow, I would almost 100% have told you, ” No, I would not be a doctor again.” At that point in my career with $300k in debt, $0 in retirement, drowning in the knowledge of my specialty and desperately trying to keep afloat… there is no way I could recommend doing this to someone else, or make myself do it again.

However, things change. As a first year attending, I got a firm grasp of my loans, my retirement accounts, and I had a plan. Even with paying my loans back monthly and maxing out my retirement accounts I still was able to save money every month. Of course, having a physician wife also helped, but she had her own set of loans to pay back as well. So at that point, I probably would have said “maybe”.

Now, about 3 years out, I’m actually not sure what to say anymore. Perhaps I’ve gotten used to the student loan debt now… the money comes out of my account and I never see it, so I never feel it. It’ll be paid off eventually. Then there is the mortgage on my house, which is also enormous, but I don’t really feel that either. I’m used to it. I think the real question to answer is:

If you weren’t a doctor, could you do anything else?

Previously, I tried to convince myself that I could have been an investment banker, mortgage broker, or do private equity eventually or something… but I honestly don’t think I could do any of those things. I had a friend from college who had a great job working for a bank, making a lot of money straight out of college while I was studying like crazy in medical school. I envied him for the financial freedom I thought his job gave him, and would have given me. However… he envied me because at the end of my long path, I would HELP people. He said his job made him feel empty… and he ended up quitting about a year later, taking a different job which paid significantly less but made him feel much more fulfilled. I don’t think he has ever regretted that decision.

What about computer science, could I code? I mean I took some computer science courses in high school and college… maybe I could have learned to code? Unfortunately, I honestly don’t think so. It’s possible that maybe I could code for fun for a little project or something. However, to sit down and actually code Python, PHP, Ruby or Java day-in and day-out is not something I think I could do. I mean, I can barely even use this “easy” template for this simple wordpress site I have. Even if I majored in Computer Science and learned a lot of different languages, I’m not sure I would have been able to hack it in the ever-changing, highly competitive tech industry.

What about being an entrepreneur and running a startup? This is something I would love to do. However, startups require both time and money, and are not very conducive to having a family. Maybe someday if I had a great co-founder, an idea we really believed in, and the hamster piloting my brain developed a second wind… then maybe.

What about something more similar…? Optometry, Pharmacy, Dentistry? Those are all fine options. I always joke with my wife that she missed her true calling as dentist because she has perfect teeth and takes very good care of them… she tries to make me floss… like everyday! Kidding aside, I think those options still have most of the same problems that medicine does.

The schooling is still very expensive, and while the opportunity cost is lower because of shorter training +/- residency, there is the issue of starting your own business or joining a group. Additionally, the job market for those 3 options are all pretty saturated.

My little brother is in pharmacy school now. So I have an idea of just how much it costs, as well as their median salaries coming out. He will have significant debt coming out, just the same as me. Hopefully, when he graduates and gets his first pharmacy job this website will still be around to guide him, in one form or another.

So… what’s your answer then?

For the lack of a better option (for myself), my best choice is probably still medicine. Lucky for me, I like my specialty and I like my job. The group of people I work with are amazing.

With all that, I’ve been pretty lucky overall.

What about your children?

Now… this is a completely different question. For my daughter and son, I would prefer they did not become doctors. I think the road is long and difficult, and I don’t see it getting any easier anytime soon. By the time they would go to medical school, I imagine student loans of $500-600k will be the norm.

When will it end?

What will be the breaking point for which people won’t want to to medical school anymore?

However, I will neither push or pull them either way. If they choose the path of medicine, then I want to make sure they understand everything from the beginning.

More importantly, I want it to be their choice.

TL;DR

Do medicine again? It depends.

For me, medicine was still probably the best option. I was lucky.

I would prefer that my children do not become doctors. Unless they really want to.

-Sensei

Agree? Disagree? Questions, Comments and Suggestions are welcome.

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