[Vent] I didn't realize how crazy our training is

Vent

So I'm doing a MBA during my third year (Did clinicals second year), many of my colleagues are coming from ~5 year working careers, and many of my friends from undergrad have been in the workforce for 2-3 years. It's absolutely unreal the things we go through compared to normal careers. I could go on and on about how my friends are making six figures in their mid twenties working M-F 8-5.

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But the craziest part? I didn't realize how brainwashed I had become until I stepped away from medicine and into my MBA. I had gotten so used to 24hr call shifts, 80 hour work weeks, and non-stop studying for high stakes exams that I thought it was normal and "okay." Starting the MBA really was a wake up call to me about how business education values developing you as a person and expecting subsequent success whereas in medical school you can have those few attendings who really invest in you, but on a systems level it's just designed for throughput at the end of the day.

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What a radical idea that medical education should put trainees first and expect subsequent success, rather expecting success via hyper-competitive board scores, endless research projects, etc and only then being rewarded.

Posted Sep 8, 2020, 5:21 PM UTC

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JiminimoniM-2•

It's why I always say physicians don't make enough, and if they do make enough, don't feel guilty about it.

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LucidityXOPM-3•

Before I started med school, I always thought $400k was such a gross amount of money I’d be blessed to make one day.

Now, I find myself from time to time unwillingly thinking how much I deserve a $400k+ paycheck one day. Not a place I ever wanted to be but here we are.

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quarantinistani•

So just make 399 K? Not bad at all by the looks of it but what would my broke ass know about money, eh?

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[deleted]•

Which is why I don’t understand why so many of my loud classmates are pseudo communists. Future physicians have a vested interest in voting in the center to right.

Edit: here comes the commie downvote brigade lmaoooo. You’ll thank me when you get that fat paycheck in the future and the government doesn’t take more than half of it, until then, stay salty

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shiftyourparadigm•

During a pandemic, no less

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Wonderful_PhraseM-3•

because Medicaid is the quality of care we all want our loved ones to have. its a garbage system

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snehkysnehk213•

"Everyone who doesn't agree with me is a communist!!!" Sure, blame med students for midlevel encroachment and not the crony capitalist non-physicians selling you out to cut costs and continue lining their own pockets. How convenient.

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[deleted]•

Venezuela isn’t real socialism bro!!! It will work this time, i promise!!

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DJcheffy•

Yeah, because it's all about personal wealth. No matter that the right has fully bought into conspiracy theories and white supremacy. No matter that they support the ultra wealthy, including the private equity firms who are buying up medical businesses and dictating physician practice not to mention firing physicians in the middle of a fucking pandemic. No matter that universal healthcare, pharmacare, childcare, strong public education could make up a lot of the difference of there are lower personal remunerations

I can't comprehend this mindset

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[deleted]•

Sorry man i want to drive a lambo.

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Lol Americans. I'm in New Zealand, my student loan is interest free and I started making better money working fewer hours than you as soon as I graduated. And yeah in the public system earnings top out lower than yours but private is still an option and an extremely lucrative one. Nor does the government take half my pay check. Yet somehow all this happens in a country where a party aligned with the US Democrats would be substantially further right than our centre-right party...

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T1didnothingwrongM-3•

Docs in NZ don't make nearly as much as docs in the US on average, my dude

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Wonderful_PhraseM-3•

5 million people total in New Zealand. No one cares about your outpost

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vucarM-1•

any comment that starts with "Lol Americans" you know is ripe with envy for America

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aaf3•

Well, some people also consider the interests of others.

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Wonderful_PhraseM-3•

How much money do you donate to charity?

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CheerioBubbleTea•

when ppl say reform the health system, they mean allocate money away from the absurd hospital administration budgets, not from physicians or nurses.

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Kiwi951M-2•

Unfortunately we both know that wouldn’t happen. Doctors are first on the chopping block because of our salaries

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Schrodingers_gato•

I can only in good conscious vote for the center / right when they have a competent leader. That isn't the case this year, but maybe it will be in the future. That said, politicians don't have your back regardless of party affiliation. I won't be voting for M4A anytime soon though.

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DJcheffy•

Good old both sides argument...

Nevermind that it is frankly untrue, which is clear from even a cursory look at the political arena

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[deleted]•

Because the GOP doesn't want me here, and hates everything that I am

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BBenzoQuinoneM-3•

And the same is true of the mainstream left and myself sadly. Its an existential fight at this point, they want to "cancel whiteness" and believe that I as a white/cis/hetero/male/Christian is the root of all evil.

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TheGodsOfOld•

I'm not conservative, but the very far left "eat the rich" classmates cannot think more than 3 steps ahead in almost all circumstances.

IMO, most people are selfish, even on the left. The very far left free education/loan forgiveness types are usually worried about their loans and think "that would fix all my problems."

They don't think 2 steps ahead and realize that more than likely their debt will remain, their salary will go down, and subsequent generations will receive the benefits.

The non-selfish types are usually 1/2nd years that bought into the savior complex. They haven't spent hundreds of hours working in an academic institute handling the poorest of the poor.

They havent seen the frequent fliers eating up thousands of dollars because they wanted a sandwich, the lady who refuses treatment until it becomes an expensive operation, the DKA patient who doesn't take their insulin for shits and giggles, the pathological liars who shot up meth right before showing up at the ER. These people are in bad situations for a reason; you can't fix them - you can only stabilize and focus on the patients who are willing to make progress.

Because this is reddit : I totally disagree with Trump and want Biden to stabilize the government. I am only complaining about the far left that has slowly become more vocal. They constantly talk out of their asses about groups they know nothing about.

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icatsoukiY1-EU•

I'm not conservative, but the very far left "eat the rich" classmates cannot think more than 3 steps ahead in almost all circumstances.

I mean can you expand on this? What's "very far left" to you even.

And how are the issues you mentioned not improved by better access/education/less poverty?

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DJcheffy•

Ah Mr wise to the world.

Yeah noone who has spent time in the hospital could possibly think that reform could help /s

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ShundoBidoofY5-EU•

I live in Sweden. University education is free, you get monetary contributions from the state for higher education and can take additional loans with very low interest for additional living expenses. We "only" make above average salary (about 3x the average salary in the country as an attending) but at the same time, stuff like 80 hour work weeks are virtually unheard of. We don't have dreaded tests that will define our fate in year two, if you fail tests just redo them no one will know and it won't impact your future. Of course it depends on your goals whether or not you think this is a good system, but for someone like me that just wants a job in a field I like and have financial security it's pretty sweet

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Also our taxes are like 30% at base level but we also have free health care and education (including higher education) so that's pretty nice. As I said, not a country to get rich in but a country to have a nice life in

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clutchone1•

Lol voting center to right would be easier if that party wasn’t the most corrupt party in the developed world, actively worship racists and rapists, and try to hurt the poor every chance they get

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[deleted]•

I mean have you seen creepy Joe and all the rape accusations he has? I guess you conveniently ignore Tara Reade to fit your agenda, it’s ok.

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"The top tax rate is 37% for individual single taxpayers with incomes greater than $518,400 and $622,050 for married couples filing jointly, according to the IRS.

The Tax Foundation and the Committee for a Responsible Federal Budget said Harris and Biden proposed raising the top marginal income tax rate to 39.6%."

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DJcheffy•

People making over 400k are the 1%.

They should be paying more taxes!

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ChromberM-1•

Cries in europoor

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ShundoBidoofY5-EU•

Doesn't cry in europoor but social security, humane working hours and no debts

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ChromberM-1•

Yeah, sure thing, but I think working more hours in Europe isn't as rewarding as working more hours in the United States and that is probably true for all Professional, although I live in Vienna which on its own is a nice city to live in. :)

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LucidityXOPM-3•

I agree, But my take on your first paragraph is that their system is set up to invest in you (Regardless of its true intentions). Our system is set up to make sure you survive. It leads to a more dehumanizing experience

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ems2docM-2•

It's true and it really sucks. It's so engrained

It really blows my mind to see programs promoting 3 year MD's

I just don't see how that helps students or prepares good and healthy physicians

Call me a hater or a skeptic, but I see it as a money making move,100%

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twistedsinM-4•

To be fair, a large portion of fourth year could be forgone aside from sub-i rotations in one's specialty of choice. The remainder of the year is largely taken up by preparing for applications, taking Step II CK, interviews, or lighter electives. I wouldn't say it's completely out of the question. If you had a program with a 1.5 year preclinical curriculum, you could take another 0.5 out of 4th year and end up with a 3 year MD and a year's less of tuition.

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shimmydoowapwapM-1•

That’s what my school has done. The 3 year track is only available for students who want to go into primary care

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twistedsinM-4•

Well in my 4 year program we don't get Summers off anyway... Straight from Step 1 to M3 and straight from ME to M4. M1 summer was the only one.

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NaxusNox•

I'm at a 3 year program in Canada rn and I am just starting, but it's a blast. A year of your life is a huge difference. Ultimately in medicine, it is up to you to learn most of the content. Medicine is dense, but it's not THAT dense. Minor details that are not relevant to clinical practice for something you are not competing for make no difference in your ability as a practitioner and a researcher. So I've just been covering everything that my lecs miss on my own, and I have more free time than undergrad, even with that lol. Idk the only disadvantage that I came upon was trying to match into hypercomp specialities, but even then, you can do that if you put your heart to it. Worst case, at my school, you can take an extra year. Plus my school has no summers so we acc have similar class and elective time, just a tiny bit faster! Will my school have a less in depth understanding of embryology and biochem than a 4 year program? Prob by a bit, but I have a strong science background, so I can explore those areas on my own. Taking accountability of your learning, and setting the trend as a life long learner, is a great thing to start here :)

In terms of the quality of physicians, like, idk, maybe I had a strong background, but I can easily nick through the relevant anking flashcards and do practice in robbins/amboss/uworld starting out. Just depends on your background and ability. Kinda reminds me of highschool: you can legit do highschool in a year or two if you are on top of it. Idk, in my mind, I see no reason for the pre-clerkship part of medicine to be as long as ya'll have it. In terms of clerkship, losing a tiny tiny bit of clerkship time from the "4th year" isn't too substantial, but that would be the biggest educational downside of a 3 year program.

tldr; I can learn what is relevant, leverage strong science background and be accountable. Saving a year worth of tuition and time is a big deal to me, so pretty happy where I am rn, and am quite certain I can match into any speciality I want, wherever I want to in Canada!

Hope that gives some perspective. Perhaps you can elaborate on what part of medical school you're finding difficult content wise? Have you tried boards and beyond and other tools?

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NaxusNox•

Oo could you share some of the negatives if that's okay? I'm honestly trying to see the downsides so I can circumvent them in whatever way I can :)

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NaxusNox•

can you elaborate

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czarmageddon69M-1•

In a 6-year program, can confirm, it blows

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ProHoo•

Wouldn’t 3 year MD programs lose money though? Maybe a silly question, but they’d be losing a year of tuition right?

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ems2docM-2•

Revolving door revolves faster gets more people in and out of the lobby

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[deleted]•

Trying to understand how this will make them more money though. You’re still graduating the same amount of students each year but only have 75% of the student body paying tuition. You’re not churning out more physicians if you don’t increase the class size to compensate for the smaller total student body

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ProHoo•

I see, makes sense

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ems2docM-2•

I want to be wrong

I'm busting my ass in med school, granted I didn't have the strongest science background like most, and the pace is damn hard and I'm not alone thinking the pace is challenging

No one can be "prepared" for really knowing what it takes to do well in medical school before doing it themselves. Some more than others, but med school isn't a breeze for anyone

So you tell someone who hasn't been through it that "hey, you can do it in 3 years! It'll be tough but if it was impossible would we make it an option? Go for it!"

They are duping people

Please show me I'm wrong because I didn't look at these programs nor do I care enough to look into them

But to get done in 3 years what it takes everyone else to bust their ass to get done in 4, some things need to be left out/sped up

And what's the reason for 3 vs 4?

I don't see it being anything else other than $$$

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vy2005M-1•

I don’t see how it’s relevant. Students pay tuition per year. Getting more people in the lobby is offset by them staying less time.

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ChemPetEMD•

There are 2 excellent 3 year MD programs in Canada. Both are accredited. It can be done

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ems2docM-2•

2 programs?

Compared to how many 4 or more year programs?

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mrsparkuruMD-PGY6•

14 english language medical schools. 2 of them are 3 year MD programs. i graduated from one. ended up as an internist/intensivist. didn't miss a 4th year but that's anecdotal from my perspective.

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NaxusNox•

Do you have any tips on circumventing the "three year disadvantage" that mac and calgary might have?

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durx1M-1•

fourth year at my school is a joke. if you passed all your clinical and have done X amount of EC hours..you basically have half a year off. sometimes more

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fifaproblemsM-3•

I see what you're saying, but I know for a fact that I will never, even in residency, work as hard as I saw my friend in private equity working. There's plenty of business careers that will suck away all of your free time just as much if not more than medicine will.

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ringostardestroyerM-4•

If the story above is true, the percentage of people who make it to that level in PE so quickly is probably infinitesimal.

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They work themselves for 5-10 years for the chance to become partners. Med students have the certainty

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hotsaucepanda16•

I'll play devils advocate here (did business undergrad decided to do medicine instead). Those six figure salaries while common often aren't going to the 9-5'ers in business. My I-banking college friends are working harder than I have ever worked in medical school and they're making the six figure salary but honestly I wouldn't want to trade my spot with theirs.

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My friend is making 150k+ 4 years out of college and works like 30 hours a week. It depends on what you do

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Apteron105•

The best deal is tech by far. I work ~35 hours and am making $140k 2 years out of undergrad—oh, and I have a fucking English degree. For a bunch of reasons I’m planning to do a post-bac and go to med school, but it hasn’t been an easy decision.

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Apteron105•

Thanks for the honest words. Life is short and not everything is logical, but I’ll definitely remember your advice in 10 years when I wonder “why the hell did I do this???”

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AverydryguyM-3•

I feel like investment banking is the one spot where they work similar with medicine on average. It sounds like they get whored out for cheap labor 80+ hours a week while they try to climb the ranks, make 100k+ a year and hope to move up. However, there are tons of other careers working 40-60 hour weeks pulling 80-150k straight or a couple years out of undergrad in engineering and business and im sure others.

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Souffy•

The difference is, in the time it takes to become an attending, those people who climb the finance ranks are making way more money. The ones who don’t climb the ranks decrease their hours and still make 6 figures or make moves to another situation.

Residency pay per hour given amount of prior education and lack of any semblance of career flexibility is one of the worst propositions out there I think

If you don’t enjoy practicing medicine quite a bit more than other similarly competitive and compensated jobs, i feel that it’s generally not a wise decision

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AverydryguyM-3•

Yeah definitely think the cost benefit analysis doesn't make sense for medicine for a lot of the careers. I know it didnt for my undergrad degree unless I end up doing something that pays a lot, but I will have worked a lot more hours over the same time as well. It is a great, stable career in a lot of ways but also can be miserable if you did it only for money it sounds like.

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clutchone1•

I-banking is so overdramatized

I worked in finance for a bit and have a ton of friends in banking

Yeah the hours are bad but it’s not insane by any means. Most of your work isn’t all that difficult, be it fucking around on Powerpoints, excels or making pitch books/presentations for seniors

You have TONS of down time when you’re waiting for comments or edits from seniors. You get meals and Ubers delivered to your office so if you work late you have perks.

The bad parts of IB are that the hours are not on a good schedule. Your manager or VP could easily ask you to get something in by 6am the next day and you may have to stay up all night or if you’re out with friends you may have to go into the office.

Sure they “work” 80 hours a week but it’s not the same as working 80 hours in residency or even in say Law

Oh and also you can leave in 3 years if you make associate where you make attending money with better hours and a much higher ceiling depending on what you do in your career

The biggest downside to banking is that it’s harder to break into than medicine as a whole. In raw numbers and classes, medicine is way harder but there are way more spots for us here. For IB you basically need to have gone to a target and network your ass off.

Med students saying “I shoulda just gone to IB or FAANG” ignores how hard it is to break into those unless you went to a really good undergrad school

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PersonBehindAScreenPre-Med•

This. I work in IT currently and across my jobs all of my users ranged from nurses to doctors to professors to c suite executives. The only people I ever got calls or voicemails from after hours were docs, directors/c level employees, and maybeee managers. They may have left right at 4 or 5 but from what I've seen from conversing with these people across organizations, it's to pick up their kid or whatever and then right back to work from home

Obviously it goes without saying that it depends on the exact position but I'm talking about what I have seen the MOST since I directly interact with a variety of people

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clutchone1•

Also worked in high finance. IB is the most glorified and overdramatized career. Yeah it’s not as great as it looks on the outside but also ppl inside inflate their hours and work so much to feel better about themselves

You have so much down time but you can’t leave, it’s not wall to wall work unless you’re on a big project. Also, the work isn’t really difficult, it’s monotonous and repetitive and boring.

The schedule is unpredictable which sucks and there will be weeks you’re working 100 hours but for the most part you’re not actively working the full time you’re there. You’re waiting for comments, making minor edits, etc trynna fill your day and look good.

Oh also, you do this bullshit grunt work for 2-3 years and you’re set. An associate makes about as much as most attendings do and the ceiling is way higher. You can also leave IB for even better hours and similar to more money if your stint was good.

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RedMeddit•

The real indicator that medical education has a toxic culture is that you believe this: "business education values developing you as a person and expecting subsequent success." IMO, every field is guilty of extorting their labor and trainees to varying degrees.

The extreme extortion of trainees in medicine sucks but is a reality I accepted before choosing to dive into medical school. As a med student with an engineering degree, the grass may look greener but there's always a trade-off. Hopefully all of us had a reason for choosing this field. Don't lose sight of that.

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meisterwafflesM-4•

A lot of people have already mentioned the things I would've said, but I did have two points to add:

  1. "Business" is a very, very broad field. I worked in finance/investment banking and in business operations at a tech company. Both are considered "business", but my lifestyle was completely different between the two. Sales, marketing, people operations, business development, hospital management, etc. are all "business". The folks in investment banking, private equity, venture capital, hedge fund, management consulting, etc. work very long, grueling hours to reach success. Just like medicine encompasses everything from the luxurious, high-paying lifestyle of dermatologists to the grueling, Q2 call lifestyle of neurosurgeons/CT surgeons, business also has a wide spectrum of different types of jobs.
  2. If you're a US MD/DO, it is very, very likely that you will match and find a job as a physician. FWIW, that means you'll guarantee a certain salary and quality of life for yourself in the future. Sure, you can make an argument that there are "tiers" and certain MDs/DOs are worth more than others, but at the end of the day, if you're a doctor who graduates from residency (which most US trainees do), you will do well. The same cannot be said of those who go to business school. There is a diminishing return on your investment depending on which b-school you choose to go to. Unless you happen to get sponsorship from your company for your MBA (which most people don't), it's a very hefty price tag (amounting to $200K over 2 years). If you're at GSB, HBS, Wharton, Kellogg, Booth, etc., that investment is more than worth it, but if you're at the DeVry Phoenix School of Virtual Business for Kids Who Can't Read Good, I would be careful about putting that much money into a degree that may or may not be worth it.
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lemiller96M-2•

This is why I feel like I’ve become so depersonalized ever since I started medical school.. you really don’t have the time or ability to be an individual anymore.

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DoneskiiM-0•

Dude how tf do so many ppl on here have friends in their 20s making 6 figures working an 8-5? I literally don’t know anyone and my social circle is pretty large lmfao. Maybe like 1 or 2 but they’re slaving away

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ssleeves19•

Before I started, I read that docs with a dual MD/MBA were happier on average than other docs. I think it’s beneficial to get a different perspective on work

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_Gandalf_Greybeard_MBBS-Y3•

Atleast in the US, you get compensated well for your effort in Medicine.

You're working the same hours in India, difference is you get paid peanuts compared to the engineers and MBA's and get beaten up by patients' relatives and crucified in the Media.

Sweet sweet deal.

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mizzvicious•

I often can not believe the "hazing", abusive type of behavior from the senior residents and attending physicians. RN here, and quite a few times have had to walk out while a resident gets belittled in front of peers, staff and patients. Its not ok, and a less than ideal learning environment

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IrishdoctaM-4•

This is what happens when medicine or any field is made into a profession and you put centrist intellectuals in charge at every point in the process.

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JIVEprinting•

I'm finishing my CPA but I was also the department tutor. MBA is a very soft program; it came into prominence when a member of Reagan's cabinet gave it some promotion. Students who want more education but don't know what to do usually go MBA, creating downward pressure on quality to meet (cash in on) market demand.

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