I was in Residency 2001-2004, so admittedly there are dynamics at play for you that I did not experience (there were fewer APPs working in the hospital setting at that time, so we weren’t constantly reminded if we had chosen another path we would have a real job by now, and the corporate climate is different—all staff being asked to do e…
I was in Residency 2001-2004, so admittedly there are dynamics at play for you that I did not experience (there were fewer APPs working in the hospital setting at that time, so we weren’t constantly reminded if we had chosen another path we would have a real job by now, and the corporate climate is different—all staff being asked to do even more with less compared to my time, though the limit on the hours per week you can work started when I was still in training—so THAT part is easier for you), but medical residents have ALWAYS been cheap labor & underpaid. Residency is a trade off: you work really hard, and you work for low pay so that you can be steeped in complex medical cases while still under the tutelage of your seasoned Attendings, and learn your trade. The training HAS to be challenging, so that you are ready to fly solo & be able to handle exhausting real life medical situations when you are done— the stakes are much higher than most professions—it’s critical that you are competent. I am sorry that you do not feel supported in your program. Try to hang in there & remember things won’t always be this hard. Do what you can—my husband would come have dinner with me when I was on-call—he understood I could be called away at any moment, but he made the effort & it helped us get through. I understand there is sometimes a fine line between being worked hard & being abused—Hospitals and Program directors need to create good cultures & go to bat for their residents—but please don’t lose sight of why you started this journey & the patients who are relying on you. It IS a journey, and a long one. One has to weigh all this when trying to decide which level of training you want to pursue, and it’s a tough choice. For me, I feel like it was worth it. It is a special profession. My unsolicited advice: live under your means for a few more years, look for loan repayment opportunities (NHSC, Military, Indian Health service, Rural communities, etc.). I wish you the best, AND I agree with Vinay—I can do both at once.
Thanks for your response Dr. Rivera. I'm still a lowly M3 so I'm not in the thick of it yet, but I based my comment on my own past job experience and level of student loan debt. Having worked in multiple jobs prior to medical school, I can say it makes a world of difference when your superiors treat you with respect and you feel appropriately valued. I agree, medical training needs to be difficult, and I'm aware that residents have always been cheap labor. The difference today is that the costs to attend medical school have skyrocketed. In addition to rising tuition, students have to defer their training (and years of earning an attending's salary) in order to pad their resumes simply to have a chance of getting in to medical school. The hustle doesn't stop once you're in medical school. This is a topic that Dr. Prasad writes about frequently. At the same time, interest rates are rising and physician reimbursement rates are going down. I'm constantly reminded by one of my academic advisors, an emergency medicine physician, that "the golden age of medicine is over" and salaries aren't going back to what they used to be. I want to be idealistic about medicine but its difficult when I have predatory tuition staring at me at one end and the system asking me for more unpaid labor in the form of resume-padding research and volunteering at the other. I think its hypocritical for many of the commenters here to be chiding the younger generation for not being idealistic or dedicated enough when the rest of the system is so blatantly cynical. The message from the olds seems to be "money for me, idealism for thee." I think residents SHOULD work long hours for the purpose of their training. That doesn't mean they need to be so woefully undervalued. They should at least earn as much as their PA and NP colleagues. If that were the reality, you would see many fewer residents calling out "fake sick".
Zac, I appreciate your points. I agree medical school tuition has become an enormous issue, literally & figuratively. I am also concerned about the growing number of pre-Med students being steered to take on more debt before they even get started. It is not right & I am sorry this is happening.
My comments have gone missing or not been posted when I have tried to share similar advice on DOXIMITY, but I’ll try again here: During my unplanned/ unwanted gap year, I moved home. I got a full-time job at a lab that manufactures products for lab instruments & a part time job at a Nursing Home where I was trained to be a CNA. It was not glamorous, but it allowed me to use my degree, earn some money, not go further into debt/actually pay off some of my undergraduate debt., spend time with my family & get some clinical experience. I was also given the opportunity to compete in my first marathon, in Alaska, as part of the Leukemia Society’s Team in Training. I didn’t plan any of those things, but at the end of it all, I had gained new perspectives, proven to myself I could handle a challenging schedule & was still drawn to medicine as a career. My second attempt was successful, but when I graduated from the private medical school I had gone to, my debt was in the 6 figure range. I worked at a Community Health Center & was able to get some loan repayment through National Health Service Corp. I think there should be more opportunities like this for loan repayment. It is a “win-win” situation for young doctors with debt & communities in need. I think the whole system has suffered, at least in part, because of the loss of the Independent practice as a common entity. I think your best shot is to be willing to do unconventional things. Live under your means initially, stick to a budget, look for loan repayment programs (see first comment). Once you have your debt under control, try to be your own boss or join a small group. Question things—this forum is a great platform for that. Best of luck to you.
I was in Residency 2001-2004, so admittedly there are dynamics at play for you that I did not experience (there were fewer APPs working in the hospital setting at that time, so we weren’t constantly reminded if we had chosen another path we would have a real job by now, and the corporate climate is different—all staff being asked to do even more with less compared to my time, though the limit on the hours per week you can work started when I was still in training—so THAT part is easier for you), but medical residents have ALWAYS been cheap labor & underpaid. Residency is a trade off: you work really hard, and you work for low pay so that you can be steeped in complex medical cases while still under the tutelage of your seasoned Attendings, and learn your trade. The training HAS to be challenging, so that you are ready to fly solo & be able to handle exhausting real life medical situations when you are done— the stakes are much higher than most professions—it’s critical that you are competent. I am sorry that you do not feel supported in your program. Try to hang in there & remember things won’t always be this hard. Do what you can—my husband would come have dinner with me when I was on-call—he understood I could be called away at any moment, but he made the effort & it helped us get through. I understand there is sometimes a fine line between being worked hard & being abused—Hospitals and Program directors need to create good cultures & go to bat for their residents—but please don’t lose sight of why you started this journey & the patients who are relying on you. It IS a journey, and a long one. One has to weigh all this when trying to decide which level of training you want to pursue, and it’s a tough choice. For me, I feel like it was worth it. It is a special profession. My unsolicited advice: live under your means for a few more years, look for loan repayment opportunities (NHSC, Military, Indian Health service, Rural communities, etc.). I wish you the best, AND I agree with Vinay—I can do both at once.
Thanks for your response Dr. Rivera. I'm still a lowly M3 so I'm not in the thick of it yet, but I based my comment on my own past job experience and level of student loan debt. Having worked in multiple jobs prior to medical school, I can say it makes a world of difference when your superiors treat you with respect and you feel appropriately valued. I agree, medical training needs to be difficult, and I'm aware that residents have always been cheap labor. The difference today is that the costs to attend medical school have skyrocketed. In addition to rising tuition, students have to defer their training (and years of earning an attending's salary) in order to pad their resumes simply to have a chance of getting in to medical school. The hustle doesn't stop once you're in medical school. This is a topic that Dr. Prasad writes about frequently. At the same time, interest rates are rising and physician reimbursement rates are going down. I'm constantly reminded by one of my academic advisors, an emergency medicine physician, that "the golden age of medicine is over" and salaries aren't going back to what they used to be. I want to be idealistic about medicine but its difficult when I have predatory tuition staring at me at one end and the system asking me for more unpaid labor in the form of resume-padding research and volunteering at the other. I think its hypocritical for many of the commenters here to be chiding the younger generation for not being idealistic or dedicated enough when the rest of the system is so blatantly cynical. The message from the olds seems to be "money for me, idealism for thee." I think residents SHOULD work long hours for the purpose of their training. That doesn't mean they need to be so woefully undervalued. They should at least earn as much as their PA and NP colleagues. If that were the reality, you would see many fewer residents calling out "fake sick".
Zac, I appreciate your points. I agree medical school tuition has become an enormous issue, literally & figuratively. I am also concerned about the growing number of pre-Med students being steered to take on more debt before they even get started. It is not right & I am sorry this is happening.
My comments have gone missing or not been posted when I have tried to share similar advice on DOXIMITY, but I’ll try again here: During my unplanned/ unwanted gap year, I moved home. I got a full-time job at a lab that manufactures products for lab instruments & a part time job at a Nursing Home where I was trained to be a CNA. It was not glamorous, but it allowed me to use my degree, earn some money, not go further into debt/actually pay off some of my undergraduate debt., spend time with my family & get some clinical experience. I was also given the opportunity to compete in my first marathon, in Alaska, as part of the Leukemia Society’s Team in Training. I didn’t plan any of those things, but at the end of it all, I had gained new perspectives, proven to myself I could handle a challenging schedule & was still drawn to medicine as a career. My second attempt was successful, but when I graduated from the private medical school I had gone to, my debt was in the 6 figure range. I worked at a Community Health Center & was able to get some loan repayment through National Health Service Corp. I think there should be more opportunities like this for loan repayment. It is a “win-win” situation for young doctors with debt & communities in need. I think the whole system has suffered, at least in part, because of the loss of the Independent practice as a common entity. I think your best shot is to be willing to do unconventional things. Live under your means initially, stick to a budget, look for loan repayment programs (see first comment). Once you have your debt under control, try to be your own boss or join a small group. Question things—this forum is a great platform for that. Best of luck to you.