The path to doctorhood is not an easy one by any stretch of the imagination.
Regardless of specialty, becoming a doctor is grueling. Start with undergraduate education. Ace you pre-med requisite classes and somehow stand out among the thousands of med school applicants. Then you get into medical school.
Figure out a specialty that suits you while also jumping through hoops consisting of tests, clinical rotations, as well as just plain arbitrary evaluations. Then you (hopefully) match into residency. You literally open an envelope that tells you where your future is heading.
Long hours then becomes an understatement. Compensation is minimal. Burnout is real. I don’t want to be overly negative though. There are positives of course. You get to take care of patients which brings an unparalleled fulfillment. You get to see your growth in knowledge and skill.
Now you just need to figure out your fellowship. Another application and match process.
And then what?
The path to doctorhood finally ends? Or does it really just begin?
At the end of all your training, you finally reach the end. But it is really just a new beginning. Like all things.
In total, I completed:
- 4 years of undergraduate school
- 4 years of medical school
- 6 years of residency in plastic surgery
- 1 year of fellowship in microsurgery
That’s 15 years!
But I know there are plenty of you reading this who have spent even more years on the path to doctorhood!
No matter how long this training period seems (and let me tell you, it seems really long!), one of its main functions is simply to lead you to your career and the rest of your life.
This may sound very abstract. But it’s true.
The path to doctorhood is very good at making you a doctor
And it better be.
That’s the whole point anyway.
Your education and training is what allows you to work and function as a doctor.
Through your training, you learn to skillfully care for patients in need. Residency and fellowship programs do a notoriously good job at fulfilling this goal.
And being a doctor is great.
There are intrinsic rewards to being a physician
These include the fulfillment from patient care as I spoke about above, the personal fulfillment that comes with self growth, and many, many others.
There are also extrinsic rewards
This includes money. But money is worthless by itself. Money is a tool to help you live your best life while also helping others.
And too many physicians still act like thinking about money is taboo. It’s not. If nobody cared about money then we wouldn’t work. People forget that the reason we care about money is so we can care for ourselves, our families, and others. That’s very worthwhile. Anyway, I’m back off of my soap box…
So in this sense, the path to doctorhood does a good job preparing you as a doctor
But the path to doctorhood does a horrible job at preparing you for your career (and finances) as a doctor
In fact, I would go so far as to say that the path to doctorhood is a hinderance to our ability to create a successful career and set our financial foundation.
Let’s go through some of the reason why…
1. Lack of autonomy
I’m not referring to autonomy in our practice of medicine. This is variable by training program. But ultimately we all need to learn to make clinical decisions on our own to become an independent and competent doctor.
I’m referring to autonomy in our career and financial decisions.
Let’s look again at the path to doctorhood and our career autonomy:
Some choice and autonomy but limited by financial constraints as well as being accepted
Sure, we have a choice as to where we apply.
But the process has become extremely competitive and is only getting worse. Most medical students will go anywhere they are accepted. Regardless of how much it costs or how many loans they will need.
Not much autonomy.
This is where career autonomy is really thrown out the window!
Yes, we choose were to apply for residency programs. We even rank them from best to worst.
But then a computer program (a computer program!) tells us exactly where we will go and for how long (if we are so lucky). We learn of the computer’s decision by opening an envelope in front of our loved ones.
It sounds like a George Orwell story…
Fellowships in general tend to have less applicants and be slightly more competitive. But it’s exactly the same, controlled process.
Minimal to no autonomy to be found here.
But then what happens?
What happens is that you graduate from your training. Now you need to find a job and start your career!
All of a sudden, the whole world is open to you! You get full autonomy. Hooray!
Well, I can tell you from experience that this excitement wears off pretty quick. It’s terrifying to figure out what you want the rest of your life to look like when you’ve had very little practice at it. This is a sentiment shared with every graduating trainee that I have ever spoke with.
It’s the equivalent of trying to perform a complicated surgery by yourself when the only practice you’ve had so far is assisting someone else by holding retractors!
Which bring us to our next reason…
2. No education
Throughout our training, we get absolutely no education when it comes to real life career and financial topics.
So again, we come out of training like a couple of kids who have never rode a bike without training wheels and are expected to complete the Tour de France.
We need to:
- Evaluate career options
- Negotiate contracts
- Set a financial foundation
- Face our mounting debt
- Create a life for our family
…all with no formal or informal eduction (unless you include those super helpful chats with your attending about the latest stock tip in the doctor’s lounge).
Financial Education 101: How to Finally Get Started on the Path to Financial Well-Being
Financial Education Needs To Be Tied Into Medical Education
Now we can all argue if it is a training program’s responsibility to prepare trainees for career and financial success on the path to doctorhood
I say emphatically that the answer is yes. Training programs all around have started to create curricula designed to improve well-being and decrease burnout. Well, here’s a great way to help do that! I’d much have preferred to learn about career strategies than get a free water bottle from our hospital…
Even more, training programs are tasked with creating good, competent doctors.
Well, financial well-being is quickly being established as a very important but often overlooked component of personal well-being. It is also being identified as a big factor in physician burn out. I experienced this first hand and found out that just creating a financial plan improved my financial well-being and made me a better doctor.
I like to think that I have been a big part in helping promote the importance of financial well-being for physicians!
But I think the biggest reason that the path to doctorhood fails to prepare us for our clinical and financial career is…
3. We just don’t see enough of what’s out there
The system of medical training puts career blinders on us.
We generally just see medicine being practiced as a career in a single setting as a trainee. Sometimes maybe we rotate among a few practice settings. But even so, we are extremely limited in our exposure to the overall practice or medicine and its impact on our career and finances.
So, when we reach the end of our training and we stare out into the vast expanse of possible opportunities, we freak out and reach for something comfortable.
And we tend to end up a career similar to one in which we trained.
- ….it’s not a good fit
- …we don’t really like it
- ….a better one is available
- ….one that pays more is out there
I almost made this mistake. At first, I assumed I would just join a practice like the one in which I trained. I was looking to make it fit to me.
But I finally realized that I was going about this all backwards.
So I created a list of what I was looking for in a career. And started looking for those jobs. Even if they put me out of my comfort zone.
And what happened? Well, I found the perfect job for me. And it’s one that I never would have expected to take before my shift and growth in mindset.
I Found My Perfect Physician Job in 6 Steps!
So what can you do to prepare yourself for a successful career and financial well-being on the path to doctorhood?
We’ve now identified why the path to doctorhood does a bad job of preparing you for your career and finances.
Regardless if you are still becoming a doctor or are in the middle of your career, there are steps you can take to improve your career and financial well-being!
1. Practice and simulate career autonomy
Do this as much as possible. If you are in medical school or training, I don’t have a good solution to the residency and fellowship match problem. For now, it is what it is.
So you have to find ways to practice and simulate career autonomy as much as you can in other ways.
If you are already practicing, re-assess where you are.
- Is it where you want to be?
- In an ideal world, what would your career and financial situation look like?
- What steps can you take to make that a reality?
A great way to do this is to practice financial autonomy. Don’t fall in the trap of ignoring your finances. Financial freedom gives you the best ability to live your life and implement your career on your terms. Get started on the path today using these 6 steps!
10 Steps to Financial Freedom for Young Attending Physicians
My Written Financial Plan Update: New Financial Goals and Priorities
Financial Freedom Through Passive Income: Year 1 Update
2. Create your own curriculum
Take your career and financial education in your own hands!
- Pick a personal finance book and read 10 pages a day
- Pick a blog (maybe this one!) and read 1 post each day (in fact, you can sign up for daily post emails here)
- Reach out to potential mentors
- Write your own personal financial plan
3. Expand your horizons
Forget the clinical careers, financial avenues, and personal circumstances that you know.
If you could create your ideal job, your ideal financial situation, your ideal life, what would it looks like?!
Forget about what you think is feasible. Just write down what you envision.
Then look for opportunities that mirror what your envision. Put away your hang ups. I eventually recognized that the happiest doctors that I saw were in unique positions that they had crafted for themselves. The doctors who just fit themselves into a mold were miserable.
Make life happen for you!
The path to doctorhood is not exclusive from career and financial well-being. In fact, being a doctor give you a unique opportunity to accelerate your journey! Here’s how I did it!
What do you think? Did becoming a doctor prepare you for your life after training in a career and financial sense? How can we make this better? Let me know in the comments below!
3 thoughts on “3 Ways That the Path to Doctorhood Hurts Our Career and Finances”
great post man! no, medical school did a piss poor job of preparing me financially. I do remember though my med school financial aid office telling me to consolidate my first and second year loans to back in 2004, and so was able to get a 30 year fixed at 2.6%! the only reason I did it was because the med school made it mandatory that we attend the meeting with the financial aid office, and there in lies the answer- make financial education mandatory. As med students we are like the military- when are med school says jump we ask how high. I think every medical school should make mandatory financial education based on principles espoused by WCI, PoF, Jimmy Turner, and of course, you man! I think 4th year of medical school would be the best time to make it mandatory given that required medical courses are out of the way and it would be just in time learning as you get into residency.
I completely agree that it should be made mandatory and also should be given by a MD/DO.
Unfortunately we just don’t pay as much attention when it’s not someone walking in our shoes!
Agree with what you and Rikki have said Jordan. The unfortunate truth is many of those who are giving the presentations are not objective and just want to upsell them. It would be good if there was more knowledge that docs can get help by educating themselves or hiring a professional who wasn’t going to rip them off.