Ok I'm older now is it worth it?

[CaribMD]

Is this worth it at my age?

GOOD QUESTION! So I wanted to start a thread on this and tell my story.

17 years RN then decided finally to go to medschool at 41 years old,
Middle aged crises maybe! But certainly something I wanted to do for some time. You see I was married the first time I wanted to go and my first wife told me NO when I was only 34, she said that I could not go and enjoy myself at medschool while she worked. So I tried to make things work but that is just a small example of how bad the marriage was and we divorced a few years later, I continued on thinking I would never go, met someone new and remarried then I kinda told her one day I still had this need to be a Doctor, expecting the worse, She said sure sounds like fun for both of us.

So I then did the "mapping out" and applied and was accepted at a stateside college at the age of 39 for a MS in nursing with more premed reqs still to finish, then the dreaded 7 to 10 year rules of how old my courses hit me and the MCAT dread and how long I may struggle with a full time job and College and getting accepted, Heck I saw a long painful road for me and thought I would be 45 or older by the time I could even get accepted in the states. SO I thought what would I like to the most in Medicine? Rural FP came to mind, I was seeing patients as a Hospice Nurse in Rural Georgia and loved it so I was hooked.
So I applied and was accepted offshore and now will graduate medschool at the age of 45.

now comes the money.

By the time I graduate I will have 180,000 in loans but I know there are ways for Rural FP to get some tuition pay back on loans due to going to practice in needy areas, and the south has many needy areas, in fact southern Rural Ga. is one area ( thats where I have a job waiting for me now) so I think I can get almost half or more payed back through this, so I'm told, but if I do not get payed back this is my math from what I made before and will make:


before age 45 grad from Medschool, 3 years residency so out at 48 plus 20 years = 68 years old

made around 50k a year as a Hospice nurse for 20 years = 1 million

lets just say 200k as a FP ( been offered higher for the job already)

200k for 20 years = 4 million so the difference is 3 million more as a Doc and if I do have to pay back my loan 100% lets take out 250k of the 3 million thats still 2.75 million more than not going to medical school, wow thats still makes it worth it in my book!


This does not take into account malpractice but my arrangement will be that I do not have to pay for malpractice since it will be a group practice.

Retirement was pushed up to 70 in recent years so I do not see 68 as unreasonable.


SO what do you think?



Please feel free to post your story or thoughts!

[NM31]

I think CaribMD makes some good points and has an interesting story and great insight. I know money is a significant motivator for people but I think that people who are non-traditional and older are looking for something more than money as well.

History: I didn't get into med school when I originally applied way back in 1997 (3.8 GPA, 10V, 10P, 13B, R) so I went to pharmacy school instead. Something that I regret now because I never even knew about the Carribean schools at that time.

I make a good living (130k) on average. The money is nice but the job itself has no respect! Patients constantly complain about their co-pays and wait times. I mean, people will wait patiently in line for a Starbucks but not for their RX. I see people all of the time spending money on other luxury items (clothes, phones, purses) and never complain about what they have to pay. I've worked at places where I didn't have time to eat or use the restroom. And, after 8 years of school, I still have to use the register. I didn't go to school to become a cashier! People get very upset when we tell them we can't ring out all 100 items at the pharmacy. I mean, that's what the front end is for. The job itself can also be kind of tedious. There's no real challenge involved... just try to get the RX out as fast as you can... just like an assembly line

I don't mean to rip the profession of pharmacy... but I think that the chains have made it a business and its not about health care anymore. You can't spend time with patients because you are constantly behind.

That's why I'm now working out a plan now to go back to med school.... because I believe that medicine is more challenging and there are more opportunities. Is it going to be hard going back and living a student's life... you bet it is... but I have to look at long term goals and lifestyle. Its what I've always wanted to do. The money will be nice too

[CaribMD]

Yeah I reread my post and I wanted to say that money is not the great motivator, in fact I plan to live close to the way I did before but without the large bill headaches and able to put away for retirement, at my age I don't care about "Living Large" and Job satisfaction is #1

[Nontradmdhopeful]

CaribMD,

I checked your calculation. Couple of things. Firstly, I noticed you did not take account for is the lost earning opportunity when you are in Medschool + residency. i.e. 7 years times 50K salary(in your case if you were an RN during those years) = 350K.

Secondly, you have made an assumption that the salary over the years would remain constant in both cases. I believe that the % increase in your salary if you were a RN every year would have been higher than that of being a doctor given you already have so many years of RN experience. For doctors profession you have to start from begining and so the yearly increase in percentage terms wont be as high as the other. Although this factor is more or less trivial if there is a big difference between the absolute salaries of both position on the day you start getting paid as a doctor.

Third, from an investment perspective (think 401K, savings, stock, options, CDS etc) which are highly dependent on the "time" these instruments were invested for, you may be loosing a substantial chunk. A CPA could run the numbers better for you but the point is that there is a loss here too..



Ok now blame it on me being a business graduate.. but I cannot help it. I know a lot of people do rough calculations and base their decisions on that.. in this case its OK but still if your final net is sensitive to other factors.. you may want to think about this too..

I know ultimately your motive is not so much on money(you probably are ok with breaking even too..), but for people who are also considering monetary benefits, they should really think twice before jumping in..


just my 2 cents.

[CaribMD]

CaribMD,

I checked your calculation. Couple of things. Firstly, I noticed you did not take account for is the lost earning opportunity when you are in Medschool + residency. i.e. 7 years times 50K salary(in your case if you were an RN during those years) = 350K.

Secondly, you have made an assumption that the salary over the years would remain constant in both cases. I believe that the % increase in your salary if you were a RN every year would have been higher than that of being a doctor given you already have so many years of RN experience. For doctors profession you have to start from begining and so the yearly increase in percentage terms wont be as high as the other. Although this factor is more or less trivial if there is a big difference between the absolute salaries of both position on the day you start getting paid as a doctor.

Third, from an investment perspective (think 401K, savings, stock, options, CDS etc) which are highly dependent on the "time" these instruments were invested for, you may be loosing a substantial chunk. A CPA could run the numbers better for you but the point is that there is a loss here too..



Ok now blame it on me being a business graduate.. but I cannot help it. I know a lot of people do rough calculations and base their decisions on that.. in this case its OK but still if your final net is sensitive to other factors.. you may want to think about this too..

I know ultimately your motive is not so much on money(you probably are ok with breaking even too..), but for people who are also considering monetary benefits, they should really think twice before jumping in..


just my 2 cents.

Sorry there are things you left out, I stated 20 years practice and the money made during the same time, 20 years left of 50k of nursing practice.

BTW 50K is the average and in the last 9 years has been pretty consistent so I think I'm fair to say in at least 40% of this time it will continue to be the same since I was paid "Top Dollar for a Hospice RN"
even with a 10% increase that's on;ly 5k more the other 60% of the time really not that much money.

401k? I earned after taxes about 3300 a month with 200 into 401k Not much to put away really. You have to have the money to put away to make anything on it and I will still have 20 years to stash a lot of cash thats longer than some and others never do.

ALso you make money during residency, Medical school is 3.5 years ( Caribbean) and then 3 years residency at 40k a year, remember I only 50k a year before so the real loss of income is 50 x 3.5 and 10 x 3=
175 + 30 = 205k lost so I will make it back in 2 years after residency. Uh 200k a year so 150 k x 2 years and boom its more than lost already (3x as much as 50k)

As a doc I will earn at least 200k ( really offered 225k to date for a 7 year commitment to a community they pay my malpractice) I will make up the income within 2 years so the final 18 will be even more,

please I looked at this very close and it is sound investment money wise and personal, I know many people who buy 500k homes and 40k cars how is that better than becoming a Doc? I think my use of money is way better.............

Hey it's the Doc in me now Besides I have a lot experience in these matters it does pay to do this even at my age!


( Nurses no Diss but you do not make that much, Yes I know of the off RN making 75k a year but they work off shifts and agency, agency is crap work you get the worst assignments believe me I know I did it for 2 years and made around 60k a year back then it = about 80k now so I do know first hand, also I was a trauma nurse and ER nurse before I know how much you can make. Nursine is a good profession and should pay more for what you know and do, but even if it payed more I still would do this, it's not the money)

[NM31]

Hey CaribMD

Be prepared to learn about the shock of being in a new tax bracket! I felt it my first full year Also, learn about investments and about where to put your money... I'm sure that the MDs that you will be joining will have advice for you on that
Student loan interest becomes a non-factor once you earn above 90k and the only thing that can really save you is a house and writeoffs. One of the techs who works with me has a cousin who is a MD who writes off everything for her pratice.. basically she pays taxes on about 1/10 of what she really earns....
I agree about looking at the opportunity cost and lost income but I also believe that money will come to you if you truly enjoy what you are doing.

[CaribMD]

Hey CaribMD

Be prepared to learn about the shock of being in a new tax bracket! I felt it my first full year Also, learn about investments and about where to put your money... I'm sure that the MDs that you will be joining will have advice for you on that
Student loan interest becomes a non-factor once you earn above 90k and the only thing that can really save you is a house and writeoffs. One of the techs who works with me has a cousin who is a MD who writes off everything for her pratice.. basically she pays taxes on about 1/10 of what she really earns....
I agree about looking at the opportunity cost and lost income but I also believe that money will come to you if you truly enjoy what you are doing.

I agree with you totally thats why I went on the web to this site for example http://www.paycheckcity.com/copaycycle/ ... ulator.asp
to find out how much income after taxes and such WOW I will have over 11k a month take home to pay bills and such compaired to the 4k I had before with my wife and I working.........................Seems like a good pay off to me!

Thats without investments and such so I think we can do better with the money, maybe in the end still have between 9 and 10k a month with retirement taken care of ? But thats what CPA's are for LOL...........

[CaribMD]

Here's a good list of pay for Docs and it is still almost 4 years old Data, really they are higher today but this is better than the other data I have seen ( most from 1999 in some places)

http://www.allied-physicians.com/salary ... laries.htm

U.S. Physician Salaries - Ongoing Salary Survey

*Survey includes base salaries, net income or hospital guarantees minus expenses
June, 2003 - Present

SPECIALTY Years 1-2 >3 Max
Allergy/ Immunology $158,000 $221,000 $487,000
Ambulatory $ 80,000 $112,000 $152,000
Anesthesiology: Pediatrics $ 283,000 $311,000 $378,000
Anesthesiology: General $207,000 $275,000 $448,000
Anesthesiology: Pain Management $315,000 $370,000 $651,000
Cardiology: Invasive $258,000 $395,000 $647,000
Cardiology: Interventional $290,000 $468,000 $811,000
Cardiology: Noninvasive $268,000 $403,000 $599,000
Critical Care $187,000 $215,000 $320,000
Dermatology $ 195,000 $308,000 $452,000
Emergency Medicine $192,000 $216,000 $295,000
Endocrinology $171,000 $187,000 $260,000
FP (with OB) $182,000 $204,000 $241,000
FP (w/o OB) $161,000 $135,000 $239,000
FP - Sports Medicine $ 152,000 $208,000 $363,000
FP - Urgent Care $ 128,000 $198,000 $299,000
Gastroenterology $265,000 $349,000 $590,000
Hematology/Oncology $181,348 $245,000 $685,000
Infectious Disease $154,000 $178,000 $271,000
Internal Medicine $154,000 $176,000 $238,000
IM (Hospitalist) $161,000 $172,000 $245,000
Medicine/Pediatrics $139,000 $168,000 $271,000
Medical Oncology $198,000 $257,000 $455,000
Neonatal Medicine $286,000 $310,000 $381,000
Nephrology $191,000 $269,000 $447,000
Neurology $180,000 $228,000 $345,000
Obstetrics/Gynecology $211,000 $261,000 $417,000
Gynecology $159,000 $213,000 $358,000
Maternal/Fetal Medicine $286,000 $322,000 $610,000
Occupational Medicine $139,000 $185,000 $290,000
Ophthalmology $138,000 $314,000 $511,000
Ophthalmology Retina $280,000 $469,000 $716,000
Orthopedic Surgery $256,000 $342,000 $670,000
ORS - Foot & Ankle $228,000 $392,000 $791,000
ORS - Hand & Upper Extremities $288,000 $459,000 $770,000
ORS - Hip & Joint Replacement $330,000 $491,000 $715,000
ORS - Spine Surgery $398,000 $670,000 $1,352,000
ORS - Sports Medicine $266,000 $479,000 $762,000
Otorhinolaryngology $194,000 $311,000 $516,000
Pathology $169,000 $321,000 $610,000
Pediatrics $135,000 $175,000 $271,000
Pediatrics - Cardiology $145,000 $282,000 $607,000
Pediatrics - Critical Care $196,000 $259,000 $398,000
Pediatrics - Hematology/Oncology $182,000 $217,000 $251,000
Pediatrics - Neurology $175,000 $189,000 $362,000
Physiatry $169,000 $244,000 $313,000
Podiatry $128,000 $168,000 $292,000
Psychiatry $149,000 $169,000 $238,000
Psychiatry - Child and Adolescent $158,000 $189,000 $265,000
Pulmonary Medicine + Critical Care $215,000 $288,000 $417,000
Radiation Oncology $241,000 $385,000 $787,000
Radiology $201,000 $354,000 $911,000
Rheumatology $179,000 $229,000 $378,000
Surgery - General $226,000 $291,000 $520,000
Surgery - Cardiovascular $336,000 $515,000 $811,000
Surgery - Neurological $354,000 $541,000 $936,000
Surgery - Plastic $237,000 $412,000 $820,000
Surgery - Vascular $270,000 $329,000 $525,000
Urology $261,000 $358,000 $619,000


SOURCE: Allied Physicians, Inc., Los Angeles Times and Rand McNally
*Updated June, 2006


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FP is in Bold cause thats what I'm doing.

[soe111]

I just joined this forum and read your story. I am seriously considering same move. Could you please give me some tips on good CaribMD programs for health care professionals with no MCAT. I have BSN, MSN and currently a CRNP. It's not about money for me, it's just the dying afffection for the profession and stong desire for independence when it come to practice.

[CaribMD]

I just joined this forum and read your story. I am seriously considering same move. Could you please give me some tips on good CaribMD programs for health care professionals with no MCAT. I have BSN, MSN and currently a CRNP. It's not about money for me, it's just the dying afffection for the profession and stong desire for independence when it come to practice.

My story in a nutshell:

Went to CC for a few years and racked up some credits going nowhere did some premed course..................Went into the RN nursing degree program and graduated with plenty of credit to spare...................17 years RN, Trauma, Cardiac, Home health, Home Infusion ( You know IV's and Picc lines, yeah I placed them peripherally and Centrally was one of the first on the east coast to do it too) then I decided hey I would love to live out in the sticks and take care of people, NP was a lot of work to get and so was MD so I said go for the Gold and started on the path, road block:

Credits over 15 years old for Medschool so wow I'm screwed right? Have to do a BS degree all over right? Wrong! Caribbean, in fact I applied and was accepted as is ..........no MCAT and those old credits, but I have made it and keep my nose studying so I'm about to hit 3rd year MS III Yahoo!



There are few schools I can recommend off the bat:


SJSM
AUA
and St. Matts (they may need an Mcat now)

These are popular schools and all have the basic things such as charter and clinicals in Greenbook Hospitals

One thing to avoid is any school who wants to give you advanced placement that screws you for Liscensure

No internet classes for medschool same as above

The school should have a loan program, the three above do, without a loan program it means the loan companies have no faith in the school ( a bad thing)

Make sure you are fine with the practice issues

All three schools above do not have California approval yet
SJSM does not have any problems with being on a disapproved list the other two are on some others states disapproved lists

the other two do have NY and FL approvals for clinicals but mind you this approval is not for Licensure so it is not something that is mandatory for licensure.

Good Luck and do your home work before committing to 150k in education.