If you’re like most premed students, the dream of being a physician is something that you’ve held in your heart for a good period of time. Perhaps you’ve been inspired by a physician role model in your life. Perhaps you’re fascinated by the expanding world of medicine— a career field that is constantly being updated with new and exciting discoveries. Or perhaps you fall under the category of “Premeds Inspired by Medical-Related TV Shows…”

Whatever the reason for your inspiration to pursue a career in medicine, you probably also are aware of the many perks to the profession. Generally speaking, physicians are respected. They enjoy financially stable careers, and they can take satisfaction in knowing that their work is contributing positively toward society’s betterment. However, the life of a physician is definitely not all roses, and the downsides to the path to an MD are also hard to ignore. These cons understandably lead many premeds to question the value of a medical school degree, to wonder if it’s all really worth it.

Arguably the greatest overarching “con” to a medical school degree is the initial financial burden. While in-state tuition at public medical schools is relatively affordable for many students, premeds typically can’t be too picky about where they end up attending med school. If they are only accepted to an out-of-state school or a private institution, they will most likely end up paying at least $50,000 per year in tuition alone. This cost (which is often even higher, depending on the school) does not cover living expenses, books, or enrollment and loan fees. Receiving scholarships for medical school is much more difficult than receiving them for undergraduate programs, and the government currently does not offer any subsidized loans for grad school either. Unless they have managed to save up a hefty sum of money prior to starting school or are fortunate enough to have family sponsors, med students attending non-state schools can easily find themselves graduating with well over $200,00 of debt. This sum will also have been accruing interest and may prove to be understandably financially stressful for any freshly graduated physician (particularly for those who have undergraduate loans also).

Additionally, while the current future of the healthcare system in the United States is a hot topic for debates, it’s also a bit of a predicament for future doctors. The Affordable Care Act largely changes the way that the entire medical system’s structure will operate, and physicians and other healthcare workers will undoubtedly be affected in some way or another. However, exactly how the new regulations set to slowly roll into action through the Affordable Care Act will affect doctors’ remains largely a mystery. While many have spent hours speculating over the future of the healthcare industry in America, the fact remains that we simply don’t know… yet. We don’t know how changes to the current (and arguably somewhat flawed system) will affect physicians’ payrolls. We don’t know how the changes will affect doctors’ working hours. We don’t even know if/how long it will take before changes become fully implemented into the system, and we definitely don’t know how long those changes will last for. With this many unknowns hanging over the future of the medical careers in America, it’s easy to see why many premeds are growing unsure of the wisdom in pursuing their dreams of one day earning their MDs.

Residency

If the uncertainty regarding the particulars of the future of the medical industry in the United States wasn’t enough uncertainty to deal with, premeds and medical students today are also faced with the uncertainty of being able to successfully be “matched” to their desired residencies. In fact, medical students are starting to have to worry about whether or not they will even be “matched” at all—favorite residency or least desired residency included. This uncertainty has arisen due to the increasing number of MD programs in the United States (such as the newly opened University of California, Riverside School of Medicine), along with an increasing number of DO schools as well.

The number of available residency spots, however, has not increased in proportion to the number of graduating medical students per year. Traditionally, unmatched fourth year medical students would be given the opportunity to participate in the “Scramble,” a process that would allow them to “scramble” to apply/be accepted to any remaining residency spots across the nation, regardless of whether or not they were for residencies to which they had initially applied. However, with the increasing number of medical students applying for the limited number of residency spots each year, it has been predicted that in several years the opportunity to participate in the “Scramble” will no longer be an option, as all spots will have already been filled. Without completing a residency program, a MD degree is practically useless.

Stress

On top of the already mentioned uncertainties, the fairly everpresent stress within the life of a medical student today can easily be considered reason enough to choose another career path. The speed at which med school instructors expect their student to learn has been compared to trying to drink out of a fire hydrant. While each medical school’s curriculum varies, the same basic topics must all be covered within the first two years of instruction, and the amount of material covered within each or these two years is significantly higher and more detailed than that of the classes covered in any years of undergraduate education.

Studying to learn this amount of material is obviously stressful in and of itself, and most medical students are used to being at the top of their classes. Finding themselves struggling to even pass a course is often a new and terrifying experience, and when many of them experience failure on tests for the first times in their lives, the stress can seem overwhelming. The toll that medical school life takes on students has not gone unnoticed; various studies have been conducted to quantify the rate of depression among medical students, and while the numbers vary between studies (from around 12-20%), all of these studies conclude that the rate of depression among medical students is significantly higher than that of the general population. Finally, even though the life of a physician is often seen as one of ease by those viewing from the outside in, this illusion is sometimes far from the truth. Physicians, like many others, can be plagued by financial worries. Malpractice insurance is anything but cheap, and with legislation in on ballots to remove the caps for malpractice costs in some states (such as California), the cost may only skyrocket in future years. Additionally, even though their average salaries are higher than those of the general population, so is their average accumulated debt. The salary of physicians in residency has not increased proportionately to the rising cost of medical school tuition. This means that despite their best efforts, most physicians will still be paying off medical school loans long after they have completed their residencies. Doctors also typically work long hours—many of which may go unpaid due to difficulties with billing processes with insurance companies. Furthermore, the stress of the burden of being held responsible for the lives of patients can definitely take a toll on an individual’s mental health as well. These career stresses often spill over into a physician’s personal life, causing further undesirable difficulties.

Is an MD really worth it?

With all these negatives aspects, it’s easy to see why premeds might find themselves questioning whether earning their MDs are really worth it or not. However, as just about any actual medical students and physicians will readily tell you, the perks of the profession still arguably far outweigh the cons. Many people search their whole lives for a career that brings them fulfillment and a sense of purpose in life. A career in medicine is one relatively sure way to find that purpose, particularly for individuals already passionate about blending science with care for humanity.

Additionally, even though the looming loan repayment plans may seem extremely intimidating, premeds should realize that repaying enormous sums of loan money is possible and will most likely remain possible, regardless of how the future of healthcare plays out in America. Obviously, successfully paying off these loans in as little time as possible will require careful budgeting on the part of the borrower, but learning to be wise with a budget is never a bad quality to work on anyways. Furthermore, there are several different governmentsponsored medical school tuition (re) payment plans, including options to work in certain specialties in rural areas or in military branches. While these programs all require committing to a certain number of years of service in their specific areas in return for complete payment of all medical school loans, many students consider these options preferable to having to worry about making loan payments on their own for many years.

Also, even though the logistics of healthcare in the United States will probably change within the very near future, the constant need for dedicated medical professionals will undoubtedly remain. If job security is determined by the demand for a service, then physicians will always have a secure field to practice in. Advancements will (hopefully) continue to be made in medicine, but these advancements will never be able to fully eradicate the sicknesses, diseases, and injuries that constantly plague society.

The costs vs. the dream

If your dream in life is to serve society as a physician, fears of the real costs of a medical school degree—fears of the costs both monetarily and mentally—should not be allowed to determine your future. Although these fears are legitimate, ways to overcome these issues still remain. If money is your main fear, then consider one of the previously mentioned loan repayment programs. If securing a residency spot worries you, then find peace in knowing that taking a year between graduation and residency to build your resume through paid research work is usually a back-up possibility. If you fear the toll of mental stress during medical school, then comfort yourself in knowing that many medical schools provide free counseling services to their students. Overall, even though the cost of a medical school degree may seem overwhelming at times, the benefits of successfully fulfilling your dreams for earning your MD degree are far greater. After all, you don’t want to someday look back on your life and think, “I wish I would have followed my dream to become a doctor…” Choosing to take the steps towards your MD now can help prevent those moments of regret later on.

This article was published in the September/October 2014 issue of PreMedLife magazine.