Dr. Crippen:

“I am curious as to whether I should pursue medical school, or graduate and post-graduate studies.  I would not be applying to either sort of programs for another two years. I am intending to take the pre-medical course load regardless, however, any insight to the medical field, research, and the realm of neuro-psychology would be greatly appreciated”.

Thank you very much,
XXXXXX

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I am not currently recommending a career in medicine for a number of reasons.

1.  The amount of money needed to finance a four-year medical education is simply prohibitive.  Most of the kids I know are in for somewhere in the range now of $150,000 or more in loans, all of which come with interest and will take most of their career to pay back. That’s not including four years of college or university.

2.  There is no question at all that the financing of health care is destined to include decreasing resources for providers. The current health care reform plan, if it gets implemented, will instantly inject at least 31 million people into a system already overloaded. There is only one way to finance this increase, pay providers less and have them work more.

The only physicians making big bucks are specialty surgeons doing complex procedures. Neurosurgeons and cardiac surgeons.  The residency programs for these programs are seven and eight years after medical school and they are brutal. They make a lot of money when they get out and they break their asses doing it.

“Most” non-surgical physicians (including neurologists) spend at least three to four years after medical school making yeoman wages and doing a lot of “service” (scut) work for the hospital to justify them getting paid for medical education. Then they don’t make enough money (and will probably less in the future) to comfortably pay off the huge debts incurred.

It’s a radically different world and I have lived and functioned in both. When I was your age, there was no liability in going to college. It was cheap and many kids had little other option other than the military, which wasn’t very popular or getting an entry-level job in some industry that would probably be a dead end. College was cheap, available and socially popular. Everyone that could did.  And when they got out, they entered a job market amenable to “college graduates”.  Didn’t matter what it was, if you had a diploma, you here hire-able because you had the price of admission.

Some time in the late 90s I think, It was found that having a degree in something unrelated to a specific job skill was non-contributory even as a price of admission. So, it slowly evolved that a college degree in functionally inconsequential things like history, English, biology and art appreciation became a very expensive diversion following which one then had to be trained for increasingly skilled employment.

Advanced college degrees are even more iffy. BS or BA degrees, especially in the pure humanities or science are worthless. The amount of money it takes to get an advanced degree with no guarantee of employment is off the screen, and is soon to change the entire spectrum of education if it hasn’t already. Masters Degree isn’t much better unless in the realm of teaching. It takes at least 6 years to get a PhD and can cost $130,000 educational debt. I know some that went a year without getting a job and finally landed one at a private college teaching with a salary of $48,000 a year.  The paybacks for educational loans are $600.00 per month for a LONG time.

If a kid gets out of high school and takes a two-year tech course in auto mechanics, he can get a job immediately and make a reasonable wage to support a family that’s pretty cost/benefit effective.  If a kid goes straight to college and ends up with a Masters 6 years later, he might get a job in a tight market as a high school teacher and make about the same as the mechanic.  But he can discuss Chaucer with his friends at parties and wear a sport jacket out to dinner.  Pay your nickel and take your choice.
That said, there is and always will be a place for higher education.  There will always be those that will rise to the top in any endeavor, but it cannot be counted on. The bad news is its connection to gainful employment is capricious and unreliable.

The reality” – your interest in higher education must eventually be directed toward getting someone to pay you for that knowledge.  That requires some hard scrutiny.  Do you have the resources required to simply make yourself more well read as a matter of personal desire and thirst for knowledge as an end in itself? Are you willing to pay a lot of money to become an interesting conversationalist at cocktail parties?  To rub shoulder with a higher class of friends? If you have the resources, that’s a perfectly OK goal. The issue of making an issue is separate. Or do you want to proceed toward a livelihood that will pay you a living wage?  If so, that requires a separate path, also becoming quite expensive.

In the end, you must work and you must make a living wage to put a roof over your head and food in your mouth. That’s the human condition. And you don’t have an unlimited time frame to get it done. The clock ticks, and the longer you’re out there figuring out what you want to do without actually doing it and getting paid for it, the harder it will be to get moving to it. Trust me on this. I have been there and done all of it.