Saturday, May 15, 2010

Not Going to Medical School

Got your attention, didn't I? Those of you who know me well know that I've been talking about medical school for a while now. I applied last year as an out-of-state applicant, knowing that I would probably not get in. Not surprisingly, I didn't. When I spoke to the admissions representative, she told me that they'd received a record number of out-of-state applications last year. This particular school is the only medical school in the state. State law says that they must admit all qualified applicants from within the state first. Then, if there are any spots left over, they can begin reviewing students from other states. So basically, we get the leftovers. Lovely. That's why it didn't surprise me all that much when I didn't get in. I have a very strong application, but I was competing with a LOT of people for only 10-20 spots (if that many). When I explained to the admissions rep that we're moving over the summer, she encouraged me to reapply if we could be moved by the end of June (because then I'd be able to apply as an in-state student). 

That was my plan for the last few months, but when the new health care bill passed I began to rethink my plans. One of the features of the new bill is a change to the way federal student loans for medical school are disbursed. Under the new legislation, students who take out federal student loans to pay for medical school must repay the government with both money (principal plus interest) AND time (I want to say six years, but I could be wrong about that). After completing school, students are required to practice medicine in an under-served community of the government's choosing. Fundamentally, I don't really have a problem with this concept. Obviously if the community is under-served, then it needs good doctors. But since James is planning to stay in the military for a full 20-year-career, this program isn't going to work for me.

At the current tuition rates for the school I'm applying to, four years of medical school would cost me more than $92,000 and that's relatively cheap. If I can't utilize federal student loans, then how would I pay for it?? We considered having me join the service with James. They would pay for all my tuition and fees, and I would earn a stipend for living expenses while in school. I would owe them one year of service for each year they paid for, starting after I completed my residency. So that takes care of that, but there's still another problem... where would I do my residency?

Probably the biggest hindrance to my going to medical school is the likelihood that my residency program and James' next station would not be in the same place. There aren't very many places where we can get stationed, and I wouldn't have a ton of control over where I end up for my residency (which, additionally, could take 3-7 years or even more depending on my specialty). By then we'll have at least one child, possibly even two. There's no way we could live in two households. First of all, it's ridiculously impractical. But more importantly than that, I could never put my training before my family. It's just not something I could ever reconcile. 

So I've decided on an alternative. After talking to my mom and my girlfriend Julie, both of whom are nurses, I've decided to go to nursing school and become a Nurse Practitioner. What I want is to help people and to practice medicine. I can still do that as a Nurse Practitioner. And unlike a physician, I would have a lot more mobility and flexibility within my career. I can go from emergency medicine to critical care to labor and delivery. I'll get to spend more time with my patients, which was the whole reason I wanted to go into medicine in the first place. The pay will still be really good, but the education and training will only be a third of what it would cost to become a physician. And I think, overall, that this route fits my family and my lifestyle much better. Some states even allow Nurse Practitioners to have their own practices. So maybe I can still open my holistic women's clinic one day. You just never know...

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