I get sick and tired of having to explain to family members, friends, co-workers on the varied and many jobs I’ve held over the years why it is I don’t simply waltz into a hospital or medical school with my lovely MD draped over my porcelain shoulders, bat my eyes, and announce, “I’m here, you may begin now.” I swear that is how simple many people assume life is once you’ve earned your MD. Let me tell you the “other side” of the story: unless you commit to training right out of medical school, your chances of ever getting to use your (in all likelihood) expensive, fancy MD go down exponentially every day.
I’ve been out of medical school now seventeen years. I never completed a residency, as I apparently saw fit to complete rehab for a prescription drug issue instead. It’s all wonderful to write I’m clean and sober, but living the reality of being broke with an awesome education really sucks!
I wish I could find an internship, residency, something, but for those few crazy med students out there toying with the idea of not going full through with at least three years of a residency program, plus the rest of the board examinations, and getting board certified in your particular specialty, your options are slim. If anyone ever tells you you can come back anytime, he or she is lying to you. I mean lying like a wet rug. I heard this from at least 2 residency coordinators. When I was ready, apparently their programs weren’t.
In order to get licensure, a student has to take and pass the United States Medical Licensing Exams. There are three parts to this exam, although really four exams (Step 1, Step2 Clinical Knowledge, Step 2 Clinical Practice, and Step 3). The total for just taking them (not prepping for them) is currently $3,335 (it will be an additional $70 if you need a 3- month extension for any exam).
Fees for membership in organizations such as the American Pediatric Association, American Medical Association, American Family Medicine Physician Association, state medical associations, alumni associations, and city medical clubs can take quite a toll on one’s wallet. In addition, a physician has to maintain current licensure in the state(s) s/he wishes to practice. Each state’s fees are different, and it costs just to apply.
When one is ready to apply for a residency, there is one central program for this ERAS. ERAS stands for Electronic Residency Application System. ERAS has its own fees, and of course, there is a fee to apply for residencies with no guarantee of so much as an interview. It is theoretically possible to spend thousands of dollars applying for a residency and never get as much as an interview.
Multiple businesses have sprung up to take even more advantage of the physician’s wallet. American College of Physicians, a great resource, and the well-respected organization has substantial fees for membership and services, such as the Medical Knowledge Self-Assessment Kit, something more and more residencies and academic positions like to see on a cv. This is just one.
Kaplan, an exam-prepping business, is famous for its guarantee the partaker of its programs will pass whichever test. Of course, they don’t offer to pay for you to retake the examination, nor can they erase your poor score from USMLE transcripts. On top of these fees go school loans and interest on these loans, unless one was lucky enough to have the money to pay for her/his education. This, unfortunately, was NOT my case, so – lucky me- I am paying back school loans to a degree I’ve found almost useless.
Having an MD without taking the Step 2 of your boards, as in my case, is almost fatal. I could get back, but I’d need a lot of financial support. Wonderful reentry programs actually exist for physicians in my exact situation (or similar). I am extremely grateful to the helpful and caring institutions which have them in place. May they be blessed a million times over! The programs do cost money, however, and I’m a single mother barely making rent. I’m currently unemployed and am stuck desperately trying to make use of this damned MD again.
When I was interviewing for medical school, two sophomores stopped in the large room in which we interviewees were nervously sitting. One of the sophomores told us all to leave, not to go on; it was too expensive and the degree, in the end, wasn’t worth it. It would be better, he offered, for us to apply for business school. (Of course, HE wasn’t actively fleeing, dropping his books and running out with his resignation flailing behind him, either.) Today I almost wish I’d taken his advice.
If I had to do it all over again, would I get my MD? I love the practice of medicine, I loved my patients. I keep current through continuing medical education hours in some chimeric hope a fellowship, internship, or research position will fall from the sky. In the meantime, the only other thing I can say about my MD is “would you like fries with that?”