Trouble Picking which Degree to Go For! - Any advice?

[Jonathan Whatley]

I don’t understand the point of this. If you prepare and dedicate the time needed, you are going to pass. This is the same with any degree, job or investment. There are extenuating circumstances of course but they are rare. Board exams and strenuous standards are obviously going to be needed benchmarks. If you cheat or fail out, that’s on the student and is entirely preventable.

This is a little too just-world fallacy. There are many instances of academic program non-completion not explained by the factors you name (unless we define "extenuating circumstances" very broadly, but you said they're rare).

[Duneranger]

I don’t understand the point of this. If you prepare and dedicate the time needed, you are going to pass. This is the same with any degree, job or investment. There are extenuating circumstances of course but they are rare. Board exams and strenuous standards are obviously going to be needed benchmarks. If you cheat or fail out, that’s on the student and is entirely preventable.

This is a little too just-world fallacy. There are many instances of academic program non-completion not explained by the factors you name (unless we define "extenuating circumstances" very broadly, but you said they're rare).

Everything in life is risk vs reward. I posted the numbers. Schools also work with students who have illness, deaths, sudden increase of personal issues etc. I have been a student in these medical oriented programs and have experienced issues where I needed a LOA. Communication is key. Their attrition numbers are a HUGE deal and they do whatever they can to mitigate them. 

If you are looking for a situation where you are covered 100% risk wise in any endeavor you take to better yourself you probably shouldn’t leave your house. 

Aside factors I listed and cheating/lack of effort, what other reasons/instances are there?

[davewill]

Okay, 99% of people. My brother started at at 250k a year and got loan repayment as a bonus. My friend started out at 310k plus bonus. It paid off.

The vast majority of people finish and pass. People who don’t either refused to put in the work or had extenuating circumstances.

People will always complain about loans.

That's fine for a well paying specialty in a big city, but what about general practitioners in small towns? These ridiculous costs are part of why we have to import doctors...and part of why the cost of health care just keeps going up and up.

What I don't understand is why you seem to think that huge prices for medical school is noble in some way.

[Duneranger]

Okay, 99% of people. My brother started at at 250k a year and got loan repayment as a bonus. My friend started out at 310k plus bonus. It paid off.

The vast majority of people finish and pass. People who don’t either refused to put in the work or had extenuating circumstances.

People will always complain about loans.

That's fine for a well paying specialty in a big city, but what about general practitioners in small towns? These ridiculous costs are part of why we have to import doctors...and part of why the cost of health care just keeps going up and up.

What I don't understand is why you seem to think that huge prices for medical school is noble in some way.

Rural pay is often the highest. You should see the locums rates. The pay I stated isn’t uncommon. Rural/Indian/VA loan repayment and PSLF are also generous. 

I never said the costs were a good thing or any of what you suggest . But due to the resource intensive aspect of medical school, they are always going to be more expensive to some degree. I never said the insane costs are a good thing.

Medical schools and accreditation bodies gatekeep the amount of new grads. That’s on them. PA and NPs fill the gaps in a lot of primary care areas. Salaries are not the reason why medical costs are high I assure you of that. You can thank insurance/billing and medical pharma/equipment companies for that.

[dfrecore]

Only 80% or so of students in 4-yr med school programs graduate.  So while it's the majority, plenty of people don't graduate, or don't pass their boards.  So 20% of those with a LOT of student debt are not making $300k a year and able to pay off their debt.

It's true that in US MD schools, about 80 to 85% of students in 4-year programs graduate in 4 years. But 96% of entrants will have graduated within 6 years. The difference is students who decelerated or took a break. (Graduation Rates and Attrition Rates of U.S. Medical Students, AAMC Student Records System, October 2022). About 97% of US MD graduates begin residency training the year they graduate. (Addressing the Increasing Number of Unmatched Medical Students, AMA Council on Medical Education, 2021).

Attrition is much higher among US students in international medical schools.

The 96% in 6 years number is going to include anyone who did not pass and had to retake a year, thus increasing the cost by at least 25% in what they would have paid.  I stand by what I said though - there are going to be many who this does not work out for, enough to say that telling everyone "it will be fine, don't worry about the cost, you'll get a high-paying job when you graduate and be able to pay off your loans" is not a great idea for many people.  Because if that were the case, then no one would complain about loans - they'd just easily pay them all off.

[Jonathan Whatley]

I posted the numbers.

You posted numbers for students who entered US MD schools, but then seemed to generalize that nearly anyone who dedicates the time and effort needed will complete that degree or any other given degree.

High attrition rates in the physician pipeline are hiding in plain sight in the high attrition of pre-meds who are discouraged and don't apply, the high attrition of pre-meds who apply but aren’t admitted to any med school, the high attrition of students at international medical schools prior to graduation, and the high attrition of international medical graduates who apply but aren’t admitted to any residency located or accepted here.

Their attrition numbers are a HUGE deal and they do whatever they can to mitigate them.

US MD school is nice work if you can get in.

Aside factors I listed and cheating/lack of effort, what other reasons/instances are there?

The analogy of drinking from a firehose is often made to describe medical school, law school, and other programs with a lot of complex content in a short time. MIT's admissions department uses the analogy for its own undergraduate program.

Sometimes the learning processes this requires exceed the current capacity even of smart, dedicated, and previously successful students, and the resources to develop their capacity aren't available quickly enough.

[Duneranger]

Only 80% or so of students in 4-yr med school programs graduate.  So while it's the majority, plenty of people don't graduate, or don't pass their boards.  So 20% of those with a LOT of student debt are not making $300k a year and able to pay off their debt.

It's true that in US MD schools, about 80 to 85% of students in 4-year programs graduate in 4 years. But 96% of entrants will have graduated within 6 years. The difference is students who decelerated or took a break. (Graduation Rates and Attrition Rates of U.S. Medical Students, AAMC Student Records System, October 2022). About 97% of US MD graduates begin residency training the year they graduate. (Addressing the Increasing Number of Unmatched Medical Students, AMA Council on Medical Education, 2021).

Attrition is much higher among US students in international medical schools.

The 96% in 6 years number is going to include anyone who did not pass and had to retake a year, thus increasing the cost by at least 25% in what they would have paid.  I stand by what I said though - there are going to be many who this does not work out for, enough to say that telling everyone "it will be fine, don't worry about the cost, you'll get a high-paying job when you graduate and be able to pay off your loans" is not a great idea for many people.  Because if that were the case, then no one would complain about loans - they'd just easily pay them all 

I’m not being flippant or cavalier about the costs, just saying it’s a risk with a lot of of reward.

The costs are reality. We can all say they are too high. But if medicine is the goal, what are you going to do? Protest? Stop pursuing your passion? You can dissect every possible scenario where ones does not graduate but the fact remains is that the vast majority of people do graduate and go on to have successful and fulfilling careers.

[Jonathan Whatley]

there are going to be many who this does not work out for, enough to say that telling everyone "it will be fine, don't worry about the cost, you'll get a high-paying job when you graduate and be able to pay off your loans" is not a great idea for many people.

We agree there!

[Duneranger]

I posted the numbers.

You posted numbers for students who entered US MD schools, but then seemed to generalize that nearly anyone who dedicates the time and effort needed will complete that degree or any other given degree.

High attrition rates in the physician pipeline are hiding in plain sight in the high attrition of pre-meds who are discouraged and don't apply, the high attrition of pre-meds who apply but aren’t admitted to any med school, the high attrition of students at international medical schools prior to graduation, the high attrition of international medical graduates who apply but aren’t admitted to any residency located or accepted here.

Their attrition numbers are a HUGE deal and they do whatever they can to mitigate them.

US MD school is nice work if you can get in.

Aside factors I listed and cheating/lack of effort, what other reasons/instances are there?

The analogy of drinking from a firehose is often made to describe medical school, law school, and other programs with a lot of complex content in a short time. MIT's admissions department uses the analogy for its own undergraduate program.

Sometimes the learning processes this requires exceed the current capacity even of smart, dedicated, and previously successful students, and the resources to develop their capacity aren't available quickly enough.

I don’t get your point. It’s hard. It has to be hard. The information is vast, it has to be vast.It’s competitive, it’s always going to be competitive. 

Even international med schools are competitive too . IMG grads also have to do residency x2 often which is a big barrier

Not everything is going to be like a go at your pace competency degree or asynchronous online schooling. Most people who do well enough in pre med and score well enough on the MCAT have proven they can handle the material. A lot of it is efficient studying skills and time management for those who struggle.

So what’s your realistic solution? Don’t do it? Make it easier? The costs are not magically going to come down nor are the standards or difficulty.

[Jonathan Whatley]

Not everything is going to be like a go at your pace competency degree or asynchronous online schooling.

True. Yet, parts are moving that way. Khan Academy free online content became the official test prep partner for MCAT. WGU built a lot of its competency-based model into pre-licensure RN and pre-certification NP programs.

So what's your realistic solution? Don't do it?

Recognize that the just-world hypothesis doesn't explain a lot of attrition.

The costs are not magically going to come down nor are the standards or difficulty.

There are different ways to slice the same pie. A lot of the cost of operating medical schools is funded outside tuition. Residency programs charge no tuition to students.