“It’s so unfair that you have to pay for your flights for residency interviews!” George, my fiancé, was indignant. “In addition to hotels, applications, and everything else!” I looked over, surprised at his outburst. It was justice, not stinginess that lit the fire in his eyes.
“Dear, we pay for everything when it comes to medical education.” I said. It made sense to me—that’s the way medical training worked after all. Debt, debt, debt, and years later, a paying job.
“But why? It doesn’t seem right that corporations pay for potential employees’ travel fare and hotel on their interview days and universities arrange for PhD candidates to come and see their programs, but medical schools and residency programs won’t. The way I see it, that’s unprofessional.”
Unprofessional? Medicine is all about professionalism. And tradition.
“That’s just the way things are,” I told George.
From what I can see, medicine leans heavily on prestige and people to entice candidates to its programs. It can’t afford (and perhaps doesn’t need) perks to do the job for them. But George has a point. In a world where money is valued so highly, the medical field remains a privileged one. Why is that so? The answer is complicated.
My first year of medical school concluded less than a week ago. I think back to the $70,000+ spent on my one-quarter-MD and part of me cringes a bit. It is a well-known (and well-accepted) struggle that enormous loans are often necessary to make it through the four years of medical school. Yet, even with the MD in our hands, at least one year of internship and, more likely than not, another two to five years of residency is needed to practice. Often, physicians-in-training will continue on to do a fellowship and subspecialize in their field, which can take another one to three years. And the cost of applying to residency? It is not unheard of for medical students to take out additional loans during their fourth year for the sole purpose of “residency and relocation.”
Beyond the monetary expenses of medical education, there is often an underlying complaint of lost time in medical school, something that is a mix of lost sleep and lost opportunities for making money, exploring the world, and even, of developing relationships. Somehow, it seems that there is the notion that medical education has a way of sucking the marrow out of life. The best years, prime years often in one’s 20s, are spent studying in libraries or wrapped up in cases in the hospital.
Still, a large part of me is idealistic. I see the pursuit of medicine as inherently sacrificial. Student doctors spend their time buckled down in books or the wards, learning how to bring others into health and wellness. I admit to oftentimes believing that it should be so—that in this field of caring and healing, our focus should always be on the other, the sick patient, and not on ourselves and our own sacrifice and debt.
I told this to my friend Arnav and he laughed at me. “You know, it would be way easier to get into medical school if being a doctor wasn’t a high-paying job.”
I thought about it and after a while, I nodded. I guess it’s true.
“Plus, there are no poor doctors; only doctors in debt.”
Hmm. True again. Indeed, it seemed an oxymoron to imagine a starving doctor. The idealist in me heaved a sigh. Arnav, as always, was deeply practical about his decision to go into medicine.
Like Arnav, many of my classmates have reasoned away the burden of their loans. Being a doctor is a secure and respectable job. Their debt pushes them to pursue fields that reimburse well. As one of my medical school friends shared with me, no one wants to stay in debt forever. The less time needed to pay it all off, the better.
Nevertheless, I believe that most of my classmates would agree that in the end, all those numbers fading away from our bank accounts will be forgotten. Already, the payments to AMCAS for applying to medical school are long-gone, lost amidst the moving process of dissecting a human body, the willingness of busy physicians to be my mentors, the privilege of being so trusted by another in clinic. Many years from now, I believe that my exorbitant tuition will be long-gone too, forgotten amidst the incredible experiences I have had, the colleagues I have met, the patients I have walked with on their journeys. These opportunities are indeed worth so much more than the entry fee that is medical school.
My first year blew by. The end was jerky—I performed badly on the final exam for neurology. Yet, even in feeling unable to remember any information, I told myself this: medicine is not about numbers. Medicine is about listening, caring, healing— things that are so human and valuable.
And so, neither will I judge myself by numbers.
Featured image:
Student Loan by Simon Cunningham