Dose of reality, please: leaving tech for medicine?
May 7, 2019 9:54 PM   Subscribe

My chosen career is giving me a crisis of conscience. I would really, really like to start planning my exit from software for a couple years from now. Tell me how you decided on a second career in medicine and transitioned - or how you realized it was a bad idea for you after all!

This isn't exactly coming from nowhere: I currently design training software for surgeons, and have had a sustained urge to hop the fence into medicine properly.

Lifestyle is more important to me than the specific role or specialty within medicine, though my primary interest is OB-GYN, and I have a deep admiration for how that work educates and changes lives.

Assume that money and time aren't deal-breaking issues, this is primarily about leaving a lucrative, ethically muddy professional track in exchange for one that will help me die feeling like I did something useful with my life.
posted by Snacks to Work & Money (24 answers total) 8 users marked this as a favorite
 
There are ways to die feeling like you did something useful with your life, that aren’t at all dependent on where your paycheck comes from.

Not the question you asked, but as someone who has struggled with finding satisfaction and meaning vis-a-vis Work, I felt compelled to respond to that.

That said, it is good you are asking this question and making plans to make a change. Life is short. Just... don’t get fooled into thinking a new job / profession will alone provide the answer you seek. Our challenges have a way of following us around. But clearly you are thoughtful, which means you will face those challenges and overcome them.

Best of luck.
posted by armoir from antproof case at 10:38 PM on May 7, 2019 [10 favorites]


This has come up a few times in the past couple weeks on the internal forums at my big tech employer...I think a lot of people are hitting a wall in tech this year. WONDER WHY.

My advice kind of depends on what sort of medical-domain career you're after. If you're open to not being an MD, you have a lot more options and flexibility. There are many birth-adjacent roles you could play that require much less formal education and can get you into the field helping real women right away. For example, it's much less time in training to become a doula or lactation consultant, and depending on what draws you to OB-GYN may actually be more in line with your ideals and ethics. Of course, it's commensurately less money and prestige. From there, if you want more clinical options and more "ownership" of the birthing process, you can "level up" to jobs like Certified Nurse Midwife. Or you could go in a completely different direction and become a physical therapist (much more education, but not med school) specializing in pregnancy-related pelvic pain and rehab, or a massage therapist who specializes in prenatal massage. As someone who's currently experiencing pregnancy-related pelvic pain, these people are just so so great.

But when you say "lifestyle" is more important to you than the role or specialty, I'm not sure what that means. Like, you do realize that before you get to whatever end-state lifestyle awaits, you'll have 8 years of med school + residency plus potentially a year or two more of fellowship, right? And that's assuming you don't also have to do a post-bac to even get into medical school, which adds another year or two on the front of that. And for that decade your life is basically shit; for the first four years you're paying dearly to have a really tiring, stressful life and for the next four to six you make an insulting wage for even less free time. What other stuff might you do with the next ten years? Are you at a point where you might possibly want to have kids? How old will you be when you finish? Have you considered that if you remain in tech for that long you could potentially save enough money to just early-retire by then and spend the rest of your days volunteering for causes you care about?

I think a lot of people in tech have a real grass-is-greener idea that in medicine you never come home struggling with your conscience, that you feel properly respected all the time by the people you work with, that the work is always fulfilling. Look, doctors like their jobs way better than lawyers do, I'll grant em that, but it's no picnic. I definitely know doctors who quit their big medical firm jobs for ethical reasons too. And in those cases it's because they had actual patients, people they came to know and like, who are no longer alive because they were not able to convince the muckety-mucks controlling the purse strings to shell out for a treatment.

Do you have close friends or relatives who are MDs? Can you sit down with them and have them kind of try to talk you out of it before you get too serious? Cause I think a lot of docs out there would be able to do a really good job of convincing you this isn't something you want to spend the next 8+ years retraining to do. I think many docs I know will tell you, "If you can think of ANYTHING else you might want to do with your life, really, do that." And they will tell you that more and more emphatically the more years old you are, because the only way training as a doctor really pays off is if you can work as a doctor starting in your early thirties, then work your ass off for the next ten years or so to build a solid practice or become a partner in a big practice while you still have a ton of energy in your mid to late thirties, then just ease off the gas and practice medicine like a solid professional for a few decades. This is somewhat less the case if you wouldn't have to go into debt for medical school, but medical school is REALLY expensive.

But again, if you do want to be involved in the pregnancy, birth, and postpartum care process, the good news is you absolutely don't need to go to med school to do that. I'd look deeper into those options if I were you.

And really, do the math on early retirement too. You could also consider early retirement then retraining as a high school math/CS teacher and moving someplace rural/poor to buy a place for cash with your big tech nest egg and teach underrepresented folks to code so they'll be able to influence where tech goes next. I know someone who did that and she is sooooo happy now. Definitely plays to more of your current strengths, you wouldn't be starting over from professional near-scratch, and then you'd also get summers off. Think about it.
posted by potrzebie at 11:24 PM on May 7, 2019 [30 favorites]


I would suggest trying to find volunteer or shadowing opportunities that let you experience the health care field. When I was in college there was a volunteer program at a Hospital nearby where we volunteered on the Hospital Floors/Units and saw the real day to day of Hospital.

Please don't let me discourage you, but you mention that lifestyle is important to you. Many Doctors work long hours and are required to occasionally be on-call at night. Medical School is 4 years of long endless studying followed by a minimum of 3 years of 80 hour weeks during Residency. Unless you took a lot of science courses in undergrad you would probably have to take at least 1 year of prerequisite courses to be able to apply to Medical School. There would also be the MCAT.

I agree with armoir from antproof case, life is short. If you really want to change careers, do it. At the same time, there are many careers where you can feel like you did something useful with your life. I think that potrzebie is right that maybe another health care field outside medicine or even teaching Math would be other careers for you to consider.
posted by mundo at 11:35 PM on May 7, 2019 [1 favorite]


Can you describe more about your lifestyle desires? I think that will help us give you better answers.

I would not work in healthcare, personally, to align my life’s efforts with the value of helping others. You’d be surprised how much time is taken up by non-patient care tasks.
posted by emkelley at 3:12 AM on May 8, 2019 [2 favorites]


My OB makes rounds at the hospital at 6a regularly. I’ve had appointments with her at 6p. She’s on call to deliver babies at all hours a couple days a week, including holidays. Both my kids were born early in the morning which means we were laboring for hours prior, and talking on the phone even before that. The OB who delivered my second (at 4am) delivered another baby before mine and tried to nap briefly before things got intense for me, we ran out of time and she had drag a bed into the room and lift me onto it herself because the nurses couldn’t run down the hall in time. My friend who is a GYN surgeon at a teaching hospital has major surgeries scheduled into the evening. It’s amazing what they do, but LIFESTYLE is not part of it. Is owning your own time part of having a good lifestyle for you? Because OB/GYNs out of the many types of doctors particularly do not own theirs.
posted by sestaaak at 5:35 AM on May 8, 2019 [6 favorites]


I met a OB - GYN surgeon who described her life managing a family and work life as beyond challenging. She was passionate about what she did for a living but admitted "this field is one where you are always aware that you are responsible for two lives intertwined - the mother and the child."

She also talked about the grind of working towards getting her MD and thinking that at the end of the road, her potential salary was going to be worth it. However, the first years of her career her husband socked away every paycheck towards paying off her medical school bills.
posted by IndigoOnTheGo at 5:46 AM on May 8, 2019 [2 favorites]


Designing training software for surgeons sounds to me like something useful that could potentially help a lot of people. Is it more that being somewhat isolated sitting at a desk all day isn't feeling good, and you want more human interaction?

The doctors I know often feel that their work is "ethically muddy," as they can't spend the amount of time with patients that they need to really help them, and in some cases are pressured to find more things they can bill for.
posted by metasarah at 6:13 AM on May 8, 2019 [8 favorites]


I'm married to a wonderful doctor that went back to school in her late twenties to do pre-reqs, med school, residency, and a chief year. Like every one has said so far, it was a really hard decade plus of school/training, but the one thing that hasn't been said enough is that the first few years of practice are also incredibly hard. She finds it incredibly rewarding and incredibly frustrating. Here in the US, the cost model and the insurance market keep trying to wring out more costs and that leads to very frustrating days when what you want most is giving people the best care you can. We both hope that this will get easier, but every day, I have my doubts.
posted by advicepig at 7:15 AM on May 8, 2019 [4 favorites]


I sent you a MeFi mail.
posted by telegraph at 7:19 AM on May 8, 2019 [1 favorite]


I would suggest working through all the potential ethical trauma associated with having to make suboptimal decisions on behalf of an organization, in a way that leads to poor care for a real human being. You may find it’s even worse than the ethical dilemmas around software.
posted by argybarg at 7:25 AM on May 8, 2019 [8 favorites]


I switched careers from a software field when I was 29 and went to medical school. The end result is pretty neat but I can’t recommend the medical training process to anyone. Take the most exquisitely excruciating thing you can imagine doing and extend that out over at least 7 years (8 for ob/gyn), plus more years if you need the prereqs too, as I did.

Think very, very hard before burning a decade of your life on this. Happy to answer specific questions if you want to Memail me.
posted by killdevil at 8:34 AM on May 8, 2019 [9 favorites]


Also, medicine is as ethically muddy as a profession can be. To cite an example from my own emergency practice, how will you feel ordering $15,000 worth of Medicare-funded intervention to try to resuscitate, diagnose and treat a severely demented, moribund 92yo whose extended family insist on everything being done to keep her alive because they rely on her SSI payments? And then seeing four patients after that who are in for preventable problems because they can’t afford their medicines or primary care?
posted by killdevil at 8:58 AM on May 8, 2019 [8 favorites]


If you're most interested in OBGYN work, take a look at being a doula.
posted by showbiz_liz at 9:17 AM on May 8, 2019


There are lots of ways into the world of medical practice, and not all of them resolve to doctor and all the years of training that entails. You might want to consider something lower key to get you in the door and explore further options from inside that world.

For instance, you can become a licensed phlebotomist in a relatively short amount of time - that's a position that involves lots of patient contact and, though you aren't making diagnoses or care plans, phlebotomists most definitely can make patients' lives and health care experiences better. You could target getting a job inside a hospital, and then use the experiences you have and relationships you establish there to figure out next steps - like nursing, etc.
posted by jasper411 at 11:13 AM on May 8, 2019


I am 41, going on 42, and started medical school at 37 (I took a year off). I am graduating as we speak and matched into a "good" residency. Medical school was nowhere near as bad as people make it out to be. But if I had it to do over again, I would have borrowed money to do one of the hugely expensive 1-2-year prerequisite programs. I did my prereqs at City College of NY while working part-time and that was really grueling and time-consuming (MUCH more difficult than med school). I would not under any circumstances begin med school at any year older than 37. That was already too old for me!!!!

Feel free to memail me. I am in a rare period where I have spare time.
posted by 8603 at 12:17 PM on May 8, 2019 [1 favorite]


P.S.: part of the response you may be getting on this thread is because OB is NOTORIOUS for bad lifestyle and high-strung people. If you're interested in other areas (maybe family med in a rural area with a lot of delivering babies?), then the lifestyle considerations are better.
posted by 8603 at 1:22 PM on May 8, 2019


I recommend reading through what is available at this site, studentdoctor.net is a great resource on this and other medical school application questions. I am a nontraditional student. I'm pretty close to the application experience and that was actually worse than medical school itself. Feel free to message me.

A few things to consider:
1. Where are you on required pre-reqs? If you don't have two semesters of biology, physics, gen chem, etc. in the past decade then you need to go back and get them. If this is the case, how will you feel about taking courses with college freshman?
2. How do you feel about studying? This is all you will be doing for the first 2 years and a lot of what you will be doing for the third and fourth years. Even for people who are good students and enjoy the material it is grueling.
3. How can you make the argument to medical schools that you deserve a seat? Just saying "I want to do something that helps people" is not going to get you in. Applications have become increasingly competitive. What will you do if you don't get accepted? How long are you willing to deal with limbo?
4. How do you feel about sacrificing your physical comfort for your training? Your mental health? Your social life? Missing important life events for school? Watching your peers move ahead with their lives while you are just grinding away in the library?
5. How many actual doctors have you spoken to about these interests? In person, where they can look you in the eye and tell you sincerely that they think you should reconsider going to medical school. How many times have you shadowed a doctor? What level of exposure do you have to the medical field?
6. How is your own health? Mental health? This is the reason that many nontraditional students drop out, they or someone in their life has a health crisis.
posted by arachnidette at 2:11 PM on May 8, 2019 [4 favorites]


Response by poster: To clarify "lifestyle": it's unacceptable to me to go back to a life where I am permanently working 80+ hours a week and also on-call. Some semblance of work/life balance and the pace/atmosphere at work is important to me. I moved to a rural area in part because of that.

Staying in software in any capacity is absolutely unacceptable, I am for sure leaving for something else eventually. I can't even begin to describe how staying is not an option.
posted by Snacks at 2:17 PM on May 8, 2019 [2 favorites]


Yes, as above, please spend some time shadowing and if possible volunteering clinically. And I second that the forums at studentdoctor.net are invaluable as a resource to understand both whether and how to play the game, with the caveat that some of the most frequent posters are the worst sort of “gunner” med students and may provide a skewed perspective at times.
posted by killdevil at 2:21 PM on May 8, 2019 [1 favorite]


(This answer is US-specific.)

I wonder if we may be misunderstanding your comment about "lifestyle."

At least in U.S. pre-med circles, "lifestyle is important" is the usual euphemism for, I would like regular 9 to 5 hours, no on-call, minimal post-residency training, and a large paycheck. Traditionally, the lifestyle specialty is dermatology. If you're looking for lifestyle, OB-GYN isn't as tragicomic as, say, cardio-thoracic surgery, but it definitely raises eyebrows.

I would recommend more research into the lifestyle of an OB-GYN. I expect many practicing doctors will tell you the toll it takes on their relationships, their children, their everything-except-work. And that's after you've run the gauntlet of probably a post-bac, medical school, residency, and maybe a fellowship.

Also, I expect you'll have no trouble finding practicing doctors who would be delighted to tell you about the various ways in which their hands end up tied by billing guidelines, a stable living situation (or lack thereof), social services (or lack thereof), etc. Many are more troubled by concrete harm to specific people whom they've met than by theoretical harm to strangers; if you are like that, I think you'll find medicine more difficult on a day-to-day basis than software.
posted by meaty shoe puppet at 2:39 PM on May 8, 2019 [1 favorite]


And on non-preview, looks like I shouldn't have taken a nap in the middle of drafting my message. Given your clarification, I definitely don't think OB-GYN (or any kind of MD) will give you the lifestyle you want, at least not for the first 10-15 years.
posted by meaty shoe puppet at 2:49 PM on May 8, 2019 [3 favorites]


Best answer: I'm wondering if you might be happier being a physician assistant, rather than a physician. The training is a lot less grueling, and my sense is that PAs have better work-life balance than doctors do. PAs can work in OB-GYN. One nice thing about being a PA is that their training isn't specialized, so they can switch specialties mid-career if they want.
posted by ArbitraryAndCapricious at 5:10 PM on May 8, 2019 [1 favorite]


Another tally in the "consider something medical that is not an MD/DO" box.

Since you mentioned lifestyle, something to consider about medicine is that, once you become a doctor - that is, an MD or DO - you are never truly not "on call" unless you leave the country. You can say that you're going to ignore work-related calls, but it's not realistic, and you'll always feel compelled to answer them.

You're always "on" in some capacity as well - always held to a certain standard, whether by the general public, your coworkers, your patients, etc. Sometimes, I hesitate to go to the grocery store after a workout because, in case I run into a patient, I don't want to appear unprofessional.

When patients mistreat me or my staff at clinic, we cannot talk back, and we cannot lose our cool. We have to remain professional at all times.

There is also the fact that you'll be putting aside 10 years of your life to become a doctor. (2 years for pre-reqs, 4 years for med school -if you get in on the first try - and 4 years of residency, at least). You may have to move around for each step of the journey.

In OB/GYN, you'll also be pretty busy.

Medicine can be disillusioning for a lot of reasons. You have to make sure that you're doing it for the right reasons. Hint: "I want to help people!" is NOT a good reason.

I don't wish to dissuade you; I just want you to be aware of some of the less-pleasant realities of medicine. I wish I had understood these things going in. That said, I absolutely love my job.

If you still really like medicine but don't want to shoulder all the responsibility and the "permanently-on-call" aspect, then the PA route might be a good option. The total time in school/training is much less, and you're not fully independent, but you can go home and forget about work. You can also switch specialties relatively easily (i.e., without repeating a 4-year residency, as a doctor would have to do), as has been mentioned above, so if you don't like OB/GYN, you can try something else.
posted by aquamvidam at 12:15 AM on May 9, 2019 [2 favorites]


To clarify "lifestyle": it's unacceptable to me to go back to a life where I am permanently working 80+ hours a week and also on-call

Another physician saying you don’t want to do medicine then. Especially not ObGyn, that is probably the worst of all to pick for hours. Even worse than EM/trauma.
posted by tinkletown at 11:00 AM on May 9, 2019 [4 favorites]


« Older Is there such a thing as a "medical record"   |   North Bay Half-Day Trip Destination? Newer »
This thread is closed to new comments.