Is medical school worth it for women?

Surgical Ceramics by Beccy Ridsdel

Women who are really good at school think a great way to celebrate that is to go to medical school. People admire you! It’s great money! And there’s flexible hours for moms!

But this is what really happens to women who go into medicine: The majority will not work full-time after having children. And once that happens, their co-workers will treat them like crap and they will not make nearly enough money to put up with the stress of variable hours and disrespect.

Women physicians are mentally behind women in other professions. Instead of learning from women in other professions, female physicians think they they will have better outcomes because they worked so hard to control everything by:

  • Considering family planning when selecting a specialty
  • Specifically avoiding surgery, due to the lifestyle required of surgical trainees
  • Planning pregnancies around training stage and timing of specialty exams
  • Delaying childbearing despite age-related fertility pressure

But none of this matters because female doctors constantly underestimate the time constraints demanded by their profession.

Part-time schedules undermine the second spouse. The second spouse can’t stay home because there is not enough money. And that spouse cannot work full-time because full-time professional jobs — including full-time medical jobs — require full-time support at home. And women working full-time — especially doctors — don’t have that support.

Flexible hours disrupt family division of labor. When female doctors accept  flexible schedules or a shortened work week the high pay can’t make up for the disorder. An office provides stimulation, guidance, and a sense of belonging, and at home professionals establish clear divisions of family labor. But “family-friendly” policies blur boundaries and home becomes the place in which there is too much to do in too little time — especially for reduced-hour physicians.

Part-time is a mirage at high levels. Law firms famously offered top women the option to go part-time, cut their salaries in half, and the women kept working long hours. The corollary in medicine is women who have sub-specialties work more than forty hours a week  even when they are part-time.

People who are great at their work like to work full-time. Those who devote most of their time to work don’t want to work with people who are working part time. If someone makes work their highest priority why should they have to work with someone who does not make work their highest priority?

You might say that everyone should be working part-time in their work and part-time as parents. But a lot of people get pleasure from picking one thing and doing it really well. For example, full-time moms are way better at their job than part-time moms.

Quitting is healthier than going part-time. You, too, would be happier doing one thing well; when you work part-time and parent-part time you end up losing the identity you forged as a high performer at work and you create weak ties in the work arena and the parenting arena. Going part-time you don’t feel happiness from gaining flexility, you feel pain from losing the opportunity to be admired for doing something well.

Leaving work is a logical choice for women. Economist Claudia Goldin finds that from 1985 to 1995 only 30 percent of women who graduated college worked full-time when they had children. Since 1995, this group decreased their workforce participation.

This decrease in participation is due to an increase in social status. And the effect is worldwide.LH When women have more power they leave the workforce in favor of being at home.

Few men want to give necessary support for a full-time partner. Everyone has the option of working full-time and having children, but you must partner with someone who is capable and willing to stay at home full-time and provide the type of emotional and logistical support necessary for performing a high-paying full-time job. Few men are available because unlike women, men do not leave the workforce when they gain power.

If you care about money you should skip medical school. Remember how I told you that other professional women are decades ahead of you? Women applying to MBA programs understand that most will not be working full-time, and they understand the benefits of an MBA program are limited given their biological clock. Therefore women go to business school earlier than men, and schools have no choice but to accept women earlier or they won’t have any women.

Women applying to medical school should do the same sort of planning. If you don’t have a subspecialty you’re unlikely to work full-time after you have kids. If that’s the case, you’d be better off financially becoming a physician’s assistant instead of a doctor.

An MD is like a diamond ring — signifies a high-end passage to the next stage of life. As soon as women become the majority, salaries go down. Look at the legal profession. Women outnumbered men, salaries went down. The same pattern is already happening in medicine. Women are the majority of graduates, and in specialties where women dominate the pay rate plummets.

But there’s good news! Most women don’t go into medicine for the money. The money is nice, but you expect that you’ll have a spouse making money. Women go into medicine for the prestige. That’s why it’s so easy for them to plan from the outset to go part-time and not even crunch numbers to see if it’s worth it.

So maybe my first premise is wrong. No woman can make part-time work come out well. But doctors actually are different from the other women. Because a doctor holds on to the prestigious title no matter where she is, even if she stays home taking care of kids.

27 replies
  1. anon
    anon says:

    as an accountant, i can tell being a family doctor does not make enough money to buy a nice house and support a family in the city. they learn that within 3 years of graduating and then soon they try to start investing and get roped into bad deals because they are book smart only. their numbers don’t lie.

    in addition, wealth management sector target doctor professionals because they are an easy bunch to scare and they are cash flow consistent, you just have to kiss up their doctor title to make them feel important.

    Reply
  2. Logan
    Logan says:

    You have some interesting points, but mainly medical school is not worth going to in our current era because medical schools have a toxic workplace culture and teach you the wrong things- which is mainly phamacological based.

    Many doctors have to unlearn what they learned in medical school when they go into practice because they realise what they learn doesn’t work.

    IMO I think medical schools need to be revamped.

    Also there are interesting sectors regarding nanomedicine, polypeptides, light therapy and other innovative research, many emerging technologies are actively suppressed by pharma corporations. Since pharma corporations fund most of the research, all the research is focused on ineffective drugs and vaccines, those which make big bucks but add little value to human life.

    Once people enter medical school, many students become disillusioned. They spend their entire academic careers memorising answers for multiple choice tests matching drugs with various conditions and can hardly think outside the box in treatment.

    That’s why medical school is mainly a waste of time….! Hopefully a new medical school model will be developed by innovative thinkers. America is not the place for medical innovation.

    Reply
  3. Bostonian
    Bostonian says:

    My wife’s best friend is an MD. And yes, she is divorced. I blame her ex-husband, who couldn’t wrap his head around what he needed to do to be a good dad and husband to her, despite my encouragements. So he ran off to marry a less ambitious woman.

    That said, it’s entirely possible he would have divorced her if he were the breadwinner in their marriage, and that would have left her in a far worse situation. I won’t be surprised if he divorces his current wife in a few years, when she gets too demanding, because divorcing once increases the odds you’ll divorce again. I think that being left in middle age without a career must be far worse.

    My wife’s friend, having made what PT characterizes as a mistake, still has her career, and thus her house, her daughter, her lifestyle, her vacations, etc. And she has a young, eager new boyfriend who has no problem doing what he can to support her emotionally and logistically.

    I tend to think there’s not a surfeit of female MDs, but a shortage of good men.

    Reply
    • Penelope Trunk
      Penelope Trunk says:

      Great, your wife’s friend got everything she wants. She got a great job and someone else to parent her kid. And she got rid of the dad and picked someone new and more fun. That’s so great for her. Except that she’s the grown up and her first job was to take care of the kid, not make things great for herself. It seems that the mom’s favorite child in the family is the mom.

      Penelope

      Reply
      • Bostonian
        Bostonian says:

        PT, sometimes it seems like most of your philosophy just boils down sour grapes.

        The ex-husband ran off because he is a narcissist and couldn’t stand that everything wasn’t about him. The MD is a great mother, who is still recovering from the narcissist’s abandonment. Belittling her is remarkably unbecoming.

        Life is full of paths not taken. The other people who took those paths aren’t all lesser than we are because of it. Insisting they must be is juvenile.

        Reply
        • Ginger C
          Ginger C says:

          I know that PT is being harsh here, and I know from personal experience that it’s hard to take. But I don’t think PT views the doctor as “lesser than we are”. She’s just as hard on all of us, herself included.

          It sounds to me like the doctor has constructed a pretty good life and her child is going to come out okay, especially compared to how most U.S. kids are turning out. But, PT is not interested in making us feel good about our choices. She wants to be clear-eyed and to communicate clearly about what the *best* choices are. Under all the harshness, PT is simply pointing out that the child cannot be getting enough time and attention from her parents given the kind of parenting PT advocates for on this blog.

          That said, I want to emphasize that very few of us can or want to raise our children in the ideal circumstances PT presents. I say “want to”, knowing that, for many of us, it doesn’t feel like a “choice”. We live in a society that doesn’t value children and where we are largely on our own and need to earn a lot of money to buy the support networks and opportunities our children need. The deck is stacked against us. I’m doing the best that I can. This doctor is doing the best that she can. PT is doing the best that she can. Yet none of us have done what is absolutely best for our children. However, I still want to read about what is absolutely best. That is important. PT cannot deviate away from the message just to make us feel good. (But I worry that if she doesn’t take the edge off the harshness a little bit, she may lose readership!)

          Reply
  4. Vanessa
    Vanessa says:

    I have a family member who is an orthopedic surgeon. She works long hours. She’s only having one kid and I think (just guessing) it’s because she knows how busy she is. Her husband has a “full-time” job in IT that seems more like 30 hours/ week. She makes very good money though and her daughter will go to all the best schools and she’ll be able to support her in adulthood without compromising retirement.

    I know a cancer surgeon. Her husband stays home. She seems so miserable to me. She works full time and she simply does not have enough home support from him for her to get time to relax. It seems like she carries a heavy load at home too. Plus, she is not saving enough for retirement. I think if you get a hard-working house husband, this could be different. I just know so many women who’s husbands stay home and then they get home and have to cook and clean.

    Also, med school/ the med school path often- not always- makes women socially inept (chicken or egg right?). Women should take a break between college and med school to get some social skills, fertility be damned. Freeze your eggs. Women want to be happy but often these MDs can’t even connect with others even if they try. And it’s so hard to be happy without social connections. Keep in mind I work with a lot of surgeons so I’m speaking mostly of surgeons.

    The happiest female MDs/ DOs I know are the ones who married surgeons/ very high income men ($300,000 and up) and so they can stay home part-time and dabble in medicine and not even worry about taking a job with benefits.

    As prestigious as medicine can seem, there are so many stressors in the field. Just read up on the issue of prescribing opioids alone. If you don’t prescribe enough you can be sued for inadequately controlling a patients pain, but prescribe too much and you’re responsible for their addiction/overdose. Drug interactions abound and patients have to change physicians. EMR and legal requirements for records also increases the stress. Also, continuing education, license renewal exams, hospital credentialing and maintaining certifications demands so much time and none of that is paid.

    If my daughter wanted to be an MD I would strongly encourage her to shadow a few a few weeks each even if it takes a whole summer. Medicine is often your whole life once you go into it.

    Reply
    • Penelope Trunk
      Penelope Trunk says:

      I really appreciate your comment because you’ve give great concrete examples of how women do their lives, but most importantly you give an example of how women think about how women (you in this case) evaluate what they see in other women.

      You said something that’s really dangerous: “She makes very good money though and her daughter will go to all the best schools and she’ll be able to support her in adulthood without compromising retirement.”

      You make the huge assumptions that the husband will want to keep working 30 hours and take care of the daughter. But it’s impossible to do that. No woman can do it so why would a man be able to do it? And you make the assumption that the couple will stay married even though there doesn’t seem to be anyone making the marriage a priority. And you make the assumption that the woman will continue with the status quo even after she realizes she is left out of the family dynamic because she’s never home, and she’s left out of the work dynamic because it’s all men.

      Penelope

      Reply
    • Jenn
      Jenn says:

      I like ur comment about social skills. It minds me of the line in. Patch Adams: you treat a disease you win you lose you treat a patient you win

      Reply
  5. Ally
    Ally says:

    I work as an after school driver for a couple who are both full time doctors. They have one child and I think the only way this works is because they have a full time live in nanny, an elderly Indian woman from their home country, who also cooks for them. One time the mom invited me to their house during the holidays to sample some traditional Indian dishes. The nanny was on break and the mom seemed completely overwhelmed by her own child. Obviously doesn’t spend much time with her. I think it’s strange when both people in a couple have intense careers, but then also decide to have a child. All their extra income goes to a kid they hardly even see. What’s the point?

    Reply
  6. Stephanie Thomas Berry
    Stephanie Thomas Berry says:

    Hmmm. The female doctors I know went into medicine because they wanted to help others. I wonder why that isn’t figured into your equation? And the fact of the matter is, we need women in health care because of their superior listening skills and feminine intelligence.

    Of the extraordinarily small sample size labeled “female doctors I know”, one is a cardiologist who has a baby-man for an ex-husband and twins she had when she was 47. She’s exhausted but happy. Another is married to a doctor; they have a family practice together in my small rural town and one child. My observation is that they are happy and make enough money to live a beautiful life with their blended family of 2 adult kids and one child together. The third is in the same town, but she left her practice perhaps for reasons described in this post–two full-time parents with three children can’t meet the needs of the children. So she became a full-time mom.

    I think what real-life success boils down to is relationships. Quite simply, if you suck at relationships, you are not going to be happy. If you are a woman with a baby-man for a husband/partner, you are not going to be happy. So many women have baby-man partners. And considering the infuriating stat that wages plummet as more women enter a specific profession, isn’t that just more evidence that one of the real problems is the dynamics of a culture shifting from patriarchy to egalitarianism?

    Reply
    • Penelope Trunk
      Penelope Trunk says:

      The fact that women are beneficial to medicine is irrelevant. We are not reorganizing the whole economy here. We are not fixing capitalism.

      So I’m going to address what you do focus on: being rude about men.If someone were so belittling to women on this blog as you are to men in your comment, there would be outrage. So I am providing the outrage. In your equation of egalitarianism the kids get nothing. That doesn’t sound very egalitarian. You do not take into account the data (that I linked to) that shows that in the case of upper middle-class families the second career hurts the kids. You need a new definition of egalitarianism that takes children into account. You might start by considering that things cannot be equal in families. Instead people can be equally cared for and loved.

      And while you’re thinking of a new definition, keep in mind that no matter what the circumstances are of the parents’ divorce, talking shit about one parent hurts the kids. So you may as well just quit it with your slurs. You are not helping anyone.

      Penelope

      Reply
      • Jane
        Jane says:

        Oh for Pete’s sake, Penelope.

        You’re not always right.

        Some men act like babies, therefore baby-making would be an apt descriptor.

        Baby-man is not a ‘slur’, it’s a descriptor.

        Come to your comments receptive, not defensive.

        Reply
  7. Roxana
    Roxana says:

    Maybe I am lucky. I am a doctor, worked like crazy some years, bought 3 apartments and rented them, found my husband who is an engineer, conviced him to buy his own house and suport me financially for 2years so I could stay home with our baby, learned to cook, clean very fast, because outside help was unreliable, and now i returned to my 40h/wk and I will take days off when the baby will get sick. We decided to have jobs, not careers, so we will not be in the top financially. Would I would choose a different career? No, because i loved medical school and work is really interesting. My first husband was/is a doctor and we were great intelectually, but not for familly related issues. Maybe it’s about people’s expectation, not professions.

    Reply
    • Penelope Trunk
      Penelope Trunk says:

      No, you are not lucky. Did you read none of the post? The whole point is that you cannot work 40 hours a week and take care of a child. Someone has to take care of your child. When your kid is old enough to tell you staying home with a nanny sucks you will stay home. Because all the other parents in your social strata have a parent at home. You are the same as everyone else. Though you might be more smug than most.

      Penelope

      Reply
      • Roxana
        Roxana says:

        I have no nanny, just a good private kingergarden. But 40h/wk feel like a part-time job from 80h/wk, so when i am home, i can be present. And the kid needs his own peer group; i did enough stay at home for his first 2yrs. In this profession i can do both, so i feel lucky. In a weird way, i apreciate that you consider me a smug, being proud is better than complaining, therefore a depressiv/anxios woman. But i am not in US, so i may not have a correct understanding on why we cannot have it both, especially now when there is an international shortage of doctors and we can negociate everything.

        Reply
        • Penelope Trunk
          Penelope Trunk says:

          Kids do not care if you are fulltime or part time. Kids don’t care if you are doing quality time. Kids want to know why going to work is a higher priority than being home with them. You don’t NEED to work. You are working because being home with your kid is boring. So you’re outsourcing parenting to someone else, who also thinks being home with your kid is boring so they need to be paid for it.

          The reason that research shows that parents who are upper middle class and have two fulltime jobs do damage to their kids is because the message to their kids is that we don’t need the money but staying home with kids is not interesting enough for me. As in, a kid’s job is to keep a parent interested.

          Penelope

          Reply
          • Roxana
            Roxana says:

            I am outsorcing education and peer group, not parenting. I would have become a stay at home mom, if education was not important or i could easily do it myself. But i can’t so i let the professional do it better than me. On the personal thing, trauma or not, i want to live an interesting life.

        • Katie
          Katie says:

          Hi Roxanna, I think you are correct that this might be a view limited to the US where they have terrible schools, and people work mega hours. I think it’s hard to do life there and so they think it’s the same elsewhere.
          It IS hard to do life everywhere…but not US level hard.
          Your private kindergarten may be excellent and your child could be surrounded by community where you are.
          But Penelope makes a point, kids under school age do notice our absence and do care. No matter how wonderful the childcare situation. There is no such thing as quality time to a 2 year old.
          Doctors always justify going back to work, they think they are saving the planet, most of what they do is handing out antibiotics and antidepressants. Doctors go back for the prestige not for the job.

          Reply
  8. Katie
    Katie says:

    I wonder if this is true outside of the US. I’m in Australia, I have many ‘mum’ doctor friends, they nearly all work part-time. They are all wealthy, and wild horses couldn’t drag them from the days they have at work. It seems a good life. It’s definitely good money.
    I know that anesthetists here are on half a million (full time) per year in many cases. I know this because I work in financial advice and we see everyone’s salaries. They move here from the UK in droves for that reason alone. It’s a pretty good part-time specialty for a mum. The lowest paid doctors are GPs and in their case a full-time equivalent salary (equal to high paid exec) can easily be earned in 3 work days. So I’m told. Pretty ok for the lowest paid role in your profession.
    I wish I’d done medicine!

    Reply
  9. Anonymous
    Anonymous says:

    Where do we find the financial resources to support women and children when male breadwinners die, divorce, financially abandon, become disabled and less able to win bread, choose careers that yield less bread? Are vulnerable women happier? Are professional workspaces misogynistic and hostile to all women whether full time, part time, patients? When did intensive parenting performed by mothers become normalized? Should we grow babies in artificial external uteruses and contract their early childhoods to professional caregivers? Do all mothers provide superior care to children, but not alcoholics, mentally ill, criminal, abusive, victims of abuse, drug addicts? For the majority of women who are not at least upper middle class, what happens to their children as adults? Should we stop letting women learn to read and study non-domestic topics? Refocus on the domestic sphere! What could go wrong?

    Reply

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