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.

Most frequently unspoken thought while talking to a therapist: Just fucking tell me what to do! A good therapist is a sounding board but a good career coach tells you your best career path. The best career coaches know the right answers because they see patterns, and autistic people are the best at seeing patterns. That’s right. When you look for a career coach, look for someone autistic. Read more

I spend half my life trying to not offend people. My safe space is the comments section here on my blog where the only social rule is: be interesting. I’m especially grateful to people who disagree with me; it’s out of control for me to chase someone around arguing with them in person, but in the comments people think: She’s so responsive! Read more

I hate them because they are so judgy. As an ENTJ I am too uncaring to spend time passing judgment on INFJs. But there’s a hierarchy of influences on our personality and autism trumps personality type, so as an autistic ENTJ I spend a lot of time expressing my knowledge about INFJs being judgy, and then I can understand how INFJs say they aren’t judgy they are just saying what they notice. Read more

We have mice. We have had mice for a really long time and I tell myself things like every apartment in every big city has mice, but I’m not really sure if that’s true.

And also I think maybe I’m too old to live with mice. I mean, I’m definitely too old to be writing about having mice and maybe I’m even too old to even be having a blog except that only old people have blogs now which ends up being sort of comforting. I mean, at least I’m not too old to have a blog.

The last straw with the mice was not that my older son said he wouldn’t come home from college for Thanksgiving because the mice were too gross. I didn’t really believe he would have come home even without the mice. He’s too sick of us.

The last straw with the mice was when I had an in-person meeting for my startup and I was so excited because I am way higher functioning when I have a startup because I don’t know how to have friends unless I am working with them. And a mouse ran over one of the women’s feet and she screamed and we just stood there. We are so used to the mice we couldn’t even pretend to be shocked. I said, “Oh, yeah. We have mice.” Both women looked horrified, and then my younger son looked horrified, and I wanted to look like a good mom so I said, “We are really upset about the mice so we’re moving out soon.”

My son looked so relieved that I started actually looking for apartments.

Then I had this idea that everyone works remote now so I’m never going to get people to work in person unless it’s really fun to be in person. I had this idea that the future of work is that the workplace is a destination. Well, first I found a townhouse that was so so beautiful and then I had this idea. Like people could pay to stay with us for workshops or host offsites. I came up with a million ideas to find one that would justify living there and having the company pay.

But mostly I just fell in love with the townhouse. It hadn’t been lived in for fifty years. The owner bought it when the area was the Combat Zone. Uninhabitable. He only refurbished it recently, after the area has gentrified. We would be the first to live there again. Most of it is original from the turn of the century. And it’s furnished. Here are pictures.

I told the agent my company was leasing. He said the landlord has turned down a lot of tenants. I ignored that. I pleaded. I actually raised another $50K so we could put it in escrow to hold the place. The agent told me he checked my credit and he said nothing came up. “Do you have another name?” he asked.

I told him, “Yeah, remember, I gave you my other name.”

“No, I mean another besides your other name?”

“Just Adrienne and Penelope. That’s it. But I don’t have any credit so I guess I don’t have a credit report.”

Everyone writes about how startup founders are different because they’re relentless. I told myself to just be relentless.

So then we tried the company as a cosigner. Then an investor as a cosigner. A cofounder as a cosigner. We did everything. We did so much paperwork that it took three weeks. At the end of three weeks they said it was all set, and the landlord said okay. The agent took their fee, and I started packing.

I packed quickly. It was just down the street so I figured we could move the fragile stuff ourselves. I didn’t want to pay for packing materials so I used all our clothes to wrap the dishes. My younger son asked me where all his shirts went. I bought him two new shirts at Target and had them delivered by Shipt and told him he doesn’t need anymore shirts right now because we’re moving.

That was four weeks ago. Our stuff has been packed for a month. I am so sick of looking at those two shirts.

Then we got the lease and it said there is no heating system. My brother told me about the Governor of Illinois buying a mansion and pulling out the toilets so it’s uninhabitable and then he doesn’t have to pay property taxes. “Maybe that’s what your townhouse guy is doing,” my brother said.

Maybe. But then why is it still for rent? And what about the agent? The agent must know that they are showing people an apartment with no heating system. Is that fraud? I don’t even know. I mean, obviously I know nothing about renting anywhere because here I am, back with the mice. The mice are suddenly looking great.

I breathed such a sigh of relief when I signed the papers to launch the new company. I like being tied to other people. I like that people have to help me if I am in business with them. I can’t seem to do it in my personal life so I need to do it in my work life. It feels so lonely otherwise.

The thing that makes me relentless is that I can live without clothes or plates or books or other things. That’s easy for me. But it’s hard for me to live without a startup.

Online business from hell: child trafficking in video games.

Artist: Li Songsong

This is how trafficking happens online. Often the system is so efficient that it never has to change to in-person.

Trigger warning.
Read more

In my courses about personality type, INFJs ask the most questions. ENTJs ask the fewest questions.

The only type less fun than an INTJ is an ISTJ. So if an INTJ wants to look fun they need to marry an ISTJ.

ENFJs were the nicest about me being late to every webinar and they were the type most likely to book a one-on-one coaching session after the course. Read more

Z has to practice his cello. But he just wants to talk about how he can’t practice. I’m like, “Just fucking practice, just pick up the cello and practice. You can’t do anything until you practice.”

I’ve been writing about my life with my kids for twenty years, but how can I keep doing it when he tells me he can’t practice because he can’t hear? It’s not interesting to read about someone else’s kids unless it’s about conflict. But this is not a conflict. Because Z thinks his whole life is over. That’s like the conflict of is there a God or is there not? It’s such a big conflict that it’s an absurd thing to write about. Read more

The Bureau of Labor says that by 2026 we will be short 1.2 million engineers. Right now, the majority of developers are men. So presumably it’s a crisis that women are not in STEM.

Microsoft is thinking that filling the funnel with girls is the way forward. Microsoft decides the Wonder Woman movie has a female protagonist, so girls will identify with her. And Microsoft announces it will solve this engineering shortfall with Wonder Woman. Coding lessons for girls! Turn your tech skills into superpowers!

But the majority of people who saw the Wonder Woman movie were male. And, the majority of those viewers were ages 25-44. So Microsoft targeted girls who want to code with a character from a movie only 2% of girls saw.

Which is because it’s likely based on a porn fantasy. But whatever, as a gimmick for coding, Wonder Woman was a huge failure. Luckily we don’t need Microsoft to encourage girls to write code because girls do as well as boys in grade-school coding classes. And girls do as well as boys in computer science courses in college, but girls don’t stay in the major. They don’t like it.

A study from Accenture shows why: girls aren’t interested in the abstraction. “The content of coding projects is typically less engaging for girls, who often prefer health and real-world problem-solving challenges.”

This study is consistent with a study that asked Harvard Business School students what motivated them, and what was the best part of their work experience. Male students were more likely to say they were motivated by competition and female students were more likely to say they were motivated by collaboration.

Stuart Reges teaches computer science at University of Washington and he shows that women and men coded at the same rate until the 80s, when women began to have other professional opportunities. Now, Reges says that after decades of all sorts of initiatives, women are no more than 20% of tech workers in any country, even in societies with otherwise remarkable gender equity.

Finally, research also shows that the less power a woman has in society, the more likely she is to choose STEM. So instead of assuming girls are oppressed and therefore do not code, why not assume girls use their power to choose not to code?

Jacquelynne Eccles found that women primarily choose non-STEM careers because they have strengths that men often lack. Eccles found that if someone has high math skills and only moderate verbal skills, the person will choose a career in STEM. However if they have high math skills and high verbal skills, the person will choose a non-STEM career. Female math students were of course more likely to be in the group with high verbal skills. Eccles concludes that women who are good at math shift away from STEM because they have so many more career opportunities than men who are good at math.

Encouraging women to go into STEM is a waste of money. Any woman who wants to can study STEM. No one is stopping women. Women are choosing not to. So stop trying to get more women to go into STEM and just leave the women alone.

What we do need from the world is marketing that gives girls credit for making good choices. The real superheroes are the ones actually listening to girls, instead of telling girls that their goals aren’t the right ones.

My son Z started getting crazy from the pandemic around the fall of 2021. He’d made very few friends in Boston before Covid, and the friends he did make from music lessons stopped coming to Boston from the suburbs. And he couldn’t really meet new kids, because Covid. Read more