Did you or DH go to medical school in ISRAEL?

amother

Seafoam

Wed, May 27 2015, 10:58 pm

I am not sure if you are talking about something other than this, but this is so far the best I've found (PPACA is just a longer name for the affordable care act and I'm not finding anything about medical school loans in that, unless I'm still looking wrong?) https://www.aamc.org/advocacy/......html and it doesn't seem THAT promising. I mean, you could do worse but it doesn't nearly cover the cost of medical school. There's a public service for 10 years that is capped at $57k, and an areas of national need that is UP TO $10,000 which considering the cost of medical school is a drop in the bucket.

So if there really is a magic unicorn that will pay back the full cost of medical school, my DH would love to know about it. Until then I still want to say there is just no way this is going to happen, much as I see how great it would be for him. Between the time and the money and the stress, I just can't see it. What

bradybunch

Wed, May 27 2015, 11:17 pm

I did not go to medical school in Israel and know little about it aside from the fact that a college friend went to Sackler. But I can comment on some other things.

First, with reference to the above post regarding "free medical education" or loan forgiveness -- the only way to get a free medical education in the US is military. Many people do choose that route but of course it comes with the commitment to active duty military service. As far as I'm aware, the majority of "loan forgiveness" programs are unavailable these days.

Theoretically, the current working program will allow students who work in the public sector (work for a non-profit) for ten years while repaying loans continuously to forgive all loans at the end of ten years. Fortunately pretty much all hospitals are non-profits; it doesn't apply to residents who go into private practice following residency. Nobody has actually had their loans forgiven via this program as of yet, and everybody remains skeptical. It is really most people's only hope right now, though. (One often unrecognized benefit to the Public Service Loan Forgiveness plan is that the forgiven loans are not counted as income on that year's tax return, as is the case in many other loan forgiveness programs; the resulting tax bill would be prohibitive to almost anybody!) Oh, this applies only to the basic federal loans which most people use for med school. If you have to take out any private loans they aren't included.

The interest rate on academic loans right now is very high.

One thing I see that concerns me is the desire to find an "easier" medical school route. Medical school is not easy (would you want it to be, to train your doctors?), but more than that, residency is much harder. Even most medical students don't realize what residency is truly going to entail on a practical level. This is a very serious commitment of both time and finances. Residents in the US generally make about $50-55k per year while working 70-80 hours per week. Loan payments need to be factored in when considering finances, as well.

I wouldn't want to discourage somebody from pursuing a dream, because I think that some people really do need to pursue certain careers in order to feel fulfilled. But this is not a decision to be taken lightly and it means sacrifice on the part of both spouses, especially when you have children already.

Last edited by bradybunch on Wed, May 27 2015, 11:22 pm; edited 1 time in total

amother

Seafoam

Thu, May 28 2015, 12:02 am

BradyBunch, thank you for the information and clarification.

Yes, I am fully aware that medical school and residency are not "easier" anywhere; I'm looking for just enough "easier" to downgrade it from "impossible" to "survivable." What we have here is a DH who truly seems to feel that becoming a doctor is the only way he will find fulfillment in life (at first I was skeptical but now that he has explored other avenues more responsibly and is coming to the same conclusion from a more experienced place, I'm hearing it clearer) while the DW is seriously terrified based on reports from imamother and elsewhere that I will have to function as basically a single mother for 8 years (that is, raise our kids from 5, 3, and 0 to 13, 11, and 8, while dad shows up for naps every few days) in addition to possibly living out the rest of our lives or something like that up to our necks in debt with maybe 10 years to catch up on it in time to marry off the kids. The whole thing just seems completely crazy to me but DH can't see any other future and it is tearing us both apart (not apart from each other, B"H, but tearing us each up inside as we are so conflicted about this) So if there is any way to make this happen without killing us, I am desperate to find out. I am willing to invest a lot in helping DH achieve this, but from what I hear it sounds like it is just beyond my capacity no matter how much I'd like to do it. I'm not a superwoman type. I can't manage the family alone, and I'll have to also contribute to the income, and it will just be too much.

amother

Vermilion

Thu, May 28 2015, 7:21 am

amother wrote:

I am the Poster on your other thread who wrote the whole long Megillah about why you shouldn't do it. Israel might be a bit easier (I am not at all familiar with it however) but as you said, it's never easy. All the things you wrote are true. I am so upset with your husband for doing this to you. It's just too late. Bottom line, it's too late. And moving to another country? Maybe on the med school front it would work, but what about you and the kids? And the very least, you finding a job? Getting used to a new country and culture and language? I am sorry for your husband that this is what he feels like is the "only thing that will complete him" but sorry dude. Life doesn't work that way. I'm a mom in the trenches and he doesn't get to do this with an unwilling wife. As I said before, I was a "willing wife" and it's still incredibly hard for me.

Your husband needs to get his act together and stop making his entire family jump through hoops for his one year old "life's dream".

amother

Seafoam

Thu, May 28 2015, 11:08 pm

I appreciate your input about what being a med school wife entails. The judgment is a little harsh, though. First of all, moving to a different country is something we wanted to do anyway for idealistic reasons as well as believing it will be a good fit for where we want to raise our family. We need to move somewhere anyway because we are currently in NY and it is too expensive and not a great fit for us. He is not "doing this to me," we are working on figuring it out together. He is not going to do it without my consent, and for a while he pursued other avenues because of my insistence. We have come a long way since the beginning of my first thread on this topic. He has his act a lot more together, as you put it. At the beginning I felt that it was not so real, but now the situation has changed - he has more experience both in academics, in life/profession, and in talking to people from different fields and programs and exploring both himself and his professional options. I now trust him a lot more when he says becoming a doctor is the right choice for him. I believe it now. At the beginning I did not.

However, believing that he can and should be a doctor doesn't give me the strength and wherewithal to make it happen. I have a lot of fears about this. Money is a big one. Time together is a big one. Wanting to move on with life and not be a student anymore is one, but not such a big one because I guess in the scheme of life 4 years is not that long even though I'm already tired of it. Residency schedule scares me. The 8-year commitment scares me, I prefer things that can be taken in smaller pieces, here I feel like if I say OK now then what happens if after a couple of years I feel I'm breaking down? That would be pretty tragic. I'd feel stuck.

bradybunch

Fri, May 29 2015, 1:33 am

I think you are approaching this very rationally. Has your DH considered PA school? I don't generally have the best opinion of that route (but as a doctor I'm biased). but I think it seems like something to seriously consider in your situation. The school itself is shorter, and there isn't residency to deal with. He would need some sort of clinical experience to get accepted, but that can be accomplished in many ways, and after 3ish years he would be done and able to get a pretty good job.

If he really feels like he needs to pursue the MD (and believe me, that is something I completely understand because I've been there), first he will have to get accepted. Does he have plans for the MCAT? How much college does he have left? If you want to PM me directly with more specifics I'm happy to share what I know, though I would assume your DH has a career counselor of some kind who can help him figure out his chances of getting accepted.

Assuming he does get accepted to med school, here's the honest truth about what it all entails: the first two years will not be a problem for your family. He will have classes and other various things, and he will have to study a lot, but managed well it's just like having a full-time job and not more. You and your children will see plenty of him. Third year is much more of a time commitment, depending on the clinical rotation; some are "easier" than others (if you are defining ease based on amount of time spent in the hospital). How student duties work varies by school; for me, surgery and OB/GYN were the two that involved me going in earliest (as early as 4:45 am at times), but internal medicine and pediatrics were almost as much time commitment because I generally had to stay later...except for overnight surgery call, which would have me in the hospital for 30ish hours at a time. Anyway, it's a lot, but often punctuated by less intense rotations like psychiatry or family medicine. Fourth year is in between -- sometimes it's intense, and other times there's almost nothing to do.

Residency is when the schedule really gets rough, and that depends a LOT on choice of specialty. I don't know if your DH has any idea what type of medicine he'd like to pursue, but in general surgery residencies involve the most time commitment, followed by internal medicine and pediatrics, followed by family medicine and psychiatry, with emergency medicine somewhere in there, followed by radiology and pathology. I went to medical school thinking I'd probably become a pediatrician, loved all of school and all of my rotations, and chose pathology largely because of the lifestyle. Psychiatry, pathology, and radiology are all pretty family-friendly. That said, on my harder months I average 60-70 hours a week, and have worked as many as 92 hours in a week. That's about as easy a schedule as any resident, anywhere, has. People in surgery are doing 80 hours a week in general, and internal medicine and pediatrics 70-80 on inpatient rotations (with months in the clinic being a bit less). Oh, and one of the flip sides for pathology is I'm responsible for a LOT of reading at home, a lot of presentation preparation and little things like that which actually mean I work more than my duty hours suggest.

I left med school with $250k in debt, but qualify for an income-based repayment plan which makes my monthly payment completely affordable. Most residents these days make about $50-55k. I have financial hardship because of my family, so my repayment is capped pretty low. I'm praying that the Public Service Loan Forgiveness pans out.

So that's my two cents. It can definitely be done, it's just really hard. I for sure would spend a lot of time thinking very hard about PA school. That said, I was a single (widowed) mother of 3 little boys for my first three years (only possible thanks to a huge commitment by my parents), then remarried and in the process inherited three full-time stepchildren. So right now I'm a mother of 6, two of whom have special needs (one is autistic), my husband commutes to a different state for the whole week for one whole semester each year (he's a professor) and also travels for work (he's currently out of the country for a month), and I'm a resident. So I figure if I can do it, albeit not without a great deal of stress and occasional episodes of thinking I'm too overwhelmed to go on, I think your family could certainly make it work. Just as long as you're going into it with your eyes wide open.

(By the way, I was 28 when I started med school.)

amother

Seafoam

Fri, May 29 2015, 2:19 am

Brady, I did not realize you were actually a doctor. Thank you for sharing your experience.

Your story about getting through medical school and residency as a single mom and then special-needs stepmom sounds frankly superhuman. I know people do these things but I am really not a superwoman type. I am afraid. My life is actually pretty cushy, I work family-friendly hours, currently DH is able to help a bunch, I have helpful local parents (we can't afford to stay local any way we figure it, though) and yet I still often feel overwhelmed and have a hard time juggling/balancing/keeping track of everything that needs to happen around here, the house is always a mess, I'm forever re-learning how to parent, you get the idea. My husband's presence and support - not chores, the "being there" part - is very important to me. I feel it's important for the kids to have an involved father. So they can have one for two years, part of the next 2 years, and almost none of the next 4 years? Still sounds painful to me.

I have been trying to push for PA. I feel that you can do a lot of the same things and make a very good income after a much smaller investment, so even if it's a step down in prestige/income/opportunity, it seems worth it to me. However DH feels more like you. He says he is pulled to be a doctor and could never be satisfied as a PA. I would love to hear from your perspective on that. I'm sure you've worked with a lot of PAs and can help clarify to what extent that is true. (Plus, due to less prerequisites, he could have theoretically started PA school already and been done in just a year and a half or so from now. Medical school he couldn't even start for another year even if he does get in on his first round of applications, because he hasn't finished the prerequisites yet and hasn't taken the MCAT yet) If you can help me "get" why he "needs" to pursue the MD rather than PA, it might help my shalom bayis a little, even though it won't really solve this dilemma! I get that there's a difference, it's just that the practical considerations are SOOOOO strong in my view that it totally outweighs the feelingsy stuff that I don't fully understand.

He plans to be finished college by the end of the summer and take the MCAT soon after. He does NOT have a good career counselor because the one in his college seems to be somewhat of a loser and we haven't figured out how to find a better one.

Regarding specialty, he says he does not want to go into general medicine or pediatrics. Pathology is a possibility though I hate the sound of all your homework. (One of the reasons he wanted to become a PA initially (changed to dr later) was because he said you don't have stress or homework, you do your stuff and then you come home and can learn or whatever.) I don't think psychiatry is an option, I know it's medical/scientific but my personal feeling is that you need to be tuned into your patients' psychology and DH is not really that type. Radiology is something he mentioned as being "friendly" but frankly I don't see how reading people's scans and such is worth all that investment! You're telling me being the MD who interprets these things is that much more fulfilling than being the PA who provides direct care all day? 8 years and $300,000 worth of more fulfilling? Please! What does residency and career outlook look like for specialties like cardiology, oncology, endocrinology, stuff like that? I could see something like that having appeal for him.

$50-55k for 80-hour workweeks after going into 6-digit debt to get there is frankly insulting. You can make $50k as a teacher in 40 hours a week with summer vacation. (disclaimer: I *AM* a teacher, I *KNOW* we work hard and do a lot at home and blablabla) And I'm going to assume it's significantly less in the holy land of lower tuition (and no idea what loan terms are like there either)

Anyway, do tell me more please, especially about the relative differences between PA and MD.

amother

Vermilion

Fri, May 29 2015, 8:51 am

OP, I am the two-above amother - I see my name is “Vermilion”, lol.

I’m not sure what to really say anymore. It’s really really amazing of you to even consider this as seriously as you are. Clearly, you and your husband are both trying to make this work within the bounds of a working, loving marriage.

However, I stand by my opinion. BradyBunch makes some excellent points - and WOW, you are a SUPER WOMAN! But again, BB is on the other side of the equation - the DOING, not the SUPPORTING. Those sides are very, very different. As I’ve said before, at the end of the day, the doctor comes home with a feeling of accomplishment and satisfaction, that all their hard work was worth it. The support spouse is pretty much left to…well, support. In many forms. Some of which are pretty frustrating, tedious, and exhausting.

You yourself keep saying over and over that you don’t feel like you can be “supermom”, that you have a lot of support right now you don’t want to give up; your husband “being there for you” is very important to you; money-wise, you’re not sure you can make it work. People “in the life” keep saying - it’s all those things and more. What else can we say? Your fears are not unfounded. All the things you dread will happen tenfold. I mean, it’s all true. And living in it is even harder than saying it or writing it out.

I am very happy with my choices, but the key thing is, *I was prepared for them*. I took this on when my DH and I got engaged. It wasn’t sprung on me after 10 years of marriage and 3 kids. And while I didn’t really fully grasp what I was in for, it was part and parcel of marrying my husband, and so we make it work. Honestly, if I was in the same situation as you and had the same fears and limitations as you feel you do, I would be just as resistant. Much respect to you, btw, for being honest about what you feel you can handle. That's really important.

PA is a wonderful, wonderful alternative. I cannot stress how much my husband has told many, many men like your husband to pursue PA instead of an MD. And honestly, it’s your husband’s ego talking when he says, “MD or bust!” Because it’s not just about him anymore. That’s what’s bothering me so much about this whole thing - I don’t think he realizes (or maybe cares?) what he’ll be putting you and his family through, and to not consider a VERY VIABLE alternative like PA is foolish and selfish.

My husband has offered to talk to your husband, if he’s interested. Let me know.

So anyway, I think I’ve said all I can. OP, you keep going in circles. I say, bite the bullet already. Everything you’re scared of will happen. It’s really up to you to decide how much you’re willing to do it anyway. But I think you would be making a mistake.

JAWSCIENCE

Fri, May 29 2015, 12:17 pm

amother wrote:

Regarding specialty, he says he does not want to go into general medicine or pediatrics. Pathology is a possibility though I hate the sound of all your homework. (One of the reasons he wanted to become a PA initially (changed to dr later) was because he said you don't have stress or homework, you do your stuff and then you come home and can learn or whatever.) I don't think psychiatry is an option, I know it's medical/scientific but my personal feeling is that you need to be tuned into your patients' psychology and DH is not really that type. Radiology is something he mentioned as being "friendly" but frankly I don't see how reading people's scans and such is worth all that investment! You're telling me being the MD who interprets these things is that much more fulfilling than being the PA who provides direct care all day? 8 years and $300,000 worth of more fulfilling? Please! What does residency and career outlook look like for specialties like cardiology, oncology, endocrinology, stuff like that? I could see something like that having appeal for him.

I went in to med school saying I was going to be a pathologist and med/surg had zero interest to me. I fell in love with pediatrics. One of my classmates was gung-ho about being a neurosurgeon and low and behold he is now a pathologist. Many, many people are surprised by what they fall in love with and find fulfilling. So you really have to go in prepared for choice of residency to be anything, even if it seems unlikely.

You should definitely know that many specialties require 3 years of medicine before specialty training (endocrine, cardio etc.). People sometimes choose to slog through 3 years of medicine that they find horrible to get to their training in cardio or GI that they find interesting.

JAWSCIENCE

Fri, May 29 2015, 12:29 pm

amother wrote:

PA is a wonderful, wonderful alternative. I cannot stress how much my husband has told many, many men like your husband to pursue PA instead of an MD. And honestly, it’s your husband’s ego talking when he says, “MD or bust!” Because it’s not just about him anymore. That’s what’s bothering me so much about this whole thing - I don’t think he realizes (or maybe cares?) what he’ll be putting you and his family through, and to not consider a VERY VIABLE alternative like PA is foolish and selfish.

It's not that simple. When I said I wanted to be a Dr. I got hundreds of well meaning people telling me I should chose to be a P.A. because it is no different and will be better for my shidduch prospects and refusing to go that route is just for gaivah or pride in saying you are an M.D. Basically comments identical to yours, except that in my case the family did not even yet exist! You don't know this guy, it is really insulting and harmful to his marriage to say he is only saying he won't be a P.A. because of his ego. His life situation may make being an M.D. too hard for his family and he should be willing to think about other careers if that is what his family needs right now, but it is not just his ego that is saying M.D. and P.A. are different careers with different training and job responsibilities. They really are different careers. They have different job prospects and different doors opens with each degree. For many this won't matter and they can be interchangeable but for this person it appears he has explored P.A. and found it to be an unfulfilling career. That doesn't mean M.D. is the answer, but to push P.A. is not a solution either. I think the training and job responsibilities of P.A. are better suited to his family life but the training and job responsibilities of M.D. are better suited to his personality form what OP has written of him. So maybe neither is the ideal job for him.

Refusing to consider ones family is indeed wrong and shows too much ego. But OP has changed since last post- she says they HAVE done more research and considered this as a family. They are looking into options that might make this more doable for them. We shouldn't push our own agendas on them or pass judgement on the spouse for having dreams and wanting to look at all possible options to achieve them. That is why I would be very hesitant to tell her her spouse is being egotistical, selfish and foolish. That's the kind of talk that winds people in divorce court.

amother

Seafoam

Fri, May 29 2015, 12:32 pm

Vermillion, I don't know that it's so obvious who you are, surely many people have DH's in medicine and all that... but if you want to post an email address that would be great. Alternatively, I already outed myself by PM to Jawscience and Bruriyah and maybe others on this thread, so if you pM one of them your email address they can pass it along without either of us having to out ourselves on the thread.

Thanks for explaining how subspecialties work. Is the fellowship as intense as residency? Is the pay about the same? Such a drag but it makes sense if one of those fields appeals to you. I feel like if you're doing 8 years of school + residency then what's another couple of years to be in a specialty that you like more and is probably more lucrative as well. It's the idea of committing to it AT ALL that scares me off. If I could do it for 8 years then I could do it for 11 years, it's the first 8 that I'm not sure about. But yeah, he already knows that he doesn't know yet what he will want to go into.

Open to explanations and descriptions of what Nurse Practitioner is like in terms of schooling, job description, etc. in comparison to PA. Thanks for the suggestion mha3484. (though I'm not sure it's true that PA's have no patient experience going in, the program descriptions I read all included a lot of clinical time though I'm not sure exactly what that looks like, and no idea how it compares to nursing)

mha3484

Fri, May 29 2015, 12:45 pm

I can only speak from resumes that I look at. Typically a Nurse Practitioner works as a nurse for anywhere from 2 years and up before entering an NP Graduate program. Some do the program quickly and some work for decades before enrolling so you gain a lot of experience working with patients.

A PA can go straight from undergrad to masters to a job. They bypass all of the RN experience that a nurse puts in before getting the NP degree. That experience is very appealing to Dr's/Hospitals/Employers so a PA can get jobs but the NPs are stronger candidates.

I am not a nurse but I see a variety of resumes. People who work in hospitals, dr's offices, nursing homes, research departments, education. I received a resume recently from a woman who is the head of robotic surgery for a large teaching hospital. I think it has a lot of versatility.

My boss who has worked in staffing for 15 years confirms this.