Wife wants to go back to Med School...having troubles with the math on this.

vi edit

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Oct 28, 1999
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Background: My wife always wanted to do Med School. She went into undergrad with that in mind, ended up liking chemistry way more than she thought she would and started looking into Pharmacy. Did the homework on that and realized it was a pretty sweet gig, applied, was accepted and the rest was history.

Fast forward 7 years later...

She's been residency trained, works in a very critical care facility staffing ICU and emergency rooms as the clinical pharmacist. She's working with docs and residents on a daily basis and hears constantly "Why aren't you a doctor? You're too smart for pharmacy" ect. The MD residents come to her for questions when they are scared to talk to their attending. When she's working the ED the docs there are always telling her she needs to go back to Med school to be an ED doc because she does so well in that environment ect.

All of that flattery and reinforcement is adding up and starting to eat at her since that was her first thought way back before chosing Pharmacy. And to make it worse she's just totally burned out with her dept, inept managers, and a weak administration that buckles to the wishes of some terrible physicians even in the face of horrible patient outcomes.

It's a storm brewing that I can't really navigate around easily.

Problem is that we are in our early 30's, just starting to get our feet under us, have two kids, nuclear family...suburbanites...white picket fence..401k yadda yadda yadda. I don't know how to really wrap my head around this.

Med School is a 4 year commitment. She wants to do Emergency Medicine which another 3 year residency. First year of Med School is 2 hours away so she'd have to rent an apartment and live there for a year while I solo it with kids. Next three years are in town and practically across the street from where she works now. All clinicals/rotations would be in the same hospital/city as we live now. She'd do her residency in the same hospital as she works at now. First year would blow ass. The kids would have a Mom on the weekends only. Next three years aren't too bad, she'd probably be around more than she is right now working full time. Residency would be okay first year, and then progressively start to suck ass again as her call nights start to add up and she's staying overnight at the hospital.

The coursework would be pretty simple, she's had more than a dozen people tell her that. She knows he stuff. And the clinicals would be even easier. So it's not a question of ability.

To be able to afford things we'd likey have to cash out her 401k and pay the penalty. Plus still need to take out student loans. In addition to that I'd likely have to drop my 401k back to the minimum at the very least through her med school years. At least her residency years she would be paid. One perk is that she'd keep her pharmacy license up to date and can bank $500-$700 a day working PRN shifts. One of those a week if she can manage it is significant money. But it's not something to count on based on course work volume.

But we are talking serious money here.

She'd be leaving a $125,000+ a year job. She'd have to cash out a 120k 401k to give enough of a blanket to pay mortgage, day care, taxes, 2nd apartment ect. She wouldn't be accrueing any more money into her retirement funds during that time. And mine would be scaled back to the bare minimum.

On top of the lost income, she already has a $70,000 student loan debt for her first round of schooling. Over the 4 years of med school that'd likely inflate up to $250k. During residency she'd at least be making $45,000 or so and we could maybe start using that income to pay back down stuff.

But the golden light at the end of that 7 year tunnel is that she'd be looking at a $350k+ salary (mal practice is covered by the employer) and more control over her career and life. ED Docs aren't salaried by the hospital and are halfway independent consultants with benefits.

What I can't fully figure out is the cost benefit of this. We're basically torching 7 years of prime income earning and wealth building for a deferred amount of debt with the bonus of tripling her income. But she wouldn't be making that until she's nearly 40 years old.

Stress on the family aside, I just don't know how to do the math on that. :|

It's basically 7 years of hell on everyone. Then 4 years of more hell trying to dig out of debt. 6 years of playing catchup on savings games to bump retirement . Then when we finally hit 50 it'll be pretty damn nice. House would be paid off, loans paid off. College for kids would be saved for. I'd likely be able to retire 5 or more years earlier and she could go half or 3/4 time and make more than she would working full time in her current gig.

And I don't know how to put a price or cost of sacrafice on that either.

And even more...what I *REALLY* don't know how to plan for is her being 50 looking back and not even remembering her kids 4th, 5th, 10th, ect birthday's, Christmas mornings, ect because life was a blur.

I'm really not feeling comfortable with the financial side of things going through schooling, and even less comfortable with the family stress and have voiced that. But her outlook on her career almost gets worse by the day and has been speeding up since returning from maternity leave this spring. She's just not a happy person with her job right now. She really wants to do this and probably can do it much easier than many other people. I just can't really digest the costs and long term benefits.
 

IndyColtsFan

Lifer
Sep 22, 2007
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My cousin is a doctor and was going through med school when I was in high school. I had seriously considered becoming a doctor until I learned about some of the things she had to go through.

I can sympathize with your wife because even though I'm 41, I still think maybe I should've done it or maybe I should get another degree. The facts that you've outlined, however, indicate to me that you'd be sacrificing too much for this to happen and I'm not referring just to the financial implications; I'm talking about her missing her kids grow up.
 

RKS

Diamond Member
Oct 9, 1999
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I know the finance situation can be tough but not as tough as working at a job that you hate. Even if you are the voice of reason she will resent you for holding her back from her dream if she doesn't give it a shot.

IMHO I would back her without question.

edit: life goes by fast regardless and you have to make time for important events.
 
Last edited:

FearoftheNight

Diamond Member
Feb 19, 2003
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I'd have serious reservations. Sounds like the cost of med school + opportunity cost of not working is going to be about half a mil. Not to mention the health/energy drain on top of missing out on the family. Seriously though...sounds like you guys have it pretty good in the middle of a global economic recession.....
 

IndyColtsFan

Lifer
Sep 22, 2007
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I know the finance situation can be tough but not as tough as working at a job that you hate. Even if you are the voice of reason she will resent you for holding her back from her dream if she doesn't give it a shot.

IMHO I would back her without question.

edit: life goes by fast regardless and you have to make time for important events.

If it were a matter of her simply hating her job, than maybe she should look for work elsewhere. As another poster said, the opportunity cost of lost wages + the debt for med school could easily end up being $500K. I sympathize with her, but at some point, you have to realize that you've chosen your path and must follow it. She has a commitment to VI and her family and that is far, far more important than a "career."
 

vi edit

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Oct 28, 1999
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The job thing with her is tricky. It's not just her current employer, it's just the fact that she knows so damn much and is constantly reminded of that. She knows she should be an MD. We really don't want to move since my parents are so close and it's a mutual benefit for us and and them with the grandkids.

Moving to another employer in the area isn't an option as any of them would be a step backwards in services offered and opportunities. She's also quite aware that she is paid well for her services. The eventual salary is *not* the reason she's considering it. It just simply makes it a harder decision. If she was going internal med/family practice/hospitalist it makes zero sense. Emergency Medicine is much higher paid and operates differently. Plus it's an area of health care that she loves working in.

This thing is an out option without totally uprooting us and having a nice long term (20 year plan) benefit at the cost of short/mid term family stress, savings, and comfort.
 

OutHouse

Lifer
Jun 5, 2000
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umm wow talk about turning your life upside down, that would be a huge huge strain on your marriage and especially your kids. they wont have a mom at all it would be like you are divorced. i commend her on her desire to be a doc but you guys got a family now, she makes a really nice salary and you guys are stable and solid. why fuck that up.
 

IndyColtsFan

Lifer
Sep 22, 2007
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The job thing with her is tricky. It's not just her current employer, it's just the fact that she knows so damn much and is constantly reminded of that. She knows she should be an MD. Moving to another employer in the area isn't an option as any of them would be a step backwards in services offered and opportunities. She's also quite aware that she is paid well for her services. The eventual salary is *not* the reason she's considering it. It just simply makes it a harder decision. If she was going internal med/family practice/hospitalist it makes zero sense. Emergency Medicine is much higher paid and operates differently. Plus it's an area of health care that she loves working in.

I confess I haven't kept up on doctor salaries, but are you sure that Emergency Medicine pays that much? I was under the impression that it was far less thatn $350K/year.

We really don't want to move since my parents are so close and it's a mutual benefit for us and and them with the grandkids.

This thing is an out option without totally uprooting us and having a nice long term (20 year plan) benefit at the cost of short/mid term family stress, savings, and comfort.

It isn't an easy decision, I'll grant you that, but for me personally, the stress of having that much debt hanging over my head with so much uncertainty (the economy, medical reform, etc) in the world would drive me insane especially when you are well on the path to having a good life.

umm wow talk about turning your life upside down, that would be a huge huge strain on your marriage and especially your kids. they wont have a mom at all it would be like you are divorced. i commend her on her desire to be a doc but you guys got a family now, she makes a really nice salary and you guys are stable and solid. why fuck that up.

I've got to agree with this sentiment. If you were a childless couple, I'd probably say go for it even with the financial implications; however, you have two kids and it will greatly impact them at this point.
 

olds

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Mar 3, 2000
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"First year of Med School is 2 hours away so she'd have to rent an apartment and live there for a year while I solo it with kids"
Deal breaker
 
Sep 7, 2009
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"First year of Med School is 2 hours away so she'd have to rent an apartment and live there for a year while I solo it with kids"
Deal breaker


+1


Also, I hate to direct the conversation this way, but I wonder what the intentions were of these doctor's upping her ego by recommending med school.

In my opinion this is something she needs to wait until later in life to do.
 

vi edit

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Oct 28, 1999
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I confess I haven't kept up on doctor salaries, but are you sure that Emergency Medicine pays that much? I was under the impression that it was far less thatn $350K/year.

We live in a hard to recruit for area. It's not a big fancy city with a lot of flash and sizzle. New hires are getting $175/hr +$20hr for overnights.
 

ChopperDave

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May 4, 2012
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"First year of Med School is 2 hours away so she'd have to rent an apartment and live there for a year while I solo it with kids"
Deal breaker

This. With all due respect to your wife this is an extraordinarily selfish proposition. The time for chasing dreams like this was before having kids, a mortgage.

It would be one thing if it was just some additional student loan debt but she's talking about overhauling everyone's lives at enormous expense and inconvenience (understatement) to her entire family.
 

vi edit

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"First year of Med School is 2 hours away so she'd have to rent an apartment and live there for a year while I solo it with kids"
Deal breaker

And that's honestly the biggest hurdle I have. The next three years really would actually be easier on us than her working full time. We both know a lot of the med students, attendings, and residents that work out of the med school and really know how much time commitment is invovled there.

It's the first year where she's out of town that just really sours the deal.

The last two years of residency would suck pretty bad too, but not like that first year. So it's really like 1 year of total suck, 2 years of kinda suck, and 4 of not sucking if not even an improvement of what we have now with her working full time.

Her current job already has her working 1/3-1/2 of her shifts either 2nd shift or on weekends. So I'm already running solo third to half the time any way. But at least she's home at some point in the days and sees her kids every day with the way it is now.
 

GagHalfrunt

Lifer
Apr 19, 2001
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I think this sounds like a done deal even if the math doesn't add up. She's unhappy now and will be unhappy for the rest of her life is she doesn't get to take this step. That's the part where you have to throw the numbers out the window. 7 bad years in exchange for 25 good and happy ones where she gets to live out a dream or the rest of your lives where she feels growing resentment and you feel guilt.

Now that you've come this far talking about numbers and workloads and all that you can't put the genie back in the bottle. Your life is about to be turned upside down one way or the other. Either you work things out to help your wife achieve her goals or every day live with the knowledge that you could have and didn't. Which path has the best chance of a happy ending?
 

vi edit

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Oct 28, 1999
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I think this sounds like a done deal even if the math doesn't add up. She's unhappy now and will be unhappy for the rest of her life is she doesn't get to take this step. That's the part where you have to throw the numbers out the window. 7 bad years in exchange for 25 good and happy ones where she gets to live out a dream or the rest of your lives where she feels growing resentment and you feel guilt.

Hammer meet nail. Thread.

:/
 

NuroMancer

Golden Member
Nov 8, 2004
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As a guy with a wife heading into Medschool right now, I hear your pain.

This is a life altering step for your family. Things are not all rosey and great even once shes out of medschool as the life of a ER doc or surgen is incredibly demanding. Having said that, if your the reason that she doesn't do this, that will weigh on your marriage for the rest of your lives. Best thing to do imo is make sure she's looking at it the same way you do, all the intangables, and make a decision together.

In the end of the day yes, there are some financial implications, but your net end result is quite positive. To me in the end of the day its only a small part of the equation, family, and the quality of life together are far more important.

Question for you, is there any chance that the system works like it does in Canada, and you are not guarenteed a residency posting in your prefered hospital? Can you end up in a different city?
 

sixone

Lifer
May 3, 2004
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Her first obligation is to you, her second to the children. Anything that negatively impacts her relationships with you and them shouldn't be an option.

Her third obligation is to protect the financial integrity of the family. If she can hang with her current job for a couple of years, get that old debt paid off and some serious money accrued to cover her schooling, that might be a good time to re-evaluation the situation.

But moving away from her husband and kids for two years should never be seriously considered.

Choices have consequences, and she should honor the ones she's already made.
 

IndyColtsFan

Lifer
Sep 22, 2007
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Her first obligation is to you, her second to the children. Anything that negatively impacts her relationships with you and them shouldn't be an option.

Her third obligation is to protect the financial integrity of the family. If she can hang with her current job for a couple of years, get that old debt paid off and some serious money accrued to cover her schooling, that might be a good time to re-evaluation the situation.

But moving away from her husband and kids for two years should never be seriously considered.

Choices have consequences, and she should honor the ones she's already made.


Wow, are you feeling OK? This is actually good advice.
 
Nov 7, 2000
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lost income after taxes is probably 550k + 120k money lost (not to mention any future gains/tax benefits). + 250k debt (not counting interest accrual). thats almost a million dollars. with 350k, lets say 230k after taxes, you are looking at 4-5 years of the new salary just to break even. thats super napkin math tho, her current job would be giving raises and such.

you will never be able to recoup the lost years of 401k contribution, but i guess the dr. mentality is it doesnt matter bc income is so high?

essentially she would be starting her career at early to mid forties, the years she should spend raising her family would be spent at school. even during residency, she may be located nearby but her work is going to be VERY demanding, likely requiring ridiculous hours.

personally, i think its too late to go back to school for such a long time and financial commitment. Her earning power is already very solid and she has a family to raise.

Unfortunately, you are in a lose-lose situation, she may never forgive you if you dont support her in this. If she goes through with it its going to be a very long and difficult process.

A close friend of my wife's just finished her residency, IMO I don't think it would be possible to do that and raise a family.
 

vi edit

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Oct 28, 1999
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Question for you, is there any chance that the system works like it does in Canada, and you are not guarenteed a residency posting in your prefered hospital? Can you end up in a different city?

Possibility, absolutely. Upshot is that where we are is a "good" program but not a desireable one. It's no where near a competive program where your qualified/desirable applicants far outweigh the available positions.
 

olds

Elite Member
Mar 3, 2000
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And that's honestly the biggest hurdle I have. The next three years really would actually be easier on us than her working full time. We both know a lot of the med students, attendings, and residents that work out of the med school and really know how much time commitment is invovled there.

It's the first year where she's out of town that just really sours the deal.

The last two years of residency would suck pretty bad too, but not like that first year. So it's really like 1 year of total suck, 2 years of kinda suck, and 4 of not sucking if not even an improvement of what we have now with her working full time.

Her current job already has her working 1/3-1/2 of her shifts either 2nd shift or on weekends. So I'm already running solo third to half the time any way. But at least she's home at some point in the days and sees her kids every day with the way it is now.

You may be able to hire help with the kids.
But there is no way a couple grows closer and kids know their mom when she lives elsewhere. Plus, she may get lonely, enjoy the freedom and meet someone in school. (Not that I think your wife is a floozy)
 

OutHouse

Lifer
Jun 5, 2000
36,413
616
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Her first obligation is to you, her second to the children. Anything that negatively impacts her relationships with you and them shouldn't be an option.

Her third obligation is to protect the financial integrity of the family. If she can hang with her current job for a couple of years, get that old debt paid off and some serious money accrued to cover her schooling, that might be a good time to re-evaluation the situation.

But moving away from her husband and kids for two years should never be seriously considered.

Choices have consequences, and she should honor the ones she's already made.

i agree good post.
 
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