Question for Doctors-what would you do?

highcream

Hi guys,
Just looking for some peoples advice regarding a big decision im at in my life.Would really appreciate any input.
Ok,so i was quite torn between med and my current course choice for a long time.I chose the latter(its another of the high point science courses) due to the fact that im literally walking into a practice and a 6 figure salary the day i graduate from the course.Id also be living at home,so no mortgagae and could probably retire within 10-15 years of working.Sounds great,right?Well it isexcept for the fact that i still cant get med out of my head.I have no idea what it is but i would slighly be leaning toward it,maybe 55-45.
However,i hear of all the surveys done about doctors who would never pick med again and it makes me think twice as i actually quite enjoy my current career choice.Not a bad "headache" to have;)
Anyway,if u guys were in my shoes would u still pick med and go through all the hard work and training again?
Thanks a lot

Xeyn

highcream wrote: »

Hi guys,
Just looking for some peoples advice regarding a big decision im at in my life.Would really appreciate any input.
Ok,so i was quite torn between med and my current course choice for a long time.I chose the latter(its another of the high point science courses) due to the fact that im literally walking into a practice and a 6 figure salary the day i graduate from the course.Id also be living at home,so no mortgagae and could probably retire within 10-15 years of working.Sounds great,right?Well it isexcept for the fact that i still cant get med out of my head.I have no idea what it is but i would slighly be leaning toward it,maybe 55-45.
However,i hear of all the surveys done about doctors who would never pick med again and it makes me think twice as i actually quite enjoy my current career choice.Not a bad "headache" to have;)
Anyway,if u guys were in my shoes would u still pick med and go through all the hard work and training again?
Thanks a lot

In today's environment in medicine in Ireland you really have to have a passion for medicine. The system will try its best to make you hate it. But if you truly have a passion for it you won't regret it.
I've been a doctor for 6 years now in two systems - South Africa for 3 years and Ireland for 3 years.
I enjoyed the practice of medicine in South Africa more but I can't say I've hated my time in Ireland so far. I would do things differently for sure, but I would still choose medicine.
There are still days when I dream of a 9-5 job with less severe responsibilities but medicine is the only job for me.
Work hours are horrible, social life is a mess a lot of the time, remuneration is not that great any more (but comfortable), career progress is the worst I have experienced or even heard about.
There are plenty of negatives but if you have a genuine passion for medicine then the highs will outweigh all of the negatives in the end, if not dont even think about it.

sam34

magic herbs, if you cannot post constructively please refrain from posting. post deleted.

iratira

It depends what type of medicine you want to do and it depends on what motivates you as a person.
what area interests you?

bleg

highcream wrote: »

Hi guys,
Just looking for some peoples advice regarding a big decision im at in my life.Would really appreciate any input.
Ok,so i was quite torn between med and my current course choice for a long time.I chose the latter(its another of the high point science courses) due to the fact that im literally walking into a practice and a 6 figure salary the day i graduate from the course.Id also be living at home,so no mortgagae and could probably retire within 10-15 years of working.Sounds great,right?Well it isexcept for the fact that i still cant get med out of my head.I have no idea what it is but i would slighly be leaning toward it,maybe 55-45.
However,i hear of all the surveys done about doctors who would never pick med again and it makes me think twice as i actually quite enjoy my current career choice.Not a bad "headache" to have;)
Anyway,if u guys were in my shoes would u still pick med and go through all the hard work and training again?
Thanks a lot

Do whatever you think is right at the time. Things might not always work out the way you expect them to. A lot can change during 5 years of university. Living at home is not ideal. There will be many more things more important to you in 10 years than retirement!

Make your choice, go for it and don't look back!


In the words of Howard Thurman "Ask yourself what makes you come alive and then go do that. Because what the world needs is people who have come alive."

Ryder

When I was in college, I could never understand when classmates, who had parents doctors, said that they were advised not to do Medicine. If my kids asked my advice today, I would probably asked them to think twice it three times about it. It is a great career, whichever pathway you choose, but busy and sometimes demoralizing. I'm sure you realize that it's not all ER/ Greys anatomy. Nowdays, you would struggle to make a six figure salary until at least 10 years post graduation, and maybr not even maybe. Money isnt everything, but in your 30s 40s, with a family and mortgage, it does matter. Classmates who graduated with me, and are now GPs, many are still not partners/permanent, despite the purported shortages.

Career wise, there aren't jobs as consultants for everyone in hospital medicine....maybe a third or less of BST entrants progress? it takes about 5yrs post graduation to be a GP, and 10 a consultant.

In summary, satisfying career, with drawbacks. If you want advice, go for it, but only if 100% sure, not 55/45.

highcream

Thanks a lot for your replies.
Can i ask,if you move to south africa or new zealand for specialty training can u ever return?Id say id be most interested in GP.
I honestly cant imagine ever working in hospital medicine in ireland,especially when there is no "way out".
Cheers

Xeyn

highcream wrote: »

Thanks a lot for your replies.
Can i ask,if you move to south africa or new zealand for specialty training can u ever return?Id say id be most interested in GP.
I honestly cant imagine ever working in hospital medicine in ireland,especially when there is no "way out".
Cheers

Training in South Africa is recognised in Ireland. I think it's the same in New Zealand and Australia.
There is absolutely no problem coming back to work in Ireland as a GP. Once you're on the register as a recognised GP you just have to open up a practice or join one, there is none of the juvenile nonsense that goes with hospital jobs about where you did your undergrad, research or training. GP service is private practice so as long as you have your training reocognised on the register then that's that.

locum-motion

Xeyn wrote: »

Training in South Africa is recognised in Ireland. I think it's the same in New Zealand and Australia.
There is absolutely no problem coming back to work in Ireland as a GP. Once you're on the register as a recognised GP you just have to open up a practice or join one, there is none of the juvenile nonsense that goes with hospital jobs about where you did your undergrad, research or training. GP service is private practice so as long as you have your training reocognised on the register then that's that.

I know a GP who is a member of the SA equivalent of the Irish College of General Practitioners. He works in a couple of different practices a day or two a week, and as a locum.
When it was announced recently that the GMS was gonna be opened up from its current almost monopolistic restricted access model (ie that any MICGP or similarly qualified doc would be able to get a GMS contract), I commented to him that it was great news and that he'd be able to open up his own practice I he wanted (the man is an awful lot more popular than the established guy he stands in for on Fridays, and that's the only day of the week that there's a queue in the surgery). He said No, it didn't apply to him, as his SA qualification wouldn't entitle him to a contract; only an EU qualification would.

Xeyn

locum-motion wrote: »

I know a GP who is a member of the SA equivalent of the Irish College of General Practitioners. He works in a couple of different practices a day or two a week, and as a locum.
When it was announced recently that the GMS was gonna be opened up from its current almost monopolistic restricted access model (ie that any MICGP or similarly qualified doc would be able to get a GMS contract), I commented to him that it was great news and that he'd be able to open up his own practice I he wanted (the man is an awful lot more popular than the established guy he stands in for on Fridays, and that's the only day of the week that there's a queue in the surgery). He said No, it didn't apply to him, as his SA qualification wouldn't entitle him to a contract; only an EU qualification would.

You may be right there. To be honest as a hospital doctor myself I'm more in touch with consultant fellowships for which all the South African fellowships are recognised. My father is South African and whilst he did his undergrad in Ireland he trained as a GP in South Africa but has his own practice in Dublin which led to my assertion. Qualifications have changed since then so your friend might be quite right.

However are you certain that it has to do with country of qualification over citizenship?
I'm not 100% sure but there are a lot of qualification issues resulting from nationality as well as qualifications.
I did my undergrad in South Africa by as an Irish citizen I'm treated differently by a lot of boards over those who qualifies in my class. For example I had to simply apply for GMC registration and was granted it whereas those who qualified in my class had to write the PLAB exams and some IELTS to gain acceptance.

highcream

Hey Ryder,
Would u really struggle to make 6 figures until 10 years POST graduation?I missed that the first time i read your post.Also,iv been told there are a lot of other costs like CPD costs,malpractice insurance.
Do these significantly impact your take home?
Thanks

Ryder wrote: »

When I was in college, I could never understand when classmates, who had parents doctors, said that they were advised not to do Medicine. If my kids asked my advice today, I would probably asked them to think twice it three times about it. It is a great career, whichever pathway you choose, but busy and sometimes demoralizing. I'm sure you realize that it's not all ER/ Greys anatomy. Nowdays, you would struggle to make a six figure salary until at least 10 years post graduation, and maybr not even maybe. Money isnt everything, but in your 30s 40s, with a family and mortgage, it does matter. Classmates who graduated with me, and are now GPs, many are still not partners/permanent, despite the purported shortages.

Career wise, there aren't jobs as consultants for everyone in hospital medicine....maybe a third or less of BST entrants progress? it takes about 5yrs post graduation to be a GP, and 10 a consultant.

In summary, satisfying career, with drawbacks. If you want advice, go for it, but only if 100% sure, not 55/45.

Xeyn

You wont struggle, you simply wont be making 6 figures withing 10 years unless you branch out into the abstract or become an IMO chief.
Unless you walk into a particularly lucrative GP practice, GP's dont tend to take home regular 6 figure salaries and medical protection insurance is expensive but absolutely necessary and even more so with consultancy.
Consultants can certainly make 6 figure salaries and take home a very good income. However. Post qualification, there is 1 year internship. 2-3 years basic training. and then 6+ years of specialist training. Thats already 9-10 years in most specialities. And thats if everything goes smoothly and you manage to get onto the SpR scheme straight after BST which is almost unheard of. Most will need to take 1-3 years somewhere along the line to get further qualifications and research to be competitive enough to get onto the SpR. Its an extremely poorly contrived system but its the only one that they have.

Ryder

I dont have the exact salary scale to hand at the moment, but interns start out at roughly 35,000 and a 6th year spr abiut 72,000. Overtime will bring a senior reg salary up close to 6 figures (in theory), but never gets paid fully (sometimes not at all), is taxed, and you would spend 80+hrs a week getting to that 6 figures.

Costs...indemnity as a trainee is paid by the HSE. CPD is largely looked after by your training scheme but for career development, especially as you progress, you would need to go to an international meeting every 2 years (costing maybe 2000? all included). Research year is manadatory in hospital specialities and varies widely in terms of the pay offered (none to full salary). Also have to factor in the additional night-time degrees needed to be competitive, which may cost up to 5000e. Probably need one of these. Also additional courses to stand out....usually international.....prob about 5000e each all included..do 2/3 of those over your training time

Money , Im sure, isnt your only care, but if it is youre going to the wrong job. I dont know many trainees who are rich (actually none) and consultants have a lot of private start up fees so it takes maybe 10 years for them to make money from private practice (those that want to)

iratira

6 figures! I'm laughing to myself sorry.

sillymoo

Ryder wrote: »

I dont have the exact salary scale to hand at the moment, but interns start out at roughly 35,000 and a 6th year spr abiut 72,000. Overtime will bring a senior reg salary up close to 6 figures (in theory), but never gets paid fully (sometimes not at all), is taxed, and you would spend 80+hrs a week getting to that 6 figures.

Costs...indemnity as a trainee is paid by the HSE. CPD is largely looked after by your training scheme but for career development, especially as you progress, you would need to go to an international meeting every 2 years (costing maybe 2000? all included). Research year is manadatory in hospital specialities and varies widely in terms of the pay offered (none to full salary). Also have to factor in the additional night-time degrees needed to be competitive, which may cost up to 5000e. Probably need one of these. Also additional courses to stand out....usually international.....prob about 5000e each all included..do 2/3 of those over your training time

Money , Im sure, isnt your only care, but if it is youre going to the wrong job. I dont know many trainees who are rich (actually none) and consultants have a lot of private start up fees so it takes maybe 10 years for them to make money from private practice (those that want to)

I am an intern and my starting salary is well short of 35,000.

highcream

Thanks a lot for your replies,this info is invaluable,not sure where else i could get info from those in the system.
Just one more thing,do u find that the pressure is much more demanding than med school.Is there a lot of bullying from regs/consulatants? Are ill patients(and their families) a lot more difficult to deal with than when dealing with the public in general?
Thanks

Sitric

highcream wrote: »

Thanks a lot for your replies,this info is invaluable,not sure where else i could get info from those in the system.
Just one more thing,do u find that the pressure is much more demanding than med school.Is there a lot of bullying from regs/consulatants? Are ill patients(and their families) a lot more difficult to deal with than when dealing with the public in general?
Thanks

Quite simply, compared to working there is no pressure in med school.

Abby19

Ryder wrote: »

I dont have the exact salary scale to hand at the moment, but interns start out at roughly 35,000 and a 6th year spr abiut 72,000. Overtime will bring a senior reg salary up close to 6 figures (in theory), but never gets paid fully (sometimes not at all), is taxed, and you would spend 80+hrs a week getting to that 6 figures.

Details on salary are available on the HSE website. http://www.hse.ie/eng/staff/Benefits_Services/
Check out http://www.hse.ie/eng/staff/nchd/benefits/salary.html
Interns start on €30,257.

Salary scale for newly appointed consultants available here
http://www.hse.ie/eng/staff/Resources/HR_Circulars/Circular%20017%202012.pdf

Xeyn

highcream wrote: »

Thanks a lot for your replies,this info is invaluable,not sure where else i could get info from those in the system.
Just one more thing,do u find that the pressure is much more demanding than med school.Is there a lot of bullying from regs/consulatants? Are ill patients(and their families) a lot more difficult to deal with than when dealing with the public in general?
Thanks

There is no question on the pressures of the job. You are dealing with multiple lives on a daily basis. It's a completely different sort of pressure from med school but as the consequences are considered more significant most people tend to feel under more pressure after med school.
I haven't experienced any bullying personally but it does take place. What's more prevalent is mentoring which can be quite detrimental to career progression for many.
Patients and patients families are often a challenge, and again, as you're dealing with the health of people they tend to be a lot more emotional. If you're not challenged by patients on an almost daily basis whether its drunks, drug abusers or just very demanding or aggressive patients and there families it means you're probably in a speciality that has no contact with patients.

Abby19

Xeyn wrote: »

I haven't experienced any bullying personally but it does take place. What's more prevalent is mentoring which can be quite detrimental to career progression for many.

I don't understand what you mean by mentoring being detrimental to career progression. Could you please clarify?

Xeyn

Abby19 wrote: »

I don't understand what you mean by mentoring being detrimental to career progression. Could you please clarify?

There is in theory a objective process for career progression. Mentoring is when a candidate is taken under the wing of a consultant sometimes to the exclusion of others and often bypassing the objective process. So while it might be great for that person it puts many others at an unfair disadvantage.

Ryder

Xeyn wrote: »

There is in theory a objective process for career progression. Mentoring is when a candidate is taken under the wing of a consultant sometimes to the exclusion of others and often bypassing the objective process. So while it might be great for that person it puts many others at an unfair disadvantage.

mentoring is a process whereby a more senior colleague (not necessarily a consultant) gives advice and guidance. It reduces anxiety and enhances prospects. It doesn't involve promotion at the expense of others (unless they have no guidance). All of the colleges have very transparent admission/progression processes, and a single consultant could not in practice influence things.

Mentoring is very beneficial, and really should be mandatory. Xeyn, you should have a look at pubmed - plenty of literature on it in medical education publications

Xeyn

Ryder wrote: »

mentoring is a process whereby a more senior colleague (not necessarily a consultant) gives advice and guidance. It reduces anxiety and enhances prospects. It doesn't involve promotion at the expense of others (unless they have no guidance). All of the colleges have very transparent admission/progression processes, and a single consultant could not in practice influence things.

Mentoring is very beneficial, and really should be mandatory. Xeyn, you should have a look at pubmed - plenty of literature on it in medical education publications

Will have to agree to disagree on this point. You are quite right on the ideal practice of mentoring. It in essence is required for training and I have had some very good mentors. However there are still very bad practices occurring in many institutes and whilst things are a lot more transparent than they used to be I know for a fact that individual consultants have sway on the points system. But I will accede that things have changed a lot in the years since the points system was introduced and its a lot harder to be influenced by individuals.

I have been in a couple of situations where I was taken under the wing so to speak, of either a consultant or spr to the almost exclusion of one or two of my fellow sho's.
and speaking to many colleagues this is not unusual. And when it comes to log book, interviews etc this is very important.

There has even been an article written by a contributor to the Irish medical times where a single consultant had essentially derailed a doctors progress in his basic training years because he didn't like him.

There are plenty of very nice personable consultants out there but many simply do not place training very high on their priority list. Equal training at the very least. And in such a competitive field it's hard to justify.

I will accept i was hasty in my statement on mentoring when i was thinking of just a few practices and ahould have been clearer, But I have yet to find a single trainee near the start of his career who feels that the Irish system is any where near acceptable or even compatible to other first rate training program's. Doctors have voted with their feet and they are continuing to vote in the same manner.

highcream

Thanks a lot for all the responses.
Iv decided to stick with what i have for the time being.I think medicine is a little too much of a lottery for me to take a chance on.When i graduate from my current degree ill start at the top of the ladder while if i graduated from med id have to start at the bottom and of course i wouldnt be my own boss and have to put up with all the other nonsense.
Its just not worth it for me,as i dont have a burning desire to help people but rather wanted the challenge that a medical career brings.
Thanks