Deciding to go for GEM

HopefulNewUser

Hi,
I'm thinking of applying to do the GAMSAT for grad entry med and I have a few questions. I'm particularly interested in experiences of people who've been in a similar position to me.
I have a science degree, a masters in science, and am in the middle of a PhD in molecular biology. I don't know if I'm completely burnt out by the PhD experience, but the thoughts of a career as unstable as that of an academic researcher is really unappealing right now, and I don't know if it's at all sustainable given the reduction in funding the sector is experiencing atm.
I have always been interested in a career in medicine but didn't get the HPAT after two tries, and decided to focus on science after that. Now I feel like if I don't make the move after my PhD, that will have been my last chance. (If this sounds very negative and like I'd be doing medicine just because science didn't work out, that is not the case at all!). I'm 27 now, and would be 28 by the time I'm finished my PhD. Is this too old to grad entry med? I know older people do do it very successfully, with families and so on, but if I go for it at 28/29, does this give my career room to progress if/before I start a family (female, btw). Anecdotally, I have heard that having a PhD/research experience is advantageous for consultant posts etc further down the line, but does it matter if the PhD experience is before medical training? Basically, I'd like to know that my experience so far isn't 'wasted', or for nothing if I go down the medicine path.
The thought of entering my 30's with a 100,000 debt is also an incredibly daunting one, and I would have to borrow for fees and living expenses as I have no savings. I would choose to study in UCC/UL, partly because of the lower costs of living (of course, I do know that these are both excellent courses). Do people find it difficult to rationalise taking out these huge loans? Basically, I'd love to hear perspectives of anyone who has any kind of similar background to me. If anyone has any info about either the UCC or UL courses, or making the decision to go back to full time study, I'd be so happy to hear your experience!
Thanks so much

repulsebay321

HopefulNewUser wrote: »

Hi,
I'm thinking of applying to do the GAMSAT for grad entry med and I have a few questions. I'm particularly interested in experiences of people who've been in a similar position to me.
I have a science degree, a masters in science, and am in the middle of a PhD in molecular biology. I don't know if I'm completely burnt out by the PhD experience, but the thoughts of a career as unstable as that of an academic researcher is really unappealing right now, and I don't know if it's at all sustainable given the reduction in funding the sector is experiencing atm.
I have always been interested in a career in medicine but didn't get the HPAT after two tries, and decided to focus on science after that. Now I feel like if I don't make the move after my PhD, that will have been my last chance. (If this sounds very negative and like I'd be doing medicine just because science didn't work out, that is not the case at all!). I'm 27 now, and would be 28 by the time I'm finished my PhD. Is this too old to grad entry med? I know older people do do it very successfully, with families and so on, but if I go for it at 28/29, does this give my career room to progress if/before I start a family (female, btw). Anecdotally, I have heard that having a PhD/research experience is advantageous for consultant posts etc further down the line, but does it matter if the PhD experience is before medical training? Basically, I'd like to know that my experience so far isn't 'wasted', or for nothing if I go down the medicine path.
The thought of entering my 30's with a 100,000 debt is also an incredibly daunting one, and I would have to borrow for fees and living expenses as I have no savings. I would choose to study in UCC/UL, partly because of the lower costs of living (of course, I do know that these are both excellent courses). Do people find it difficult to rationalise taking out these huge loans? Basically, I'd love to hear perspectives of anyone who has any kind of similar background to me. If anyone has any info about either the UCC or UL courses, or making the decision to go back to full time study, I'd be so happy to hear your experience!
Thanks so much

There is a 35 year old PhD in my class. If you want to do it, then don't worry about age or debt. The debt will be paid off in 10 years at a rate of €800-€1000 a month. Tuition is also tax deductible.

taxignorant

I agree with repulse also but it depends on how much you want it. Consider the following,
a) Do bank still lend living costs (100k) or just fees (62k)?

b) If having children is important to you it is going to be very hard. I have two kids, they are out of the baby stage but they still need lots of time and attention and they deserve that. I have a very supportive partner, you need someone to lean in with you as the book says. It might not be ideal putting off trying to conceive for too much longer if you want children.

c) There are some US blogging Doctor moms, some of whom have had children while still in college, it might be worth checking out their experiences. I am happy to share any "wisdom" I have gleaned via PM. I do think it is possible but you need lots of support and cash helps to ease the way with things like cleaning that you can not bother with if no kids involved but is essential with kids. You still need to dedicate enough time to study. Becoming a parent makes you super efficient with your time because you have to be.

bella11

taxignorant wrote: »

I agree with repulse also but it depends on how much you want it. Consider the following,
a) Do bank still lend living costs (100k) or just fees (62k)?

b) If having children is important to you it is going to be very hard. I have two kids, they are out of the baby stage but they still need lots of time and attention and they deserve that. I have a very supportive partner, you need someone to lean in with you as the book says. It might not be ideal putting off trying to conceive for too much longer if you want children.

c) There are some US blogging Doctor moms, some of whom have had children while still in college, it might be worth checking out their experiences. I am happy to share any "wisdom" I have gleaned via PM. I do think it is possible but you need lots of support and cash helps to ease the way with things like cleaning that you can not bother with if no kids involved but is essential with kids. You still need to dedicate enough time to study. Becoming a parent makes you super efficient with your time because you have to be.

I think this is a bit over the top! Lots of people have kids in their late 30s now, telling someone they should start trying to conceive at 28/29 just because they want to study medicine is definitely over the top! There are lots of options and supports. My cousin that’s a consultant now just had her first child at 38. If you graduated at 34 and went straight into GP, this would be about the same if you decided to have a child after finishing. And you’d be graduating at 32-33 if you started 28-29! !

taxignorant

bella11 wrote: »

I think this is a bit over the top! Lots of people have kids in their late 30s now, telling someone they should start trying to conceive at 28/29 just because they want to study medicine is definitely over the top! There are lots of options and supports. My cousin that’s a consultant now just had her first child at 38. If you graduated at 34 and went straight into GP, this would be about the same if you decided to have a child after finishing. And you’d be graduating at 32-33 if you started 28-29! !

Perhaps misspoke I meant after 34/35 after the poster graduates and completes internship, I thought that is the age they mentioned. Of course plenty of people do have children into their 40s but fertility begins to decline after 35, and risk of complications rises.

It is a very personal decision when to start trying to conceive of course and I'm not casting any aspersions on anyone, I have friends who took a year off training schemes to do all sorts, so I am sure you could do that if you wanted. And that is why I was referring the poster to the existing blogs, because I do believe that it is possible

taxignorant

taxignorant wrote: »

Perhaps misspoke I meant after 34/35 after the poster graduates and completes internship, I thought that is the age they mentioned. Of course plenty of people do have children into their 40s but fertility begins to decline after 35, and risk of complications rises.

It is a very personal decision when to start trying to conceive of course and I'm not casting any aspersions on anyone, I have friends who took a year off training schemes to do all sorts, so I am sure you could do that if you wanted. And that is why I was referring the poster to the existing blogs, because I do believe that it is possible

I'm sorry I do see now I had the posters age incorrect I apologise

ma003

The banks only give a loan for fees now right? Just clarifying as I saw the comment above mentioning living expenses.

I would say go for it if you really want it but you might have to have kids later but if having kids earlier is a priority then obviously maybe you should think hard about it. As mentioned above though having kids in your late 30s happens a lot even outside of medicine.

I am also 28 now and just finished my undergraduate degree as I worked for a few years before going to college. I have currently applied and am also looking at UL as the living costs are cheaper but I am going to have to try to do some sort of part time work and probably rely on family a bit too. Even though I am mostly set on doing it, the 100000 euro debt just for fees is the one reason that I might decide to back out. I know the starting out pay isn't great and to have to pay 900 euro a month back in loans is a something to take seriously!

Has anyone had experience in paying back these loans?

I'd say don't let age put you off though if you really want to do it but as you mentioned other things such as kids and finances I guess you have decide on what your own personal priorities are in your life!!

taxignorant

ma003 wrote: »

The banks only give a loan for fees now right? Just clarifying as I saw the comment above mentioning living expenses.

I would say go for it if you really want it but you might have to have kids later but if having kids earlier is a priority then obviously maybe you should think hard about it. As mentioned above though having kids in your late 30s happens a lot even outside of medicine.

I am also 28 now and just finished my undergraduate degree as I worked for a few years before going to college. I have currently applied and am also looking at UL as the living costs are cheaper but I am going to have to try to do some sort of part time work and probably rely on family a bit too. Even though I am mostly set on doing it, the 100000 euro debt just for fees is the one reason that I might decide to back out. I know the starting out pay isn't great and to have to pay 900 euro a month back in loans is a something to take seriously!

Has anyone had experience in paying back these loans?

I'd say don't let age put you off though if you really want to do it but as you mentioned other things such as kids and finances I guess you have decide on what your own personal priorities are in your life!!

You need to consider the cost of childcare as well unless you have family that can help. For a baby full-time in creche it is currently around 1000+ a month or 800+ for a minder. At one point I was paying 1700 for my two kids, when the childcare ecce scheme kicked in we paid around 1250 - 1500. We are budgeting 1250 per month for after school care and mid term breaks while I'm in college. I'm doing this in an upside down way, starting older at 37, kids in school and financially secure, maybe that is an option?

I'm totally not trying to discourage you, it's all in the planning. Maybe you don't have rent to pay or you have family help or a partner that can support you. I really do hope you can find a solution you are happy with. We need plenty more docs and we need medicine to be more family friendly to do that.

taxignorant

Sorry to keep banging on about the unpleasant bits but can anyone give an estimate on the professional fees and courses required post grad eg ACLS etc? There used to be a training grant a long time ago, I believe that was scrapped in the last recession. Did it get replaced with anything?

repulsebay321

ma003 wrote: »

The banks only give a loan for fees now right? Just clarifying as I saw the comment above mentioning living expenses.

I would say go for it if you really want it but you might have to have kids later but if having kids earlier is a priority then obviously maybe you should think hard about it. As mentioned above though having kids in your late 30s happens a lot even outside of medicine.

I am also 28 now and just finished my undergraduate degree as I worked for a few years before going to college. I have currently applied and am also looking at UL as the living costs are cheaper but I am going to have to try to do some sort of part time work and probably rely on family a bit too. Even though I am mostly set on doing it, the 100000 euro debt just for fees is the one reason that I might decide to back out. I know the starting out pay isn't great and to have to pay 900 euro a month back in loans is a something to take seriously!

Has anyone had experience in paying back these loans?

I'd say don't let age put you off though if you really want to do it but as you mentioned other things such as kids and finances I guess you have decide on what your own personal priorities are in your life!!

900 x 12 = €10 800

With overtime, you should make around €55 000 in intern year.

So your take home pay after tax and loan payments (and the tuition tax rebate) is around €30 000 on the low end your first year out.

ma003

repulsebay321 wrote: »

900 x 12 = €10 800

With overtime, you should make around €55 000 in intern year.

So your take home pay after tax and loan payments (and the tuition tax rebate) is around €30 000 on the low end your first year out.

Oh fab thanks! I didn't think you could make that much in overtime! I was looking at the base wage from the Hse website! Thanks again!

taxignorant

How much is the tax rebate on tuiton? I had read it was 800 euro once off.

Any idea on professional fees?

Also if the poster is looking to have children th milling overtime might only be possible for a year or two. How much overtime is expected?

Do interns pay pension levy @ 10% roughly? I believe people on temp contracts pay and then have to apply for a return? ( This is what is happening to my partner currently ).

Thanks a million for the information.

repulsebay321

taxignorant wrote: »

How much is the tax rebate on tuiton? I had read it was 800 euro once off.

Any idea on professional fees?

Also if the poster is looking to have children th milling overtime might only be possible for a year or two. How much overtime is expected?

Do interns pay pension levy @ 10% roughly? I believe people on temp contracts pay and then have to apply for a return? ( This is what is happening to my partner currently ).

Thanks a million for the information.

It's normal to work 55 hours a week in intern year. Nobody will get the 39 hour week that the base pay is calculated on.

Having a child would mean the intern needs to have a mixture of either supportive family, a non working or flexible spouse, a childminder or a creche.

Interns and SHOs can expect to move to different hospitals in a region, and need to plan for it.

I know a 4th year who is 37 and just had her first child. I know a couple who are both interns and having a child. People make it work.

thomasdylan

repulsebay321 wrote: »

900 x 12 = €10 800

With overtime, you should make around €55 000 in intern year.

So your take home pay after tax and loan payments (and the tuition tax rebate) is around €30 000 on the low end your first year out.

Are you a recent intern? I'm not sure this is true. That would be making over 20k in overtime. Intern overtime is paid at 1.25 time overtime now not 1.5 times and interns are doing less and less hours every year. You don't have that many interns doing 80 hour weeks anymore.

I would have concerns about being able to pay back 800e to 1,000e a month in loan repayments over 10 years. It is a huge commitment.

Flimsy_Boat

thomasdylan wrote: »

Are you a recent intern? I'm not sure this is true. That would be making over 20k in overtime. Intern overtime is paid at 1.25 time overtime now not 1.5 times and interns are doing less and less hours every year. You don't have that many interns doing 80 hour weeks anymore.

I would have concerns about being able to pay back 800e to 1,000e a month in loan repayments over 10 years. It is a huge commitment.

I just downloaded the HSE pay scales for 2020. For a 39 hour week, the gross salary is €37 502. That is 18.49 per hour. Overtime paid at an increment of 1.25 is 23.11, so in order to make €55 250 per year, you would have to average 55 hours per week (or 16 hours of overtime) for 48 weeks in the year. These calculations allow for 1 month completely off work and no continuing education allowances. Seems plausible?

SHOs have a basic salary of 44 000, which is a nice jump.

taxignorant

Please correct me if I am wrong but do we take out pension levy at around 10%?

Does anyone have info on costs for things like ACLS or required courses that we have to pay ourselves and IMC registration cost?

DivaDanto

For anyone who has a prior undergrad in health science you skip a paygrade to 48k in your first SHO year which isnt bad to be fair.

Not sure about ACLS. Think depends on the hospital
A friend of mine is in one of the dublin hospitals and it was covered but you do have to pay for the medical/surgical exams which are around 800 euro I think

humboldt

DivaDanto wrote: »

For anyone who has a prior undergrad in health science you skip a paygrade to 48k in your first SHO year which isnt bad to be fair.

Have a source/list of courses for that? Cheers

DivaDanto

Theres a pdf file from hse comes up if you google "health science degree skip a pay grade sho" will come up

Iscreamkone

DivaDanto wrote: »

Theres a pdf file from hse comes up if you google "health science degree skip a pay grade sho" will come up

What health science degrees would this include?

humboldt

DivaDanto wrote: »

Theres a pdf file from hse comes up if you google "health science degree skip a pay grade sho" will come up

https://www.hse.ie/eng/staff/resources/hr-circulars/hr-circular-002-2019-re-incremental-credit-for-nchds.pdf

This the one you were one about Diva? If so, I'm on the list, provided I get in (and survive) GEM Thanks for that

humboldt

Iscreamkone wrote: »

What health science degrees would this include?

Section 16(a)(ii) of the revised NCHD Contract, which issued on the 9th April 2018, states that incremental credit will be
granted for “time spent gaining a graduate qualification (prior to completion of internship) in the health sciences subject to
a limit of one incremental point of progression for any such qualification”.
This change was introduced in recognition of the fact that NCHDs in our workforce may have attained a previous
qualification in health sciences. Since the current NCHD contract was introduced in 2010, the routes of entry into the
medical workforce have become more varied. Doctors may have previously qualified in other fields and have subsequently
returned to university to undertake medical degrees. Individuals in this position will now avail of a maximum of one point of
incremental credit in respect of a relevant degree in the health sciences. In circumstances where degrees in two different
fields of relevant studies in the health sciences were undertaken, one additional point of incremental credit may be
awarded subject to a global maximum of two points. Where a degree and a higher degree, for example a Masters are
obtained in the same field only one increment may be granted.

Applied Healthcare
Audiology
Biochemistry
Biomedical, Health and Life Sciences
Clinical Speech and Language Studies/Therapy
Genetics
Health and Social Care
Human Health and Diseases
Human Nutrition and Dietetics
Medical and Health Sciences
Midwifery
Neuroscience
Nursing – General/Psychiatric/Intellectual Disability
Occupational Therapy
Optometry
Pharmaceutical Healthcare
Pharmacy
Physical Activity and Health Science
Physiology
Physiotherapy
Psychology
Public Health and Health Promotion
Public Health Sciences
Radiation Therapy
Radiography
Speech and Language Therapy
Microbiology
*This list is not exhaustive

Anita Blow

Flimsy_Boat wrote: »

I just downloaded the HSE pay scales for 2020. For a 39 hour week, the gross salary is €37 502. That is 18.49 per hour. Overtime paid at an increment of 1.25 is 23.11, so in order to make €55 250 per year, you would have to average 55 hours per week (or 16 hours of overtime) for 48 weeks in the year. These calculations allow for 1 month completely off work and no continuing education allowances. Seems plausible?

SHOs have a basic salary of 44 000, which is a nice jump.

No intern I know earned 55k.

Can only speak for Dublin hospitals but it's only a few surgical specialities that you'll be hitting >50 hours. Most medical specialities you wouldn't even really get more than 5h overtime in the week.
I imagine overtime will be less now with the additional SHO/intern posts

taxignorant

Anita Blow wrote: »

No intern I know earned 55k.

Can only speak for Dublin hospitals but it's only a few surgical specialities that you'll be hitting >50 hours. Most medical specialities you wouldn't even really get more than 5h overtime in the week.
I imagine overtime will be less now with the additional SHO/intern posts

Actually less hours suits me down to the ground! 45 hours at least complies with EWTD

I had read an average earning of 44k gross for an intern somewhere in the last couple of years. That tallies more with those hours. I think there is a night allowance also.

Anita, can you shed light on the pension levy scenario? Are taining doctors part of pension scheme?

thomasdylan

Flimsy_Boat wrote: »

I just downloaded the HSE pay scales for 2020. For a 39 hour week, the gross salary is €37 502. That is 18.49 per hour. Overtime paid at an increment of 1.25 is 23.11, so in order to make €55 250 per year, you would have to average 55 hours per week (or 16 hours of overtime) for 48 weeks in the year. These calculations allow for 1 month completely off work and no continuing education allowances. Seems plausible?

SHOs have a basic salary of 44 000, which is a nice jump.

55 hours a week average for interns would have been expected a few years ago. Not so much now. You'll do those hours on surgery but not usually on medicine and not on ED or Psychiatry intern jobs.

There's a few hundred more interns now than there were 8-10 years ago. Hours are less for most people starting out which is a good thing.

Paying back massive loans will have a big impact on ability to get a decent mortgage. Then there's the stresses of having to move jobs around the country every six months or year.

Extra expenses would be medical council fee which is 600e a year and MPS which is probably 200-300e.

taxignorant

thomasdylan wrote: »

55 hours a week average for interns would have been expected a few years ago. Not so much now. You'll do those hours on surgery but not usually on medicine and not on ED or Psychiatry intern jobs.

There's a few hundred more interns now than there were 8-10 years ago. Hours are less for most people starting out which is a good thing.

Paying back massive loans will have a big impact on ability to get a decent mortgage. Then there's the stresses of having to move jobs around the country every six months or year.

Extra expenses would be medical council fee which is 600e a year and MPS which is probably 200-300e.

Thanks so much for the information, it is invaluable.

How much of the moving around is it possible to avoid if you are Dublin centric? With kids in school I would prefer to stay within 1 hour of Dublin if I can.

Anita Blow

taxignorant wrote: »

Actually less hours suits me down to the ground! 45 hours at least complies with EWTD

I had read an average earning of 44k gross for an intern somewhere in the last couple of years. That tallies more with those hours. I think there is a night allowance also.

Anita, can you shed light on the pension levy scenario? Are taining doctors part of pension scheme?

Doctors are part of the Single Public Pension Scheme so you pay an ASC which probably is 10%.

As for staying Dublin centric, it will vary. Intern rotations are according to hospital network so you’re usually no more than an hour/90 min from the main hub in that network.
Some basic training schemes are national schemes and so involve moving anywhere in the country, while the likes of medical BST are again done according to hubs similar to intern year.
HST however is usually national regardless of scheme.

taxignorant

Anita Blow wrote: »

Doctors are part of the Single Public Pension Scheme so you pay an ASC which probably is 10%.

As for staying Dublin centric, it will vary. Intern rotations are according to hospital network so you’re usually no more than an hour/90 min from the main hub in that network.
Some basic training schemes are national schemes and so involve moving anywhere in the country, while the likes of medical BST are again done according to hubs similar to intern year.
HST however is usually national regardless of scheme.

So for anyone not familiar with the public sector, from my understanding if you work for less than two years you can reclaim a portion of pension entitlements upon leaving. If you do more than two years you receive part pension upon reaching the agreed age.

If you have existing public sector pension accrued you can merge it with your pension from medicine.

The levy is nearly 10% calculated after the other deductions and it can feel like a chunk. Its important for people to be aware of that when they are thinking of paying loans, rent and living expenses.

I looked up the ACLS/PALS courses and they costs around 600 euro as well though may be paid for by your hospital or may not be required depending on the particular scheme.

It seems similar in the states. There is a website called mother's in medicine that paints a very sobering but also inspiring picture of the reality of training, though obviously there are some differences as it has mainly US contributers.

Factors like the effect of maternity on your career, having to move around so much and the effect on your relationship, how to study, the working hours involved and the expectation by the job that medicine will come above your own and your families wellbeing are discussed. Worth a read for both male and female candidates considering entering training. No point going in with our eyes closed!

thomasdylan

taxignorant wrote: »

Thanks so much for the information, it is invaluable.

How much of the moving around is it possible to avoid if you are Dublin centric? With kids in school I would prefer to stay within 1 hour of Dublin if I can.

It's almost impossible to only train in Dublin.

Intern jobs now are sometimes 6 months St. Vincents, 6 months Wexford or 9 months St Vincent's, 3 months in Mullingar/Tullamore. There are intern jobs that are purely Dublin hospitals but I think these are fairly competitive. (it's a good while since I was an intern and the jobs have changed a lot so I could be a little off on this).



After internship options are medicine, surgery, gp, obs/gynae, anaesthetics, Ed, paeds. The 2 year medical BST is at least 6 months outside Dublin in Drogheda, Letterkenny, Mullingar etc. Surgery would likely be 1 year Dublin, 1 year outside Dublin. Then HST could be literally anywhere. Anaesthetics could be anywhere in the country. Dublin GP schemes will almost certainly involve hospitals outside Dublin.

There will be night shifts and probably 24 hour call which can create big childcare issues. I found those shifts became a lot tougher after 30.

If you have children a supportive, flexible partner is almost essential.

You will never be unemployed as a doctor but if you have a decent job now it will be 7 or 8 years before you notice a big income improvement if you are replaying back 800e a month.

taxignorant

thomasdylan wrote: »

It's almost impossible to only train in Dublin.

Intern jobs now are sometimes 6 months St. Vincents, 6 months Wexford or 9 months St Vincent's, 3 months in Mullingar/Tullamore. There are intern jobs that are purely Dublin hospitals but I think these are fairly competitive. (it's a good while since I was an intern and the jobs have changed a lot so I could be a little off on this).



After internship options are medicine, surgery, gp, obs/gynae, anaesthetics, Ed, paeds. The 2 year medical BST is at least 6 months outside Dublin in Drogheda, Letterkenny, Mullingar etc. Surgery would likely be 1 year Dublin, 1 year outside Dublin. Then HST could be literally anywhere. Anaesthetics could be anywhere in the country. Dublin GP schemes will almost certainly involve hospitals outside Dublin.

There will be night shifts and probably 24 hour call which can create big childcare issues. I found those shifts became a lot tougher after 30.

If you have children a supportive, flexible partner is almost essential.

You will never be unemployed as a doctor but if you have a decent job now it will be 7 or 8 years before you notice a big income improvement if you are replaying back 800e a month.

Thanks so much for the information it is really helpful! The day after the nights are tough alright, I have already been working nights past 30 but I,m used to it now and even without needing a loan it will indeed be a good few years before I get back to former income (my mortgage is paid) ... but must be mad!

The main concern I have then would be HST the uncertainty around locations for that. I feel 3 or 6 months with big commute might workable once or twice but I cant imagine four additional years in HST with constant moves, no wonder people move abroad for shorter more family friendly schemes. My kids would be starting secondary school at that point so are the only options living away or moving their school? Do most people put off having children or do their families move around with them? My partner is super supportive but its a big ask on children who have no choice.