jackshepard

Thanks again to everyone for taking the time to read and reply. I apologize for not being able to come back to the post more frequently. To those who have seen Gattaca … I just realized how much my life resembles the main character's. I clean up after the medicine residents (and nurses, too, to an extent) while watching them go about their duties. There was a scene where the lead janitor tells the main character, when you clean the glass Vincent, don't clean it too well. You might get ideas.” To start things off … thanks to those who have explained the residency application process. It's an absolutely brutal process that is draining in every way – financially, physically, mentally; kind of like medical school itself. You guys (and gals) have presented the facts as well as I could have. The process is costly. And it becomes more and more meaningless the longer I am from my graduation. KatieMI gave me some insight into the fact that some programs prefer foreign MD grads because the programs are shadier than others. I never thought of that before, but it makes a lot of sense. As for the suggestions to go into other careers: Going the PA route is an absolute negative. I have spoken to PA's who are involved in the admissions process. They told me that they regard MD's and med school dropouts applying to PA schools as second class citizens. One even told me that the admissions folks were extra harsh to a foreign MD grad applicant. Going overseas to become a physician has been suggested to me in the past. It's true that US MD's are highly regarded in just about every other country. However, to become an actual physician would require that I take that country's exams. That means having to devote time to studying. And time is a commodity that I simply cannot waste – because I need to put food on the table, etc. Also, it's absolutely true that the longer an MD grad is removed from graduation, the more worthless the MD becomes. The only exception is if the MD grad has actually practiced medicine (such as when foreign MD's apply to US residency spots). Using my MD to get into other career fields is not that simple anymore. With the global financial slow down, many places are reluctant to add on non-producing jobs. And with the rise of sue-first-talk-later, many places that were once willing to take on MD's without residency are hesitant to do so. And believe me – I've looked into all of this. To be a professor or a teacher would require more education (Masters / PhD level) and licensing. To be any kind of administrator in a hospital would require Attending status and / or an MBA (keep in mind that the hospital's ultimate goal is to make money). To be a research professional (not lab tech) would require a PhD – labs that are spending enormous amounts of money on talent would rather hire someone with an education that was focused on research vs medicine. To be a consultant” in Pharmaceuticals would require actual medical licensing. The last place that actually replied to one of my many online job app submissions told me they were looking for someone who has worked in Heme / Onc for at least 5 years. So they're essentially asking for someone who has done Internal Med residency, Heme / Onc fellowship, and worked as a Heme / Onc attending for 5 years, and be willing to take a $80k job. When I reminded the HR lady of that, she connected me to one of her higher-ups, who said that the best she could do was to offer me a 1 year unpaid internship” in the company. I turned that offer down as quickly as the first girl I asked out did to me way back in the day (I was an awkward, nerdy, overweight teenager). The jobs that are available – well, I feel way overqualified to do (including what I'm doing now). I have a friend who is a manager at a Walmart. He says I'm welcome there any time. I haven't taken him up on that yet, but the 10 % employee discount is pretty tempting. The military has always been an option of mine. My generation was heavily involved in Iraq and Afghanistan. It sometimes pains me to think that I did not contribute to the country as much as many of the guys I grew up did. But as much as I want to enlist in the Marines, I am too old to do so (31 yo, though in the best shape of my life). Recording and publishing lectures is a great idea. Unfortunately, I simply don't have the time or resources to devote to that. I know someone who does youtube videos. His 10 minute videos often take 4 hours or more from pre-production to getting uploaded. The work involved is far more arduous and time-consuming than the average person would be capable of handling. This is why I have no problem with youtube video producers accepting advertisements to help compensate some of their time. The Missouri assistant physician” thing looks promising. Maybe it'll be worth holding out for that. But I have a bad feeling that it will not stay in motion due to the AMA's need for control. I'm also doing more research into direct to NP programs,” but that sounds less appealing due to the cost of education. Meanwhile, I think you guys are right in that I need to see what nursing is really like. I will talk to my nursing friends to see if they can offer any help. Right now, I am eager to step into the medical world, so I could be seeing the daily nursing duties with rose-tinted glasses. To the person who asked how I am doing both on this thread and through personal message: Thank you so much for caring. It means a lot, especially when I don't really communicate with my family. The legal stuff involves them and not me. Well, it did involve me in that it cost me a great deal of time, energy, and money. And being with an unsupportive gf didn't help. I'm just glad we didn't bring a child into this world. I'd be a horrible father and role model. I'm not sure about depression. I do have anhedonia, poor sleep, and feelings of guilt, but those are more likely secondary to circumstances. Negative on SI, HI, seeing things other people can't see, believing the TV is talking about me, or believing that I'm actually working for the FBI's spying-on-nurses division.

Thanks for the reply. From what I've seen while observing the nurses at work, their job seems to be fast-paced and checklist-oriented. This seems to make the work hours appear shorter than usual. And the nurses I've met don't seem nearly as jaded as the residents, who are typically working 90+ hours per week. I have to disagree with you about the "respected and regarded" part though. It seems like the nurses are the ones who are looked up to much more than physicians. The reasons are not reasonable though. For example, I've heard patients complaining that they only see their doctors for 10 minutes a day, but they get to see their nurses all day. They therefore rationalize that their doctors don't care about them - not knowing that their doctor spent 3 hours researching the best way to deal with their problem with the least amount of harm possible. Like I said, the difference in respect toward doctors are nurses are unreasonably skewed - I just think it's skewed more towards nurses.

Thanks for all the responses. Just a few things to clear up any questions about my background. I graduated from school with an MD degree. I was able to pass Step 1, Step 2 CK, and Step 2 CS. I haven't taken Step 3 yet as that exam is meant for first year residents. As for why I wasn't able to get a residency: This is something that those who have not been in my situation will never fully comprehend. There are more and more medical schools opening up each year. Yet the number of residency spots remains stagnant. Getting accepted into medical school was already a brutal challenge. I had no idea that just passing wouldn't be enough to secure a residency spot. During my time in medical school, the number of applicants skyrocketed. Last year, the numbers were 40k applicants for 20k spots. And the number of US grads who can't get a spot is increasing rapidly. There's ongoing discussion about this, but nothing will be done. To most of the medical field, we are the pariahs. Very few in the field are willing to advise or mentor us. My school has stopped communicating with me because I am no longer able to generate any revenue for them. Ever seen the movie Gattaca? I often feel like the main character – one who is genetically inferior competing amongst the elite (an exaggeration, of course – but you get the idea). Anyway, the increase in the number of applicants vs spots available has caused an increase in the required score to pass each exam. I had to repeat some exams. I have always been an average student who just happened to be the most hard working (ie I was completely financially independent at 18). Unfortunately, that wasn't good enough to avoid struggling in med school. Add to that plenty of things out of my control, and you can sort of get an image of my background. These issues include things like family issues (with law enforcement involved) and my own health issues currently checkups with Oncology q 3 months (and it's just awesome having to stretch those out because I can't afford it). I apologize, but I don't feel comfortable sharing any more than that. And I am not looking for any pity. We've all faced problems. I'm sure some of you have had much worse. To those who are saying to keep trying: The chances are far too low to be worth the struggle. The cost of applications is one thing. For someone in my position, I'd have to apply to 150+ programs throughout the country. The application process is about $3k. Then I am responsible for all travel expenses. At the same time, it is very hard to find any decent employment. An MD without residency is worthless. Some believe that we can just go to research or the pharmaceutical industry. This is false. If you were in charge of a research project, would you rather have an MD who was not trained to do research? Or would you rather have a PhD grad whose entire grad education has been about research? If you were in charge of a pharmaceutical company, would you rather have an MD who has basic med school / first year residency level knowledge of medications? Or would you rather have a physician who has gone through residency and practiced and knows practical applications for the drugs in question? Regarding the loans: The only reason I am not as distressed about the loans is that I will not be responsible for them come 15 years. You may have heard of the pay as you earn program. With any federal loans (which covers all med school expenses), I just have to pay a certain percentage of my income for the next 15 years and then the loans will be wiped clean. For most successful grads who eventually become physicians, they'll have paid off their debt long before those 15 years. But for the rest of us who will not have that opportunity, we will become society's parasites. I hate what I have become, but I see no choice but to embrace it. So that's where I am now – 1 year out of school and working a just-above-minimum-wage job in a local hospital. I supplement my income with manual labor outside of my regular work hours. I am friends with several nurses and nursing students. As I love teaching, I started helping some of my nursing student friends with the better understanding of some topics. They appreciate that I am going at the topics in a different direction. Ie. I showed them how to memorize the clotting cascade and all the major drugs related to it – from Heparin to Warfarin to direct factor 2 inhibitors to direct factor 10 inhibitors. Another of my prouder moments was helping them to comfortably understand Potassium and Sodium balance. Ie. know that Hyperkalemia is due to K out of cells (Beta Blockers, DKA / low Insulin, acidosis such as vomiting, or other cell busting events like tumor lysis, rhabdo, injury, etc) or K failing to leave the nephrons (CKD, decrease in Aldosterone production such as Addison's Disease, and anything that antagonizes Aldosterone like Type 4 RTA by Spironolactone, Lisinopril, Heparin, Phenytoin). I even prepared notes for them so they can review and memorize in the most efficient manner. My closest friend of the group told me that it would be a shame for me to just give up on medicine like that. He suggested that I should go into nursing so that I could still be of some use to the medical field. Sorry if that was too much of a rant. And sorry for any typos or grammatical errors. I am typing all up all of this before my shift starts. I strongly believe that I can succeed in nursing. I will not have problems with the academics, as I've cut every toxic thing out of my life (including the aforementioned family issues). I am just not sure if the application process will be as painful as getting into med school. And I am not sure what kind of discrimination (if any) I'll face prior to, during, and after nursing school. It's a shame that I can't find others like me. It seems like most of my fellow pariahs / parasites have removed themselves from medicine. One guy is struggling to run his own business. Another returned to his home country (not for medicine). Thanks again for listening / reading.

Hi all. New user here. I apologize if this is in the wrong subsection. Mods, please move as needed. I'll get straight to the point. I am a recent US MD graduate. Did not get into residency. Major reasons were beyond my control. But with the continued trend of having more US grads competing with a stagnant number of residency spots, my story is hardly unique. Anyway, I passed Step 1 and both parts of Step 2, which were required for graduation. I have worked alongside nurses and have a great appreciation for what they do. I thought about going the RN route prior to embarking on the MD adventure. I understand that becoming an RN will take more schooling. I am certain I can handle it as well as any other person transitioning from a different career into nursing. And the loans required don't scare me. I bet I have more than 99 % of RN students! What are your thoughts about this? Have you all run into MD to RN folks? Will my MD background be an asset or liability when it comes to applying for RN schools or RN jobs post-school? Thanks for taking the time to read this.