Casiobashio wrote:shcmike wrote:
You learn virtually nothing from medical school. It is residency where you learn things, so it is very similar. It is "real world experience" where you learn medicine.
It is not similar at all. All of 3rd year of medical school is one long practice run for being a generalist. By the time you graduate medical school you will feel comfortable taking care of a ward of patients with common medical problems under minimal supervision.
Neurosurgery, you are correct, is all learned in residency. You seem like somebody who is literally obsessed with prestige, or maybe watched too much Sanjay Gupta on CNN (who, by the way, does not have a JD). Why the hell would you want to be a Neurosurgeon if your goal is to be on the forefront of health policy in america? Neurosurgery is a 7 year hellish residency program where you learn the highly specific skill set of operating on the brain and spinal cord. Your residency will be a string of 80+ hour work weeks, by the end of which you will remember virtually nothing about general medicine, and you probably wont care at all about law. You will be an expert at the microdiscectomy and craniotomy though.
Your plan might make sense if you were choosing internal medicine/family/pediatrics and you wanted to focus on health policy for a particular demographic. Or if you wanted to start a medical-legal partnership for low income populations. Hell, even general surgery would be defensible, if you see yourself as a young Atul Gawande (again, no JD).
To be clear...MD/MPH = 5 years. JD = 3 years. Neurosurgery residency = 7 years. And you sound like the kinda guy who would then go for the spine fellowship, so lets tag on an extra year to be safe. You are looking at a about 16 years of post-bachelor training. If you started medical school right after college, you will be 38 years old before you have your first job that pays higher than minimum wage for your hours. This job will likely be as an attending on a neurosurgery service, and have almost nothing to do with law or policy, because it will have been 8-9 years since you graduated law school and you will be in debt. You won't turn down that 300k+ assistant professor salary.
Just skip the law school part, bust your ass on Step 1 and 3rd year clerkships, publish some badass neurosurgery research and get into a top residency. Get involved in the american association of neurologic surgeons, and use the MPH as your stepping stone into a policy position from within the AAMC. At that point if your career is held up due to a lack of JD I will literally eat my hat.
Studying all weekend, so I abandoned this for a few days. First off, I am in a 4-year MD/MPH, so I get both at the same time. Also, I am interested in spine; however, I am more interested in academics, because my research focus is on spinal cord injury. Neurosurgery has enfolded fellowships unless you do endovascular, which I am not interested in pursuing, or peds, which I am interested in. I don't watch CNN, but I know who you are speaking about; however, he is FAR from my idol. You may also appreciate this article in the NY times called "Is There a Doctor in the House? Yes, 17. And 3 in the Senate". I am not interested in this solely for money; however, I do want to live comfortably and provide for my future family, as we all do. Honestly, there are a lot more things I could pursue for the potential of higher returns, especially in the wake of health care reform uncertainty.
A JD comes in handy in research and administration. I am very interested in woking at the University of Miami, and my ultimate goal is working with the Miami Project. I want to help cure paralysis. This is what initially got me involved in neurosurgery. It amazed me to see someone with minimal functionality and movement regain that due to surgery. I look up to a guy named Barth Green, Paul Fellers, and Pedro Greer. Health policy spans WAY more than merely primary care. Every section of medicine has a different focused patient population, and policy reaches each of these people individually. I have done a lot of work abroad, and my focus has, and will always be, Latin America, hence my love of Miami. My focus has changed from international work to work domestically, because health poverty is largely overlooked here. In medicine it is "sexy" to work abroad. True change does not happen by me helping one patient at an outreach I do one week out of the year, like international medicine achieves. Surgery is a good field to help make a lasting change for obvious reasons, but it is so minimal in its impact. As I said in my PS for medical school, healing one person changes their world; however, I want to have a far reaching impact. I do not want to be on CNN, or some BS reality show about physicians.. I want to do this for me, and for those people I am helping. Policy experience would help me be able to tailor policies, funds, medical resources, etc. to the population I help. A JD may not be necessary; however, I want to vet all my options, especially with the opportunities I have been afforded. I am a life-long learner, and want to be educated as much as possible to ensure that I achieve MY goals. My family always put the main focus on education as I grew up, which I take to heart, because my parents did not go to college. A JD is something I am considering if it actually gives me the tools I need to impact my patients in the way I hope to impact them. If it does not, then I will not get one. My goal is not to practice medicine in the sense that I do not want to solely do surgery my whole life. Eventually, I want to transition into an administrative role. I have considered a MBA for years, and am going to get one if I do not get a JD. The JD has been more of an after thought knowing that the degree would set me up for administration, while also setting me up in a greater way to influence policy. However, if the MPH would suffice, then hell I wouldn't mind saving 1-2 years and getting a MBA. As of now, I just feel like the MPH may not give me all the skills I need, but the true skills are probably learned through experience.
I am interested in neurosurgery for many reasons, and I currently do research with a few neurosurgeons at my school. At the end of medical school you are not trained as a generalist.. That is far from the truth. You do have some idea of how medicine works, and have some VERY minimal ability to practice alone, but you are not good enough to be alone, hence residency. You have basically learned the language, but your true critical thinking skills are built after medicine. To me that seems much like law school, where you learn the basics of law and interpretation but you learn concrete skills in the field. If that was the case for medicine, it would be like dental school, where you could practice alone after 4 years. Also, the last thing you said I agree with 100%. Academic medicine is much like law it sounds like, where name means more than anything. Everyone wants to recruit Harvard, Hopkins, UCSF, etc. trained physicians in academics, which sounds a lot like people have described for law.
The main predicament is that I would probably forget what I learned in law school by the time I could truly use it; however, I have heard residencies will recruit people based on extra degrees, because it is basically an added free bonus to have someone versed in business or law as a resident. However, there is NO way I would get a JD based on that. I definitely need to see it as something that works into my future. When thinking about things of this nature, I definitely am the type of person that looks into the future; however, my focus of the future extends WAY beyond my 30s, where many people's view does not. Again, it sounds like if I would not use it until 20-30+ years down the line, that it would probably be a waste of time on many levels.
I am merely gauging the usefulness of a JD now, and am actually meeting with an attending at my school who has a MD/JD. It seems like he may dissuade me from it based on our emails, and he received his after he was an MD. I definitely do not want to rush into a decision, because it is a HUGE financial and time commitment. From what I have heard from the residents I work with, it could be a million+ dollar decision in terms of future salary from practicing neurosurgery, and graduating with 150k+ in debt makes me want to be sure that the loss is worth it. Regardless of my track, I will be in my mid 30s when I finish. I took 2 years off before school started, as many of my peers do, so time is definitely on my mind.
