Thanks to a surprisingly competent group of interns I also have time to write on this second topic.  Medical kids enjoy and don’t expect back to back articles to ever happen again! Cheers!

The best thing about the MCAT is complaining about it.  It’s the first universally recognized rite of passage that the rest of the world gets subjected to.  Marines have their crucible, PhDs defend dissertations but pre-meds have a slightly more difficult SAT and you better believe you’re going to hear about it.

So when I read that they were revamping the MCAT I had mixed feelings.  I was relieved that there was no talk of diversity, because I knew that if there was it would only be to say that minorities under-perform and that’s kind of a downer.  When I read that the MCAT was originally designed to combat the then abysmal attrition rate I thought ok, they are going to say the MCAT was needed so kids wouldn’t take on debt and then drop out with no MD to show for it.  Turns out the article really was just about the MCAT.  I guess I am programmed to see certain things everywhere even if they don’t exist.  But hey, while we’re talking about diversity and debt let’s go ahead and address those issues.

It’s no secret I hate doctors whose parents were doctors.  I hate them because I think 1) they have an unfair advantage and 2) most don’t actually want to be doctors it’s just the family business and they want to continue the standard of living in which they have become accustomed.  Ironically, the revamped MCAT is supposed to be a better indicator of the latter, aka whether someone actually WANTS to become a doctor.  Please.  I started studying for the MCAT a year and a half in advance.  Second generation doctors start putting in time in 8th grade.  You think a few psych and socio questions are going to make a difference? Pass.

It would be more useful instead to make a separate test, have a nonprofit administer it in say, middle school in economically disadvantaged areas, and give youngsters who show an aptitude for becoming a doctor a chance to participate in a program that preps them in a similar fasion as the spoiled rich kids get.  Get them used to taking standardized tests.  Show them around a lab. Demystify the process a bit for those who would otherwise not be exposed.  The organization would have to have a for-profit arm so rich kids could join (otherwise the elite would smell an agent trying to level the playing field and destroy it).  The tuition for the for-profit arm could then go to the non-profit arm for scholarships and the like. It’s a genius plan.

There is not much one can do about medical school debt.  Medical school requires labs, cadavers, equipment, space, textbooks with the latest medical breakthroughs and instructors who have actually worked in the field.  It’s not like law school which as near as I can tell has no costs that couldn’t be virtually eliminated.  I know of truckers who’ve passed the bar in numerous states by listening to law lectures on tape while driving on long hauls.  One in California had never graduated from high school, didn’t speak English as a first language and never had owned a computer.  You can however, level the playing field just a bit by simply reversing the search order from finding those who have the potential to be good doctors within the sample set of excellent test takers, to finding good test takers within the sample set of those with the potential to be excellent doctors.  I’d think the latter would work harder to get those test scores up than the former would on their bedside manner.  Everybody wins – even the cold fish with the 44 MCAT.  He or she would have been happier in business school.

Well here we go.  No I haven’t written in awhile BUT due to a mercifully slow night you in the medical community are about to get an article that is relevant to you.  Yay.

There are two types of doctors: doctors who want to be doctors and doctors who want to be successful.  Doctors who want to be doctors work at hospitals and volunteer/have lives outside of the hospital.  Doctors who want to be successful build private practices and spend all their time, whether at the dinner table or in the operating room, trying to figure out how to make that private practice more successful.  In a non-bimodal world I like to call reality, most doctors go back and forth.  Unexpectedly, debt is the reason for this, whether you have it or not.

Debt.  Most doctors have it.  Most would like to pay it back. Most opt for the guarantee of hospital work, a standard salary, and the ability to comfortably make their loan payments.  Comfortable by debtor’s prison standards.  But there are any number of things you could have done to be comfortable by debtor’s prison standards…particularly by age 37.  At that age you could already have 20 years experience in say, retail, and be managing several stores.  No, you became a doctor to be slightly better off than comfortable, and to have a nicer car than the soccer mom who “works in IT” part time.  So you enter private practice.  Suddenly there are all these business considerations.  You didn’t get an MBA, you got an MD.  Aren’t these things supposed to handle themselves? Health Information Technology? What is that? Why do you care? You just wanted to get paid more and the doctor in private practice, six years your junior, has a much nicer car than you.  Then the practice has a bad year.  Suddenly your paycheck shrinks.  Doctors are supposed to be isolated from the economy! So you go back.  The process repeats itself.  You think you’ll do better at a different private practice.

Debt. A lot of doctors don’t have it.  Their parents are doctors and their parents work in private practice.  Joining a private practice is just what you do.  You don’t notice at first how much time you spend doing administrative tasks.  Plus, you’re new so it is to be expected.  The wake up call comes when you’re told that you need to start bringing in patients to the practice.  Pulling your weight it’s called.  You are puzzled.  You can’t create more sick people and existing sick people have doctors if they can afford it and you remember what happened the last time you brought in a sick person that could not afford it – though at the time you were just happy that it’s prominence on your review may have caused your seniors to overlook the rookie mistakes you made.  But those only affect patients and not the bottom line.  One day you wake up and realize you’re in your 30s, have no debt, a nice car you got for a great deal by going to your dad’s dealer and it dawns on you that you don’t need quite so much money.  You just want to practice medicine and enjoy life.  So you go to a hospital.  Hours are great, patient care is great.  But suddenly nobody is talking to you at the country club.  You think it’s because your car looks a little dated since their was a redesign on next year’s model.  You think of upgrading.  You can do it, but it’s a stretch.  You’ve already noticed a bank account that once held steady is now very slowly, but very deliberately, on the decline.  Then some pencil-pusher calls you into his office with questions about a test you ran just to checkout a hunch.  This non-doctor, non-peer, has the audacity to ask YOU about a medical test? You don’t presume to ask him about pencil sharpeners and off the rack suits.  So you go back to private practice.  The process starts over.  Things will be different at a different hospital.

I am not the biggest fan of kids.  I did my rotation through pediatrics and was told I’d be a good pediatrician because I didn’t let emotions get in the way of medicine, and because children are more comfortable with a female doctor.  Pass.  One of the things I did notice though was that there were alot of fat kids.  Half of the kids were in my humble opinion fat enough to be the “fat” kid in their respective class, the one with no friends that everyone poked fun at.  My thought is that an anti-obesity campaign is so benign as to be almost useless.  Michelle Obama is a beautiful, empowered, intelligent woman who could raise awareness about any number of issues.  Then I heard about Rush Limbaugh, a morbidly obese, fat drug addict, attacking the first lady over her anti-obesity campaign.  This indicates the type of bald-faced hatred that still permeates a great deal of the 48% of the country that did not vote for Obama.

I do not know exactly why I found Limbaugh’s commentary to be so much more offensive than Sarah Palin’s similar comments.  Palin constantly goes out of her way to take shots at the first lady, going as far as to dedicate a plate of smores to her in the defiant act of eating dessert.  Sadly, I suspect the reason for this is that Sarah Palin, who is losing her battle with age, is still in far better shape than Rush Limbaugh.  The hypocrisy of a man who can lose well over 50 lbs and not look any different criticizing someone for combating childhood obesity cuts through my political apathy and strikes me as absurd.  It also demonstrates that I was wrong about two things.  First, that the first lady should have taken on something more concrete, and two, that childhood obesity isn’t such a big deal.

Hillary Clinton and Michelle Obama are very similar.  Beautiful, brilliant, ambitious – but when Hillary was first lady these traits were used against her.  She was attacked for it.  I can still remember in middle school seeing the bumper stickers that read “Impeach Clinton and her Husband.”  Michelle Obama learned from history and purposefully chose something seemingly innocuous and adopted the middle America friendly moniker “Mom in Chief.”  But is childhood obesity really that innocuous?

The fat kids I met were not the fat kids I remember from school.  They didn’t play video games 20 hrs a day, didn’t have chocolate constantly smeared on his faces, liked and were good at sports.  Well, not all of them.  There were some “traditional” candy-loving, video-game playing chess club attending geeks.  But the point remains, childhood obesity isn’t primarily due to what kids DO it’s about the FOOD children have access to, particularly in poor communities.  And that is a very worthy political issue.

Benito talks about how everything he learned in law school was either useless or a lie.  One of my greatest fears was discovering any similarities between medical school and law school.  The human body is the human body and science is science, I assured myself.  Law is just crap made up by old people to protect their property.  Sadly, I must admit that nutrition is one area where medical school takes on a sort of law school-esque motif.  First, doctors are not nutritionists and the entire industry is not based on prevention.  Second the food pyramid is bullshit.  People don’t need meat.  People don’t need dairy.

The Obamas learned something, alot of things from the Clintons.  I understand it would be political suicide now, but perhaps if the Obamas are as active as the Clintons are in their post-whitehouse days perhaps they’ll take a play from the Clinton playbook and go vegan.

I decided to do a little mentoring in honor of Black History Month so I went back to my undergrad Alma mater and sat on one of those panels for one of those events only uncool freshman and officers in the Black Student Alliance go to. Not surprisingly I was not the only doctor there. One of my colleagues, when asked what was the difference between the kids who got through (med school) and those that didn’t, replied “we’re all donkeys following a carrot on a stick. The ones that make it never stop and eat the grass all around them.” When asked to elaborate he said “we’re also not the ones who starve to death.”

It was the only insightful poignant thing said in a discussion that revolved around numbers and the giant elephant in the room- which of course was how to address the plethora of concealed discriminatory tactics meant to keep blacks away from math and science and pursuing careers in this necessary field.

Therein of course lies the dilemma of the black student. For the white student, after you’ve followed the carrot for a reasonable length of time hell, eat some grass. You only live once. The black student has no such luxury. Why? Because we remember our forefathers who DID NOT get to live once, and to honor their legacy we will follow the carrot until we collapse so long as we don’t see Jim Crow’s son on our backs with the pole and string.

It’s hard to decide whether to confront the younger generation with the truth. They should have the benefit of the knowledge earned with the broken lives of our greatest minds but knowing the truth comes at a price and that price is madness.

I’ll be the first to admit that I don’t think about these things on a daily basis.  I can’t.  No, I am not saying one can’t, I am saying I personally can’t do it.  I get up, I go to the hospital and I have one thing on my mind: learning the medicine and the politics to get where I need to be in my medical career.  I deal with racism, and to a lesser extent sexism, on a daily basis but I don’t try and make changes for everyone, I try and find exceptions for me personally, and when I’m done, I go home to my white boyfriend with REAL as opposed to the Mike Triforce (aka imagined) abs and let him take care of me.

But once a year, usually in February, I try and confront the madness…the madness that in the very process of simply looking for exceptions for myself as opposed to trying to change things at the expense of my own career is the very thing that this 400 year-old evil machine wants me to do and the very thing that makes me unworthy of the legacy of my forefathers even though the generation before mine loves to stand next to me in a cap and gown…once, twice, thrice, then with a white coat…all around while people just like me suffer from ailments so severe as to make any bodily harm trivial.

Shifting gears a little bit, it’s also mind boggling for me when I contemplate how alone I really am.  I couldn’t say any of this at the mentorship program.  All the mentorship program is designed to do is help the machine keep tabs on all of us…to keep us all in once place.  And what do we get in exchange? I get a weak salve for my conscious and some pre-med kid already well over 100k in debt gets a few names he can call in the hopes that one of them can sssssstretch one of those exceptions into a double exception, perhaps if there has been a race scandal recently.

Sigh.  Phase 2 of the Racial Calendar.  It begins with the Doctor King Holiday, goes to Black History Month, is almost always followed in March by a racial scandal on a college campus…until we are all save d by warmer weather and March Madness.

So I am on call and it’s Christmas Eve. So far it’s been pretty standard. Alot of drunk driving fatalities, alot of long suffering cancer patients going home and alot of sick children. I wasn’t even going to bitch but for two things 1) I am covering for someone who doesn’t even celebrate Christmas and 2) I just got a text from Mike Triforce reading “I’m working. R U?”

First, that bastard is working by choice. Every year he goes into the office on Christmas Eve and stays until late on Christmas day to get face time with the movers and shakers in the firm and to make up for 11.5 months of not doing shit. He then makes his family wait (he insists they not but he knows they will anyway) for three hours before eating Christmas dinner, until he arrives, looking extra frazzled and of course bearing extremely extravagant gifts. It also allows him to avoid bringing the Princess to his parent’s house because even he has the decency not to bring that filthy tramp into his parent’s home on one of the holiest days of the year.

So I call Benito looking to bitch and of course that makes the situation worse. First I mention working on Christmas Eve and immediately feel bad because Benito has no work or job. I try and recover saying it’s just the plight of the professional, but then I realize technically Benito is a professional. Then I hear his mother on the line saying she wished Benito had somewhere else to be Christmas Eve, or anytime for that matter, even if it wasn’t a job so she wouldn’t have to keep explaining that her 30 year-old balding son lives with her and has no job prospects despite having more education than most Professors. His mom got off the line and then I cursed Benito out for making me feel worse not better.

I called Alpha Man. At least he has a few part time jobs.  He got on my nerves responding to everything I said with some hippie-zen bullshit before turning the conversation to healthcare generally, Obama’s health plan and two seconds later the 2012 election. I noticed his voice sounded funny, and he replied it was cold in Fairmount Park where he set up his tent and his teeth were chattering. Once again I felt bad and proceeded to curse him out. It’s always awkward talking to An ex around the holidays anyway.

I called Icarus but he was so drunk I was shocked he’d even been able to answer his phone. He kept babbling about pills and lights and trees. To be honest I am a bit tired of what I consider to be an overdramatic display to convey that he is some kind of tortured literary soul. You’re a substitute teacher, a conveyer of worksheets, a temp for a shifty job that already gets no respect. Yes you have a Phd and the fulltime person has an Associates degree but at least when they are on a plane and their is a heart attack no one mistakes them for being useful wasting precious time. I cursed Icarus out.

Now I know you see a pattern developing and I will have you know I didn’t curse out KF Li or even leave a profanity filled message on his phone. Neither did I curse out Erin whose number I actually have in my possession.

I called well-adjusted Erin with high hopes. I could feel the pressure of my coming bitch session as the minutes of my precious break began to slip away.  But then tragedy. Erin’s aunt had just passed away and so I was forced to listen to tears shed over someone I had not pronounced…so sad. I gave her my condolences and said my break was up, which it almost was. But I was still mad.

I called Benito back and cursed him out for not telling me about Erin’s aunt. When I was finished he told me that it wasn’t her aunt, but her great aunt, as in her dead grandfather’s dead brother’s second wife also divorced whom she had never met and been dead for over a week. Oh hell no. I cursed Benito out for a third time to practice what I was going to say to Erin.

I called her from the hospital phone so as to thwart the caller ID. Guess who answered her phone all Christmas-happy sparkly? So I lace into her and get this, she goes she’d already taken 4 calls from friends who had to work Christmas/Christmas Eve and just couldn’t deal with another so she embellished a bit. Then she gets all preachy, there are worse things this and that and at least you have a job and family and don’t spend the holidays depressed etc.

I really would like to curse out the person who invented the phrase “it could be worse.” I was livid at the thought of Erin wallowing in her self-righteousness, a feeling I could have been savoring if I had never called her. It had crossed my mind to weigh the satisfaction of venting with the feeling of superiority that comes from helping people at Christmas time. To be honest I was probably trying to have my cake and eat it too, figuring more people would be like Benito and allow me to vent and stroke my ego.

But whatever. Erin won this round. I will wait until New Years when she is watching the ball and feeling lonely and be sure to make out with Simon in front of her. Unless I have to work then too. I have been here so long I have no idea what day it is.

So I am out at a restaurant with SG and some of her doctor friends. The night is a waste. All but one of the male doctors came in their scrubs which is a non-starter and the only one who didn’t removed his until then welcome hand on my knees when his buddy not so subtlely let it slip that he was engaged. The tool then turns his conversation to Egypt where he had recently vacationed with said fiancée and turns out half the table had been. I hadn’t said anything in awhile so I make some cliche crack about rich doctors.

The table goes silent. They look indignant. They say that as residents they make “nothing” and that I make more than anyone at the table. They then proceed to nominate me to pay the bill. I am speechless.

For a split second my half-lawyer instinct kicks in and I drop plastic. They proceed to order drinks and after dinner appetizers. Yes, they ordered more food after their entrees as soon as it became free to them. I had to sign the name of one of those douche bags and report my card stolen and I hate using Mike Triforce tricks.

SG here. Yeah. That just happened. First, in my profession’s defense it’s not like Erin has never seen Scrubs and doesn’t know Medical residents resent their low pay COMPARATIVE TO LEVEL of EDUCATION. Nevertheless I’ll admit the situation is akin to the rich kid with a paper route lamenting his economic situation based solely on his income from that endeavor. I can personally atest to the fact that no one present at the dinner actually has to live solely on their residency wages.

Look, doctors are not economists. If they were they’d have chosen finance.  Benito and Alpha Man have written endlessly about the inter-generational transfer of wealth and Erin wrote “my rich friends make less than my poor friends” so it’s sort of understood what we mean when we say we’re poor. It’s not that we have a low wage necessarily or a high one with alot of debt we mean that we lack the current and foreseeable economic means to provide for our basic needs without running afoul of the legal system. Doctors don’t understand that like Eskimos don’t understand the rain forest. It’s just too far removed from their perspective.

So what is the doctor’s perspective? A young doctor considers his or herself to exist within their own bright future’s history. They know in 20 years they’ll be telling stories about how they built themselves up from nothing. They believe their own shit before they’ve even eaten the meal. But let’s get off doctors before I’m labeled a turncoat. The problem is not doctors after all, it’s America.

Building something from nothing is the most popular American legend. In fact the ability or right to do so, as opposed to a. system of aristocracy or slavery was at the heart of our greatest wars. But the fact that that right exists does not mean that it’s practice is common if for no other reason that those who are successful at doing so necessarily deprive their children of the chance for doing so by providing for them. It’s called the middle class.

Now I know this post was long before I even began talking but here is my point about student debt. It deprives families of that middle-classness by creating a black hole for funds that would have been down payments on first houses or a used car after school or a loan to start that small business. Rather than any of those things kids get a piece of paper worth less than the crumbled newspaper homeless people use to insulate themselves against the cold. Doctors are given much but feel they are independent and self-made. The broken debtors give everything and borrow to give more and receive nothing…but feel they are dependent internal infants sucking at society’s bottle.

Remember as a kid, probably somewhere around 4th or 5th grade, your parents stopped being able to help you with your homework?  Now, if you’re like me with parents who had college degrees (and then some) you probably remember asking yourself, how your parents who not only finished regular school but went to some kind of super school that requires a lifetime of saving AND was so important that it was worth it to live in a tiny prison-like room for four years to attend.  All that and you can’t multiply fractions?  So sad.

Eventually you stopped asking your parents for help with your homework.  That’s what older siblings, tutors and perhaps a little more concentration and a little less TV was for.  But most likely you never reconciled the fact that your parents were intelligent, functioning, employed adults who either didn’t know or had forgotten something so essential that it’s taught universally in grade school.

If we had engaged in this simple mental exercise we most likely would have concluded that much of what we were learning wasn’t necessary to be a functional adult.  Of course then we’re left wondering why they teach us things in school we don’t need.  I realize I am asking alot here, and if you were any kind of normal child you would have simply concluded that school was simply an instrument of childcare and torture.  It never would have occurred to you that perhaps school COULDN’T really prepare you any better than it already was for what was ahead.  If it had then most likely you would have ended your formal education as soon as possible.

I took the opposite route folks.  I decided to go to school where I knew that everything I learned had a purpose and an application.  That knowledge is at the core of my sanity.  I’m almost 30 and I’m nearly a decade away from any given specialty.  I don’t even care.  It could be two decades.  But everything I am learning has a literal life or death purpose, and if I ask an attending for assistance he for damn sure knows the answer.  Or someone dies. 

I’ve talked to Benito a little bit about how law works, how partners have no general body of knowledge and expect underlings to have all the answers.  Judges renowned for their apparent wisdom hire fresh law grads to write their decisions.  Salaries for graduates vary widely and its not uncommon to make six figures for a couple years and then less than the average plumber for the rest of your professional life.

I like being a doctor, but I am not in love with medicine.  However I think 9 out of 10 people will do more to avoid what they hate than to have what they love (with the notable exception of addicts).  And I hate it when the world, particularly one I am asked to invest in so heavily, makes absolutely no sense.  So I became a doctor and decided to work with a body (as opposed to a body of law) that was clearly formulated with a single, rational mind, as opposed to many irrational ones.

So please, particularly if you’re borrowing money, think about what you’re doing.  Does it make sense? Can someone ten years further down the path you’re on do what you’re doing right now? If you’re anything other than a professional athlete and the answer is no you might want to rethink that.  I’m just saying.

So there have been alot of things to get used to working at my new job.  Just about everyone goes on vacation between the 4th of July and Labor Day.  Just about everyone works between 8 and 6.  Many people are content with their current jobs and plan to work there until they retire.  They see their children and significant others.  If you refer to someone as the “nice” guy that’s usually not enough to identify them.  If you refer to someone as an “asshole” usually that is enough to identify them.  But there was always something more…and unfortunately for nurses that “something more” was the fact that my new profession wasn’t subservient to another.

I know being a paralegal and a nurse have many differences, but at the end of the day they are subservients to lawyers and doctors respectively, and it doesn’t matter if the former has been on the job 40 years and the latter is on their first day…JD equals “Just Do what I say” and MD equals ”My Decision.” 

So what do we do? We live with it.  Paralegals because we need a check.  Nurses because they do a valuable service and help people.  That is the first major thing that separates a nurse from a paralegal.  Their job has meaning.  Yay! Plus for nurses…except that doctors know this and they abuse nurses even more because of it.  The second and last major thing that separates nurses from paralegals is that it’s relatively easy to go from being a paralegal to lawyer, relatively difficult to go from nurse to doctor. 

I am not all that familiar with the nurse/medical school curriculums.  I would think as a matter of common sense that the bodies of knowledge overlap.  Therefore, if medicine was not a profession, and medicine was not a business, and we as a society simply wanted to provide the best healthcare to as many people as possible it would SEEM that nurses should have expediated ways of getting their M.D.  If doctors looked at nurses like people who were simply taking the long way around to their eventual destination they would treat them with a little more respect.

But let’s be real.  That’s never, ever going to happen.  If you’re in nursing school and you’re already bitching about how med students/doctors say that you should breeze right through your curriculum then this really isn’t the job for you.  Nursing curriculums are getting harder, longer and more expensive and nurse salaries and prestige are not rising accordingly.  If you already have significant deposits in the resentment bank and you’re several years away from day one get out now.  Not for yourself but for your future patients.

I know this one nurse in her fifties who after thirty years of getting passed by doctors in the parking lot in beemers she decided to mortgage everything she had and get one for herself.  Naturally she couldn’t afford it so she “traded down” to a lexus after transferring the lease to her debt-ridden idiot son fresh out of lawschool.  Then she got laid off and now works as a low-level pencil pusher in some insurance company.  Her son and husband lost their jobs in the same period of time…so her son “traded down” to a brand new Mustang ala Mike Triforce.  Like mother like son.  At least he’s not dating a diseased bar skank (love you princess!) The point is don’t be this woman.  The question is…how?

The key is to define yourself as something that’s not your job.  That’s one reason why the best nurses are mothers…though not the one above.  Maybe you play/coach a sport.  Maybe you love dancing, or traveling.  Maybe you love write or garden.  If you’re a nurse you care about people.  There is SO MUCH more you can do to help people (particularly kids)…but don’t do it for people.  If you’re a good nurse you’ve done more than your fair share.  This you need to do for yourself because it will help you on the job and give you something that a doctor can’t belittle.

Oh, and before the doctors start commenting…this was written with the blessing of Simon’s Girlfriend

So my cousin Bobby was making his college decision last year around this time. He committed to Maryland (where he’s from) but then got into Johns Hopkins off the waitlist. At the time I encouraged him to go to Hopkins because Maryland kids are thuggish and Bobby was still known as “Young Breezy aka Bitches n’ Tits also known as TYD.” TYD stood for “Throat Yogurt Dispenser.” However Aunt Jenine wasn’t rich so Bobby had to take out a fair number of loans.

So I spend a weekend with him this summer and instead of listening to my helpful hints about orgo this silly ass can’t stop talking about how healthcare reform is going to adversely effect his earning potential. Seriously?

Look young bucks- you’ve got 15-20 years before you see a DIME from practicing medicine. Undergrad, Med School, and Residency alone is 12 assuming no time off and graduating as fast as possible. Second, We are NOT bankers…we’re not activists either but definitely not bankers.

Here’s what I mean. It’s fucked up but understandable that Wall Street bitches about financial reform BECAUSE the assumption is they are trying to get paid as much as possible period AND because Wall Street Reform lowers what a banker with said mindset can make. As doctors we 1) are supposed to at least pretend to care about patients and 2) healthcare reform doesn’t affect doctors who are just trying to get paid.

I think the first point is self-explanatory. As for the second hey, if you want to become a highly specialized doctor in dermatology, plastic surgery or some other useless field and make a killing nothing is stopping you. Join a lucrative private practice that only caters to individuals with Cadillac Insurance policies. Quietly stop accepting Medicare and Medicaid patients…once you have a decade’s worth of loans to pay off. But please don’t let me hear you bitching about your future salary when yo Mamie was paying for the paper you wiped your ass with 18 months ago.  That goes double if your parents are paying for the whole multiple decade endeavor. Seriously fuck you.

When I was a kid growing up I lived next door to a girl named Jessica. We were thick as thieves for five years until my parents moved. I only found out recently via facebook that her dad was a doctor, even though I vividly recall referring to him as “Mr. Goldman.” She told me that her dad didn’t like to use the title outside of the hospital as it created a “stay one step ahead of the joneses” mentality.

I love you Mr. Goldman. Here’s hoping in the future neighborhood kids call me Mrs. Belmont. Hint hint Simon.

Three steps to get where I am for free 1) full-ride to college 2) get into medical school 3) Join the Army.

If you want to be a doctor you want to take standardized tests for the next 15 years. They keep getting harder. You better be able to do well enough on the first two (PSAT and SAT) to get into somebody’s college for free. Fall back is the best public school in your state. DO NOT go to a private college. Med School is MCAT plus grades plus nothing. Even if your MCAT and GPA and strength of schedule are exactly the same as someone from a public school your admissions officer is just as if not more likely to have a grudge against a specific  school like a Duke or a UPenn due to a perceived professional slight or even a sports grudge.

Get into med school. No brainer right? Wrong. You need to take the MCAT off cycle. You need to knockout tough courses in the summer and preferably at easier schools. You need some research experience on your resume. Your high school chem teacher majored in chemistry and had a real high GPA.

Finally join the Army. They will pay for med school in exchange for a commitment that conveniently is the length of your residency and you won’t have to pay rent or taxes. Plus if you’re a guy, the only thing that gets more play than a doctor is a soldier. If you’re a girl you ain’t gonna have slot of time to meet guys but if you’re in the military I can guarantee it won’t be a problem.