Choosing a medical field: Money Talks or Passion Rules?

Athensillustrates the rule that communities with too many poor people have too few doctors caring for them. As one of the poorest counties in the nation for its size,ClarkeCountydoesn’t have nearly enough primary care doctors to go around.

But maybe the Georgia Health Sciences University-University ofGeorgiaMedical Partnership, now teaching its third cohort of medical students, can help.

“The opening of GHSU-UGA medical school in Athens helps increase the number of doctors serving the vast rural communities in Georgia, which have been underserved for a long time,” said pediatrician Cheryl Dickson, the associate dean for student and multicultural affairs at the Athens campus.  “And we encourage students to be oriented towards primary care.”

Back in 2008, the last year for which data are available, a study by the Georgia Board of Physician Workforce showed thatAthensneeded an additional 95 internal medicine doctors to meet standards created by the American Medical Association. The gap could be even larger by the time 2015, as the data shows.

That said, the same 2008 report shows thatAthenshas adequate – or even excess – numbers of specialists in dermatology, plastic surgery, nephrology, neurologic surgery and urology.

“There aren’t any dermatological emergencies at 3 a.m.,” said Paul Baker, a third-year medical student in at the newAthenscampus.  “These higher-paying specialties often end up being the more competitive ones, both because of salary and lifestyle.”

A report by American Association of Medical Colleges drives home the point. The number ofU.S.medical school graduates choosing residencies in family medicine, internal medicine, or obstetrics and gynecology has fallen by approximately 1,500, 1,000 and 500 respectively. One reason future doctors turn away from primary care, according to the report, is the significant income gap between general and specialty practices.

The prospect of earning less unnerves some med students who expect to graduate with heavy debt burdens.

“Ideally, I would like to practice preventative medicine or humanitarian medicine for a few years before settling down,” said Theodora Brandon, a third-year medical school student in GHSU-UGA Medical Partnership. “However, I won’t be able to do that because of my loans.”

Thousands of medical school graduates face this dilemma each year. And instead of pursuing their ideals, which involve helping people most in need, they choose to train as surgeons in big cities so they can erase debts earlier.

“For those of us in my class who must take out student loans for medical school, we will owe up to $200,000 by the time we graduate,”Brandon said.

Actually, $200,000 in student loans is not huge. InGeorgia, students who graduate from private medical schools like Mercer University School of Medicine or Emory University School of Medicine often owe $300,000 to $500,000 by the end of their professional training.

The lowest paid medical specialists are pediatricians (who average $156,000 per year) and family medicine practitioners ($158,000 per year), according to a 2012 survey done by Medscape/Web M.D.The most lucrative specialties are radiology and orthopedics, where earnings average $315,000 per year. A medical school graduate facing $300,000 in loans will need to work twice as long as a family doctor in a community, as opposed to a surgeon practicing at a hospital, to pay off the loans.

It would be wrong to assume that money motivates everyone who chooses in a highly paid specialty. Sierra Green, a third-year medical school student, who developed an interest in orthopedics when she was too young to consider the financial ramifications of that choice.

“That is not the case for me,” Green said. “I simply like helping people.” And she knew from personal experience that orthopedic surgeons have the chance to fix what’s broken in human bodies.

Passion also drives Paul Baker’s plans for the future. . Having scored well on the board exams this summer, he is positioned to make a strong application for a high-paid specialty such as radiology or orthopedics. Instead, Baker plans instead to train as a psychiatrist, one of the lowest paid specialties.

“Compensation is only one aspect of career choice,” said Baker. “Working with a patient population that you find rewarding can be far more satisfying than hating your job but bringing home a hefty paycheck.”

Describing one’s earning power as high or low, of course, is all relative.  Barbara Schuster, campus dean for theAthensmedical school, emphasizes that doctors, regardless of specialty, fare better than other professionals even in tough economic times.

“The first thing I tell my students and their parents when they come to medical school is that you will definitely get a job after graduation,” Dean Schuster said.

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