The Cost of Quitting Med School
At work, we have a lunch routine. It involves realizing that it’s long past noon, we’ve all forgotten to eat, and we may as well coordinate delivery. We exchange money or cover the next day’s meal. We work in the social sector, so we almost invariably look at our banking apps, and I give due thought to my spreadsheets. My life exists in them. It’s part of my job to make events on a budget, tracking how to grow financial and cultural capital in the non-profit sphere. This blends into my personal spending: spreadsheets for groceries, gas, car repairs, meals out, and semi-affordable martial arts classes. Spreadsheets for projected income and for potential times of unemployment. I imagine line items for indulgent expenses while I live with four roommates. This is all slightly complicated by the fact that in March, I withdrew from medical school.
This is not in and of itself a bad thing. (Per one Dean’s assessment, it was simply “a bad fit.”) But the simplest fact of the matter is that my gracious and generous parents paid for my education. I withdrew with no savings, but with no debt, either. Moreover, luck-by-birth came with luck-by-hobby: old writing jobs and arts pursuits made me a hireable non-graduate. I know what I like again, and I can do it for a living—which is less than common.
According to a 2014 study, only 47.7% of surveyed American workers were satisfied with their jobs. In this sense, doctors are about average. A 2012 study from Medscape found that half of physicians would pursue the same career again. It also found that 45 percent reported not feeling “rich,” due to debts and expenses. These pile on early. Last year, 49,480 people applied to American medical schools. Between the tests, transcripts, primary application, secondary applications, travel for interviews, and repeat tests and applications, the process alone can cost several thousand dollars. Upon enrollment, tuition can climb to over $58,000.1 Over 24 percent of applicants were trying for the second time or more, and overall, only 41 percent matriculated. According to the American Association of Medical Colleges, the behemoth middleman behind tests and applications, accepted students had an average science GPA of 3.63. Moreover, accepted students are often published researchers, and accomplished in some obscure hobby that makes them unique—despite their Sisyphean willpower to focus on studying.
The attrition rate is slim. Medical school typically lasts four years before additional, paid training begins. In 2007 the AAMC found that 94.2% of students finish within seven years. But, somewhat notoriously, perfectionism and anxiety keep students from telling each other when they struggle. (In my own experience, a few students confided in me after they knew that I had fallen behind.) I found it extremely uncomfortable to let on that I was unhappy. Other students continued to ace exams, party hard, and recover in time for band practice while I scoured YouTube for a study method that might stick. I had stress-induced anxiety, depression, and chest pain so severe that I couldn’t move. It was startlingly simple to withdraw via email, after all of the mayhem for admission.
There isn’t a formula for emotional debt, and I can’t bring myself to calculate what my parents spent on me over the years. There is no way to repay their generosity in full with an already winding career path. I simply owe nothing to the government or a bank, and apart from mild consumer debt, I started my current job with no money. I am slowly—very, very slowly—building up. This zeroing is my privilege. Moreover, it’s the zeroing that taught me something new. Since I dropped out, more medical students than I can count have expressed to me, in private, their wish to quit, and their disappointment in themselves for staying.
If I could recreate the resources I had and redirect them, I would. The money could go toward my friends’ scholarships, or offset costs for a kid who wasn’t born rich. The time could go to building a more egalitarian application process. I like to think that if I won the lottery, I would pay off my friends’ loans and therapy fees so that they could explore something else in life—something less binding, that requires fewer feats of payment and performance. Instead, the money is gone. It was absorbed into a medical school whose acceptance rate goes down every year.
I currently make $30,000, before taxes. (This is roughly 16% of the lowest-paying U.S. medical professions.) My paycheck is divided between my HMO, rent, debt, and the expenses of a social life that is often teetotaler and bookish. I save the small remainder. Three hundred dollars recently went toward new brakes—an amount that would barely cover one medical textbook, but made me consider giving up my car altogether. I regularly donate money to scholarship funds and clinics, but to what end?
Political rhetoric calls the student loan debt in this country “dire.” Medical school is dire on steroids. It can pay generously in the end. (Despite not feeling “rich,” six figures are six figures.) Getting there, though, requires inhuman gumption or a benefactor or both. It shouldn’t bar so many capable young people from considering one of our world’s irreplaceable professions. It should pay well, because it is often unspeakably difficult. But equal access should be the rule, not the exception. I didn’t earn my freedom from the barriers between intelligence and opportunity, and no one deserves the barriers in the first place. There are students—compassionate, hard-working, and much more capable than me—who simply cannot afford to apply to medical school. Or, if they make it there and find themselves miserable, there are those who cannot afford to quit without insurmountable debt.
Colleen McLellan works for a wonderful non-profit in New Orleans, Louisiana. She practices capoeira, hosts a radio show, and almost never misses medical school.
1 The average applicant applies to 15 schools. The standard application, called the AMCAS, is sent to the initial school for $160 and to any additional schools for $36 apiece – after which a secondary application, costing anywhere from $25 to $100, is often required. Each application requires every official transcript the student has, at $10-$20 apiece. This is all in addition to the Medical College Aptitude Test, or MCAT, which conveniently bundles the cost of testing and score distribution into $300. But the MCAT content changed last year, and a newly designed prep class will run you over $2,000. (Many people take the MCAT more than once.) There are fees for recommendations, travel expenses for interviews, and additional tests and fees for applying to Doctor of Osteopathy programs.