Hacker News Reader

Comment by gachavez | Hacker News Reader

Fellow MD student here. I feel your pain. I've planning to just do PGY-1, work as a GP at urgent care night/weekends and do software dev full time.

View on HN

48 yo surgeon here - be careful, bc without board certification, you'll limit yourself to who will let you work in their clinic. You're getting paid for residency, just do two more years, get your FP / int med certification.

As an aside, I went to UNC Chapel Hill 1992-1996 and it cost $2k/year tuition. Now it's $20k. We've had a shift in attitude in this country of "why am I paying for something that benefits someone else," but it's going to bite us in the ass down the road as intelligent / hard working people say "why should I accumulate debt to work that hard? I'll just choose something else."

General Surgery and OB/Gyn have gone from being the hardest residencies to get, to now only requiring you graduate from medical school. The hours and the pay are the reason. Orthopedic surgeons get $1000 to put a scope in a knee and scrape a little whereas general surgeons get $400 to take out an appendix in the middle of the night. Ortho is hardest residency to get.

I was top 25% of my class and if I tried to become a surgeon 10 years earlier, I wouldn't have. Most older surgeons were top 1% of their class. My senior partner was, and man is he super smart. Anyway, I still love my job, but the hours suck (80/week). Society benefits from my service (returning sick people to the workforce) and taxes I pay ($200k / year). Not too bad return on investment, imo.

You're going to work as a "GP" with at most one third of the training of almost every other doctor in practice? Seems like you're shorting your future patients a bit. My advice as someone who sees a lot of patients who were incompetently managed at urgent care is to avoid going this route. You're setting yourself and your patients up to fail with potentially devastating consequences.

This is not surprising. On my last two visits to late night urgent care I encountered complete incompetence. On the first occurrence, the Doctor did not know how to suture my hand. She put in four sutures when at least twice as many were needed and placed them way to close to the margin. She failed to even clean it properly. It ripped open again while I was sleeping. On the next, unrelated visit, the doctor was drunk. His face was all red and he reeked of alcohol.

> You're going to work as a "GP" with at most one third of the training of almost every other doctor in practice?

Not really a GP, more like a glorified triage nurse. Urgent care is where they give antibiotics out generically, and immediately transfer anybody sicker to the ED. (worked there, done that as part of residency)

PGY1 gets you a license, but most private insurers will not reimburse for non-board certified providers.

Reply on news.ycombinator.com