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Comment by lapcat | Hacker News Reader

You're correct except for one word: "lucrative".

To this day, almost two decades after I left my philosophy PhD program (without a PhD), I still have massive student loan debt.

Even if I had completed my degree, though, philosophy PhDs aren't particularly lucrative. Tenured professors at major universities do ok, but the road to getting tenure-track jobs and then tenure is littered with the bodies of grad students.

I don't think starry-eyed 21 year olds deciding what to do are much different from starry-eyed 17 year olds deciding what to do.

It's worth noting, by the way, that the United States has a shortage of medical doctors.

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> It's worth noting, by the way, that the United States has a shortage of medical doctors.

That's a pipeline problem. What the U.S. actually has is a severe bottleneck in available places at medical schools and for residency training.

Let's do note that on that graph which mapped a variety of increased costs, the only thing that increased faster than college costs was the cost of medical. That's connected to the shortage of doctors. Regulatory capture isn't just an issue with higher ed.

What the U.S. actually has is a group of people intent on keeping their doctor wages high by limiting supply through regulation and bottleneck creation.

As a med school dropout (best decision of my life), were I to "go back" to early college: I would have instead pursued a BSN (which my college offered!), to set myself up into eventually becoming a nurse practitioner. That way, if I decided to not complete graduate school, I'd still have an applicable role/job within medicine. Were I to have graduated that program, I also would have been able to practice much earlier (albeit limited scope, per US State).

Instead, what does an uncredentialled Chemistry Bachelor do after dropping out of medical school? ...I became an electrician, which allowed me to help people without sacrificing my lifestyle.

If your goal also includes "make substantial sums of money," I always recommend to preMeds they consider all the different ways someone can make money helping people without having to sacrifice your entire early adulthood.

The majority of my medschool classmates refer to me as "the dumbest smart guy they know," but in confidence several have expressed jealousy at not having to work so much (for IMHO so little, as physicians). Just cogs in an overly-complex, wealth-extracting machine...

> the dumbest smart guy they know

When you’re smart enough to understand the consequences the of your “dumb decisions” and have the EQ to navigate the aftermath.

It's incredible realizing that I have two decades of work experience, and have peers that have been "in the field" for less than a few years!

To each his own. I think higher education in America is primarily designed to degrate and beat students into submission.

As I've heard repeated elsewhere, the road to tenured PhD is paved with grad-student bodies.

Nurse practitioners are the overused. If you are on medicaid, at least in my state, you are almost guranteed to be seen by a nurse practitioner rather than an actual pyschiatrist. Even if you aren't on medicaid, which medicaid is usually better than any other marketplace insurance for selection of providers and service, getting seen by a nurse practitioner is very common.

Additionally, while many may be knowledgable about the medications they prescribe, I have had nurse practitioners prescribe me medication they didn't even know existed, as in during my session I asked for a specific medication based on a personal recomendation from a freind in the field, they didn't know what the medication was and looked up on google and then prescribed it to me.

There are good nurse practitioners, but they simply should not be prescribing long term pyschiatric medication with the level of schooling they have.

It takes 2 years to become a nurse, and 3 years to become a nurse practitioner. Additional certification is required to prescribe certain medications, but even then the amount of training and classes a nurse practitioner will take to understamd medications is very small compared to a psychiatrist.

It's absurd. NP's have been the solution to psychiatist shortage and it seems no one cares. Most likely, because anyone who knows is zombified by SSRIs by shit NPs or is in the medical field so their vision is already clouded by bias. Nurse takeover is a joke. Anybody with 2-3 years of schooling should be relagated to changing bedpans and putting in IVs. Not functioning as psuedo doctors.

>they didn't know what the medication was and looked up on google and then prescribed it to me.

How human that this practitioner admitted to not knowing something; then took the time to look up the drug's factsheet; and then trusted you enough to take your friend's personal recommendation.

>There are good nurse practitioners

Agreed. And terrible physicians, as well as good.

>...but they simply should not be prescribing long term pyschiatric medication with the level of schooling they have.

Agreed – with the additional thought that even physicians overprescribe these mind-altering substances in far-too-abundance.

>NP's have been the solution to psychiatist shortage and it seems no one cares...Nurse takeover is a joke.

I think most people "on psych meds" really just need better friends / families / societies / healthcare . It is most unfortunate that we are our own worst enemies, sometimes; particularly in allowing US healthcare expenditures to be highest with no obvious benefit (to patients).

It all made me so sick decades ago that I quit before even starting.

You are right in the context of the power NP's have compared to regular doctors. The primary difference in an NP and a doctor practically is pay. They do so much similar stuff, even though they shouldn' be allowed to. NP's prescribing meds, like a child with bazooka shooting at mentally ill people.

That’s only because doctors collude to limit the number of available residency places.

I programmers were smart, they would:

1. Lobby the government to prohibit anyone from practicing programming without a license.

2. Limit the number of licenses granted each year

Fortunately, we don't have the social skills to make that happen.

Also, the vast majority of software bugs are annoying at worst, with no death potential. Powers that be would react a lot more aggressively if stack overflows routinely led to bodies on the pavement.

Considering the number of ransomware attacks and other viruses that infect hospitals, it wouldn't surprise me if stack overflows had quite a large body count.

The irony is that part is not commensurate to the risk of the software being developed.

<That’s only because doctors collude to limit the number of available residency places.>

Available residency slots are dictated by the funding made available through the Medicare program and ultimately Congress.

Out of curiosity, why cannot hospitals fund residency slots on their own with some riders (the resident should work in the same hospital for x years)? It seems odd that the medical profession is not willing to invest in the training of the next generation of professionals without government help.

They do sometimes. People don’t realize how much of medicine, generally, is funded through the government. Additionally, society gives medicine a lot of leeway to act selfishly because the core practice of healing is so altruistic.

Broadly, it’s the same issue that all jobs have: it’s cheaper to hire pre-trained professionals than to hire and train.

Because they need to support their executives and capital projects / debt service. That’s the discretionary budget… training doctors doesn’t improve the bottom line.

Hospitals are really quasi-government entities. Their pricing structures have price controls based on Medicare reimbursements. A third of hospital revenue is Medicare and Medicaid.

Both programs have been slowing rate growth, which in turn impacts private insurance as well. The institutions haven’t been successful in reducing cost growth. ACA built out regional cartels^H provider networks, essentially eliminating competition.

> ultimately Congress

Who is successfully lobbied by organizations of doctors

Congress doesn't make decisions in a vacuum

Which was ultimately lobbied at such a low a number by the AMA, the primary organization representing doctors interests in congress. https://qz.com/1676207/the-us-is-on-the-verge-of-a-devastati...

Not a bad idea, actually, especially with all these new tools

Good idea from a job severity/ protectionist standpoint or from a “protect the craft and quality for the good of the public” sort of way?

Why not both? Even better if you have to obtain accreditation as a professional in every different market because EU software is different from US software is different from Indian software...

There are a lot of economists who make arguments against protectionist policies. A common refrain is that it leads to higher consumer prices.

Unfortunately since most of our jobs can be done remotely, that would likely drive a ton of software jobs overseas.

I was trying to keep my comment short. Such a regulatory regime would be expected to close such obvious loopholes.

In much the same way that a doctor in $FOREIGN_COUNTRY cannot practice telemedicine in the USA, I would expect the regulations to make a distinction between software (and services provided by software) developed by foreign and licensed programmers.

>much the same way that a doctor in $FOREIGN_COUNTRY cannot practice telemedicine in the USA...

U.S. retired doctor here. This is a fascinating possibility that never occurred to me until I read your comment. Could a foreign doctor not set up a system whereby she/he could appear to be in the U.S. while being in a country that's essentially unreachable by U.S. authorities? And take payment in cryptocurrency?

> Lobby the government to prohibit anyone from practicing programming without a license.

No way you're getting consensus on this one, but even if you could, it's too hard to stop. If you charge for compilers, and only provide them to licensed developers, hippies will make and distribute compilers for free.

The hippies wouldnt be licenced but if they could they cant provide a certified corporate party to be liable for damages.

Consensus isnt needed, just enough beurocracy to make development expensive.

It isn't a problem, it is a feature the AMA wants to have.

In addition, you must complete a four year degree in whatever before going to medical school.

This is really a weird requirement and most other places in the world don't have it, without suffering any setbacks when it comes to outcomes of treatments.

Imagine that every programmer would have to study, say, Latin for 4 years before being allowed to code.

Agreed. It might make some sense to require undergrad chemistry and biology for med school applicants but presumably that could be squeezed into 2 years of undergrad. Possibly a customized curriculum could teach it faster or as part of med school.

Mine was in political science.

In Canada there are some universities which allow exceptional students to apply after the first 2 years.

Isn’t a limited pipeline intentional? Keeping the supply constraints keep wages higher.

Well, the OP did say “the bulk of” — some people, like you, are surely carrying debt for non-lucrative degrees.

But the pipeline of lawyers, doctors, MBAs, etc. is quite a bit larger than self-pay philosophy PhDs, and a large fraction of those professional degrees are full-freight, $70k/year (plus living expenses!) of pure debt.

Not all lawyers and doctors are the same. Consider public defenders. And physician compensation can vary dramatically depending on whether they're a general practitioner or specialist, rural or urban, etc.

Ironically, the ones we need the most are paid the least.

Of course, that's assuming students finish their degrees and get jobs. Plenty of people drop out of school, and they don't get refunds! Law students fail to pass the bar, etc.

Yes, and indeed, this is exactly the argument used by the Public Service Loan Forgiveness program, in which public defenders / nonprofit lawyers / rural nonprofit doctors’ loans are written forgiven after 10 years of public service so they are not saddled with a lifetime of debt they can’t pay off due to choosing careers in public service. You’re in a supposedly “lucrative” career with a high debt load, but choosing not to pursue the typical high-income pathway.

That program has many gotchas, but at least this reflects a recognition that debt creates incentives that society may not want.

For Law, it's not just about not passing the bar. It's about getting into a top 10 law school and getting a top clerkship. And then getting into a top firm. Yeah, some people don't end up on that train and do OK but it's probably not a great ROI even if they pass the checkmarks.

> Ironically, the ones we need the most are paid the least.

That isn’t ironic at all. If they were paid more, we wouldn’t have a shortage.

It’s an implication of a system that pays commensurate to what one contributes to the economy rather than commensurate to what one contributes to society.

> I left my philosophy PhD program (without a PhD), I still have massive student loan debt

In humanities fields, if the department thinks you belong in the program, they pay you to attend. They'll give you fellowships, TAships, and RAships. If they don't give you those, they're telling you not to attend. This is a harsh truth.

That's not generally true. I attended a state university, and the department simply didn't have the funding to pay for its graduate students.

However, I did in fact receive some TAships and lectureships while I was there, and even a dissertation fellowship. They didn't pay well though.

>That's not generally true. I attended a state university, and the department simply didn't have the funding to pay for its graduate students.

I mean, maybe? I know a number of state schools, certainly not all of them, but plenty that can afford paid spots for PhD students in the humanities that are certainly enough for someone to support themselves on. It doesn't pay as well, nearly as well, as jobs that humanities student with a good GPA from a good university can get in the private sector, but its not bad at all.

Some departments have money, and some don't. Simple as that.

I find it very odd that people are trying to deny my experience here.

We're wondering if you were perhaps mislead somewhat, because in our experience its quite rare for a department not to have any funded PhDs with stipends.

> We're wondering if you were perhaps mislead somewhat

I wasn't. But I'm not going to write an autobiography here. I already regret revealing personal details in this thread.

> in our experience its quite rare for a department not to have any funded PhDs with stipends.

Who is "our" and what is your "experience"? Are you referring to Telemakhos and yourself? Are either of you even former humanities PhD students? And how many departments have you surveyed such that you can make a judgment of rarity?

I'll be very honest with you, I've never met a humanities PhD student without funding who should've been pursuing a PhD, and if the department you were in was so poorly funded that it couldn't give out stipends, then it's likely that you would've never found a job in academia afterwards anyway.

Look, its not your fault, some people don't end up in the right undergraduate programs, they don't meet the right people, make the right connections, and get into good PhD programs with funding. In any other case, if you don't have a lot of money and time to waste, its almost always a bad idea.

> I've never met a humanities PhD student without funding who should've been pursuing a PhD

1) In your entire life, how many humanities PhD students without funding have you met? Perhaps you think that, somehow, you've magically met most of them, since you seem to believe there aren't that many.

2) It's just your opinion whether an individual "should've been pursuing a PhD".

> if the department you were in was so poorly funded that it couldn't give out stipends, then it's likely that you would've never found a job in academia afterwards anyway.

My former department has placed many tenure-track positions.

I think what may be going unsaid is there are some predatory practices that puff up the idea of a PhD to get people to attend a department that is otherwise struggling. It sounds like what you describe is rarer in better programs. That shouldn’t be taken as personal or an immutable law, just a general observation.

> I think what may be going unsaid is there are some predatory practices that puff up the idea of a PhD to get people to attend a department that is otherwise struggling.

No, it was already said:

>>> We're wondering if you were perhaps mislead somewhat

>> I wasn't.

To reiterate, I was making a general point. You making it personal does not negate that point. If you re-read what I wrote, I was not implying you were mislead, but also that it isn’t rare in lesser programs. Not everything has to be true about you and your personal experience to be valid.

> I was making a general point.

Nobody here has any evidence that their so-called "general" points are any more than their own personal anecdotal experience.

You're all trying to pretend that somehow you're experts and I'm just some clueless n00b, but that's ridiculous. At best, we're all on equal ground.

So your point is that well-renowned graduate programs are on an equal financial footing as those that are less well regarded?

I think it’s fairly well established that better programs have better funding. This generally results in more funding for PhD prospects. It’s great that you want to share your anecdotal experience, but don’t pretend that it means it’s a incontrovertible generalizable truth.

>Nobody here has any evidence

When someone relies on absolute language like “nobody” or “everyone”, it’s a clue they are making an emotional rather than a reasoned argument. In this case, there is data about funding and PhD opportunities.

> So your point is that well-renowned graduate programs are on an equal financial footing as those that are less well regarded?

No. I don't know where in the world you got that from what I said.

> I think it’s fairly well established that better programs have better funding.

It's not that simple. Funding can vary widely by university and department. You want to make it uniform, but it's not.

The reputation of a program is determined by a number of factors, and it can change over time. A lot depends on the particular professors who happen to be there at a certain point. And sometimes giant public universities are able to compete with smaller elite private universities by sheer size, i.e., the size of the faculty.

>No. I don't know where in the world you got that from what I said.

I’m trying to be generous by helping to clarify what you mean otherwise it comes across as someone arguing for the sake of arguing.

>You want to make it uniform

Not at all, and that was never said or implied. My point is the opposite; that programs differ in funding. I just take it a step further to make the point that lower funding leads to less funded PhD opportunities. Take early during COVID; funding temporarily dropped when many foreign students could no longer attend meaning it was easier for a self funded student get into a top program (I know because that’s what I did.) That same funding dynamic plays out with lower ranked schools because they tend to get much less research dollars.

>the reputation of a program is determined by a number of factors

Again, I don’t think anyone is disputing this. The point is about how reputation is related to funding and funding is related to PhD opportunities.

> otherwise it comes across as someone arguing for the sake of arguing

It's funny how you don't think this applies to you, especially since you came in almost a day after the HN discussion started and long after everyone else stopped replying. In this way, you prolonged an argument that had already come to an end.

> That same funding dynamic plays out with lower ranked schools because they tend to get much less research dollars.

Well, the humanities tend not to get a lot of research dollars, period.

> The point is about how reputation is related to funding

And my point is that they're not as closely related as you seem to believe.

>Well, the humanities tend not to get a lot of research dollars, period.

And it’s no coincidence that the humanities have the highest rate of self-funded PhDs.

>my point is that they’re not as closely related as you seem to believe

You may need to explain why govt research grants and endowments tend to follow the higher ranked institutions. And if you look at some of the ranking structure, they are explicitly tied to financial aid which is tied to endowments. I’m not saying it’s perfect or ideal, but ranking, money, and graduate positions are all intertwined.

> You may need to explain why govt research grants and endowments tend to follow the higher ranked institutions.

Institutions. Not departments. Within the same institution, some departments may be very well funded, and some departments may be poorly funded. This is basic stuff that you should already know, and if you don't, then you certainly shouldn't be lecturing me.

My patience is worn out here. This back and forth is not interesting. I don't wish to continue with you any longer.

I see you only cherry picked a part of that statement. Surely you understand that research grants are awarded to professors and departments? As are many donations are earmarked for specific programs and departments. Those research dollars are what directly fund grad student positions. And the rankings are relatively stable, although there can be jockeying in some specific tiers. Schools like John’s Hopkins, UCLA and Michigan will be near the top of health care research dollars as well as top rankings in practically any year. Your posts read as someone who is trying to rationalize personal decisions rather than someone who knows how the system works.

> Are either of you even former humanities PhD students?

I have my PhD in Greek and Latin. I applied to many schools for my PhD program and, on the advice of professors who had told me what I repeated above, accepted admission to the department that gave me the best aid offer, not necessarily the one with the best reputation. They were right, and I never paid a dime for my education.

> accepted admission to the department that gave me the best aid offer, not necessarily the one with the best reputation.

That's a personal choice, but it's an obvious tradeoff with downsides. If you have a non-monetary goal — after all, pursuing a PhD in the humanities would be a crazy way to make money — then why would you let money stand in your way?

> They were right, and I never paid a dime for my education.

They were right in what sense? You could also never pay a dime for your education by never pursuing a PhD. Regardless, you spent valuable years of your life on it. That's a big investment, and time is more precious than money.

I am glad that you admitted, though, that some more prestigious schools may have less financial aid. There appeared to be a kind of denial of this reality before.

>then why would you let money stand in your way?

Just because money isn’t a primary motivation doesn’t mean it isn’t a consideration.

They're not denying your experience. They are, however, pointing out you didn't do your research Well when picking programs to apply to.

I've been in different universities and the experiences for the same departments very considerably. You specify on your application whether you want your admission to be conditional on funding. One communications department for example would typically admit only 2 to 3 students per year on funding. I thought it was very competitive to get into. But of course if you tell them you're willing to pay your own way admission becomes much easier.

Other departments may not be that upfront with the deal but all people applying to grad school should understand these Dynamics.

> They are, however, pointing out you didn't do your research Well when picking programs to apply to.

That's presuming a whole hell of a lot, and it's insulting. You know absolutely nothing about me or my history except what I've already said, which is not much.

I'm not here to be second-guessed by anonymous rando strangers.

You self-funded a philosophy PhD with loans at age 21?

I'm talking about deciding at age 21 to go to grad school, like deciding at age 17 to go to undergrad.

> Tenured professors at major universities do ok, but the road to getting tenure-track jobs and then tenure is littered with the bodies of grad students.

I'm reminded of that quote from Interstellar: "I never really fully considered the possibility that I wasn't the one."

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