1,493 karma · joined March 16, 2017
In the US, it's 4 years of undergraduate college + 4 years of medical school + 3 years (minimum) of medical residency training.
In my native country in SE Asia, it's 5 years of medical school + 2 years of medical residency training + 1 year of remote posting (go to a remote area to work in order to get medical license). And the medical school is publicly funded, so it's pretty much free (you have to buy books yourself, of course, and pay a small amount for lab fees etc. for chemistry, anatomy labs).
To me, the system in the US is unnecessarily complicated/long and it not only burdens wanna-be doctors with debt (not to mention that because of the high cost, mostly the affluent/well-off kids--mostly the kids of doctors/lawyers/well-paid professionals--can now afford go to to medical school), but it helps them justify the $250K+/year salaries (part of the reason why the healthcare is expensive in the US) that they earn right after their residency programs.
I myself even had to call both Citi and Capital One to verify my legal residency status to them for having their credit cards. Banks in the US are catching up to this it seems.
Your friend who moved 250K from HSBC to WF, I wouldn't be surprised if s/he is now being monitored by the US intelligence.
I called FedEx support and they explained me why this happens. Turns out, people who deliver packages/mail have strict deadline to deliver their packages and on days when there are just too many for them to finish delivering everything, they mark it as delivered and actually deliver the package on the day after.
First, I want FF to be around for a long time to make sure there's no browser monopoly by Chrome. That's the primary reason I use FF.
I also trust FF more regarding privacy. So I use FF to log in on sites like my banks, credit cards, and government sites (like IRS and social security). I even use FF to check my Gmail. I use Chrome to browse less trustworthy sites across the internet, and sites that I really don't mind Google tracking my visit such as HN, Reddit, etc. The only Google product that I use on Chrome is YouTube. :)
Thank you, FF engineering team for keeping alternative alive on the web.
This looks like a really great (clean and performant) JS library for interacting with data grid. I'll definitely remember to try it for my next side project.
A quick question: is there a way to make only some of the columns read-only in the grid? I looked through the doc [https://www.datagridxl.com/docs/setting-options] and it seems like user actions for columns are all (applied to every column) or none. If DataGridXL.js allows assigning read-only to a subset of columns, it'd be great to add that in the doc with an example.
Thanks for your hard work and especially for allowing others like me to try it for free!
The thing that sets apart good instructors from mediocre ones is the passion they have toward teaching (esp. the good ones seem to have empathy as in they want students to succeed and understand the materials that the instructors themselves probably took a good amount of time digesting when they were in students' shoes).
For the opportunity cost part, I have to agree with you to an extent. But let me present my rough calculation. I can probably make ~70-120K/year for 10 years before I reach the age of 32 (assuming I don't get laid off in the meantime and assuming I'm not lucky enough to be employed by FAANG). To make it simple, let's assume make an average of 95K/year (average of 70K+120K) for 10 years starting from when I graduate from college. So my take home pay in Los Angeles would be 65K/year. Suppose I can live relatively frugal in LA and save ~30K/year for those 10 years, my investments would have probably grown to about 415K in 10 years (assuming there is no recession and the returns for my investment averages 7%/year; https://www.investor.gov/financial-tools-calculators/calcula...). That is NOT a lot of head-start for those who chose to do programming (or cannot afford to go to med school).
Remember that programmers are actually one of the better-paid professionals among those who graduate from college every year. Also you have to keep in mind that a lot professions have issues keeping their jobs when they get older (e.g., old programmers tend to have a difficult time finding programming jobs while maintaining their senior salaries unless they are really good at what they do; employers will prefer find young, fresh programmers who are willing to be paid less and can spend a lot more time at work than older programmers, but that's for another discussion). Doctors don't have that problem (at least for now because the supply of doctors is artificially limited in the US).
Also, if you are really hard-working (and greedy) as a doctor, you can take two jobs (as a hospitalist or attending) at once. I know two doctors (from my country), who live in CA suburb and make ~500K+ by working at two hospitals (of course, they have to work 6 days a week, alternating 3 days at each hospital). Alternatively, you can run your own practice (either as primary income or just a side hustle on weekends). My wife used to volunteer at several private clinics in NY metro area. Most of the generalist doctors (i.e. Internal Medicine) she volunteered for see ~30-40 patients a day (actually one doctor sees 70-80 patients a day!). They make ~$80 net (that is assuming the patients uses medicaid/medicare, which is actually at the lower end of the pay per visit) from each patient (because my wife enters the code and helps with miscellaneous things around the clinic for them). These clinicians are making each year ~$8030 patients20 days per month * 12 months a year = $576K/year. All of these doctors she volunteered are above 60+ years old. I am not exaggerating about that. Of course, this is in NY-like metro area where population is diverse and dense. Some rural area doctors wouldn't have such opportunity to make that much money, but what I'm saying is that generalist doctors sure have opportunity to make significantly more than 250K/yr average.
All in all, I'm not buying that the opportunity cost of becoming a doctor is a sacrifice one mad. It is (in my opinion) part of the trade-off one have to make to get a steady and pretty good income for the remaining 30 years of your working life (assuming one retires at 62, but if you are a generalist doctor--i.e. not related to ICU or surgery--you can work until 65+ just like the anesthesiologist from my host family. With 250K/year income (https://www.kaptest.com/study/mcat/doctor-salaries-by-specia...), you can easily catch up for the missed opportunity cost in a reasonable time frame.
I have two college friends who are now full-blown specialist doctors (one orthopedic from UCSD and another psychiatrist graduated from JHU). Both of them came from well-off backgrounds (in fact, both of them have at least one parent who is a doctor). Their parents helped them connect with practicing doctors in famous hospitals (e.g., children hospital of Philly) when they were in college, and both of these friends already had a handful of internship/externship experiences at credible hospitals when they graduate from college.
The psychiatrist friend even took one year off to study for USMLE step 2 before she applied to med school. Who can afford this kind of luxury? It's simply because her parents are both doctors (one psychiatrist and one anesthesiologist) and make a total of easily 600K/year back in 2009.
In comparison, while she (my friend) was studying for USMLE step 2, I was frantically looking for a job in 2009 after graduating from college (the same class year as her).
If one does a bit of research on doctors, one may likely find a positive correlation with their parents being wealthy (and also being one of their parents being a doctor). To become a doctor, one has to be born in a truly middle-class family (like parents earning at least 200K/year total with nowadays dollar kind of middle class).
So by the time one becomes a full-blown doctor at age 32 (usually in the US, it only takes ~12 years to become a generalist doctor, who specializes in Internal Medicine, from the time s/he graduates from high school), s/he is making 250K. I wish I could make something like that as a programmer, but we know that that kind of salary is reserved for people who work for FAANG and/or are at the top of their game in the software field. For doctors, that is just the starting salary.
This is all to say that I disagree that the medical debt is much of a concern for US doctors once they become one. It is the unnecessarily convoluted path, which they have to take to become a doctor, that is more of the problem.
Foreign medical graduates who scores above 65-70th percentile have no problem getting into residency programs (I've made a comment above with more details as to how I know all this). For a green card holder, you just need to get ~60th percentile of the USMLE score (which translates to about 240+ in step 2 CK and step 3 USMLE scores).
All I wanted to say is that the bar isn't too high for a US citizen to get into a residency. That doesn't mean though that the path to get into residency is easy. It is extremely convoluted and requires a lot of persistence and planning. That's where (along the way) people fall through the cracks.
To become a full-blown doctor in the US, one has to jump too many hoops and hurdles including -- 1. maintaining 3.8+ GPA (out of 4.0 max) in undergrad while paying overpriced college tuition (which encourages students to take relatively easy course load other than the required ones like organic chemistry, biochem, a couple of basic math and physics classes, etc.); 2. pay yet another loads of money to attend med school, which is where you actually begin to learn something relatively useful; 3. volunteer unpaid at various research and/or healthcare institutions to beef up one's resume (which is only affordable/possible if you are well-connected and/or have money to volunteer); 4. pay exorbitant and unnecessary exams (each 8-9 hours long spanning sometimes 2 days for Step 3 USMLE: https://www.princetonreview.com/med-school-advice/usmle) that promotes rote learning (and you forget what you memorized ~2 months after the exam anyway); 5. pay a lot of money to apply for residency programs while footing the bill (hotels and air travels) yourself to go around the country for residency interviews; 6. spend 3 years (minimum) in residency while spending ~60+ hours per week in your first year doing the grunt work that no senior doctors want to do (e.g., night shifts/floats) 7. maybe spend another 2+ years in fellowships if you want to be a specialist
In contrast, one just need to do these in my home country to become a doctor (I know India has a very similar system to train their doctors): 1. get a high score in national standardized/matriculate exam (in my country, ~5% of top students have option to go to medical school) to get into public medical schools (there are four of them and three of them are definitely pretty good) 2. spend 5 years studying medicine (to be honest, they can cut out the first year if they want to, but it's still better than spending 4 years as undergrad in the US) 3. spend another 2 years as a rotational intern at major government hospitals (OBGYN, Surgery, Child, etc.) doing what the residents in the US system do [from what I've been told, those 2 years are certainly more demanding than the residency years in the US system] 4. take masters degree to specialize (takes ~3-4 years)
The quality of the doctors produced by these two aforementioned systems is not that different. How do I know this? My wife (foreign medical graduate) is a current medical resident at a US hospital and we have a lot of friends in the US residency programs, some of whom are foreign medical graduates. In order for them to get into these residencies as foreign graduates, they have to score on average better than their US counterparts (on top of having to work pretty hard to gain experience in the US because 99% of hospitals/medical institutions in the US don't allow volunteers/externs/interns unless one is trained from the US pipeline and is a citizen).
So the question is why is the path to becoming a doctor in the US needs to be paved with so much expenses and hurdles? Who established this path?
I'll close my long rant with what my wife recently told me after spending a year as a medical resident in the US, (I'm paraphrasing her a bit here) "I don't want to be a patient in the US hospital when I'm old. We need to go to somewhere like Singapore for treatment (she worked at a hospital in Singapore for a bit before coming to the US)."
I meditated to find Nirvana back then. But as I grew older, I realize that Nirvana is interpreted very differently even among Buddhist scholars, and thus is a relative/personal term. Nowadays, my definition for Nirvana is just to have a day without a lot of bad karma (hate, jealousy, anger, fear, anxiety) in my head. If I don't meet that daily goal, that's okay as well. For that, I find myself not needing to meditate and just need to be aware to distract my mind if I catch it in a state of bad karma. Maybe meditation will help some people catch their mind of dealing with bad karma, and maybe that approach might yield better results than me simply trying to be more self-aware and be more stoic. :)
100% agree. I was born a Buddhist and was a devout Buddhist until I was 13-14 years old (then I became an atheist). I went to monasteries for weeks on end to meditate. But what I found was that meditation is not for me. I cannot get rid of my recurring mental sufferings (anger, fear/anxiety, jealousy/envy, self-/guilt) just by spending more and more time in meditation.
One thing that I found extremely useful is stoicism (at least in the way I interpret it). I simply learned to accept that these bad feelings come and go, and that is the nature of being a human. There's nothing wrong with having such bad feelings, which I personally call as 'bad karma'. I just need to be aware of them (which meditation supposedly helps detect, but I find myself being able to do without meditating equally well) and be at peace with the fact that they come and go in my life as a human.
What is in my control is how long I dwell on these moments of bad karma. For that, I always try to get myself out of these bad-karmic situations by trying to see things in a bigger picture or in longer term (e.g., 'Well, I am not making as much money as I want to now, but that's okay because even if I don't earn more than what I do now, I can still retire pretty comfortably by living a minimalistic life. Alternatively, I just need to work maybe 2-3 more years with the current income to save up to the level of savings at which I want to retire. In the worst case scenario in which I get sick/disabled, I will just learn to adapt as human beings and other living beings are observed to do in adversity.') Trying to see things from such larger perspective makes me feel pretty content and thus, releases me from a lot of anxiety issues.