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What To Do If You're An Older Student Who Did Not Match

Op-Med is a collection of original articles contributed by Doximity members.

After several years of clinical rotations and endless hours of studying for the infamous USMLE exams, now is your time to re-evaluate your life and decide if you are going to pursue residency as a medical doctor. Many professionals with other degrees and Master’s Degrees enter into medicine to fulfill an underlying thirst for further medical knowledge and skills. Sometimes students graduate in their 50s or 60s and residency programs are seeking the “young” applicants, despite years of experiences and excellent grades and scores on the boards. What will you do?

Medicine as defined today is not a profession for becoming rich and famous as in the past decades due to cutbacks in insurance plans, Medicare and Medicaid payouts. Many family practice doctors are choosing to leave the profession to open urgent care clinics, pursue lucrative telemedicine opportunities, or to work for pharmaceutical companies in research due to burnout. The daily grind as we call it in primary care is burdensome. Try working ten years of Monday to Friday nine to 10 hour workdays with little coverage for vacations and you will understand why doctors are leaving primary care. Many doctors also pursue part-time work as a method of better balancing life pressures such as caring for children and aging parents. Cutbacks in payouts from insurance agencies to doctors is diminishing and so many charting parameters are now required to be evident in a chart in order to get funded by insurance companies that this becomes an impossible chore to complete in a 10 minute visit. Patients are frazzled and you will be dealing with angry patients on a daily basis. No longer is medicine dealing with the politeness of the “Leave it to Beaver” family.

If you are an IMG (International Medical Graduate) or U.S. graduate and did not get your residency this year, then you really need to do a cost-benefit analysis as to how you will choose your next steps. If you are an older graduate, then you will have to evaluate retirement goals and work-life balance. If you are already practicing as a chiropractor or PA, perhaps you can expand to add alternative procedures such as trigger point injections, Vitamin IV’s or botox injections to your already-established career. The best way to get into residency at an older age is through direct contact with the medical director.

Consider medical writing, editing, or being a reviewer for journals. It is possible to be employed on a full-time basis. And, employed from home. Why not imagine yourself living on the beaches in a tropical paradise? The U.S. Virgin Islands are a US territory where you can enter the island without a passport if you are already a U.S. citizen or resident.

Consider setting up your own clinic and hiring doctors and nurse practitioners to work in your clinic. There are many companies that will help you set up an urgent care for an initial cost of $50.000. Who says that you have to work at the clinic? You now have the skills and experience to run a clinic. You may have; being an older student; other investments that you can borrow from to set up your business.

Applying to NP and PA programs is a great option as well. With a medical degree, a PA program would be the quickest route to practice medicine as to practice as an NP requires first an undergraduate and then graduate degree in nursing. With accelerated RN to BSN to MSN programs, this could take about five years. With your undergraduate medical degree, you could get directly into a PA program and be finished in two years.

If you are in your later years and are used to a high salary, then making around $50,000 for the next couple of may not be all so glamorous once you hit the grind of the days, the call, the loss of weekends and holidays, etc. Evaluate how many years you plan to work. If you do pursue the residency program then expectedly you do not mind working into your 70s in order to substantiate potential financial losses initially. You will be working when your friends are retired.

Having an MD degree opens up many doors but you will need to really sell yourself and create a powerful LinkedIn profile, social media, and perhaps consider creating your own LLC Company. There are excellent tax benefits.

I do not see the door as closed but I see wonderful doors opening for you.

Connie Lapadat, NP, is a family nurse practitioner in El Cajon, CA. She is a 2018–19 Doximity Author.

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