Is 40 Too Old For Med School? Here's The Truth. #476

Two first-gen doctors answer your real questions: How to open a business bank account, and whether starting Medical school at 40 is still possible. 

This week's Q&A covers two questions that represent completely different stages of the first-gen doctor journey: a neurology resident finishing training and building her business, and a 40-year-old premed, wondering if the dream of becoming a doctor is still possible.

THIS WEEK'S QUESTIONS:

QUESTION 1 — From Mouna (Neurology Resident):

"I just created my LLC to do locum work, and I'm looking into opening a business bank account. Do you recommend a traditional bank versus newer online banks? Some of the online options have built-in bookkeeping tools — do you have experience or a preference?"

QUESTION 2 — From YouTube Comments:

"I am 40, coming from a career as a psychotherapist, married with children, with a mortgage, and $135K in student loan debt. I'm considering general surgery, psychiatry, neurology, internal medicine, and family medicine. I'm taking one class at a time and targeting 2030 for application. Any advice?"

SUBMIT YOUR QUESTION FOR NEXT WEEK:

We do Q&A episodes every week and we read every question submitted. Here is how to reach us:

📱 Text us: 833-230-2860

📸 DM us on Instagram: @docsoutsidethebox

💬 YouTube comments: www.youtube.com/@docsoutsidetheboxpodcast

📧 Email: team@drniidarko.com

Your question could be answered in next week's episode.

RESOURCES MENTIONED:

Business Banking:

- Relay: relayfi.com

- Found: found.com

- Novo: novo.co

Disability Insurance (mentioned by Mouna):

- Set for Life: setforlifeinsurance.com

Student Loans and Financial Aid:

- Federal Student Aid Loan Simulator: studentaid.gov/loan-simulator

- Income-Driven Repayment: studentaid.gov

Non-Traditional Medical Students:

- AAMC Non-Traditional Resources: students-residents.aamc.org

ABOUT DOCS OUTSIDE THE BOX:

Dr. Nii is a General Surgeon. Dr. Renee is an OB/GYN. We are first-generation Ghanaian and Haitian physicians who paid off $662,000 in student loan debt in 3 years, built a locum tenens agency, and navigated every major medical career decision without a family blueprint.

We created this podcast for first-generation doctors — physicians who are the first in their families and lack the inherited knowledge about money, contracts, career strategy, and the unwritten rules of medicine that many of their colleagues learned growing up.

New Q&A episodes every week. Real questions from real first-gen doctors.

Find us everywhere:

- YouTube: www.youtube.com/@docsoutsidetheboxpodcast

- Instagram: @docsoutsidethebox

- Website: https://drniidarko.com/

DISCLAIMER: Dr. Nii and Dr. Renee are physicians, not financial advisors or attorneys. Content shared in this podcast reflects personal experience and should not be considered financial, legal, or medical advice. Please consult qualified professionals before making financial or career decisions.

Transcript

Welcome And Today’s Two Big Questions

SPEAKER_00 0:51

All right, on this episode of Docs Outside the Box, a 40-year-old pre-med texted us that he or she is married with kids, has a mortgage, already has$135,000 in student loan debt, has a career already as a psychotherapist, and is asking, should I still go to medical school? And then next, our second question is a neurology resident finishing her training has asked us about business banking options for her new physician business as a locum tenant. We've been opening business accounts since 2013 and uh we got opinions on this. So welcome to the QA episode of Docs Outside the Box. Here we're gonna answer your questions with our honest answers. Dr. Renee, you ready to get into this? I'm ready. Let's go. All right, Dr. Renee, we have our first question. This is about business and particularly Locum's business and opening up a business bank account. So this is from Dr. Muna, who sent us a question before. And it says, Hi, Dr. Ni and Dr. Renee. This is Moona again, neurology resident, last year of residency. Thank you so much for all the information you share on your YouTube channel and podcast. It's been incredibly helpful. I took your advice on disability insurance and signed up for Set for Life. I had a quick question. I created my LLC to do locum, and I'm looking into opening a business bank account. Do you recommend a traditional bank versus newer online banks? Some of the online options have built-in bookkeeping tools. So I was curious if you have experience or a preference. Thank you. Now I don't know if you remember Dr. Renee. We had Dr. Muna from last year send us a question. Do you remember?

SPEAKER_02 2:35

Yeah, I do. I remember Dr. Muna. Yeah.

SPEAKER_00 2:38

Yeah. Yeah. So first of all, I want to say shout out for almost finishing your neurology residency. You're almost there, right? That's a big deal. And um, it kind of sounds like us, really, which was, you know, towards the end of our residency, or at least for me, fellowship, that we were setting up our locums, getting ready to kind of work independently. Whereas our classmates, our colleagues, they were gonna go and do additional training or maybe go work at a private practice or some type of academic institution. Um, so she's kind of really following our path, so to speak. So um I just want to say shout out for her for that.

SPEAKER_02 3:12

Yeah, thanks for that question, also.

SPEAKER_00 3:15

So the other thing, too, that we didn't shout her out for is she's got her disability insurance due set for life. Um, for folks who don't know, that's the uh company that we went through to get our disability insurance. And as a matter of fact, that was the first step that we took towards paying off our$662,000 of student loan debt. Where it was. Yeah, we had really high, actually, you had really high disability insurance. And um, we switched that to something that was better, I think that was more cost efficient, sleep with you like that. Yeah, and um that started started the process. So shout out to you, shout out to you for that.

SPEAKER_02 3:49

Yeah, and shout out for set to Sep for Life. If you go to them, let us know that, let them know that we sent you.

SPEAKER_00 3:55

Yeah, it's in the show notes, so make sure you guys check it out. All right, so let's let's get into this. So that's that's what she was here for. She she we want to talk about business banking. So for everybody who wants to know, we've been doing our own business in some form um since 2013, right? So through all the different businesses that we have, your business, Dr. Renee, my business um with Darko Media, um our business together as a locums company. Um, you know, we've just been opening up multiple business accounts. So um we have a lot of opinions, or at least I have a lot of opinions about it. So I would say this. As we've said all that stuff, we have opened online bank accounts personally. We've also opened up a business bank account that is a traditional bank account. But over the last several years, I've been aware of several online business accounts that are just like online banks that are just for businesses. These weren't available in 2013. So knowing what I know right now, can you guess what I'm gonna say?

SPEAKER_02 5:02

I think you're going to say online business banking account.

SPEAKER_00 5:06

There you go.

unknown 5:07

Yep.

Why Subaccounts Change Everything

SPEAKER_00 5:08

Yeah. Yeah, you know me really good. Predictable. Yes, yes, yes. Predictable and boring, that is true. Um, particularly with money, you know me. I like to be predictable. I don't like to take risks. Um, but I'm gonna say, uh, Dr. Moona, that I would say at this point right now, go online bank, online banking. Like I said before, this wasn't available back in 2013. You had to do a brick and mortar, and now uh bank accounts or business bank accounts that are specifically, like I said, for business, they're out now. So um, so I'll just leave it to you like this. Um, the big things that I would really focus on are monthly fees, right? As well as built-in bookkeeping. And I have some I have three choices. Um so the reason I'm pausing and I'm taking my time with this is I'm looking at these business bank accounts and I'm like, yo, like I wish we had this right now. So we have a traditional bank, they have an online banking option, but what these other options have, like, we don't have those whatsoever. So I would I would just say that for me, I think the biggest thing is creating multiple accounts under one business account. And my I might be getting getting this confused, but basically kind of like sub-accounts. That's what I'm trying to say. See, that's why I have you on, because you make it always clear. The ability to have sub-accounts is huge. You know where I'm going with this, right? Um, so Dr. Moona, we have one bank account for our business, and we can't create multiple accounts. And I'm gonna tell you why it really matters for locums. And Dr. Renee, chime in whenever you want to do this, whenever you want to. So the way how I look at it is this when you start doing locums, Dr. Moona, and you get paid, you're gonna get a large payment into your bank account, your business bank account, right? It's gonna be, let's say, for example, you get$15,000, it hits your account, right? The smart thing to do is actually to create sub accounts. Have an account that is your operating account, right? Where you pay bills, you pay your credit cards, um, you pay for flights if you need to. Then there's another account that you need to have, which is just for tax savings.

SPEAKER_01 7:24

Right.

SPEAKER_00 7:24

Right. So remember that$15,000 ain't all that yours. Right. Is that good, Ibonics? Ain't all that yours. Right? That's the mistake that I think that's the mistake that you and I both made when we first started out. I don't know if you made that mistake.

SPEAKER_02 7:40

I think so. I think I think so too. I think having to separate everything out um manually is, I mean, it's doable, but it's just a little bit more cumbersome.

SPEAKER_00 7:54

Yeah, yeah, I think so. So I think that's the mistake that I made was everything went into one account and you like you're spending money, but you're not really diverting money away, right? So you're gonna have to pay taxes eventually. So you need to always take about 30%, maybe even 35% of that$15,000 and put it into a separate account because the IRS is gonna want their money. And you want that in a separate account so that when you're spending whatever's left of that in the other account, you want to make sure that you're always leaving some ready for to pay the IRS. So I would say account one is operating, account two is for tax savings. I would say account three, you want to use for business expenses, right? Travel, equipment, stethoscopes, books, you want to use that for if you want to go to a conference and you want to pay for things, those type of things. And I would say four would be a buffer account or like an emergency account, just in case you are thinking that you may need a little bit more to put into your retirement or maybe even into your uh your savings, or excuse me, into your um taxes, your taxes, you might need that, right? Yeah, so I would say four.

SPEAKER_02 9:07

Yeah, because you're when you're taking money out for your taxes, you're estimating, but you won't know that final bill until your taxes are done. So if there's a shortfall, then you have that extra buffer account to just kind of pull from.

SPEAKER_00 9:23

Yeah, yeah. So I I I think what I ended up doing ultimately, which is really cumbersome because I didn't have this option, is you know, I would just take out like 40% actually, and I would put it like on another account, like another platform, like a like allied bank. I would put it there, and it would just get confusing because then I'm like, what did I take this 40% out? What was it for? So these new accounts that can do that, I think is is really amazing. So just remember account one operating, account two taxes, account three, that would be for business expenses, and four is like an emergency fund, right? Yeah. Um, the other thing that I didn't think about necessarily is when you are working with a CPA, they're going to need, well, depending on how good they are, they're going to need access to your account. And the ability for them to log into your account and download your statements, that makes things very seamless. They don't necessarily need to have access to like be able to buy things or spend things. You don't want that. But the ability for them to, you know, track expenses, to do bookkeeping, um, that's huge.

SPEAKER_01 10:31

Yeah.

SPEAKER_00 10:31

We can't do that with a regular brick and mortar bank account. They don't allow multiple accounts.

SPEAKER_02 10:36

Yeah. So yeah. So you think we're gonna be switching soon?

The Four-Account System For Locums

SPEAKER_00 10:40

That's uh so it's funny. Like, Dr. Moona brought this up, and I was like, yo, like I think we need to we need to move. So I I got the I got the list right here. So here's the three bank accounts that we are considering. I think you should consider this, Moona. Is there's Relay, there's Found, and Novo, right? I think all three are they're solid options for the business, right? We're not sponsored by any of them. So I just looked at all three of them and I like what they all do. They, you know, for the most part, all do the same thing. There's some minor differences. Um, but the things that I think you should be looking for are you want zero monthly fees. You want to be able to create multiple subaccounts, like I like I mentioned, without having to pay extra fees, right? The key thing also is built-in bookkeeping. And what you'll see is, you know, it's not just important to get money, you also have to be able to tell your bank account, you want to be able to tell the taxes, you know, like I spent money on flights for this business expenditure, I spent money on this food for this expenditure. You don't want your CPA to have to go back at the end of the year and do that because they're gonna charge you like 200 bucks an hour. So if your business bank account can do that for you automatically, that's huge. Um you also want to be able to give multiple users access, right? So what I mentioned before. So if you could give your your CPA access to that without actually necessarily being able to change things, that's huge, right? You may even have a virtual assistance.

SPEAKER_02 12:05

Transactional access, yeah.

SPEAKER_00 12:08

Yeah. And then obviously the last thing you could probably guess is make sure it's FDIC insured. And they these things are all you gotta be sure nowadays. You gotta be sure nowadays, right?

SPEAKER_02 12:21

Yeah, you wanna be sure, you wanna make sure of that.

SPEAKER_00 12:24

Yeah, Alfred, if you could put like a five-point checklist of that too. So I I always say zero monthly fees, multiple sub accounts, built-in bookkeeping, multiple user access, and FDIC insured. Those are the things that you should be looking at. And all of those, those banks, they they cover all those things. So and I and I the other thing too, also I would say is make sure you set this up before your first check arrives. You want to know that where exactly your check is gonna be deposited into, right? You want to get a clean slate.

SPEAKER_02 12:56

What if she already started?

SPEAKER_00 13:00

What do you mean?

SPEAKER_02 13:01

What if she already started doing her locums gigs?

SPEAKER_00 13:05

Well, that's a good point. If you if you've already started getting your locums gigs, you want to make sure that you go back to your locums company and you want to make sure that you're getting paid under your LLC. If they have direct deposit, obviously give them the direct deposit to this business bank account.

SPEAKER_01 13:26

Right?

SPEAKER_00 13:27

Um, you want to make sure you try to keep everything as separate as possible. What comes in from the locums company and goes into your business bank account should not be commingled with personal business. That is a big mistake. I don't know if you want to comment on that. Um, do you want to comment on that? Did you do any of that stuff before we got married?

SPEAKER_02 13:47

In the beginning, yes, before we got married, right? Uh, which is why it was such a hot mess. Um, which is why you always say I was on the lamb with the IRS. But part of it was that my expenses, you know, for locums and you know, payments and taxes, everything was mixed in, right? So all my personal stuff that I was spending, all my business things that I was spending, all of that was just commingled. So I would say if you already started, you know, kind of commingling, try to unmingle as much as you possibly can, maybe write down some sort of log or ledger as to what you've kind of already spent, um, what your income was, just kind of what your expenditures were. And then with the next check that you get, have that direct deposit into the business banking account and start fresh from there.

CPA Access, Bookkeeping, And Fees

SPEAKER_00 14:44

Yeah. I think one thing that we like people may want to know like why do you need to bookkeep and why do you need to keep track of these things? Because, you know, once you get that$15,000 check, you know, the goal is to try to keep us keep as much of it as possible for yourself. So you want to use that business money, that$15,000 for your business, right? So every time you use it for something that's related to your business, that becomes a tax deduction. And what a tax deduction means is it makes it less, it makes yourself less liable to get taxed by the IRS, right? Less of that$15,000 is going to get taxed. But if you start putting in personal food or you put like, you know, let's say you get a Netflix account and it's not related to your business and you're paying that with your business account, or you know, you're using gas, your business account to pay for gas to drive you for personal reasons, you need to be able to show that to the IRS if they if you get audited and say, hey, these expenses that I use with my business account were for business purposes. Right. So I agree if you getting a ledger, if you've already started locum, started doing locums is super important. Separate that stuff. If you haven't, start fresh, start with a clean slate, make sure it goes straight to the account.

SPEAKER_02 16:07

Yeah. Make sure you only use your debit for the business banking account for business purposes only. And that that helps to keep everything clean as well, right? Is that you know when you're on a locums gig or you're doing anything for your business, CME, um, licensing, DEA, renewal, all of those things will go through your business account. So just use that particular debit card.

SPEAKER_00 16:32

Yep. That's it. Clean, straight to the point. Mona, listen, you're gonna crush it. Congratulations on finishing up your neurology residency. And uh listen, like I I gotta give you props for being prepared to do this right before you're finishing residency. A lot of your residents, they're not thinking about this. So you're gonna be all right. You're gonna be good.

SPEAKER_02 16:51

Yeah, thanks, Mona.

SPEAKER_00 16:52

All right, our second question. This is right up your alley, Dr. Renee. Um, actually, this is right up my alley, as we're both non-traditional students. Um, you ready? Ready. All right, here's the question. Thank you so much for sharing your experience through residency and for being so transparent. By the way, guys, this question was sent to us on YouTube after episode 475. Okay. Um, I am still a pre-med, but a general search, but excuse me, but general surgery, psychiatry, neurology, internal medicine, and family medicine are specialties I am considering based on fit and interest and return on investment as a non-traditional student. I am 40, coming from a career as a psychotherapist, married with children, with a mortgage, and of course, student loan debt of$135,000. Damn. Any advice for me? I am doing okay. He's giving more information, or she's giving more information. I'm doing okay, getting A's and B's, and I'm looking at 2030 as I am taking one class and one lab at a time to finish all of my prerequisites. Prerequisites. So basically, what this boils down to is am I too old to go to medical school? 40 40 is 40 is is this is a real conversation. This is something that you really need to think about, guys. Um, what's your thoughts, Dr. Renee?

Relay, Found, And Novo Compared

SPEAKER_02 19:42

Well, I've been asked, as you know, this question plenty of times. Am I too old to go to medical school? But my answer always comes to, well, are you dying? Because if do you plan on dying anytime soon? Because chances are the answer is no, but you gotta have a realistic plan and you you have to have realistic expectations. So 100%. Uh you want me to get into it?

SPEAKER_00 20:10

Well, let me just say this. The fact, let's give them props or her props. The fact that they're getting A's and B's, that's huge, right? While working through, like, listen, they're getting A's and B's, they got a job already, right? So they're getting A's and B's through all the prerequisites, right? They're married with kids, they got a mortgage, they got student loan debt. Like, this is obviously someone who is is capable of being able to handle med school, right? Like they're already handling multiple things, I believe, right? Yep. So they're already showing us that they can handle difficult situations. So I just wanted to say that. Like, you're already showing us that you got the the gusto. So yeah, I think basically what we're gonna jump into is is it too old? So yeah, go ahead, Renee.

SPEAKER_02 20:51

Yeah, yeah. And then the other, the only other thing I'll add is, you know, as a non-traditional student, especially with all of that, you are showing that you truly do want to go into medical school, right? Like this isn't just something that like you're like 18 and oh, I want to be a doctor, um, which may or may not be true at that age. So congrats to you for that. Yeah, let's jump into it. So 40 years old in 2026. Too old, but planning. But planning, well, I'll I'll never say too old. I will never say too old. I will say have a realistic expectation and plan of what you're going to do. So if you're 40 years old in 2026, you plan on going to entering medical school in 2030, that means you'll be 44 years old. So let's start establishing that timeline, right? Because the timeline is going to matter.

SPEAKER_00 21:45

So if all goes well, I mean they're applying at 2030.

SPEAKER_02 21:50

They're uh well, no, not necessarily. They said that they would be coming in at 2030. Is that right?

SPEAKER_00 21:59

He says, he says he is or she is, I am looking at 2030. I'm assuming that's a tough one. Let's just how about this? Let's just assume they are applying at the year 2030, at 44 years old. Boom.

SPEAKER_02 22:13

Okay, well then if they are applying at the in the year of 2030 and not actually entering in until tw 2031, then that means they'll be 45 years old. Right? So at 45 years old, if everything goes well, then you're looking at graduating at the age of 49. So graduating at the age of 49, now you have to start thinking this is this is where it starts to count in terms of residency. Now there are two-year residencies, there are three-year residencies, four-year residencies, and then upwards from there. Right? So you have to kind of decide what uh number of years of residency you'd like to do. Now, all of the residencies or specialties that you mentioned before, internal med, family med, um, you know, that's that's three years. If you're looking at neurology, what was the other one?

SPEAKER_00 23:15

So there's so if they're doing fair, all right, guy. So if you're doing family medicine and internal medicine, those are three-year residencies. That means you are finishing training at 2038, which puts you at 52 years old. Right? If you decide to do psychiatry, which is four years, you're talking 2039, which is you'll be 53. If you do neurology, that's four years and possibly a fellowship. We're looking at between 55 and 57, right? Um and if you do general surgery, you know what I'm saying? Right? If you do good old general surgery, which will do you right, that's five to seven years, depending on if you do research. We talk about 54, 56. You graduate in, right? Anywhere between 54 and 56 years old. 2040 to 2042. Sheesh.

SPEAKER_02 24:04

I did mention that there are two year residencies, which there are. Um, one, only one that comes to mind right now is preventive. Uh medicine. So there is that option as well. If you wanted to do that, you can look that up and see what you can do with a preventive medicine residency. So, you know, we're looking at finishing medical school at the age of 49, not finishing um your training any earlier than the age of 51. If you do a two-year residency and then much later, obviously, depending on the other residencies that you do. Now, after you've done that, the question becomes how long do you plan to practice? And that will determine, you know, that will be determined by a lot of things. Well, that will hold hold on.

Clean Books And Avoiding Commingling

SPEAKER_00 24:55

Before you even get to that point, right? So, you know, we're gonna have a graphic on the screen, or we may have already had the graphic on the screen. I I the magic that Alfred does, it's amazing. So hopefully you guys are checking us out on YouTube because it's it's amazing. But I I do want to say this whether you're finishing your general surgery residency or any of the other residencies, there's a possibility that your kids can be in college by then. Right? Um, think about it, your mortgage is still gonna be there, right? And you would have been making a residence salary somewhere between the range of$60,000 to$80,000. I don't know how much they're making now. It might even be higher than that. Um, through all of all these issues that are going on in your life, these are the things that are still going on. And I and I'm not even really talking about the math. So I just wanted to just kind of establish those things first. So I I apologize, Dr. Renee, for getting in in your way.

SPEAKER_02 25:48

No, so yeah, those things are going to be going on as well. Um, the question of how long you plan to practice, I think is definitely something that's still on the table, right? Do you plan to retire at retirement age, what we consider retirement age basically in this country, right? 65, maybe 66 years old. Um, so you have to think about well, how long are you going to practice and whether or not that's going to give you some level of at least life satisfaction? Let's, you know, before we even talk about the money and the return on investment, is that going to give you some life satisfaction? Um if you plan on retiring later, then that's fine. But again, those things are going to be tur determined by a number of things. Probably the number one thing is going to be your health, right? How healthy are you now versus how in the foreseeable future healthy will you be at the age of 65, 70, and so on and so forth. So you have, you know, in in terms of a timeline, right? Because this is really what I think people worry about. People mostly worry about the timeline before they even go into the finances, which I think eventually they go into the finances, but I think people start thinking about timeline first when they say, Am I too old to practice? So I think you kind of did like a little bit of a primer knee of well, what does this look like financially? What does this look like in terms of morph? Oh, that's what I'm saying. You did a little bit of a primer. So I think I think we need to get into that because that cannot go without consideration, especially in light of having a family and people who depend on you for their living.

From Banking To Big Life Pivot

SPEAKER_00 27:38

All right, so we so now that you so you established a timeline, right? So uh you are the the person who's listening, they're gonna be basically practicing starting in their 50s, their mid early 50s, maybe mid-50s, right? So I I just wanted to mention the full financial picture. So you already have$135,000 in current student loan debt. Boom, right? Med school is going to add anywhere between$200,000 to$400,000 to that, right? Depending on if you go to a private or public school. So that's anywhere between total debt now by the time you are ready to start practicing on your own, anywhere between$335,000 to possibly$500,000, maybe even$600,000 of student loan debt. It's just something to think about. Just something to think about by the time you're ready to do that. Unless there are scholarships, right? And remember, during that time, right, that you have that debt, like that's you're making a residence salary for several years during that time, right? Just something to think about. You still have a mortgage, you still have children. I don't know if your spouse will be working during that time. Like these are just the realities to think about during that time, you know. But the key thing is in the graphic before is listen, like we also put in how much uh attendings are going to be making, right? So we're talking about anywhere from family medicine starting at a$220,000 to a general surgeon making close to$450,000 a year. And that's conservative numbers. So the reason I'm mentioning that is the numbers are high, the stakes are high, right? But if you're smart with how you are with your income and how you many years you're practicing, yeah, the debt is gonna be very manageable. So I agree with Dr. Renee, like the timeline is important, the financial math is important also. Um, but I'm not just we're not saying this as a reason not to do it. It's just that you got to be able to plan for what is coming up. You can't just be hyped, you gotta also be hyped and also be realizing, like, yo, this is what I'm facing over the next, you know, 10, 15 years.

SPEAKER_02 29:47

Right. Exactly. You know, and we we establish that timeline based on you getting into medical school the very first time that you apply, right? And so hopefully that is exactly what happens. Otherwise, you know, if that's not the case, then obviously you need to push the timeline, you know, a little bit further into the future. But I as far as answering the question, is it too late or am I too old to go to medical school? Like I said, uh, you know, you plan on dying soon, right? I unless you plan on dying, then the answer is likely not. It's probably you're probably not too old.

SPEAKER_00 30:28

But you just gotta you gotta finesse it, I think. So I do want to ask you a question. Like, is it possible you can share like your post back journey, like the four years that you took? Because you started med school, what, in your 40s?

SPEAKER_02 30:42

Okay, like you know what, Nee. You know what?

SPEAKER_00 30:45

No, because there was a little bit, I have to admit, guys, this episode was a little too serious. I gotta bring some levity back into this. But you did take some, you did take time off. Can you can you talk in a shortened version about the time you took off, the post-back journey, how you like tell us a little bit about that?

SPEAKER_02 31:00

Well, I mean, you know, my my situation is certainly a lot different than this situation, right? Because this going to medicine was gonna be my first career, real career. Um, but I graduated from college, you know, five years um of college, actually. I was 23 years old. Um, the plan was to apply to medical school.

SPEAKER_00 31:23

That's what I'm saying.

SPEAKER_02 31:24

Yeah, I probably was. Um the plan was to apply to medical school two years later. But after those two years, I realized I wasn't ready. Um, so it got pushed another two years. So I ended up spending four years out um after college and entered medical school when I was the age of 27. So, you know, my situation is a little bit different, but during that post back journey, you know, I did my I did a DIY, a DIY post back, actually.

SPEAKER_00 31:55

And can you just can you describe what a postback is, just so folks can understand?

SPEAKER_02 31:59

That's what I'm about to do. My bad, my bad.

SPEAKER_00 32:00

You know, but you know, because you always be telling me to explain things, so I'm telling you, you know, I'm sorry, but it's been a while since we recorded together.

Timeline Math For Starting At 40

SPEAKER_02 32:07

Yeah, yeah. So a postback program essentially is those classes that you take. They're usually undergraduate classes that you take after you have graduated from college, right? So 10 hence post-baccalaureate, after your baccalaureate. Um, you can do it in a program, in an officially structured program. They do have post-back programs that are run through colleges, uh, but they also have the you also have the ability to do a DIY, which basically means you go to a college, you sign up for one or two classes at your own discretion. You take those classes, you're not in an official program, but you're doing it so that you have a little bit more flexibility. Um, you maybe want to pay for it on your own and don't necessarily need loans to pay for it, which is what I did. Um, and so, you know, doing a DIY post back, I was able to work. I at one point I had like four jobs, four like part-time jobs doing this post back, trying to pay for it. Um, so I ended up doing that, you know, for about two years. And then the next two years was when I was still working, studying to retake my MCAT. And then that last year, in that last two years, I was actually applying to medical school. And at that point, I was working as a high school teacher. So, you know, while my journey looks a little bit different, um, the reality is whether or not it was worth it. Because even at that age, right, I had to ask myself, am I too old? Because the the adage is right. The adage is right, you know, you go, you go to high school, you go to college, and you go straight into medical school. Uh, but there came a point where I had to have kind of a conversation with myself to say, well, do I really want this?

SPEAKER_00 34:02

Um, you you're obviously four years behind, do you or four years into this? Do you think in yourself, oh man, like I'm behind the eight ball?

SPEAKER_02 34:14

Yeah. Yeah. I mean, actually, I was like five years behind, right? Technically, quote unquote behind. Because I had creeping college.

SPEAKER_00 34:21

You see how you're creeping to 40?

SPEAKER_02 34:22

Now how you creep into 40, knee. How you creeping to 40? 20 plus what makes 40, knee.

SPEAKER_00 34:30

Jesus Christ. Yeah, okay.

SPEAKER_02 34:32

That's yeah, that's that jersey, man. That St. Benedict's Matt.

SPEAKER_00 34:35

Hey, hey, hey, hey, hey, watch that. Watch that. The best, the best high school in the country, yo, is St. Benedict's Prep. All right. Newark, New Jersey.

SPEAKER_02 34:46

No, but there was a point at which I had to have that conversation with myself because I did feel like, man, you know, I'm not, I'm not where I'm supposed to be. You know, and then I thought to myself, you know what? Where I'm supposed to be is where I am. Because if I was supposed to be anywhere else, that's where I would have been. I I just would have been there. Right.

SPEAKER_00 35:05

So I thought- Do do you do you think the the Renee coming out of Mets? Or excuse me, the Renee coming out of college, right? In what, 1970? No, I'm teasing. The Renee coming out of college, where she was academically, is that the same person who Renee was after finishing the postback and getting ready to apply to medical school four years later? Well, that's the way the same person.

SPEAKER_02 35:28

Academically, that's an easy answer, right? The answer is of course I was different. The real question was Were you better or were you? Well, yeah, academically, yeah. Because I mean, that's the whole point of me doing the post back, right? Was that academically I knew that I could not compete with what I had in college to go into medical school. But certainly after the post back, retaking my MCAT, yeah, it was definitely a different person academically. But honestly, I think that people, I think that people look at the academic piece um without looking at the entire picture. And the really the entire picture is you have to look at whether or not you are a different person, not just, you know, not just a different student.

SPEAKER_00 36:13

Yeah. I I would say this. Thank you for sharing that. I would definitely say the same thing. I was a non-traditional student. I applied to medical school two times. In between, I took two years off.

SPEAKER_02 36:23

Yeah, because you just graduated like two years ago, right? Yes, I did. You're like fresh and new.

Training Length By Specialty

SPEAKER_00 36:28

What does that make you? What does that make? Robin the cradle. Robin the cradle. You just graduated. You stepping up, you step up on all my what I'm trying to say. So I would say this. Although I wasn't 40, I did go through those points of like, yo, am I behind? Um, you know, wondering if I'm too late. Um, and like, did I miss my window? And remember, I I shared in previous episodes, like, man, I was during those two years, or right before I started those two years where I was trying to figure out what I wanted to do. I mean, I was trying to get a job at Sears, I was trying to get a job at the Sports Authority, I was trying to get a job at AT, Foot Locker ATT. I was struggling. I was struggling, man. And I tell you, like, it's it's like you think to yourself, like, yo, I told everybody that I wanted to be a doctor. I had stopped watching the TV show ER. Like, it was just like, I was mad. Trigger, trigger warning. You know what I'm saying? So I I just I just want you to know that it's not too late, right? Because, you know, there's always this feeling of I'm behind, but you got to look at it as I'm building, right? Give me, come on, give me those snaps, right? I'm building and and there's a difference. So I would I would say though, you know, sharing our stories. I wanted you to understand why, you know, we're sharing our stories, but what I saw when we got into medical school is that the top performers in med school were those who were the non-traditional students, right? I don't know if you remember, like they just tend to be more intentional, they're very intentional about their time. They don't got they don't have time to fuck around, basically. Yeah, you know, they're not trying to get lost in the noise. Um, like you said, like they got kids, they got a spouse, they got a mortgage. Exactly. They know what it's like, yeah, to be a life experience the life experience that they have compared to a 22-year-old doctor is th that's two different things. Yeah, you know, and I I think that you doing a career pivot, that's just gonna make you a better doctor.

SPEAKER_01 38:30

So yeah.

SPEAKER_00 38:31

But I I will say this that I do have some questions that I think you need to ask yourself before you, you know, you really, really pull the pull the you know, really go to bat with what you're gonna do in 2030. Um, these questions are question one is can our family financially survive on a resident salary? Right?

SPEAKER_02 38:52

Or no salary initially, right?

SPEAKER_00 38:56

So as a resident no salary. Med school does no salary, that's a good point. Residency, you're talking about sixty to eighty thousand a year. Once again, this is going back to just not only talking about the inspirational and the timeline, but does the math make math sense? Right? Question two are we willing to add$200,000 to$400,000 in new medical school debt on top of the$135k that we already are carrying, right? Knowing that I won't be able to start paying that off until I'm in my mid-50s.

SPEAKER_02 39:33

And also on top of potentially school for your children.

SPEAKER_00 39:40

Mm-hmm. That look like they're gonna be on their own. I'll just tease it. I'll just tease it. I'll just tease it. Question three. Can our family handle the schedule that comes with medical training? Now, obviously, if you already decided that you want to be a doctor, you're probably already thinking about this, but this is true. Can our family handle the schedule that comes with medical training? I'm talking about nights, weekends, holidays, missed birthdays, right? Have we had an honor?

SPEAKER_02 40:06

I was gonna say, can you can you go into that, right? Because I think that a lot of pre-meds actually do not know what this they they don't they hear, well, yeah, the schedule is grueling, but I don't think they actually understand what that means.

SPEAKER_00 40:24

How about this? I think the best way to describe it is let's talk about our schedule. Right? So we went to med school, what, 20-something years ago now, right? Or we got yeah, we graduated 20 years.

SPEAKER_02 40:35

20 years ago, this year.

SPEAKER_00 40:36

We graduated 20 years, and I think the way in which our education was was perfect. We were in a systems-based education. What that means is we studied the body in systems as opposed to just the traditional way. You do anatomy and then you do physiology separately, and then this semester you do biochemistry, and we ain't do all that. So we did, for example, we did the um the neurology system, the neuroscience system. We studied the anatomy of the brain, the spine, the neurons, but we also did physiology, the biochemistry, the pathology, the surgery, all of that stuff for that specific system we did, and I loved it. So we would have what four classes a day in the morning?

SPEAKER_01 41:17

Yes.

SPEAKER_00 41:18

Yeah, so we'd have classes basically from 8 a.m. to maybe roughly around one o'clock, two o'clock.

unknown 41:25

Right.

SPEAKER_02 41:25

Yeah, to like 12, and then maybe do a lab. So yes. Yeah, so maybe up until about two. Between 12, between noon and two o'clock. Yeah.

SPEAKER_00 41:35

Monday through Friday, right? Monday through Friday. And then every two weeks we had a quiz based off of stuff that we covered over the previous two weeks. We always did that, right? You remember that?

SPEAKER_02 41:50

Very consistent. Yes.

SPEAKER_00 41:52

Very consistent. Every two weeks there was a quiz, and it's basically a huge test. It's not even, I don't know why they call it a quiz, just say it's a test, right? You ever notice that there's a different connotation between a quiz and a test? But they're the same thing, right? It's a little test. It's a little test, but it counts a big deal.

SPEAKER_01 42:09

Yeah.

SPEAKER_00 42:10

But what I would do is when I finished, from two o'clock or three o'clock till like five o'clock was a time where I would just, you know, making myself something to eat. I'm talking with family. I watch TV, we're watching music videos. This is like, you know, come on, guys. This is the early 2000s, right? Going to Chipotle. Going to Chipotle, falling asleep. Falling asleep. But yo, from six o'clock, from six o'clock in the evening till come almost what? 11 o'clock? Midnight, studying. And when I say studying, uh my goal was by the end of the night, I needed to review everything that we covered that day. Right? Everything that we covered, I needed to review and understand everything that day. I didn't need to memorize it, but I needed to review it and I needed to understand it. And then unless you mess it with your girlfriend. Right. We weren't dating back then.

SPEAKER_02 43:07

So then the other Yes, we were.

SPEAKER_00 43:10

Shit. This guy's like, the other girlfriend. I didn't I didn't write I didn't write it for all this drama. And then you got to manage that too. Listen, side check. No, Tisa. But listen, you you have got you have got to cover all of that stuff, right? And then not only that, I need I went back and I reviewed what we covered in the previous days also, right? So you're doing that Monday through Friday. Saturdays, look like I don't know what anybody thinks. Saturdays, remember in the morning time? We're studying, right? Saturdays from like, I'll be honest, like 10 o'clock until like what two o'clock, four o'clock. We're trying to cover everything in the whole week, right?

Debt, Income, And ROI Reality

SPEAKER_02 43:54

Yeah. And the it's a lot of work. It the thing is, it's not just your didactic classes, right? That you're sitting in the classroom, you know, trying to figure out. You have to be in the anatomy lab so that you can go through all of the cadavers, which some medical schools don't even use cadavers anymore. So, but for us, um, in our time, you know, you had to go through all of the cadavers and, you know, look at all of the structures that you needed to know, and not just on your cadaver, but everybody else's cadaver, so that you could figure out what you're gonna do when the practical exam comes along, right? Because that wasn't part of the quiz. Practical exam was a, was a little, you know, a separate um exam. So there, you know, there's your Saturday, and then we went to an osteopathic school. So on top of all of that, then we also had to study our osteopathic manipulations and try to figure out, you know, all of the maneuvers and things like that. So there was that as well. It's a lot, right?

SPEAKER_00 44:57

So there's really, in my opinion, if you want to succeed at this, there are no days off. A day off is a missed day. That's the way I looked at it, right? It was a missed day to review, it was a missed day to quiz, it was a missed day to reinforce something. Um, so that's where, like, if you have to do something related to family, it's it's you have a decision to make. There's a decision to be made. Yeah.

SPEAKER_02 45:24

And it's you have a big decision to make. Yeah. Um, and that's that's the first two years. Um the next two years is where I think a lot of people, a lot of pre-meds don't understand what those next two years are like. Um so today, today I actually um took my kids to their pediatric appointments and there was a third-year medical student there. And in your third year, again, depending on the school that you go to, you may or not may not be in the city in that your that your medical school is in. So for our school, um, we had different sites across different states. So just because we went to school in Kansas City doesn't mean that our third and fourth years were in Kansas City. So some people ended up in New Jersey. Some people ended up in Oklahoma. Some people ended up, yeah, I mean, you name it, they ended up in different places. Um, and you don't necessarily have a choice to go wherever your school, you know, wherever you want to go, your school will tell you. Now, if you're lucky enough to be at a school who only does rotations in the city, that doesn't necessarily mean it's only in that city either, right? It could be that city and the areas are surrounding that city. So for us, we did end up staying in Kansas City, but Kansas City area also meant we went all the way out to Hoisington, Kansas, which is which was about a five-hour drive away. Um, so you know, that's one thing to consider when you're thinking about, okay, well, what schools am I going to apply to? What is my schedule really, really going to look like if I have a spouse, kids, you know, and other types of obligations that I need to attend to.

SPEAKER_00 47:21

And it's harder to take days, it's harder to take days off when you're in your clinical years.

SPEAKER_02 47:26

Correct, right? Because you have to present as the student to a facility, a private practice, a clinic, a hospital. You might be part of a team of students who are there with residents and the attending. So you can't just not show up, right? This isn't like class where you go, I'm not going to go today. Um, you have to actually show up because if you don't, people are actually looking for you. They want to know where you are. Um, so it that will reflect in your evaluation. Um, so you know, you you may not be able to take off. Um, there have been plenty of things that we missed. I missed, I think I missed um, I missed the wedding, I missed the funeral, I missed definitely a few graduations. Um so these are the things that you have to think about as well and talk with your spouse to say, hey, there's going to be a lot of sacrifice, and I might be missing these things. You might miss your kids' own graduation.

SPEAKER_00 48:31

Yeah. Yeah. You just might. It's, it's, yeah, it's deep. It's deep. Yeah. Let's let's keep let's keep it moving. Let's keep it going. Um, question four Am I pursuing medicine because I genuinely feel called to serve patients in this way, or because I'm looking for financial security? That's a good one. All right. So I'll be honest with you. Yeah, absolutely. Beb, you you know how you know you think you know me. Both can be true, right? But you just need to know, you need to know which one is driving you the most.

SPEAKER_01 49:01

Yeah.

SPEAKER_00 49:02

So I would say that I had a fifth question, but I ain't gonna do that because I thought about it. I was like, yeah, I don't really.

SPEAKER_01 49:06

What is it? Let's hear it.

What Med School Life Really Takes

SPEAKER_00 49:08

Um it's which specialty aligns with both the general interest, my genuine interest and the life I want my family to have during training.

SPEAKER_02 49:17

Oh my god, that's such an important question.

SPEAKER_00 49:20

Well, the reason I think about that is like if you're a general surgery resident or if you're an orthopedic surgery resident, is your life as a resident that much different than if you are an internal medicine resident or a family medicine resident? That's the reason why I think I said that.

SPEAKER_02 49:34

I think the answer is yes. I think the answer is yes. I think so.

SPEAKER_00 49:42

Okay, then boom. Let's do this then. Question five. Which which specialty aligns with both my general interest and the life I want my family to have during training, not just after or during?

SPEAKER_02 49:56

Yeah, I I think the answer, right, really depends. Because so while internal medicine let's let's say, let's assume, let's assume that the schedules are all the same, which we know they're not. But let's let's say that even if the schedule of an internal medicine resident were the exact same as a general surgery resident, right? I think the pressures are different. The pressures are different, the type of residencies are different, such that they produce a different vibe and a different response from the person who is going through those programs. You know, and that's not to say that you know, internal medicine is easy peasy, that's not true, but I think general surgery is good lord, like just you know, whip me chains and whips. I'm drowning. You know, I think that's I think the pressures are different, and when the pressure is different, you you don't leave those pressures at the hospital, you bring the pressures home.

unknown 51:13

Yeah.

SPEAKER_00 51:14

I I I I think that is okay, you're right. You changed my mind. So that's the reason I asked it. I I just was thinking, but you're right.

SPEAKER_02 51:20

There is just Lord, I saw you go through residency.

SPEAKER_00 51:24

It's just to think about it. It's just things to think about. Um, but I think we need to close this out because we're getting a little bit long in the tooth. Let's let's close things out. So I just want to say, I didn't get the name of the man or the woman who wrote this in, but I just want you to know that we're rooting for you. It's super important, right? Like the fact that you're already asking these questions, um, you put a lot of careful thought into this. And look, like you've already gotten student loan debt, you've already gotten a degree, you're already practicing, so you already understand how this goes. So listen, I think you're gonna succeed in medicine, you know? So I think I think this is for you. Um, I would just say this though, like, like you're not gonna hear from me. I'm very like as a general surgeon, I'm very blunt with a lot of things that I say. So I oftentimes will just not give you the the I won't just say just follow your dreams. I gotta give you the math, I gotta give you the timelines, and just say, look, like it's great to be to have the inspiration, but also at the same time, you gotta know what is ahead of you so you can properly plan for this. So you gotta dissect it.

SPEAKER_02 52:26

You gotta dissect it.

SPEAKER_00 52:27

Yeah, you gotta dissect it. You know, I don't like to take risks, yo. You gotta run the numbers, yo. Do both, run the numbers, have a family conversation, speak to the spouse, you know, you know, choose a specialty that interests you, but also think about the fact that you gotta have your whole family in mind, also. And um, it's not just about your career, actually, to be honest with you. It's not just about your career. So one thing that I would I wanted to ask you, and I was thinking, for someone at this age, right? You know where I'm going with this. No, it's knowing the di knowing the differences in the specialties and how much they get paid, right? Which when you think about it is really not that big of a not that big of a like change and so forth. If that person were to ask you, what should I go into? Like family, like out of the list that they gave you, family medicine, neurology, um, general surgery, which one would you choose for that person if they wanted your opinion?

SPEAKER_02 53:25

Just based on age?

SPEAKER_00 53:29

Just the whole picture, what this person wrote in.

SPEAKER_02 53:31

Age, well, I that's children. I mean, that's hard to decipher, right? Um because if you I'll give my answer.

SPEAKER_00 53:40

How about this? Let me start by you. You can think about why you're while I'm giving my answer. I would say for me, I would say choose primary care. I would say choose primary care because I think you have to think about the physical abilities as you get older, your ability to concentrate, stand, you know, particularly in general surgery, like, yeah, like you can have a really great elective practice, but there are a lot of times where you have to take call. There's a lot of times where even for your elective patients, you're gonna have to take call for them. And that means you're gonna have to be getting up at two o'clock in the morning doing operations, you know, at crazy hours, and then still have a full day, right? I'm not saying that you won't be able to do it, but just I think the low-key hack is just if you can make a significant amount of money just using your brain and being in clinic for a long extended period of time, particularly for you where you're talking about starting in your 50s and maybe even now practicing and still making a significant amount of money in your 60s and possibly even to your 70s to catch up. In my opinion, if you were asking me, I would say go to primary care route. I'm not saying you can't do general surgery, but it's just you ask me, and I'm just giving you what I would say.

SPEAKER_02 54:43

So I see I now I see where you're going with this. Okay. Yeah. It I would have to agree. I would tend to agree. Um, because being at an age now where I have to be. Of work is definitely it's the same as before, but it ain't the same as before, if you know what I mean, right? It's like, yeah, the physical demand is the same, but my response to the physical demand is not the same. You know, I I do find myself going, you know, like Danny Glover. I'm getting too old for this shit.

unknown 55:26

Yeah. Yeah.

SPEAKER_02 55:29

You know, when I want to sleep, I want to sleep. You know, um, when I don't want to stand in the OR for two hours, I don't want to stand in the OR for two hours. Um, so yeah, I I see where you're going with this. If you are considering the age, everything, family, all of that, the stressors of it, yeah, I would say primary care would probably be your best bet.

Clinical Years, Travel, And Sacrifice

SPEAKER_00 55:53

Yeah. So listen to Dr. Moona and to our uh hopefully upcoming uh physician in 2030 or 2030, well, 2035, excuse me. Um, I want to say thank you very much for writing in. I love these type of episodes. Like this is the reason why this podcast exists, right? Is for people who are trying to figure this stuff out without a blueprint. Um, kind of just the way how we did it, right? So listen, update us, Dr. Moona, update us, uh pre-med student. Let us know what you guys have decided. Um, we generally want to know how this turned out for you guys. Anyone else who's interested in writing in, everything is in the show notes, whether you're listening on book on your DSPs or if you're listening or watching us on YouTube. Um, we listen and look at every question, and you know, hopefully you get your question answered on this show. So make sure you guys subscribe and uh let us know uh what you guys think. We'll catch you guys on the next episode, y'all.

SPEAKER_01 56:50

Peace.