In this episode, we address doctor’s student loan debt and if the public should care or not in addition to answering two listener submitted questions about pursuing an MBA while in med school and bullying in residency.
In this episode:
[03:51] Keeping up with the Darkos segment
[13:01] Student loan debt from college, med school, and beyond
[16:29] Should the public care about doctors’ student loan debt?
[21:10] Q&A: Should I get an MBA or an MHA or a JD?
[37:08] Q&A: I feel like I’m being targeted in residency. What should I do?
[47:03] Effects of bullying on residents
[57:09] The difference between receiving feedback vs. being targeted
Keeping up with the Darkos segment
As we’re recording this, Dr. Renee just came back from her 63+ hour on call weekend shift. With these on-call shifts Dr. Renee doesn’t have to be in house unless there are certain things going on.
This weekend was pretty light in terms of patients. Dr. Renee had one c-section she had to complete and then delivered another baby and that was it for that night. She was able to leave the hospital after those two deliveries and get a full night’s sleep in her hotel room.
However, it was a pretty eventful stay because instead of booking through AirBnB, they booked directly through the host to get better pricing which was definitely a mistake.
The Darkos have stayed at that particular AirBnB before and the host usually will text the day of arrival to find out when they’re going to be there. Dr. Renee pulled up to the AirBnB at midnight after her shift to realize that the host had never confirmed the stay day of like she usually does.
Dr. Renee called and texted the host but since it was late she didn’t answer. Instead of trying to enter the AirBnB and potentially putting herself in danger, Dr. Renee decided to leave and go stay at a hotel instead.
Around 3 am, they received a text message from the host reminding them that they had cancelled the stay due to scheduling conflicts and Dr. Nii forgot all about it. It all ended up working out in the end but it definitely could’ve been a bad situation.
Student loan debt from college, med school, and beyond
The doctors share a clip from several other doctors on Instagram sharing how long they were in school and how much student loan debt they accumulated. Dr. Nii attended 14 years of schooling between college, med school, residency, and a year of fellowship for a grand total of $332,000. Dr. Renee also had around the same amount of debt so between both of them, they had $662,000 in student loan debt.
Should the public care about doctors’ student loan debt?
Dr. Nii thinks that the public should care about this but Dr. Renee thinks that they won’t because it doesn’t directly affect them and if they were going to care about it, it would’ve happened already.
Q&A: Should I get an MBA or an MHA or a JD?
We discussed the pros and cons of MBAs heavily in episode 318 so make sure to go check out that episode. If you’re not familiar with what an MBA (Masters of Business Administration) is, it’s a graduate degree that provides theoretical and practical training for business or investment management. An MBA is designed to help graduates gain a better understanding of general business management functions.
An MHA is mastering leadership and management tools to effectively run the business side of healthcare delivery and financing organizations and to manage teams of healthcare professionals. The types of jobs that you can expect for MHA are director of hospital operations, a clinic manager, director of patient safety, director of business development, chief executive officer, chief nurse, or nursing officer.
A Masters of Public Health is where the focus is preparing for a career in population health and community awareness. It has an emphasis on the practical aspects of public health as well as in-depth information about disease and research methods. The type of jobs you can get are community outreach coordinator, health educator, health engagement marketing manager, epidemiologist, environmental health scientist, and more.
Both Dr. Nii and Dr. Renee have an MBA and did a dual degree program where they got their DO degree and MBA during the summertime of their first two years. Normally if you’re getting an MBA without going through a medical school, you have to take the GMAT but if you’re in a dual degree program, you don’t have to as they will accept your MCAT scores.
Some MBA programs will have you do an extra year. Our MBA program was in conjunction with our medical school, but the caveat was that we had to complete both medical school and business school in that four year timeframe.
If you want to do this you need to consider how much it’s going to cost. For example, if you look at the average MBA program that’s affiliated with a dual degree program, we’re talking anywhere between $50,000 to like $120,000 for the MBA program alone.
The next question is should you get it before or after med school. If you are going into residency, there’s not gonna be much time for you to really exercise those MBA skills during your residency unless you plan on doing some type of online business or some type of business while you’re in residency or some type of consulting work while you’re in residency. The true win from getting an MBA is can you exercise those skills in whatever business or focus that you’re gonna do.
When Dr. Nii finished his MBA, he immediately went into residency and did not use it at all for the next six years until they were focusing on paying off their student loans. Now that they’re running their own businesses their MBA skills are coming in handy.
Deciding whether or not to pursue an MBA is really dependent on several factors like if you are really into business and could possibly take a sabbatical after medical school before going into residency to really put the skills learned in your MBA program to use. It really all comes down to what are you planning on doing with your career and if pursuing an MBA makes sense for your goals long term. Maybe that gap year looks like an administrative residency before or after you go into your clinical residency.
Just know that getting an MBA is not a necessity to be in an administrative position. If you wanted to be Chief Medical Officer or CEO of a hospital, an MBA is not absolutely necessary. There are plenty of C-Suite executives who don’t have an MBA, MHA, or a JD.
Even though Dr. Nii did not use his MBA during that six to seven year period, getting the MBA changed his perspective on medicine big time and getting the knowledge was a game changer for him. It helped him really understand the business of medicine in addition to the motivations of hospitals, healthcare organizations, pharmaceutical companies, the government, and how it relates to them as physicians. He also feels like getting his MBA made him think more strategically. For example, he was thinking of things like how can we cut costs here? How can we be a little bit more efficient here? How can I get paid a little bit more?
Dr. Nii started working as a locum tenens doc which meant he was responsible for taking care of his own healthcare, medical malpractice, and more. With that said, it is not absolutely mandatory to get a dual degree to have a successful career.
Q&A: I feel like I’m being targeted in residency. What should I do?
A recent study in Jama showed that anywhere between like 15 to 28 or 30% of residents described being bullied in residency. Dr. Renee actually experienced this when she was in residency and it almost caused her to leave her program early.
Dr. Renee dealt with an attending who would berate her for no reason. One day, he berated her in front of everyone over something she didn’t even do. The resident who actually did the thing that he was upset about was sitting right there but the attending went after her instead.
Dr. Renee was completely fed up with it all and called up the Chief of GYN and expressed her frustration. She told her that if the attending said one more negative thing to her, then she was out.
Before she got to this point, Dr. Renee had gone to her division chief and let her know about the situation. We highly recommend going and talking to a trusted mentor if you are experiencing bullying in residency.
Even throughout the bullying, as hard as it may be, it is important to continue to act professional at all times. Sometimes people try and push your buttons to make you act out and risk being kicked out of the program.
It is also very important to document what is happening so that you have records of it so it doesn’t blow back on you when it’s all said and done. Every residency program should have a way for you to make a complaint either through your program director or some type of compliance way where you can anonymously make these type of complaints or alert someone and them know what’s going on.
When this happens, you also should try to not react with emotion which is easier said than done. You really just need to keep a level head and not react poorly to it.
Effects of bullying on residents
Some of the effects of bullying on residents are low job satisfaction, depression, anxiety, or anger. Other effects can be things like substance misuse, low self-confidence, burnout, or even quitting residency. This oftentimes leads to this continual cycle of bullying for the next generation of students and doctors. So for example, people got hurt back in the day and because they got hurt and nobody stepped in, then they decide to continue that cycle and inflict that hurt onto somebody else.
If you make a complaint to your program director, your program director has to take action this. Sometimes you may even have to just go to your human resources department depending on what type of situation that you’re in.
The difference between receiving feedback vs. being targeted
A target usually is targeted for the stupidest reason otherwise it would just be feedback. Being targeted is when you’re being constantly berated and they are finding a tiny thing to get on your case about.
Sometimes it may be hard to determine if you’re being targeted or not but a good rule of thumb is if you’re getting feedback that sounds more like being berated than constructive feedback, then more than likely you are being targeted.