Monday, January 12, 2015

MiM Mail: Starting medical school, need encouragement

Hi MiM,

In six weeks I am supposed to start my first year of medical school. It's been a long time coming. I trained as a nurse, worked as one for a while, and then decided to pursue medicine. I finished off the prerequisites I needed, applied and got in (to a medical school in New Zealand - where I am from originally). My husband and I had a surprise pregnancy right before I was supposed to start medical school so I deferred for a year. I now have a gorgeous six month old and have been enjoying working casually as a RN. However starting medical school beckons, and I find the idea now terrifying. The unknowns of how to manage it all with a baby. I have an extremely supportive husband but he is also studying a PhD so is busy. We have great childcare sorted - our baby will be at the university day care right around the corner from the medical school. I'm not really struggling with the idea of leaving my baby as I'm not the full time stay at home type, but I am afraid I will find school all consuming and miss out on her. Also from a financial perspective having us both studying sucks - my husband gets a small stipend we can survive off but it's hard when our friends are buying houses and taking dream vacations, and we can only afford meat once a week! I suppose I am using this post and community as I imagine many others do - to seek out encouragement and to hear stories from those who have gone on before. How did you do it with a baby? Any ideas on how to manage financially? Is it worth it in the end? Etc. Would love any encouragement, inspiration, advice you can spare.

Thanks so much,


  1. First things first. Congratulations on your lovely new baby as well as acceptance into medical school! And your husband is a PhD student as well? What a brilliant couple! :)

    I'm a medical student and also your neighbour in Australia. We have HECS to cover our medical school fees. Is there similar study assist in New Zealand? I would be surprised if there isn't.

    As well, I know medical students who are struggling as you are, yet the Australian government does help and in a couple of cases helps considerably so they can make ends meet. Again, I would be surprised if New Zealand doesn't offer similar aid for students.

    Do you plan to live in New Zealand after you graduate, or do you plan to return to USA? If you plan to live in New Zealand, then it may be perfectly fine to be a physician in New Zealand. But realise the training for most specialties is quite a lot longer than in USA (e.g. emergency medicine takes a minimum of 7 years but more realistically 9 years or more to finish, whereas in USA I believe emergency medicine is 3 years). However, the salary whilst a registrar (=resident in American English) is far better than the States. However, the New Zealand dollar has a poor exchange rate with the US dollar, so perhaps it equalises? I don't know New Zealand, but approximately 50% of all Australian medical students become GPs (=family medicine physicians). As a point of interest, Australia and New Zealand each recognise the other's training in most if not all colleges (specialties). You could apply to practise in Australia fairly easily from New Zealand, I reckon.

    If you plan to return, I would advise against medical school overseas. It's becoming more difficult to return. And it'll be unlikely you'll be able to match into competitive specialties (e.g. most surgical specialties except perhaps general surgery though general surgery is still difficult, dermatology, radiation oncology). But specialties like family medicine, psychiatry, paediatrics, internal medicine and others may be possible. Bottom line: It's best to attend medical school in the nation you wish to live.

    Have a look at the similarities and differences between Australian and American medical educational systems. I believe New Zealand is very similar to Australia, and both very similar to UK, as we're each part of the Commonwealth. At the very least please have a look at Table 3.


    1. Hi BA - just to clear up a misunderstanding:

      ---FM physicians have 4 years of residency training after medical school and take care of adults, children, pregnant women, and do basic obstetrics and basic procedures.
      ---IM physicians have 3 years of residency training after medical school then 0-6 years of fellowship and take care of adults
      ---GP are people who have completed only one year of residency (called internship) after medical school.
      ---PCP - any physician who provides primary care, including but not limited to: IM, FM, pediatricians, etc.

      GPs are quite rare as it is very unusual for someone to not complete their residency training. Usually if you don't complete your residency, you don't practice medicine clinically (although you might work in health care in some other way).

      It's true that about half of American doctors are PCP, but GPs are NOT the same as FM physicians, and the term PCP encompasses more than just those two anyway.

    2. Thanks for your comments Borzons. :) Although I'm not entirely sure what I've said contradicts what you've said?

      As far as I can tell, the only item I might've possibly misunderstood is the GP = family physician bit. However I'm in part assuming this from an American family medicine physician I know who moved to Australia and practises as a GP now. But perhaps I did misunderstand the connection between GP and family physician across nations?

      As well, in the past it may have been true GPs are allowed to be called GPs after internship year. However, today I believe GPs are a specialty and need to be registered with the Royal Australian College of GPs. To my knowledge I don't believe the one year would qualify them as GPs today.

      Regardless, thanks for elaborating! I'm sure it's all quite helpful information, and trust it benefits all. :)

    3. 'It's true that about half of American doctors are PCP'

      I'd like to please clarify I never stated 'half of American doctors are PCP'. Rather I was referring to Australian medical students of whom approximately half do become GPs in Australia. I'm speaking in an Australian context. Hope that clarifies the matter somewhat better! :)

    4. Aaaah yes it does appear GPs are different in Australia. And nope, you did not say half of American doctors are PCPs, I did! Just chatting about it a little more because it's something I find interesting :)

      On a side note, the distribution of specialty doctors is very uneven - in cities there aren't nearly enough PCPs to go around, and in the country it's the opposite. Specialty choice, I think, is driven by the fact that a lot of American medical students graduate with > $150,000 in debt. To me, that is just a very sad reflection that the US as a whole doesn't seem to think we should invest in the health of our people.

  2. Hi There,

    I tried to post a few days ago so I am not sure if that post is still in the ether somewhere or what so hopefully I am not double posting!

    Firstly massive congrats on both your little one and entry to med. Both huge achievements in themselves. I did wonder which med school you have been accepted into as I am in NZ and about to commence med school in Auckland. Might be nice knowing someone else who is in a similar position. I have two primary school aged kids so it's a slightly different stage than yours but I am not sure it's any easier as they both now have a number of different after school activities to keep up with in addition to just the regular after school home time. I probably also make my life a little harder than it has to be by limiting the amount of after school care they attend to only extremely busy periods of uni which means that for the most part of the university year I am mum from 2-8.30/9 mon-fri. The baby stage however is demanding in a wholly different way and I can appreciate not wanting to miss out on you little one especially with all those milestones in the first year. There is one thing I have learnt from being mum and that is that your capacity just goes up with what is required of you. I used to only have the capacity to last till I knew hubby would be home from work until he had to be away for a longer stint and all of a sudden knowing that made me have capacity for the duration that he was away. I am positive that your capacity will stretch to what you need it to be to get through this year and the next and the next. I also know that time with your kids can be one of the best balances there is to the intense study that is required. I always felt that way taking my son to his rugby or my daughter to gymnastics or whatever they had on, it was a good break and I just had to learn to work smarter :)

    In terms of the financial stretch. There is now way to beat around the bush with that one. It's just plain hard. Its doable but it is hard and at times you can get pretty weary from being on such a tight budget. All I know to do is to look to why I am doing this and to the knowledge that it will be worth it in the end. We totally rely on the Working for Families allowance and if you live in Central Auckland (we do not unfortunately) you can also be eligible for a sizeable Accommodation Supplement. Those two things can really help in making ends meet. Depending on how you feel about it you can also get a student loan living cost payment which you do have to repay but it can be helpful to buffer particularly tight seasons.

    From all accounts there seem to be mums successfully making their way into and through medical school every year and while I am sure it's never easy I am also pretty positive it is possible. Is it worth it? I think so and I hope so.

    Let me know if you are at Auckland. I'd love to get in touch



Comments on posts older than 14 days are moderated as a spam precaution. So.Much.Spam.