What are the advantages and disadvantages of studying medicine?

Every year, about 43,000 people apply for medical studies.Only 9,000 of them get a place to study. But what are the main reasons for and against a medical degree? Here you will find the most important nine aspects (4x PRO, 5x KONTRA) that I found during my research:


Doctors are satisfied with their work (1/4)

According to a representative survey by the Medical Monitor of more than 10,000 registered physicians in Germany, 91 percent are satisfied with their work.96 percent enjoy their work, and 98 percent find their profession meaningful and useful. This is particularly impressive when you compare the medical profession with the average employee. Overall, only one in two people is satisfied with their work. As a doctor, you have a much lower risk of being dissatisfied with your work.

German clinicians are already closer to the population average.In a 2012 survey, “only” 70 percent rated their job as attractive. Six out of ten doctors were satisfied with their working conditions.

International studies paint a similar picture: In the US, 95.5 percent of physicians are happy with their profession, according to a Gallup poll.A study in the UK ranked 274 occupations according to their life satisfaction: doctors came in seventh place.

The surveys also show that the profession can cause stress and burn-outs.In the survey conducted by the medical magazine, 29 percent of doctors describe themselves as burnt out. An American study compares physicians with the population and finds a significantly higher risk of burn-out and dissatisfaction with work-life balance.

Doctors earn above average (2/4)

Doctors are among the best-earning professions.

According to StepStone’s 2017 salary report, the average income of physicians in 2016 was 79,538 euros. This is 62 percent higher than the average salary of a full-time employee (48,900 euros). In principle, income varies depending on seniority and promotions (assistant doctors earn significantly less than specialists), the field of expertise (e.g. general medicine, surgery or radiology) and the location (both inter- and national).

The starting salary for assistant doctors is approximately 52,800 euros gross per year.

This leaves a single with about 2,800 euros net per month. Some graduates are drawn to better-paid countries, such as Switzerland. There, an assistant doctor earns 70 percent more salary (91,200 euros gross). Due to the low taxes, even about 6,000 euros remain in your own pocket per month, which is twice the German salary. Even if one takes into account that products and services in Switzerland are on average 55 percent more expensive than in Germany, one can still “afford” 40 percent more.

Physicians have significantly smaller income fluctuations than other occupational groups.

The payment in hospitals is based on the tariff, the billing of cash-strapped patients is based on the budgeting of the health insurance funds.

The low variance can already be seen from the starting salary: Assistant doctors are paid according to tariff and receive 52,800 euros per year.For young lawyers and business economists, on the other hand, the income varies between 25,000 euros and 140,000 euros with a similar average.

Another example is the net income of established physicians: the bottom 19 percent of practice owners achieve a net income of 83,000 euros, while the top 14 percent come to 331,000 euros.On the other hand, a self-employed individual lawyer is sometimes left with only 35,000 euros in profit per year, while partners in the top law firms can earn up to one million euros per year.

Overall, there is a greater variation in income in other industries, such as finance or law鈥?with similar average incomes.This is partly because there is no up-or-out system in medicine. For doctors in the hospital, the income depends on the years of service and their promotions. And these (e.g. from specialist to senior doctor) are often better anticipated than in most other industries.

The following graph gives you an overview of your earning potential as a physician depending on your chosen path (clinic doctor, employed doctor in a practice or self-employed as a resident physician):

Different specializations for different interests (3/4)

The 33 different specialist training courses leave room for your individual interests and strengths.

With excellent fine motor skills, you could become a first-class surgeon. If, on the other hand, you are interested in genetic connections, you may want to focus on human genetics.

As a specialist in hygiene and environmental medicine, you are often involved in counselling and are concerned with practice and hospital hygiene.This topic, for example, is highly topical: more and more people are infecting themselves with multi-resistant bacteria in hospitals. Some of those affected even die from these infections when even reserve antibiotics no longer work.

While surgeons and anaesthetists work primarily practically and directly on the patient, radiologists and histologists analyze and analyze recordings andsamples and only transmit the diagnosis to the patient.

In the medical cosmos there are thus a variety of specializations, each of which focuses on other activities and tasks.Not every doctor operates or examines patients. Within medicine, there are basically many different career paths open up for you.

Status and Prestige (4/4)

As a future doctor, you have a respected profession.

According to a Forsa survey on professional prestige in 2016, 87 percent of Germans think that doctors enjoy a very high reputation. This puts them in second place behind firefighters (93 percent). Internationally, the picture is the same: everywhere doctors have a high reputation in society. With the decision to study medicine, you also decide on a career with prestige.

This is no surprise: as a doctor, you have successfully prevailed against many other applicants for a place at university, look at excellent salary prospects and help other people who are in need.These three things give the profession a special aura together. But why is this relevant?

  • Benefits of transactions. If you want to rent an apartment later, apply for a loan or are looking for an investor for a project, you benefit from the prestige that surrounds your job.

Detached from your stable income, many people will , at least unconsciously, also orientate themselves to your status when they enter into contracts with you.

  • Advantages in partner selection. This point is of particular benefit to men.
  • Women are generally attracted to men with high social status. This selection mechanism has evolved over thousands of generations of evolution. In the past, people who regularly brought large prey to the group were at the upper end of the dominance hierarchy. Today, it is people in competitive professions who have prevailed against numerous other interested parties. It’s not without reason that doctors end up in the top four of the most attractive professions on Tinder. As a (successful) doctor can choose from a larger pool of interested partners.

  • General advance of trust in many situations of life. The relationship of trust between doctor and patient is also transferred to private life.
  • In contact with strangers, people tend to trust doctors rather than insurance brokers or bankers.

    However, choosing to study medicine for reasons of status alone is a bad idea.For example, your strengths and interests should be much more important. For example, if you have no interest in helping sick people, you will end up in a completely wrong profession.

    Instead, these considerations should have a supportive role: provided that all the important factors are met, the prestige of the career is an additional reason for this option.For everyone else, there are many alternative career paths that are also associated with high social status.


    You save much less life than you think (1/5)

    Many graduates choose to study medicine for altruistic reasons: they want to help people, save lives and pursue meaningful activities.In fact, however, an (additional) doctor has a much smaller effect than is often assumed. What is the reason for this?

    #1.1 You only generate a small added value. If you look into your shoe cabinet, you will find an average of 17.3 pairs of shoes as a woman and 8.2 pairs of shoes as a man.But not every pair of shoes is equally important: if you didn’t have shoes at all, you’d have to move barefoot or on socks from A to B. So the first pair of shoes is essential. In addition, you will need shoes for various purposes: sports shoes, business shoes, winter shoes and flip flops. But after you’ve covered all these needs, the next pair of shoes will give you minimal benefit.

    There is also a similar correlation between the number of doctors in a care area and their effect on patients’ health.If there is no doctor in an area, we die of all kinds of diseases without access to medicines and treatments. However, once there are a few doctors, illnesses and deaths are reduced enormously.

    Additional specialists in specific fields (e.g. cardiologists) continue to improve health.But from a certain density of doctors, all people can be treated in a care area. The next additional doctor will then bring only a small benefit (e.g. reduced waiting time), similar to the 23rd pair of shoes in the shoe cabinet.

    Gregory Lewis, a public health doctor, has studied this very connection: he has compared the number of doctors to the so-called Disease-adjusted Life Years (DALYs).They indicate how much life is lost due to premature death and limitations such as disability or illness. His results confirm the above considerations: the first doctors reduce the DALYs strongly, but then the “additional benefit” of the next doctor decreases further and further.

    In Germany, we are at the flat end of the curve with 221 doctors per 100,000 inhabitants: we are so well cared for that an additional doctor has only a weak effect.Lewis estimates that an extra doctor saves the equivalent of 25 lives throughout his career.

    #1.2 You only replace another doctor. If you decide not to study medicine, there is nuptment less.

    Instead, another person takes your place. Because, as we have already seen, there are about five times more people than there are places. Since the competition for the study places is extreme, there is usually no “quality difference” between you and the next best applicant.

    In other words, just because you decide to become a physician, there is no longer a doctor after your studies.Only if your work as a doctor would deliver above-average results (e.g. because you would be a gifted surgeon), you could at least marginally increase the “average doctor quality” in Germany with your decision to study medicine.

    #1.3 You can only examine one patient at a time. As a doctor, you can only treat one patient at a time.

    You cannot work in three operating theatres at the same time or prescribe two treatments at the same time. Unlike software solutions, for example, your work as a doctor cannot be scaled. Your working time sets a limit on the effect of your work.

    Waiting semester and opportunity costs (2/5)

    Since the winter semester 2015/16, you have to wait 14 semesters for a place in human medicine if your numerus Clausus has not been sufficient for a direct start of studies.Normally you would have completed your medical studies during this time and would have been working as an assistant physician for a year. Students from other subjects have been working for several years. This means that you lose a lot of money compared to an immediate start to your studies.

    During the seven years of bridging, you can complete an apprenticeship (鈧?00 per month over 3 years) and then look for a full-time job for another four years (鈧?,000 per month over 4 years), but you will earn just under 鈧?30,000 gross.After that, you have to study for at least six years before you can earn your first income as an assistant doctor.

    Without a waiting semester, however, you would have worked as a doctor for seven years at that time and during this time (incl.salary increases according to tariff) earned approximately 400,000 euros. From a purely financial point of view, you will lose 270,000 euros gross if you wait seven years for a place at university.

    This alone leads us to conclude that you should definitely minimize your waiting time.

    A paid degree at a private university in Germany or abroad, which costs, for example, 15,000 euros per year, is often a better decision than waiting for a place to study.

    The waiting time is also at the most productive time of your life. Between the ages of 20 and 30 you have virtually unlimited energy, your body is still spared from biological decay and you (often) have no obligations like a family of your own.

    In these years you should “step through the accelerator completely” and lay the foundation for your future.To remain in a kind of waiting position for seven whole years in this window of time seems to me to be wasteful. It is often wiser not to queue up and take a different path instead.

    The competition is high (3/5)

    As of the winter semester 2014/15, there were 9,000 study places and 43,000 interested parties.Only one in five could therefore start studying human medicine. The places are awarded according to the 20-20-60 rule: 20 percent go to the graduates with the best grade average. A further 20 percent goes to people who have accumulated enough waiting semesters (now there are 14).

    The remaining 60 percent are awarded by the universities according to their own criteria: some rely exclusively on the numerus Clausus, others also hold selection interviews or take into account the medical test.Some of these universities calculate an average of medical tests and abinotes, while others calculate the result to the Clausus numerus. For example, if you are in the top 10 percent of the medical test, you can improve your NC at some universities from 2.0 to 1.2.

    But of course many graduates with an excellent grade average also take the medical test, so that they do not lose their advantage.Conversely, for the “average graduate”, good results in the medical test are often put into perspective.

    In order to get one of the coveted places with certainty, you need an NC of 1.0 or 1.1, depending on the state.

    Only 1.5 percent of all graduates achieve this. In relation to the 40,000 interested parties per year, only a fraction can be sure that they will actually get a place at university.

    The medical test, which tests, for example, visual imagination, basic scientific understanding and memory performance, is basically nothing more than an intelligence test.It filters out individuals with strong cognitive abilities.

    A 1972 study based on data from 1940 to 1972 found an average IQ among physicians and medical students between 125 and 130.This means that the average doctor is among the smartest 5 to 2.5 percent of the population. You should locate yourself in this IQ region if you don’t want to have any disadvantages in your job later.

    Universities select because of the high demand for intelligent and conscientious people.Places in human medicine are about as competitive as pledges for the top courses at Stanford or Harvard.

    But as soon as you are accepted by a university, you have passed the thinnest eye of the needle.If you have made the right choice with your medical studies, the chances of a successful career as a doctor are relatively good after the promise.

    Expensively purchased flexibility (4/5)

    With a completed medical degree, you can also pursue an alternative career.A total of 12 percent of all graduates do not work as a practicing physician, but pursue a different job. If you have a good degree, you have a career as a consultant or investment banker, for example. Other graduates work in health policy or research.

    Companies also know that you need to be smart and disciplined to (a) get a place and then (b) perform better than others within this group.

    Unlike a bachelor’s degree, you don’t invest three years, but six to seven years until you graduate.So you study three to four years longer. This is only worth it if you are 100 percent sure that you want to work as a doctor. When it comes to keeping your options open and flexible, studying medicine is the wrong choice. Other alternatives, such as business studies or maths, are more suitable for this purpose.

    Sunken costs, 1.0-a-year A-levels and expectations (5/5)

    Of the graduates with a high school diploma of 1.0, at least 36 percent opt for medical studies.More than one in three with a perfect A-level wants to become a doctor. But why? On the one hand, it is conceivable that students who want to study medicine work particularly hard and therefore make up a larger proportion of the 1.0 graduates. On the other hand, however, it may also be that these students choose medicine because they belong to the small group to which this decision is open at all.

    In addition, medicine with a high status of the profession, the image of the “high-achiever” and good pay “attracts”.The decision to study quickly becomes a self-starter.

    Those who have worked hard for a medical study place rarely orientthemselves. Even if, in the meantime, interests have changed or new opportunities have arisen, few graduates are seriously considering alternatives.

    Finally, the door to study is now open. You have invested a lot of time, forgo parties and time with friends. And now we should simply throw away this opportunity, which many other graduates yearn for?

    This mindset is known in science as “sunk-cost-fallacy”.Sunken costs are costs that have already been incurred and can no longer be reversed. Therefore, they should not play a role in your future decisions. In fact, we often do the exact opposite.

    For example, you bought movie tickets for tonight.In the afternoon, your best friend calls and invites you spontaneously to a party. Although you’d much rather see your friend again, you’ll cancel because you’ve already bought the movie tickets. However, you have already incurred the costs for the cinema. Whether you watch the film or not, it doesn’t change anything. The only meaningful comparison is between the future costs and benefits of your alternatives.

    So if you want to make the right decision, you shouldn’t argue for a good A-level when you decide for or against a medical degree.

    After all, parents’ expectations often play a major role.You should take over the practice or continue the family tradition. Whether these expectations are communicated directly (“You study medicine or you’re going to disenter.”) or indirectly (“It would be a great pity if I had to sell my practice.”) they have a big impact on your decision. And that’s problematic when they drown out your inner voice, which actually wants to do something different. Then you lay the foundation for your later dissatisfaction.

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