In our March episode of the PRCCast, Mondays With Mel, special guest, Lexy Fancher Dominguez shares her experience, opinion, and insight on her life as a current medical student. From extreme financial barriers to the commonly known “physician burnout crisis,” Lexy touches on the main challenges med students face and how they impact the future of medicine, overall patient experience, and the medical community.
The long (and expensive) journey
According to Student Debt Relief, the average length of undergraduate, or pre-med study, is four to five years, followed by another four years of medical school and another three to seven years (depending on your specialty) of residency before finally jumping into your career. This decade of school is more than just a huge time commitment, it’s also just the beginning of a mountain of expenses. Not only do med students have to pay for school, but they also have several exams and test preps that are quite costly—even applications to medical school and residencies can hit the wallet.
“When I first began applying to medical school, it was about $600 for the application, “ Lexy said in the episode. “Then, it cost even more for secondary applications.” Once Lexy began med school, the fees kept piling higher. “You also pay for test preps and question banks to help you study for the test you also have to pay to take.”
Unfortunately for the next generation of doctors, the journey to become a physician only increases in price every year. The average cost of a four-year medical school ranges from $150,000 to nearly $400,000—not including the annual increases or cost of living. “Everything is expensive, it’s not just getting into medical school,” Lexy said. “We need to create a better way for physicians to not be in such massive debt.”
The intense financial barriers that med students face also place some future physicians at a disadvantage just by their financial class, making it harder for organizations to curate a more diverse workplace. “It’s critical to have a diverse array of physicians working in a hospital,” Lexy says.
Indeed, a better financial system must take place for everyone, not just a specific class of people—this isn’t diversity. Expanding opportunities for financial models to support medical education would simultaneously lower educational debt and improve the patient experience with happier, financially free physicians.
Competing against yourself
As a medical student, there is no doubt that competition is everywhere. However, struggles arise when students are competing against themselves in several board exams and test environments. “After your first two years of med school, you must take a test that basically determines your future as a ‘do not pass go,’ until you pass this test,” Lexy says.
The high stakes of these tests create an enormous amount of pressure on one person for one test. As Lexy explains, these tests are scored numerically with an average of 229. However, depending on your field of interest, you may need to score at least 250 or above to even be considered. If you do not pass the test, you must take it again with the “failed” first score remaining on your record. If you do pass, but not exceedingly pass, then you are also out of luck because that score sticks with you and you cannot retake the test.
Board exams are not the only tests med students see, adding to the reoccurring stress of becoming a doctor. “I would study for eight hours a day, six days a week at the library, and still go home to study more,” Lexy says. “These tests are isolating, exhausting, and anxiety provoking.” By crushing students with stress, medical school aims to weed out those who may not belong. Unfortunately, this also burns out those that do, making them start their career with a mental health deficit.
As burnout studies show, stress is the silent killer. Med students learn that their patients come first in their satisfaction and care. However, med students and physicians must also be mindful of their mental health, especially with the immense limitations and pressures affecting them. The future of medicine is now, but at this pace, the future reads debt and a never-ending cycle of pressure to get there.
Sources and further reading:
Average cost of medical school
Average medical student debt in 2017
Doctors feel bad: Why are so many doctors miserable?
PRCcast Mondays With Mel: Burning Out Physicians Before They Begin with Lexy Fancher-Dominguez