Applying to Medical School (3) : The True Cost of Attending and the “Sunk Cost” Fallacy

This post has been sitting in my “drafts” for quite some time and, honestly, I still probably wouldn’t have gotten around to writing it were it not for my upcoming review of my 2021 Financial Goals…

As I have shared with some of you who have written to me privately by email, at this time, I have decided not to pursue medical school. I have gone back and forth about this decision for YEARS, however, coming to terms with a few things has gotten me to a place of mostly contentment with this decision. A few things…

The few things mostly have to do with my motivations and desires. While these are enmeshed and overlapping, I will do my best to pull these apart here:

1) Sunk Cost – I think part of my motivation to continue down this path had to do with the sheer amount of time and money I had invested in this endeavor. Beyond just the upfront course costs, there was also the missed year of professional earnings, retirement savings, and accumulating student loan interests that resulted from me returning to school full time to take premed courses. When you make that sort of investment of your time and money it is difficult to walk away. Unlike if I had pursed a graduate degree or had been working, walking away was made more difficult because I felt like I had nothing to show for that time. I still feel this way. However, I have also come to realize that this “sunk cost” cannot be a primary motivator.

2) True Cost of Attending – One of the great things about being an older premed is that physicians don’t feel obligated to give you the “rah, rah, you can do it” pep talks. Instead, many of them were brutally honest about the “true cost” of a career in medicine, and how much more complicated that choice becomes for someone in their 30s. PRIOR to the pandemic, I talked to happy physicians who were supportive and encouraging, but I also talked to miserable physicians who talked to me about the constant sacrifice of time, happiness, and money that the study of medicine requires. While I think it is possible that I could have been one of those happy physicians, especially if I found a way to make medical school cheap, I realized that I was not willing to make the other sacrifices…at least not at this point in my life. For a long time, I think when I would have these thoughts I would just attribute it to me being a lazy person. I’m not a lazy person. Instead, I’m making a different choice about how to spend my energy, talents, time, and money.

3) Service to Community
– I turned to the pursuit of a career in medicine just before I graduated from graduate school. My own recent interactions with health professionals and my research on the reproductive care of black women made me passionate about ameliorating healthcare inequities. My academic work in graduate school had also left me feeling like “my feet didn’t touch the ground.” What did it matter if I could have erudite conversations with my fellow graduate students…how did that improve the lived experiences of anyone? While I don’t think the answer to that question is important to everyone, it is important to me. And it will continue to play a large role in shaping my professional work. However, medicine is not the only way to be of service to my community.

4) Stimulation
– And finally, prior to going to graduate school I was working a corporate job. While the pay wasn’t bad (seriously, I made more money at 26 without a master’s degree than I did at University B), I was constantly bored and unchallenged. I loved graduate school and was convinced that medicine would provide me with a way to continue being stimulated, while also being of service to others, and eeking out a decent living. As I concluded above, I realized that there are also other ways to do this that don’t require investing 7+ years of my life in additional education and training at the cost of many other things.

Okay. That’s most of it. Almost all of it. People in my life have had different thoughts about my journey with medicine and their influence on me was more or less significant at different points. When I made this decision, I didn’t talk to anyone about it. Didn’t ask anyone for their opinion. Didn’t solicit advice. At the end of the day, this is my choice and I’m the one who has to be comfortable with it. And, for the most part, I am. There is a chance that some of this contentment has to do with me finding an alternate path to achieving much of the above (I told y’all before that I’m a planner) but that is for another post.

7 thoughts on “Applying to Medical School (3) : The True Cost of Attending and the “Sunk Cost” Fallacy

  1. Loved this post.

    I figured you had your reasons. I went to law school at 37 and it was a huge mistake all the way. I sacrificed EVERYTHING. My financial security due to the loans, my future earnings becasue of the PSLF program, my relationship was broken because of it, and I wound up not really thinking it was a good fit.

    Now I will admit that sometimes, being a tiny female, it’s fun to see people’s faces when they find out- I generally never tell anyone unless they ask becuase if ONE MORE PERSON assumes I could make a six-figure income if I wanted I’m going to scream. Also because since the bar wants thousands of dollars to make my degree “legally inactive” and I protest that, I don’t want anyone asking me for advice.

    Had I skipped it, I might still be in the happy place I was before I started and would likely now own enough house equity to retire. We were offered a deal by a friend to buy a house that has since appreciated about 500% which we turned down because of my law school goals. Instead, I scrounged to buy a small two-bedroom over a bar. lol.

    I didn’t want to tell that story until you had told yours, because these are personal decisions and everyone comes to their own conclusions. But if I had listened to my instincts and not the “you can’t have wasted this year” opinions of everyone, I’d have quit after the first year.

    Congrats and it feels like a strong decision and great things have come from a year of ups and downs and big decisions. I think the thing people don’t tell you is that any decision results in a “road not taken.” That’s why a world of options can sometimes feel like more of a burden. But then… you feel guilty about first world problems and so on…

    Liked by 1 person

    • I love this comment.

      Thank you so much for sharing more of your story with me. “I figured you had your reasons…” Don’t we always… 🙂

      “I think the thing people don’t tell you is that any decision results in a “road not taken.”” THIS! I have always been someone who was far more comfortable regretting something I did than something I didn’t do. I think it’s why I got so far down this road. But I think I finally decided that I owed it to both past and future AP to be comfortable with having not done something.

      “That’s why a world of options can sometimes feel like more of a burden. But then… you feel guilty about first world problems and so on…” Get out of my brain.

      Like

  2. I was always going to support any decision you made about this, so I’m supporting this one too 🙂 I think it’s pretty normal (for better or worse) to have all kinds of roads not taken, some really significant though some not. One of the things about entering middle age for me has been trying to get to grips with that — with the real closure of possibilities that were once open, and also with the visceral knowledge that there’s no such thing as doing all the things you want to do, and with the reality that we can do anything, but it’ll pretty much always come with big tradeoffs. All of which is to say you will probably be in a state of mourning over your medical career for a while, maybe forever, and that’s ok. [I just yesterday gave myself a version of this lecture about having children, so it’s fresh in my mind.] I’m glad you made this call for yourself without consulting anyone else. I think that’s often best when the decision is this big. You consulted widely at many stages of this process, but ultimately you had to make the call for yourself so why confuse it? And when the grieving period settles down a bit maybe you can look for ways to do some of the things you were excited about about medicine.

    I also really like that having gotten your financial life so much more in order you can now make big decisions from a place of relative calm and stability instead of shame and panic!

    Liked by 1 person

    • Thanks, C. 🙂

      I have sent you an email asking you a few other questions. Mostly because I am nosey…

      “And when the grieving period settles down a bit maybe you can look for ways to do some of the things you were excited about about medicine.” 👀 Lol, I’ve told y’all, I’m a planner. I may not be headed down the medical school road but a different road. I will circle back to this when it is appropriate to do so…

      “I also really like that having gotten your financial life so much more in order you can now make big decisions from a place of relative calm and stability instead of shame and panic!” This! I reached this decision around the same time that I started applying for a new job in earnest and as the interview process for my new job started. And then, after I was offered the new job and I had a viable alternative (so I wasn’t just fleeing University B) I sat down again to see how I felt about my decision. I really continued to feel good about the decision and the biggest concern was looking like a flake to the Pennyfolk (my parents and besties know me lol).

      But yea, getting under $90K+ this year was a mindset shift. Everything isn’t about my debt anymore. I feel like I am rolling the ball at least on a flat road at this point and that I can make decisions that are free of shame and panic about my student loan debt. Honestly, my biggest concern at the moment is not allowing paying off debt to become “my thing.” What happens when it’s gone?

      Like

  3. I’m happy you’ve made a decision you feel good about. It’s tough to let a dream / plan go, but it’s often for the best. The AP you are now knows more about yourself than the AP you were when you first considered medical school, and can make better decisions for the AP of the future. And although it doesn’t matter what I think, I will say that I’m relieved for you. I’m happy you will be able to more easily dispatch your debt, and I’m excited to hear about the alternate path to you being of service to your community and staying stimulated in your life. Congratulations on making a very tough decision! The Pennyfolk are, as always, rooting for you!

    Liked by 1 person

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