Hi everyone,
I've just finished my first year in naturopathic medical school (ND or NMD) where I am in a dual degree program (meaning I'll end up with a doctorate in naturopathic medicine, masters in oriental medicine, and be able to be a licensed acupuncturist) that is 6 years long.
I realize that most folks on this forum may not be familiar with the schooling and details surrounding all of that, but in short, for naturopathic med school we do the same basic sciences as in MD/DO school, but learn more modalities (botanicals, drug interactions with such, etc), and are also in classes 35-40 hours (or actually more for the dual degree that I'm partaking in). The profession is licensed in a little less than half the states with OR, WA, and AZ giving the broadest scope of practice so that we are able to work as primary care physicians (prescribe drugs, etc) and use all of the schooling that we were trained in.
I'm extremely passionate about this field. (It saved my life and turned my health around after allopathic, ie conventional medicine, didn't help my situation.) I live the 'lifestyle' and have done so for several years. I have a strong background in both the sciences and the 'alternative' medical arts, but I'm facing a dilemma and I'm hoping that folks will be able to speak to this. I honestly don't really care about what letters I have behind my name as long as I can practice in the way that I want to and make a good, decent living while helping folks as much as I can with what I know and will learn in the future while in school. I don't want my job to be my entire life -- I would like balance and perhaps, have kids with a loving partner in the future.
I'm older, meaning, I'll be turning 32 in just a few more days.
I'm in a relationship that may be ending because he doesn't want to stay in this city for the length of time that it will take for me to finish my program. (We moved up to this state together a couple years ago). So I'm dealing with a lot: my primary relationship possibly ending and my confusion as to whether pursuing these degrees is the smartest thing for me to do -- looking at the profession as a whole (I'm ignoring the problems with the school right now as that's not what will matter in the long run).
OK so here goes:
1. Residencies are extremely competitive and there are not enough residencies to go around for every student. Hence, they are extremely competitive.
2. By the time the 6 years are up, I will be around $350,000 in debt (assuming that I will not also try to work 20 hours/week starting my 3rd year -- however, there are many classes and postgraduate seminars that happen on the weekends -- I'm not quite sure how working will figure in because it's difficult for me to work the 7 hours/week I do right now).
3. Most folks end up starting a business to start their own private practices -- I'm starting to realize that I don't really want to own my own business; I'd rather focus on practicing the medicine and not have to deal with the infrastructure of running a business. There are some jobs out there, however, they are definitely in a tiny minority - this field is only growing, albeit still on the 'fringe'.
4. I came to this profession originally because I felt as though it was the best primary care out there and I really wanted to work with low income underserved immigrant/minority populations. I'm realizing that with this debt load, I will have to specialize -- which is not primary care.
5. I'm struggling with the question of do I specialize? or do i focus on primary care? what are some questions that you asked yourself?
6. and where do i want to settle down? this is a question that i wouldn't want to answer without 'a partner', but my current partner is a musician who admittedly states his need to be selfish right now in order to do the work he needs to do to be successful in his career. he has no idea as to where he may move to and sees himself being extremely mobile in the next several years. i guess, i would even like having a region or regions to look into to begin networking, but he isn't able to tell me areas he may be.. maybe LA.. but he doesn't want to be in a committed relationship either.
(it's extremely important for us students in this profession to begin thinking about these questions while we are in school now as we don't all have the opportunity to do a residency after graduation.
7. i am considering doing a PA program and pairing that with an acupuncturist degree due to the decreased amount of debt, 'guaranteed' job, and flexibility that perhaps being a PA may have. And the program is short, 25 months long. or perhaps a nurse practitioner degree for the same reasons, but with the opportunity to open up my own clinic in the future if i decided on that option. however the doctorate in NP would be 15 months for me to get the bachelors in nursing, work full time for a year, then the NP degree which would be another 3 years. or perhaps a DO program - i'd be picky about the particular school and would want one that held more to the traditional values that osteopaths had in the past when andrew still founded the profession (i would only need that one degree and i could add on postgraduate work to do the kind of medicine that i would want to practice). i would need to retake my basic sciences in order to be able to prep for the MCATs and then hope that i would get in.
I know all these programs are competitive, but i also know that if i can target something that i want, i will do everything i can to get there. i know it will happen and i know that i can be disciplined in order to handle a very rigorous schedule.

i'm sorry for this long rambling letter, but i feel as though there are many other professional women out there struggling to find balance between a professional life and personal life and the kind of balanced life that they would like to lead.

what are some questions that you asked yourself during this decision making process? anything you think might be helpful info for me to have, folks to talk to, things you thought about, etc i would appreciate very much!

thanks!

PS please note that the degree i'm currently pursuing is considered to be 'accelerated' in a sense -- most folks think i'm a little nuts, but for the few that have done it, they haven't regretted it and it was what was right for them.

I think those are really important issues that many people end up facing at some point. It is good that you are facing them early, before racking up too much debt, so that you have more options.

I don't have any actual advice about your situation, but I do have a few random thoughts.

Would a job in a "wellness clinic" might be a reasonable option? You would not have to run a business, but you could still practice primary care medicine and earn a decent living. Your customers would probably not be minorities or underserved, though.

I think it would be tough to make a career out of serving the underserved because of your debt. Maybe you could volunteer with them occasionally but make a living doing something else.

There is nothing wrong with choosing where you want to live without the input of a potential partner. If there are only 3 states where you can do what you want to do, then plan on living in one of those states. You may find a partner who wants to live there, too. Otherwise, you may end up with someone who "must" live in another state and then you will have to compromise your own career in order to stay with him. Not that that's not a valid choice, but it is definitely a recurring theme here on MomMD.

I hope everything works out for you.

Hi Naturedoc,

I am an ND currently considering MD or DO school. I hope that hearing about my experiences will help you in some way.

I graduated from Bastyr (not sure where you are), but I felt like I had decent residency opportunities (although I think that is changing with the economy because so many of them were in private clinics). The main problem being that BU itself seems hesitant to place moms in a residency position. I was offered the teaching fellowship, but turned it down because I was also offered a job in my favorite preceptor's office.

I love naturopathic medicine - I learned some incredibly valuable tools and therapeutic approaches that I don't think I could have learned anywhere else. But after working a year as a "resident," I have become frustrated by a few things. I am starting to feel limited by my role as a naturopathic physician, especially since my husband has been moved to an unlicensed state (I can't make enough to support the family, so we must go where his opportunities are - this is pretty common for my nat med friends with families). Access is very limited in unlicensed states unless you can afford to basically give your services away. For me, I realized that I would be spending 60-80 hours a week for 5-8 years to build a practice that could sustain me in the way I want, have no job security or retirement plan, and still have an unfulfilled curiosity about "standard" medicine. Thus I am thinking about putting the time and effort into becoming an ND/DO or ND/MD and be able to truly deliver the kind of care that I want to be able to offer (integrated primary care).

I know I have not addressed very many of your questions, but I do have to run right now. Let me know if you would like to continue this conversation.

Well, 350 k in debt seems like an awful lot if you have no guarantee of landing a residency and are so limited in what states you can eventually practice in. It sounds like your current partner may not be willing to compromise anyway, whatever your situation is. So, you need to think about yourself now. You will regret it if you do not! If you make compromises now, without the commitment of your partner to you, you may not be happy in the long run. It sounds like you have some doubts about starting your own practice anyway, and this is the way to make a living in your field, so maybe you should reconsider. Or maybe there is another way to practice the way you want to and pay off your debt. I would try to find mentors in your field to talk to about your specific concerns. You may find you can practice the way you want to and it will all work out. Just don't make a big career decision based on your partner's need to move around right now. Good luck and let us know how you make out!