Breaking into IB as an orthopaedic surgeon
Hey there,
I need some honest advice.
I'm a 31 year old orthopaedic surgeon in training from a European country.
Despite all the work I've done to become an orthopaedic surgeon and having 8 years of experience in the field, I have found myself helplessly enamoured with finance.
Must have caught the bug around 6 years ago when I started investing my hard earned cash… initially started with bonds, then stocks then derivatives. Kept on diving deep down the rabbit hole reading about all things business & finance and realised I was spending most of my free time reading and studying finance (even textbooks by John C Hull etc).
I have come to the realisation that despite all my hard work and dedication towards medicine and surgery, I have lost interest in surgery and I want to pivot into finance, preferably IB given the fact that learning financial modeling and getting deal experience are both so vital to the profession and open so many doors.
I was thinking of applying to a top business school to do an MBA or MSc finance in order to help with my applications (tried applying as a grad this time round [currently completing an unrelated MSc] but was not successful).
I would love to have your take on it, specifically whether this is a realistic goal, whether the MBA/MScFin would be helpful and other possible suitable routes to finance other than grad roles given my healthcare experience.
Thank you for your time.
Comments (54)
Given your background, I would leverage your medical degree into working at a healthcare focused VC or PE firm - know a ton of former doctors who do this. Finance professionals always need someone around with a medical background to do proper due diligence (essentially be able to say if a device/drug works from a scientific standpoint) on portcos and possible acquisitions.
Given your age, I would not think going into investment banking would be feasible/enjoyable for you. You would be too old to come in as an analyst, on the older side even for an associate, and this would require an MBA - at this point that would be a ridiculous amount of educational experience/pedigree for you.
Working for a healthcare focused buyside shop would be attainable and give you the opportunity to make much more money than trying to break into IB. It's unclear whether you have or are in the process of getting your MD - finish it if you haven't done so already, then begin networking and reaching out to shops. If you truly have done your research on finance and are knowledgeable from a technical perspective, you'd be a shoo-in at a lot of firms if you can interview well - especially for the medical device industry as a former orthopedic surgeon.
Thank you.
MD has been completed several years ago and have been working as a surgeon and physician since. Currently half way through orthopaedic residency.
Currently completing an MSc by research in a biotech-related project, which has generated patented IP.
Was always looking at the traditional entrance to finance, never thought going directly into PE/VC would be attainable, though that's definitely great to know.
Any particular resources you might be aware of re HC PE/VC?
Not too knowledgable on the topic but recently came across a talk from a guy who graduated med in the UK, worked as an eye surgeon for around 5 years, then did a top MBA and then moved straight to buyside in a healthcare focussed PE firm
Bro wtf
I'm going to give you the best career advice you'll receive:
Stay as orthopaedic surgeon. Relocate countries if you have to (USA/UK pay crazily well) but don't go into finance.
You've lost interest in surgery? You'll lose interest in finance too. We all get bored with things after a whole - that's life. Suggest you find what it was that interested you with medicine in the first place and rekindle that spark. Reading a few books about finance and investing a couple thousand on the side is paining a lovely picture of finance, but the reality is completely different.
Realistically, you will need an MBA to get into IB. 1 year to study and apply, 2 years for the degree, means you'll be well into your mid 30s by the time you start full-time and that's assuming you have no issues with hiring (because firms ARE going to ask why a mid-30s surgeon wants to work with 21 year olds punching numbers into an excel spreadsheet, and you're going to have a hard time justifying any reason you attempt to provide). Multiple hundreds of thousands of dollars/euros lost in both expenditure and opportunity cost from studying rather than working.
Then, when its 3am and you're updating slide 47 of the pitch deck, reformatting all mentions of 'Mn' to 'MN' because your MD insists that the correct abbreviation for 'million' must be entirely capitalised, for a proposal that you know is a pointless waste of your time because you know your bank will never win this one anyway, you are going to question what the F you are doing with your life, why the F you just wasted 3-4 years to get into this position, and why the F you gave up the role of actually helping real people (and getting paid crazy sums of money to do it) through major surgeries (cousin is an orthopaedic surgeon; I've seen first hand how important your work is) to align logos on an electronic document that nobody really cares about.
Sure, you could pivot to some healthcare-focused VC fund (or try and start there immediately, which will be ridiculously more difficult), and you may have a better time of it, but you are still going to come up against day after day of menial task and you'll wonder how on Earth you managed to paint the grass so green on the other side.
The idea people have of what "finance" will be when they work in the industry is an illusion they have built based on reading the WSJ or watching films / tv shows.
"High" finance at the junior level consists of sending diligence list trackers, sending outreach emails, aligning logos on ppt, scheduling calls / Zooms, oh and occasionally working on a model that is 90% BS assumptions.
Maybe if you're in PE you'll do more on the due diligence side, but most of that consists of hiring outside consultants and advisors to justify your initial assumptions or rip apart the seller in order to get a better price.
It is only a matter of time (enough 4am nights) before it loses its allure.
Very well said UncookedBooks couldnt agree more
You spoke nothing but facts. Don't forget when you can't move forward on the CIM because the client won't fucking send one of the due diligence items that we asked for for the thousandth time.
I don't know where you're based, however the situation in europe is v diff from that in the states - and I don't know where you got the idea that docs are well compensated in the UK because they're just not (hence the strikes).
Compensation in continental europe is circa 100-120k pa base with no significant bonus after 5 years of med school a postgrad degree, 2 years of internship, and 4-8 years of postgrad training depending on specialty and endless exams during training.
The only consolation is the possibility of private practice, which in most instances is hard to scale beyond 400k pa as you are temporally limited by the number of patients you can physically see.
I know finance isn't the wolf of wall street - I've spoken to enough bankers to know the tedious and seemingly meaningless tasks they are put up to on a daily basis. Given that, it opens so many doors and is incredibly well compensated, with such compensation beginning relatively early and getting better relatively quickly, not to mention exit opps (despite how hard they may be to come by) and providing you with the skills to be able to work in a number of different industries.
Just my take
Doctors in the UK are incredibly well compensated. The strikes by nurses and junior doctors are for increased pay. Consultant doctors are raking it in, and are currently discussing striking for improved work-life balance (and they already enjoy a better WLB than most other countries). You are usually even better compensated, by orders of magnitude, if you work through locum rather than NHS.
I don't think you quite appreciate how frustrating and soul-crushing having to stay awake for 36 hours straight to organise a data room and increase font sizes on a PowerPoint can be. The very first time you do it, you will look back to late night shifts in residency, where there was a real and meaningful purpose for toiling away, and rue the day you decided to shift. You can read all the stories of the menial aspects of IB that you like, but I can guarantee it will hit you significantly harder than you could possibly expect once you start.
I genuinely believe you will earn more throughout your career if you stay as a surgeon. If you started over at 21, sure, you miiiiight luck out and be one of the 1% of the 1% that go IB > PE > HF with 7-8 figures in comp. Most burn out, and most don't get the offers. You, as a mid-30s surgeon (assuming MBA etc) are so much more up against it. Don't throw away a very well-respected, well-paid and fulfilling career for your grandiose perceptions of finance.
These are my thoughts and ultimately, you'll do what you think is right, as you should! Wish you the best whatever you choose, but I really do think you should focus on surgery.
My ortho who has operated multiple times on me went to Harvard Medical School and pulls in a few million every year. He's specialized in sports med
Yeah but he probably pays 2.3 million a year in personal liability insurance and another 100 a year in school fees, on top of other costs.
Not as good as you think bruv
2+ mill in personal liability? How many claims does your source for that have against them lol
Extremely inaccurate numbers.
Where are you in your residency? Finish your residency and fellowship, become an attending (actually start making real money) and if you still hate it you can probably work your way into a life sciences VC (lots of MDs there who consult on med devices, etc.)
Bruv, this industry is shit and in decline.
Everyone here lies about their salaries, and all you do is push paper like any other job. The Americans love overstating their worth and their job because it's their identity and their life, it's kind of pathetic.
I would rather have been good enough to do medicine.
You're comparing literally the top 0.1% of doctors to the average finance guy. 99% of doctors in Europe make less than 200k
Thanks for your brutal honesty. It's really what I need.
The grass isn't so green here either. Comp is quite terrible, way less than what people think we make (this is europe not the states!)
Attendings here make circa eur110k pa base with no possibility of a bonus (after 5 yrs med school, 2 yrs as an intern and some 5-8 years of postgraduate training depending on what you're doing).
I get that we have a more meaningful job and all , however that kinda salary is pathetic. Private practice is a diff story but still hard to scale beyond 400k pa.
You need to re-locate to the U.S. once you're done w/ your residency. Easier said than done, I know, but a work visa for you shouldn't be hard.
Bro please don't speak on what you don't understand. It's virtually impossible for an IMG to match into ortho in the US (talking like <10 people globally per year and these are super top of their field guys).
IB isn't what you're after if you're looking to make such a radical pivot.
Based on what has intrigued you into finance is markets. Find your way into capital markets / hedge funds / asset management. Again, wont be an easy pivot but that is the direction you want to go.
Thanks for your advice. I was thinking IB instead of markets simply because IB opens so many doors.
In fact I had asked a similar question a couple of months ago re markets… and was told to forget it and apply to IB instead 🤣
Markets would be more interesting probably, though rather limited in scope and exit opps.
How could one possibly break in though?
I have an undergrad life sciences background kindaa similar to you (but in US). My 2 cents:
1) Realistically at your age you need an MBA, which will make you an IB associate. It's very common to see 30+ year olds as associates (military backgrounds or worked in industry), its very rare but I've also talked to 2-3 'doctors' who either dropped out of med school or went straight after 4 years into an healthcare IB group, but this is only possible through aggressive networking etc, very unlikely scenario.
2) Otherwise, wayyy more realistic path is through Equity Research, specifically Healthcare ER groups. My background with self learned finance was able to get me in front of GS/MS & other top healthcare ER groups. I can't even count the number of roles where they preferred having a MD/PhD etc. After 2/3 year you could switch to IB from here (saw a dentist do this) or move to HF after couple years or even stay in ER where top Analysts(MDs) can rake in MMs. Still in this case you would need to show you have a solid understanding of finance and need to network like crazy.
Kudos
Thanks that was very helpful. Would it be possible to PM? - would like to connect if possible
I'll pm you. :)
I'm not sure if this is as common in Europe (or if it's what you're interested in), but there is plenty of private equity interest in acquiring private surgery centers in the US. I believe there is some regulation that requires a physician to have ownership in the practice. The PE firm provides the capital for growth and acquisitions, and transactional/financial expertise, while the physician provides the expertise in whatever medicine they are practicing. Typically, post-closing, the physician will stop doing as many surgeries and will focus more on business management and deal making.
Obviously this requires you to lead/own a private practice first, but could be a good blend of finance and medicine.
Don't listen to most people here. They are very young, immature and probably frustrated by the beginning of their career.
Deep inside, you should know if you feel passionate abt medicine or abt finance.
Personally, I had no interest for medicine, even if I was paid millions, and find finance super interesting.
Your background will be valued in any high finance job: IB, ER, HF, PE, etc.
If you feel interested in markets (analytical, etc), consider ER and/or HF. If you feel more interested in deals, meeting people, etc. IB and/or PE
I don't understand why some of these comments say " you will be working insane xyz hours doing PowerPoint" like doctors don't have to work similar hours at the beginning of their career, and deal with much of of bullshit
because why the hell would someone that studied medicine go into ib as an analyst lmaoooo that's such a waste of esoteric/valuable skillset + knowledge. How many people know how to use excel/ppt and how many people know how to perform surgery? He's better off sticking with surgery, imo
Why are you ducking following me
Dipshit
The long hours for medical professionals are not an issue.
There are things that are more harmful/stressful.
Emergencies, brutality of life and brutal biographies of some patients, disability and death, the realization that as a doctor you can't help many many people/patients, suicidal behaviors (unsuccessful, successful suicides etc), and so on. As a physician, you experience all of this and more.
If he's orthopedic though he could probably pivot to sports medicine. If he works for one of the sports teams he could largely avoid most of what you are saying.
Array
You can be a surgeon and do finance on the side. The other way around is impossible. Stay put.
We may have found the next Michael Burry. Bro what are you shorting besides bones?
Edited
I'll be brutally honest with myself and ask whether I am leaving surgery to pursue finance because I am genuinely passionate about it or whether some part of me is just incomplete and I am looking at making more money and high finance as a means to fill that gap and am thus "genuinely passionate" about it. You went into medicine and surgery for a reason, I think you need to do some soul searching as to what you're really looking for instead of what you're worrying about above.
You're a surgeon, money is a by-product and not something you need in and of itself. That's what makes you so prestigious: you don't need money. You don't need recognition. You're confident enough and complete, money is nothing more than a mere resource to provide you and a family a more comfortable life free of financial worries so you can focus completely on serving the community with your work
8 Years experience as a surgeon and you're 31? My man WHAT that just makes 0 zero SENSE.
Separately, check out this fund manager: https://www.vanityfair.com/news/2019/07/hedge-fund-manager-chip-skowron-on-life-after-prison
Idk if you want to skip the fraud component, but this could serve as a business plan for you man.
Became a doc at 23. It happens much earlier than US in europe
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