I am a young doctor facing a difficult decision

Basically, I'm this 26 year old junior doctor in the U.K. who had been dreading to leave the profession for greener pastures.

I'll be honest. I didn't want to train as a doctor in this country because of the meager pay, the long training, the lack of geographical flexibility (you get sent around the country, you often have to choose between your ideal residency vs. your ideal city, which is for me London and only London). I hated that I will only be part of a massive public and underfunded service, I hated the general lack of innovation, prestige, and competitiveness. A family doctor technically earns the same banded pay as a neurosurgeon.

I love flying, I love London, I love financial hubs, love good looking offices and want to look like a cool corporate elite. Medicine, especially in the UK, offers none of that, 99.9% of the time.

So I had my eyes set on Consulting/IB. I craved to have McKinsey or GS on my LinkedIn, craved to have sexy, million/billion dollar things to write on my CV.

I come from a mid-market non-target school brand in the UK. I had perfect scores for my high school diploma, had I opted for a liberal arts degree I would've had a decent chance at going to Oxbridge, and almost certainly in any top London school. But medical school demands 4.0s (or straight As) no matter where you go. I didn't care about university branding when I was 18.

I didn't enjoy most of clinical medicine, and ended up with pretty mediocre grades. A 2.1, or 3.3-3.7 equivalent in the USA. But it didn't matter for my residency. I was very active in academia and was genuinely passionate about heart surgery so I've been published in great journals, and had presentations in European, American, and even global heart surgery meetings. So I got into a good clinical training program in a leading centre.

I knew I wanted to leave early in my final year in med school. So I was spending most of my time prepping for standardized tests etc.

I applied to Wharton - dinged. I sent a 3 page CV and wrote crap on my essays. I was so out of touch with how the world really work. I made many changes, applied to Yale SOM's MBA and LBS' MiM - received offers for both.

Now I'm in a dilemma.

My initial plan was to join a T1/T2 boutique strategy consulting and work my way towards VC in the Asia pacific in the long term.

But now I am having second thoughts. Much of the business world isn't as fancy and bling as I imagined. It is a lot of hard work and toil too. A good compensation isn't guaranteed. YOU need to be good, and it's a competitive world out there.

I will be going into heavy student debts if I go for the MBA. But it isn't H/S/W, and given that I have a non target undergrad medical degree and just one year experience in a different country, I have to be realistic - I will almost 100% not get a senior associate level MBB job in NYC or SF or Boston. It'll probably be Deloitte etc. at best. because of the debt I won't ever be able to go back to clinical.

If I go for the MiM, I have enough savings and financial aid for the year. This financial liberty is important to me. I really don't want to be in a lot of debt. Given the London competition for MBB, I would be extremely happy to land a post-MD level position at a T2 firm such as L.E.K. post MiM. But I am not sure how useful the MiM is going to be. is it all fluff and no substance? It certainly feels a little bit so when compared to a proper MBA from such a top 15 US school as Yale. However it is much less of a financial investment so I can always go back to medicine, and see it as a diversification of my experience, no strings attached.

I am really afraid of making the wrong choices. I don't want to end as up a junior level analyst in a big 4 implementation practice with limited exit options. I am afraid that I will miss how rewarding clinical medicine can be, the hugs from patients, feeling close to others, feeling that you're making an immediate impact on lives - they are priceless.

Any thoughts/life wisdom? which one should I go for?

Comments (12)

May 15, 2020 - 11:30pm
db99, what's your opinion? Comment below:

Hey OP, have you considered applying directly to MBB or Tier 2 consulting firms in London to avoid MBA loans altogether. You are in a good clinical training program at a leading center and you have published in great journals. These make you competitive. If you network heavily with MD consultants at MBBs and prepare well for case interviews, you could land an offer

hmmmmmmmmmmmmmmmmmmmmmm
  • 3
May 16, 2020 - 6:39am
Goldfish_Sachs, what's your opinion? Comment below:

I have. However I do view a business education as more than just a job-landing vehicle. Have always had an interest in business but never had the opportunity to explore it academically.

I do hope to avoid US MBA loans at this stage of my career - I feel my pre-MBA experience is limited and have little value to US recruiters.

This led me to the LBS Masters in Management. It is much less a financial burden for me, plus I save a year. So if recruiters here in London are going to see it as valuable (additional skills and knowledge base for the job + brand name and credibility), I will be happy to take a year out for the experience and added value.

May 16, 2020 - 1:41am
BankCredit993, what's your opinion? Comment below:

so why did you want to go to medical school when you were 18? trying to get behind the driving factors behind your decision making and what you ultimately want out of your career. the blingy aspects of finance and business started to appeal to you but then you realized it wasn't a guarantee and there was risk involved, but it's not clear what's driving your thought process. do you actually like the job finance people do, or consulting people. It seems like you like the medical stuff you're doing but don't like the pay/location issues etc.

May 16, 2020 - 7:49am
Goldfish_Sachs, what's your opinion? Comment below:

It was mostly driven by a combination of things - it is a well respected profession, it is very rewarding, and it generally pays quite well when you get to attending/consultant level (especially in a country with a two-tier healthcare system, like where I grew up in).

Now, however, I enjoy the problem-solving aspects of medicine, I find a lot of satisfaction when I give advice/give consult, and I love clinical research that looks at real world data and outcomes (not the biology/chemistry kind of research).

I do like the job finance and consulting people do, especially in roles that involve strategy and data-driven decision making. For consulting, I see many parallels. Team structures are very similar to medicine, the nature of problem solving is similar, the role of publishing reports and opinions in thought leadership is similar etc. For finance, I think it is such an exciting field. I especially like PE/VC, think there is so much growth and value-creation going on. However I don't think I will ever be good for the most technical and quantitative early and mid-career roles in finance. I am not the most quant person.

MANY doctors, academics, and scientists think they are smart and know everything and see finance people as no-substance, corrupt, and hedonistic. But these people really haven't a clue and are living in their bubble with no knowledge of what keeps the economy and the world running. Similarly I know there are many in high-finance who think they're the most elite people in the world and look down on essential workers or nurses who are actually doing impactful things.

I respect people in both career streams, and recognize the good and ugly side of each.

I guess the main things driving my thought process now - is (1) having a greater sense of control over my location (it is easier to switch geographical location for business roles than medicine - which involves licensing, place in a rigid training pathway etc.) for both my partner and my family, and (2) to do something that will open up further growth and career opportunities, not just pigeonholing into, say, a niche surgical specialty.

And my main concern is that I am not super young having done so many years in med school. I feel I cannot afford to make many wrong decisions in the next few years. I don't want to end up in a boring business function with limited exit opportunities, or in a boring clinical specialty which daily tasks only involve following clinical guidelines and getting consults from other specialties. Clinical training, especially in UK, is unforgiving and limiting. If you leave for too long you might never get back intro training. If you keep calm and carry on you are likely going to lose the opportunity to explore other functions and develop yourself because most of these things add no value to the monolithic and growth-averse UK national health service.

The above may sounds a little fragmented. But I am quite lost and am just typing whatever comes to mind so a third person can perhaps understand better my raw thoughts.

May 16, 2020 - 2:03am
leltec, what's your opinion? Comment below:

> Any thoughts/life wisdom?

Yeah, I think you have a number of issues in how you're thinking here.

> I hated that I will only be part of a massive public and underfunded service, I hated the general lack of innovation, prestige, and competitiveness.

You've got to be creative and you've got to take risks if you want to make anything of any career. If you want money, try to find a role in the US or the like. If you want geographic flexibility, learn a language or join MSF.

> I love flying, I love London, I love financial hubs, love good looking offices and want to look like a cool corporate elite. Medicine, especially in the UK, offers none of that, 99.9% of the time.

> So I had my eyes set on Consulting/IB. I craved to have McKinsey or GS on my LinkedIn, craved to have sexy, million/billion dollar things to write on my CV.

If that's what you're looking for, first of all you shouldn't even consider consulting relative to banking. Consultants only do the fancy offices on Fridays and for significantly less time - and typically dress much more casually. Their work is also significantly less likely to end up in the newspapers regardless of impact. You'd also have a much higher chance of having that kind of asshole attitude called out for what it is in consulting, whereas in banking you might fit right in

Second, if that's what motivates you, you're 1. going to be super disappointed (it's never going to live up to that), 2. not going to have longevity - that's not going to sustain you through the hard work and BS, and 3. going to hate it even if you get it.

> was genuinely passionate about heart surgery

What happened to that?

> join a T1/T2 boutique strategy consulting and work my way towards VC in the Asia pacific in the long term.

Why?

> Much of the business world isn't as fancy and bling as I imagined. It is a lot of hard work and toil too. A good compensation isn't guaranteed. YOU need to be good, and it's a competitive world out there.

Wow, that is quite an insight.

> I will almost 100% not get a senior associate level MBB job in NYC or SF or Boston.

None of them hire senior associate roles out of MBA, so certainly not.

> It'll probably be Deloitte etc. at best.

Heaven forbid. Quite frankly my friend you come off like a brat, don't talk to potential employers like this.

> is it all fluff and no substance?

The degree is largely irrelevant. What recruiting does it give you access to that you don't otherwise have now? Does it put you where you want to be geographically? How does the Yale MBA stack on those questions?

> I am really afraid of making the wrong choices. I don't want to end as up a junior level analyst in a big 4 implementation practice with limited exit options. I am afraid that I will miss how rewarding clinical medicine can be, the hugs from patients, feeling close to others, feeling that you're making an immediate impact on lives - they are priceless.

First, you'll go nowhere and achieve nothing if you're too afraid of failure. Second, holy S** you need to determine what you actually want before you delude yourself with any of this nonsense. No one is going to be able to weigh your idealistic tradeoffs here but you.

May 16, 2020 - 9:23am
Goldfish_Sachs, what's your opinion? Comment below:

Thanks leltec.

I wanted to put all my assholey and superficial thoughts out there so I could be my most true self without the need to polish my motivations. I want to be put in place.

I did consider finding a role in the US - it is, in fact,still on my options list. The downside of this is that it will take another 2 years or so taking exams, networking, and finding the right residency program, with no guarantee or certainty as to where I will eventually end up in. I understand I do have to take risks, so this is still an option and something that I may actually do If I don't end up in business-school at all.

Being in a global city inspires me. I like the hustle and bustle, the new developments, and I like diversity. Things like these make me feel alive. I also genuinely like and admire the work that finance and consulting people do. So the combination of both is very appealing to me. What is the kind of motivation that keeps the people in these fields working through the hard work and BS? Do you mind sharing some personal experience and views? What is the common theme among those who really enjoy their job? Do they, too, enjoy the superficial things?

Coming to heart surgery. I still love it, it's the only specialty I truly love, but there are only SIX proper training positions in heart surgery in the country every year. Among those, 1-2 max are in London - where I want to live. The rest are dotted around the country, mostly in rather remote cities and this is going to be the next 10-15 years or so of my life. I don't see myself doing that just for a single aspect of my career. There is my partner, my family, my friends, and other opportunities such as networking and entrepreneurship that is just so much easier in a central location.

As for my VC plan - I would like to live in Asia in the long term. I am of east asian origin myself and have a strong personal interest in affairs over there. I think there is plenty of opportunities in the healthcare sector for startups to tap into while working with governments to improve delivery and access. It's a high growth region and that sounds exciting to me.

Post-MBA role - Having spoken to a fellow doctor turned consultant, I have been under the impression that post-MBAs with a couple years of experience tend to join as a (senior) associate while MD/PHDs tend to join either as a senior analyst or junior associate. The Oxbridge MDs tend to go straight to junior associate level even without work experience (in London), while those from non-targets tend to have around 2-3 years under their belt before joining at the same level.

LBS MiM - London is great and I will have no complaints working here. Sure, I can network without LBS, so I won't benefit as much as other international students who did their undergrad elsewhere and want a London job. But I do think LBS would open up more doors in a more direct manner than myself networking the hard way. Also a good number of alumni are working in my targeted firms. Main concern is the value of this degree apart from network/recruitment events. Are the skills and experiences gained actually valuable to employers? Can this experience + my MD complement each other as a good package?

Yale MBA - I prefer the US as a country compared to the UK and would be much more open to living there permanently. There's just more space, better weather, more diversity, and more cities to choose from. So the Yale advantage, to me, is that (1) I won't ever have to do an MBA again, (2) I can explore the USA. The main disadvantage is that (1) It's too expensive and I feel I will really be punching above my weight for a post-MBA role in a tier 1 firm in the US without much relevant experience + have to pay the debt, and (2) Going to HBS is my dream - I wont ever get there anymore with the Yale MBA because precisely I can only do it once, and obviously I am underweight for a HBS MBA now. But maybe I can work hard, grow, and still aspire to be a HBS student?

I don't have strong feelings towards USA vs UK. Love the US but it isn't top priority to me. To me, the city I am based in is most important, the country not so much. As it stands I see my long-term future in Asia so it doesn't matter anyway.

I appreciate your comment - these type of comments force me to think about what I want, and it is exactly what i need.

So i guess my primary question is this. From your perspective and thinking as a recruiter, what would you make of someone like me:

Scenario ONE - in LondonNon-target local school MD, decent academic achievements, only one year but geographically relevant experience, Master in Management from LBS, gunning for a senior analyst/junior associate role in London. Reach MBB. Target LEK/Deloitte.

Scenario TWO - in the USA, maybe boston or smthNon-target foreign school MD, decent academic achievements, only one year experience from another country, Yale MBA with relevant internship, gunning for an associate role (post-MBA). Reach MBB. Target LEK/Deloitte as well. Boutiques like Clearview is IMO too competitive and too elite because MDs dont stand out, and literally 80% of the MDs are HMS grads.

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May 16, 2020 - 1:07pm
BankCredit993, what's your opinion? Comment below:

Bro you are so lost I don't even know where to start. since when did HBS become a dream of yours? like a year ago? I think you're not in a bad spot at all, you've just got some quarter life crisis and a big case of "grass is greener". the way you're being particularly capricious towards the actual career you would be embarking on is an issue. it's like you have big caveats with each one. you'd only do finance/consulting if it was a reputable MMB/GS god forbid Deloitte (which is insane). you'd only do medicine if you got a spot in heart surgery in London.

^^^ that's not how fucking people think about their careers - you're flipping it around. first decide what you actually like and enjoy doing and THEN try for the most prestigious thing within that track, and even if it's not the most prestigious place you're still doing what you'd actually want to do. I'd take a gig at some small $200mm HF anyday over the top heart surgeon job in NYC (say I was somehow qualified) because I know what type of work I enjoy doing. MBA and not getting into MBB vs another consulting seat that is 95% as good is turning you off to the entire country. you want your cake and to eat it too.

in my opinion you should not be this flippant about flip/flopping on what your actual career is but now look, you may not be a career driven person at all. you may not give a fuck about what actual career you embark in as long as it provides the ancillary benefits of your life that you value more. like say there was prestige in being a janitor, you got to wear suits and someone paid you $500k a year in london to do it. Based on how you've described yourself, you'd take this job anyday based on the ancillary aspects vs. the fact that you're cleaning toilet bowls for 5 hours a day. and look this is totally fine if that's your way or thinking about things, but you've got to realize that yourself if that's the case. Otherwise you just can't have everything. life is a series of compromises. very few people in the world get to have everything they want the way they want it. and the ones who do are either incredibly lucky or have persevered through high amounts of risk, which you are unwilling to do.

May 16, 2020 - 1:11pm
BankCredit993, what's your opinion? Comment below:

also Re: your two scenarios both seem fine. they're both equally fraught with risk but that's completely normal. just understand that and work hard to overcome that risk. you will have a solid yet unexceptional profile and will just need to put in the elbow grease to push it over the top. at least you're in the game.

May 16, 2020 - 1:39pm
Goldfish_Sachs, what's your opinion? Comment below:

man i never realised what an irresponsible brat i was being.. your small HF vs. top NYC surgeon scenario is a wake up call. i don't think i'm ready to say that I would enjoy one over the other and that's precisely where my problem is

thanks man. i guess i need a frank conversation with myself.

appreciate this

  • Associate 2 in HF - Other
May 16, 2020 - 5:02pm

Yeah good place to start. just have the "what do I actually enjoy and what do I value in life" brainstorm with yourself. good old pros and cons list. only difference is your 26 instead of 18 but it's never too late to figure this out (well it can be but you're not too late)

Jul 22, 2022 - 1:43pm
arabellamaulsby08, what's your opinion? Comment below:

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