Being a young physician these days has its challenges. But Daniel Davis and his wife, Julie Dang, have almost cleared one tall hurdle: in June, they will both finish their residencies at the University of Texas Health Science Center at Houston.
“It’s been a long road,” says Daniel, a pathology resident. “During the first year, I didn’t see Julie at all,” he says. Julie is an internal medicine and pediatrics resident.
While residents these days are limited to working 80 hours a week — to older physicians, this might seem like a light load—Daniel feels there are other things that have made residency more difficult. As an example, he cites insurance companies’ limitations on the duration of patients’ stays in hospitals. “You have rapid turnover, so you see more patients and have to fill out more paperwork. And the amount of medical knowledge is exploding. So I think medical training is just as hard now as it was 20 years ago.”
But despite the long hours and overwhelming paperwork, Daniel and Julie’s marriage survived, which is more than they can say for some of their colleagues. “We went to two of our classmates’ weddings, and they were both divorced after the first year of residency.”
Julie thinks being married actually helped her get through her residency. “It has been very comforting to have Dan to come home to. He has helped me to get through medical school and residency by being a welcomed distraction away from the stress of exams and work.”
Medical school romance
Daniel and Julie met during their first year of medical school at the Kirksville College of Osteopathic Medicine, A.T. Still University in Kirksville, Missouri.
“I actually had a crush on Dan's friend, who I sat next to in class,” says Julie. But then, Daniel happened to switch seats with his friend, and he and Julie got to know each other. “He was very persistent in following me around after class, which was pretty sweet.” They were married a few years later, when they were completing a rotation at the National Naval Medical Center in Bethesda, Maryland.
During their final year in medical school, they went through residency “match” together. It was a very stressful time, Daniel admits, because they were trying to match as a couple. Thankfully, they both matched at the University of Texas Health Science Center at Houston.
“Residency makes marriage that much harder,” Daniel says. “I think marriage is hard to begin with — in a good way! I just think you have to make an extra effort. And you have to remember that residency is just for a time — that it passes.”
Julie has advice for other couples in residency. “Be there for each other. My residency has been very draining because I’m required to take a lot of in-house calls,” she says. “Dan would bring me dinner or pick me up the next morning after my call with a smoothie or Frappuccino® in hand, so that I wouldn't have to drive home drowsy. The little things go a long way when you are tired and weary.”
The challenge of medical school debt
But now that they’ve survived residency with their marriage intact, they see more challenges ahead. Like many new physicians, they are carrying significant education debt. Daniel’s medical school education was paid for by the Navy’s Health Professions Scholarship Program, which he signed up for while earning his undergraduate degree at Indiana University. But he still has loans from his undergraduate education, and Julie carries loans from both her undergraduate and medical school educations.
Daniel and Julie are not alone. According to the American Medical Association, the average medical student in 2009 left medical school with $156,456 in debt. And 79% of medical-school graduates have debt of at least $100,000.1
“Back in the mid-90s, medical schools didn’t charge med students nearly what they do now,” Daniel says. “It puts you in a very vulnerable situation.”
Data from the American Association of Medical Colleges show that median private medical-school tuition and fees increased by 50 percent (in real dollars) in the 20 years between 1984 and 2004. Median public medical-school tuition and fees increased by 133 percent over the same time period.1
Daniel fears that the large amount of debt will discourage young students from entering the medical field. “We’re expected to do more and more work, for less and less pay. I’m just thinking that the pool of med students is going to get smaller and smaller.”
Medicine — still a good choice
This summer, Daniel and Julie will head back to Bethesda, where Daniel will pay back the Navy for his medical school expenses by serving at the National Naval Medical Center for three years. Julie is still looking for a job.
“The job market out there is really tighter than we anticipated,” Daniel says. “Often, physician assistants and nurse practitioners are hired over a new physician because they are cheaper to employ than hiring a new partner to the practice, and it makes the job market tight.”
But despite the challenges, Daniel says that he and Julie are glad they made the decision to become physicians.
“We wouldn’t do anything else. You know, like any other job, you complain about certain things. But I think most medical personnel — including nurses, physical therapists, etc. — choose their jobs because they really get to help people and make a difference. It’s just a nice feeling.”
1. American Medical Association website, Medical Student Advocacy page. Available at: http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/medical-student-section/advocacy-policy/medical-student-debt.shtml. Accessed April 8, 2010.