Medical students face uncertain future

Soon-to-be doctors face paying off loans, impact of universal health care Pooja Shah spent four years at Rutgers University in New Brunswick pursuing a major in public health and a minor in biology.

She then applied to medical school, accepting admission to St. George’s University on the island of Grenada.

The Edison resident’s rotations have been at Woodhull Medical Center in Brooklyn, N.Y., for rotations in obstetrics/gynecology and surgery; a medicine rotation at St. Michael’s Medical Center in Newark; and a pediatrics rotation at St. Joseph’s Healthcare System in Paterson.

With no income coming in, her costs have included four years of undergraduate tuition, room and board; five terms of basic sciences education in Grenada at a cost of $21,000 to $29,000 per term; five terms of clinical education at $21,000 each term; malpractice insurance at a cost of $350 for each of the five terms; two years of room and board in Grenada, which was about $4,000 each semester; an oral examination fee of over $1,000; a graduation fee of about $560; five terms of textbooks at around $800 each term; airfare to Grenada for two years, which was estimated at $700 to $1,000 four times each year; and other living expenses.

Shah said she is “very concerned” about being able to find a job during the last year of her residency, especially with loans looming over her head. The 26-year-old said she hasn’t looked at her total amount of loans yet because she is “a bit scared to,” but a friend of hers has at least $250,000 to pay back.

“With many hospitals shutting down and the way the economy is going, I am very worried I will not find a job. What makes me upset is I hear on the news that there is a cry for doctors; however, with hospitals shutting down, there are not enough residency programs to train doctors,” she said. “There are plenty of doctors out there, but not enough residency programs. If you look up the residency rates of how many people do not place in one program, it’s a good amount. They have good scores, good grades and great recommendations, yet with not enough seats in the programs, how can they be trained and get a job?

“It is hard enough to be in debt/loans and then not get a residency spot,” she continued. “It’s frustrating and hard on the person who worked for years of their life to be a doctor. So, before people cry that there are not enough doctors, open your eyes: there are plenty out there. They need to be accepted into a residency program. Personally, if more spots open up, the more doctors can be trained and be able to help people.”

Shah said that it can take anywhere from three to seven years to finally be able to practice, and most people join a practice before going off on their own, so the costs accumulate before being able to be paid back.

“I would probably work on my own. … it’s your own hours and the way you want it — unless you find a good practice; then, go for it. But working on your own is what I like more. I am going to have to help raise a family and work,” she said.

In addition, with the impending changes brought about by the adoption of President Barack Obama’s health care plan earlier this year, Shah said she is “a little nervous, scared and concerned” about how it might affect her.

“I don’t know how it will affect me, since I haven’t started to practice. I just want to make sure in the long run I can pay my bills, pay off my loan/debt and be able to raise a family. … But I really don’t know how the health care plan is going to work and what will come about from it.”

Matthew Terranova, 29, of North Brunswick, is in the second year of three years as an internal medicine resident at Robert Wood Johnson University Hospital in New Brunswick.

Under the care of an attending physician, he has varying schedules each month.

Working about 60 hours a week, including weekends and overnight shifts, as an employee of the hospital, Terranova ultimately hopes to join a primary care practice.

“I think for what I’m looking to do, I don’t think it will be very difficult [to find a job],” he said. “People going into this field have a good amount of interviews and opportunities.”

Terranova was responsible for four years of undergraduate school tuition at Bucknell University in Pennsylvania, and then four years of medical school at the Philadelphia College of Osteopathic Medicine. However, he said he is “very lucky” since most of his expenses have already been paid off.

In addition, the former North Brunswick First Aid & Rescue Squad volunteer said there is a shortage of people going into primary care, which is his ultimate dream. Although those who go into specialty fields tend to receive more financial compensation, he said he does not have a desire to specialize in anything specific.

“[Primary care] is something I always saw myself doing. I like the outpatient setting of an office. I like the relationship with patients, getting to know them over the years, forming a rapport, making a bond and trust,” he said, reflecting on time spent shadowing Dr. Ronald Lau of East Brunswick.

In terms of the future, Terranova said a universal health care system will give insurance to about 30 million people who were previously uninsured, which could result in people visiting the emergency room of a hospital as a clinic, thereby causing a shortage of doctors.

“Primary care is already busy. Add 30 million people who would now have insurance … while not changing the number of primary care doctors, [and that could make it worse since] there is already a shortage,” he said.

Despite all of the challenges, Terranova said that money or health care changes do not change his outlook on his chosen career.

“My experience for two years as a resident has reinforced why I did this. Most of the time I’m glad to do this because it feels like I’m doing what I’m supposed to be doing. I feel comfortable as a physician, and health care reform or not, that’s not going to change my opinion,” he said.

Therefore, he advised other medical students to stay in the field as long as they truly have a passion for it.

“Making someone heal or treating somebody — money could never give you that feeling. The reward is in making a difference,” he said. “It comes down in the end to, are you excited about what you’re doing? If you’re not, then you should be doing something else.”

Contact Jennifer Amato at

jamato@gmnews.com.