Need financing help due to student loans, doctors loan?

[jaylw314]

13 minutes ago, rwabdu said:

I really appreciate your support. I found learning to fly during residency has been a wonderful way to keep myself healthy and happy. It’s like having a super power. Few things in the world make me happier than going for a flight! I managed to pass my private check ride during my third year of residency and I plan to find a way to buy my dream plane and continue this wonderful passion into fellowship and for the rest of my life. In 9 months when I graduate and sell my house I could probably pay off the entire airplane, but the plane I want is available now, so I’m going for it. My instructor who is one of my best friends and who I really trust and is here now to teach me how to fly a new aircraft. Got to find a way to make it happen!

Just remember, if you do get Mooney, we expect pictures

 

[jetdriven]

8 hours ago, Parker_Woodruff said:

Jimmy Garrison at GMax American Aircraft could probably point you in the right direction.

https://www.gmaxamericanaircraft.com/

If he were buying a new 52,000$ Ford F150 Lariat he would be in and out the dealership in two hours. 0% for 72mo and all.

[Hank]

5 minutes ago, jetdriven said:

If he were buying a new 52,000$ Ford F150 Lariat he would be in and out the dealership in two hours. 0% for 72mo and all.

Where can you get a new F150 that cheap? Around here they all seem to be 65+!

Not a problem for me, I wouldn't have a Ford truck . . . .

[Derek]

@rwabdu, I used Currency (terrible name for search engine reasons) to get a loan for about half the purchase price when buying my J. It was very easy and the process was quick. 

https://www.gocurrency.com

And they have an aviation department.

https://www.gocurrency.com/air/

I only had the loan for a few months before paying it off.

[Skates97]

On 8/18/2021 at 7:57 PM, kmyfm20s said:

I have used these people in the past. They were great!

https://www.usaircraftfinance.com/

I used them when I bought my D back in 2016. 

9 hours ago, JohnZ said:

 rwadbu, I am pro-purchase. 

I can't provide the same financial perspective as some of the experts here, but there are other good reasons for stretching a little bit now to buy something you enjoy. The sooner you get an airplane, the more years you will have to enjoy it. Of course, that is a benefit that can't have a dollar amount assigned to it. You know you'll be making those big doctor bucks in a few years and it wont be a problem then... something else to consider is: will the airplane you buy now be a long-term ownership airplane, or something that you're only looking to own for a few years then upgrade? Fortunately in the Mooney world we have options. For your 450nm trips, Mooney is a good choice. That should be a nonstop flight in most models. I visit my parents relatively often who are about 450 miles away and the flight takes about 4:15 one way, and 3:30 the other way, depending on winds in our F model. 

Perhaps, depending on your situation, another thing to consider: can you get a personal loan from a bank or family member? There are some perfectly sound airplanes that can be bought for about $50k... Think a 60's C or E model. I believe personal loans can go up to about $20k or so, which means you may be able to get something with cash and just pay off the personal loan. Of course, keep a maintenance budget in mind. The airplane is no good to you if it is sitting in the hangar awaiting expensive repairs that were not budget for ahead of time. I think budgeting on $10k in MX for the first year will keep you ahead of the curve as far as that is concerned. 

Good luck with your search... it would be great to see you follow up this thread once you secure financing and begin your search with a pre-approval. 

I can echo this. When we bought our D it was a stretch. No major debt, just a mortgage and a car payment at the time, but I didn't have the cash to purchase it out right, although I had access to funds in the event that post purchase expenses came up as they often do. I did however know the trajectory of my finances/career (yes I know things change and don't always turn out the way we think). For about 4 years I made the payments on the plane and flew it all over the place making memories. We were able to see family in AZ (about 2-3 Mooney hours) and UT (about 3-4 Mooney hours) more than we ever did before. One weekend we flew up to UT on a Friday afternoon to surprise my sister for her 50th birthday. The next day we flew to AZ to see my parents and sisters. Then Sunday evening we flew back to CA and I was back at work Monday morning. That would have never happened without the Mooney.

I bought the nicest plane I could afford that was flying consistently. Over the years as funds were available I upgraded it and the final piece went in May of this year, a GFC500. The plane was also paid off in January of this year.

In June we bought a place in Pagosa Springs, CO about a mile from the airport and sitting on the 7th fairway. Yesterday morning I was able to attend the funeral for the father of one of my friends, then go to the airport and be touching down just under four hours after taking off, driving would have taken 13 hours. This morning as I'm typing I'm watching airplanes arrive and depart, hot air balloons in the distance, and enjoying the clean mountain air.

But, I will also echo the comments about pressure to fly after a long work day, when you're tired, etc... It can and does lead to fatal mistakes. I was leaving the airport a couple years ago when I watched a Duke take off and crash. It was a surreal experience as I couldn't believe the fireball 2/3 of the way down the runway was the plane I had watched just lift off. He was a local dentist who had moved his family from SoCal to UT. He would work during the week and fly home on the weekends. Doing the math of the flight time he would have been flying into Heber, UT in the middle of the night. Everything in my mind as the days went by and facts started coming out was "Why didn't he just go to bed and get up to fly in the morning?" I venture to think that had he waited until the morning to fly he would not have made the fatal mistakes that he made.

http://www.kathrynsreport.com/2019/04/beechcraft-b60-duke-n65my-fatal_20.html

https://aviation-safety.net/wikibase/224121

Probable Cause and Findings
The National Transportation Safety Board determines the probable cause(s) of this accident to be:

The pilot’s use of an unapproved elevator control lock device, and his failure to remove that device and correctly position the elevator before flight, which resulted in a loss of control during takeoff. Contributing to the accident was his failure to perform a preflight inspection and control check, likely in part because of distractions before boarding and his late departure time.

[Htwjr]

I had an uncle that was pretty wealthy tell me do not finance things that depreciate.  I have tried to follow his advice and it has served me well.   I am not sure an airplane depreciates though if maintained properly.  I had another uncle that was a pilot tell me when I was young and used to fly with him some " Son if it floats, flies or frigs...rent it."  I am 0/3 following his advice.  I can relate to your position as my daughter is in her third year of ob-gyn residency.  I will echo the prior advice to live below your means.  It is much better to actually have money than to act like it.  I am sure you will be fine.  If you are smart and hard working enough to make it through med school and residency I am sure you can handle airplane finance.  I would recommend to find a plane that someone else has already upgraded with most of the stuff you want.  

[thinwing]

cant imagine how he would have the time for plane ownership right now.My friends residencies in general surgical back in the 80s must have been rougher...maybe a partnership would workout with shared use and somebody else to help with maintance and inspections.My first airplane ,a year out of school and student loans...was a 3500 stinson that needed 4000 engine work.It wasnt ifr capable but a 450 mile trip was doable at 110kts.

[kmyfm20s]

Rich people leverage their money, poor people leverage their money too far:)

[ilovecornfields]

36 minutes ago, thinwing said:

cant imagine how he would have the time for plane ownership right now.My friends residencies in general surgical back in the 80s must have been rougher...maybe a partnership would workout with shared use and somebody else to help with maintance and inspections.My first airplane ,a year out of school and student loans...was a 3500 stinson that needed 4000 engine work.It wasnt ifr capable but a 450 mile trip was doable at 110kts.

Residency now isn’t what it used to be. No more “if you only take call q2 (every other day) you’ll miss half the good cases.”

About 10-15 years ago they made a bunch of rules which they have continually refined to make residency kinder and gentler. I believe this had coincided with the expectations of a certain generation about how they should be treated. There are some patient safety concerns as well however the landmark case which lead to all this regulation likely wouldn’t have been prevented by work hour restrictions because plenty of well-rested residents would likely have made the same mistake and by restricting work hours you restrict the amount of time residents gain experience leading to residents graduating with less experience than their predecessors (https://psnet.ahrq.gov/primer/duty-hours-and-patient-safety).

Sorry if that’s a bit of a rant. I understand the reasons for the restrictions but those of us who have trained and taught during the transition have definitely seen a change in behavior and knowledge after the changes took place. When I was an internal medicine intern you were expected to know EVERYTHING about YOUR patient. If the attending asked you if the patient had any pets, you were supposed to know the answer (including how many, what type, and whether they were indoors or outdoors - bonus points if you knew the pet names). I remember as a hospitalist attending after the transition when they had eliminated overnight call for interns (in my opinion, the single most valuable experience of internship) I asked one of the interns a question about his patient - unapologetically, he replied “I don’t know. I just got him this morning. He’s not my patient.” I asked him “Well, if he’s not your patient then whose patient is he?” He replied “yours?” We had a discussion after that. 
 

I guess what I’m trying to say is that as a surgical resident it’s very likely that he does have time to fly. He will also have the income to support buying and maintaining an airplane. Hopefully he has the judgement to do it safely. When I took my commercial check ride the DPE commented afterwards “I’m really surprised your a doctor. You’re the first one I’ve flown with that has any common sense.”

Edited August 20, 2021 by ilovecornfields

[ilovecornfields]

37 minutes ago, philip_g said:

Did the gentleman ask for help securing financing or did he ask for a run down on Dave Ramsey's theories or did he ask for a rant about millennials? I've lost track in this dumpster fire.

Lucky for him, he got all three!

[KLRDMD]

1 hour ago, ilovecornfields said:

I remember as a hospitalist attending after the transition when they had eliminated overnight call for interns (in my opinion, the single most valuable experience of internship) I asked one of the interns a question about his patient - unapologetically, he replied “I don’t know. I just got him this morning. He’s not my patient.” I asked him “Well, if he’s not your patient then whose patient is he?” He replied “yours?” We had a discussion after that. 

Don't get me started on call. We do traditional call, which, as you metion is tremendously valuable. Every year I lose applicants to other residencies that don't do call. It is inconceivable to me to not do call as a resident. At 3AM on a Saturday night, with a GSW in front of you, your attending is with the guy that shot your patient, and you look around the room and it is just you - that's when you learn anesthesia.

[Hank]

1 hour ago, kmyfm20s said:

Rich people leverage their money, poor people leverage their money too far:)

Anyone who leverages their money too far will soon become poor . . . .

[Becca]

1 hour ago, ilovecornfields said:

Residency now isn’t what it used to be. No more “if you only take call q2 (every other day) you’ll miss half the good cases.”

About 10-15 years ago they made a bunch of rules which they have continually refined to make residency kinder and gentler. I believe this had coincided with the expectations of a certain generation about how they should be treated. There are some patient safety concerns as well however the landmark case which lead to all this regulation likely wouldn’t have been prevented by work hour restrictions because plenty of well-rested residents would likely have made the same mistake and by restricting work hours you restrict the amount of time residents gain experience leading to residents graduating with less experience than their predecessors (https://psnet.ahrq.gov/primer/duty-hours-and-patient-safety).

Sorry if that’s a bit of a rant. I understand the reasons for the restrictions but those of us who have trained and taught during the transition have definitely seen a change in behavior and knowledge after the changes took place. When I was an internal medicine intern you were expected to know EVERYTHING about YOUR patient. If the attending asked you if the patient had any pets, you were supposed to know the answer (including how many, what type, and whether they were indoors or outdoors - bonus points if you knew the pet names). I remember as a hospitalist attending after the transition when they had eliminated overnight call for interns (in my opinion, the single most valuable experience of internship) I asked one of the interns a question about his patient - unapologetically, he replied “I don’t know. I just got him this morning. He’s not my patient.” I asked him “Well, if he’s not your patient then whose patient is he?” He replied “yours?” We had a discussion after that. 
 

I guess what I’m trying to say is that as a surgical resident it’s very likely that he does have time to fly. He will also have the income to support buying and maintaining an airplane. Hopefully he has the judgement to do it safely. When I took my commercial check ride the DPE commented afterwards “I’m really surprised your a doctor. You’re the first one I’ve flown with that has any common sense.”

It’s interesting to me.... I know nothing about residency, but I know a lot about human factors and CRM.  And one thing we’ve learned in those fields is that rest matter in both knowledge retention and avoiding mistakes, particularly in high stress, performance matters, complicated situations.  As they relaxed the residency hours (something I only read about in the news), I found myself wondering if there was some influence of the many doctor-pilots taking lessons learned from aviation safety and trying to apply it to medical safety.  As a patient, I would like everyone performing surgery on me to be well rested.  And yes I would like them very experienced too (and I get your point of less work means seeing less things).  I don’t know the way around it, because doctor training is it’s own thing, but maybe the solution is also found in aviation - rather than declaring someone an ATP at the end of a “year,” they are declared it at the end of a set number of hours of experience combined with demonstrating of certain skills.  

[ilovecornfields]

11 minutes ago, Becca said:

It’s interesting to me.... I know nothing about residency, but I know a lot about human factors and CRM.  And one thing we’ve learned in those fields is that rest matter in both knowledge retention and avoiding mistakes, particularly in high stress, performance matters, complicated situations.  As they relaxed the residency hours (something I only read about in the news), I found myself wondering if there was some influence of the many doctor-pilots taking lessons learned from aviation safety and trying to apply it to medical safety.  As a patient, I would like everyone performing surgery on me to be well rested.  And yes I would like them very experienced too (and I get your point of less work means seeing less things).  I don’t know the way around it, because doctor training is it’s own thing, but maybe the solution is also found in aviation - rather than declaring someone an ATP at the end of a “year,” they are declared it at the end of a set number of hours of experience combined with demonstrating of certain skills.  

That has been proposed. There was a big movement to add an extra year to residency because of the experience lost with the work hour restrictions (but then that has huge effects in cost, throughout, etc..).

There’s a popular stress vs. performance curve that shows that your performance increases with increased stress, up to a point. The goal is finding that point, teaching people how to manage stress and exposing them to as much as possible in a supervised environment (residency) before they encounter it for the first time on their own.

As @KLRDMD aptly pointed out, when you get that trauma airway and you realize that either you’re going to control the airway or the patient is going to die right in front of you is a time when you’re very thankful for your past experience. I didn’t like taking call either, but standing in front of a critical patient and realizing that I was the one that needed to fix it taught me valuable skills. As a resident, someone is always being paid to help you and be available for you (I remind the residents about this all the time). As an attending, you’re often on your own. Whatever you fail to learn as a resident (and fellow) will be to your (and you’re patients) detriment after you finish your training.

Residency was not fun. I did two. My wife did a fellowship as well and none of it was fun. That being said, we’ve both very appreciative of the training we received and the things I learned overnight in the hospital as a resident have saved my a$$ multiple times as an attending.

[EricJ]

2 hours ago, philip_g said:

Did the gentleman ask for help securing financing or did he ask for a run down on Dave Ramsey's theories or did he ask for a rant about millennials? I've lost track in this dumpster fire.

You must be new to the internet.

Welcome.  

[Becca]

3 hours ago, ilovecornfields said:

That has been proposed. There was a big movement to add an extra year to residency because of the experience lost with the work hour restrictions (but then that has huge effects in cost, throughout, etc..).

There’s a popular stress vs. performance curve that shows that your performance increases with increased stress, up to a point. The goal is finding that point, teaching people how to manage stress and exposing them to as much as possible in a supervised environment (residency) before they encounter it for the first time on their own.

As @KLRDMD aptly pointed out, when you get that trauma airway and you realize that either you’re going to control the airway or the patient is going to die right in front of you is a time when you’re very thankful for your past experience. I didn’t like taking call either, but standing in front of a critical patient and realizing that I was the one that needed to fix it taught me valuable skills. As a resident, someone is always being paid to help you and be available for you (I remind the residents about this all the time). As an attending, you’re often on your own. Whatever you fail to learn as a resident (and fellow) will be to your (and you’re patients) detriment after you finish your training.

Residency was not fun. I did two. My wife did a fellowship as well and none of it was fun. That being said, we’ve both very appreciative of the training we received and the things I learned overnight in the hospital as a resident have saved my a$$ multiple times as an attending.

 I worked in Mission Control for the Space Shuttle.  We had a long, and intense, training period to certify.  But we also had mandatory time off and sleep shifting time during missions, under express supervision and orders from the flight surgeons to have the schedule with that built in.  (And yes the flight docs working in mission control had to follow their own advice given to the rest of us).

I am a litigator now (I know big shift from engineering), and lawyers seem to have incorporated none of these lessons into their practice.  They just expect top performance 24/7 and if you can’t do it the view is you aren’t cut out for the job.  Me, if I was ever putting my entire business online at trial (let alone my personal freedom in a criminal trial), I would insist on a larger but better rested legal team.

my takeaway from all this, is that if you don’t make the time off mandatory, high performers in these intense professions will not take the appropriate rest periods and people that toughed it out in previous generations will be critical of the weakness of folks who can’t tough it out.  I am not sure where they leaves us.  I think adding the extra year to residency seems smart.

Edited August 21, 2021 by Becca

[ilovecornfields]

1 hour ago, Becca said:

 I worked in Mission Control for the Space Shuttle.  We had a long, and intense, training period to certify.  But we also had mandatory time off and sleep shifting time during missions, under express supervision and orders from the flight surgeons to have the schedule with that built in.  (And yes the flight docs working in mission control had to follow their own advice given to the rest of us).

I am a litigator now (I know big shift from engineering), and lawyers seem to have incorporated none of these lessons into their practice.  They just expect top performance 24/7 and if you can’t do it the view is you aren’t cut out for the job.  Me, if I was ever putting my entire business online at trial (let alone my personal freedom in a criminal trial), I would insist on a larger but better rested legal team.

my takeaway from all this, is that if you don’t make the time off mandatory, high performers in these intense professions will not take the appropriate rest periods and people that toughed it out in previous generations will be critical of the weakness of folks who can’t tough it out.  I am not sure where they leaves us.  I think adding the extra year to residency seems smart.

I actually agree with most of what you’re saying and thanks for calling me out as a Grumpy Old Man.

I guess I’m just disappointed with the way things have changed. When I was a resident the expectation was that it was going to be really hard, you were going to learn a lot and by the time you finished residency you would know what you needed to know to be a good doctor. Now it seems a lot of emphasis is placed on lifestyles and making things easy and this translates into physician’s behavior after residency.

In the past, if you had a surgery in the morning and had pain that night you would call the surgeon and they would try to help you. When I had shoulder surgery the surgeon gave me his cell phone number and said “If you have any questions, call me first.” Now,  no one wants to be bothered with taking care of patients after hours so if you call the surgeon their answering service will simply tell you to “go to the ER.” So will the pediatrician if you tell them your kid has a fever or the family medicine doctor if you have a sore throat.

It’s just sad to see the trend of doctors not wanting to take “ownership” of their patients and acting like shift workers instead of the way it used to be where doctors seemed to take pride on being there for the patient.

I agree you have to be able to take care of yourself in order to take care of others (and perform your job well) but I think there is a balance and the pendulum has swung toward putting yourself first at the expense of the patient.

Edited August 21, 2021 by ilovecornfields

[Hank]

8 minutes ago, ilovecornfields said:

I agree you have to be able to take care of yourself in order to take care of others (and perform your job well) but I think there is a balance and the pendulum has swung toward putting yourself first at the expense of the patient.

As a modern day patient, I find that I have to manage my own care. Some docs even ask me what treatment I want to pursue!

I'm not a doctor. Made it through high school, college and grad school with two Engineering degrees (BSME, MSE) without ever taking a single class in basic biology. 

The two and a half decades I've spent in medical manufacturing have given me insight into some things, especially statistics and their underlying assumptions and hypotheses. If only reporters had a clue about those . . . .

Back to weeding through trash reporting, trying to make sense of things. But yes, I was vaccinated as soon as I became eligible, back in Feb. Someone please distribute some data without the political overlay, and stop telling me that I should follow your advice because you know better than me . . . . .

[carusoam]

@rwabdu, got a minute for some finance questions?

Are you still hunting a financial answer?
 

If I were the community financier of wayward Mooneys…

I would want to know a few things about what the potential Mooney buyer has in mind….
 

1) What Mooney are we buying?

2) What is the purchase price of said Mooney?

3) Where is that Mooney currently located?

4) Where is that Mooney going to live?

5) Will it have a hangar?

 

Typical first year questions to have answers for…

6) Is the pilot familiar with transition training?

7) Is the pilot familiar with the cost of insurance?

8) Is the pilot familiar with the cost of annuals?

9) Is the pilot familiar with the monthly cost of a hangar?

 

Lets get some hypothetical numbers out in the open…

 

See if we can get the easy stuff out of the way first…. If that is successful, then we can cover the health and safety aspects of a new pilot flying in IMC after 2am in the winter crossing wrong cold fronts….  

Best regards,

-a-

[ilovecornfields]

21 minutes ago, Hank said:

As a modern day patient, I find that I have to manage my own care. Some docs even ask me what treatment I want to pursue!

I'm not a doctor. Made it through high school, college and grad school with two Engineering degrees (BSME, MSE) without ever taking a single class in basic biology. 

The two and a half decades I've spent in medical manufacturing have given me insight into some things, especially statistics and their underlying assumptions and hypotheses. If only reporters had a clue about those . . . .

Back to weeding through trash reporting, trying to make sense of things. But yes, I was vaccinated as soon as I became eligible, back in Feb. Someone please distribute some data without the political overlay, and stop telling me that I should follow your advice because you know better than me . . . . .

Well, Hank as far as I recall I haven’t told you to do anything and I’m definitely not a politician or reporter so I’m sure that was directed at someone else…

There’s plenty of data out there - just pick up a copy of the Annals of Internal Medicine or NEJM and you’ll see plenty of COVID studies. If you’ve never taken a biology class though you may not be the most qualified to interpret those studies.
 

As an engineer, though I’m sure you’ll agree that not everyone is equally qualified to interpret the raw data and it’s a little unrealistic to think that you can do it better than the experts. I regularly download my engine monitor data but I have no idea what I’m looking at — so I pay Savvy to do it. When I had to do a precautionary landing due to a rough running engine I sent them the data and asked them what was wrong, instead of trying to diagnose it myself based on my feelings, beliefs and social medial contacts. 
 

I fully support making your own decisions but when your life is at stake sometimes it helpful to listen to the experts when making those decisions.
 

I sense the frustration, though. I’m frustrated too. 

Edited August 21, 2021 by ilovecornfields

[Hank]

@ilovecornfields, don't be so sensitive. My comments weren't aimed at anyone in particular, just a general frustrated blast at the dunderheads who have replaced reporters and think that their personal opinions are the real "news" that we all need to hear (and follow without questions).

[Becca]

11 hours ago, ilovecornfields said:

I actually agree with most of what you’re saying and thanks for calling me out as a Grumpy Old Man.

I guess I’m just disappointed with the way things have changed. When I was a resident the expectation was that it was going to be really hard, you were going to learn a lot and by the time you finished residency you would know what you needed to know to be a good doctor. Now it seems a lot of emphasis is placed on lifestyles and making things easy and this translates into physician’s behavior after residency.

In the past, if you had a surgery in the morning and had pain that night you would call the surgeon and they would try to help you. When I had shoulder surgery the surgeon gave me his cell phone number and said “If you have any questions, call me first.” Now,  no one wants to be bothered with taking care of patients after hours so if you call the surgeon their answering service will simply tell you to “go to the ER.” So will the pediatrician if you tell them your kid has a fever or the family medicine doctor if you have a sore throat.

It’s just sad to see the trend of doctors not wanting to take “ownership” of their patients and acting like shift workers instead of the way it used to be where doctors seemed to take pride on being there for the patient.

I agree you have to be able to take care of yourself in order to take care of others (and perform your job well) but I think there is a balance and the pendulum has swung toward putting yourself first at the expense of the patient.

I am equally guilty of the the gentle-delicate-flower perception of the generation after me too!  You should have seen me in law school every time a classmate complained about reading or low grades ("let me tell you about the controls class where no one got over a single digit percent score on any tests")  I do think, back in Mission Control, language mattered.  You were taking mandatory rest because it was necessary for safety and performance of the mission - e.g. it was part of doing your job right.  It was also nice that it gave you appropriate time with your family/leisure time, these things are important and good to prioritize, and all.

As a patient, I also don't like how doctors just say "go to the ER" either.  I think there are solutions to this that don't wreck doctors lives (sorry this is me thinking as a systems-fixer thinker messing around with business practices that I really have no knowledge of), and the answer is larger teams (For what its worth, I think this is true of lawyers practices too).  If there were 2 or 3 people on the team, instead of one, you just pass off the pager (virtually), but there's always someone to call but no one person is ruining their lives by taking calls nightly.  I have a friend who joined her children into a pediatricians co-op that does this very thing.  Its a couple dozen local pediatricians in independent practices that take turns being on call, they pay a fixed monthly fee for the service, and parents can call a number 24/7 and always speak to a pediatrician and even get emergency exams/weekend visits without going to an emergency room.  I suspect the doctors probably only end up on night or weekend duty once a month or so in order to provide this service to all their patients.

Anyway, I think these are interesting problems that cross industries that employ high performing, highly trained people, and there's lots of lessons to be learned out there on how to do it better.

Edited August 21, 2021 by Becca

[A64Pilot]

12 hours ago, ilovecornfields said:

I actually agree with most of what you’re saying and thanks for calling me out as a Grumpy Old Man.

I guess I’m just disappointed with the way things have changed. When I was a resident the expectation was that it was going to be really hard, you were going to learn a lot and by the time you finished residency you would know what you needed to know to be a good doctor. Now it seems a lot of emphasis is placed on lifestyles and making things easy and this translates into physician’s behavior after residency.

In the past, if you had a surgery in the morning and had pain that night you would call the surgeon and they would try to help you. When I had shoulder surgery the surgeon gave me his cell phone number and said “If you have any questions, call me first.” Now,  no one wants to be bothered with taking care of patients after hours so if you call the surgeon their answering service will simply tell you to “go to the ER.” So will the pediatrician if you tell them your kid has a fever or the family medicine doctor if you have a sore throat.

It’s just sad to see the trend of doctors not wanting to take “ownership” of their patients and acting like shift workers instead of the way it used to be where doctors seemed to take pride on being there for the patient.

I agree you have to be able to take care of yourself in order to take care of others (and perform your job well) but I think there is a balance and the pendulum has swung toward putting yourself first at the expense of the patient.

It’s not just the Medical profession, At least in the US Society has changed, the concept of hard work and hardship paying off for the rest of your life just isn’t worth it anymore. I think for example it’s why you see so much less flight training now.
People won’t consider difficulty like they used to, even Military basic training is greatly different, the concept of working and going to school is scoffed at, who does that anymore? Borrow money instead it’s a lot less difficult that way. Make it hard, and the average person just quits now and your graduation rates fall below min acceptable,so you make it easier to get graduation rates back up.

Its been my experience as an older retired guy (insert Lieutenant joke here) that it’s best to not borrow money unless every lender wants to lend you money, then you worry about who will give you the lowest interest rate, if your having to shop for a lender that will, then your going to pay a higher rate. 

Yes last several years the returns have been great, but I remember the bad old early 80’s where inflation was double digit, and investments didn’t even break even. I fear we will be seeing a re-run of those times, but then old men get paranoid about money, its our nature.

 

Oh yeah, “ Get off my Lawn”

Edited August 21, 2021 by A64Pilot

[rwabdu]

 

With regard to modern surgical residency: Hard to say working 75-80 hours a week for 5 years with 4 days off per month is being treated too softly. The reason, in my opinion, that residents are limited to 80 hours per week and a minimum of 4 days off a month is because abuse was occurring, but I wasn't around then. My father and grandfather were doctors / surgeons. Every one of my senior surgery mentors has told me that our care and education is much better than they were in the old days. When I go home at night the residents take turns covering for each other so we can get a little sleep and take better care of our patients during the day. The volume of work has not changed since the duty hour rules, its just been shifted to be more efficient. When I take call sometimes I operate for 20 hours non-stop bouncing from room to room. I have a 60 bed ICU with ECMO and transplant and cardiac units, a level 1 trauma center and an average of 300 in-patients who I am personally in charge of as the chief resident, not to mention the emergency room which often sends us more then 30 consults in 24 hours. I do this without an attending in the hospital - but they are 15 minutes away. The scope of the General Surgeon has also changed significantly from what it once was. No longer do many surgeons do abdominal, chest, vascular, transplant, aortic, pancreatic trauma etc like the old days. Additionally, 80% of our grads do a fellowship for additional years to sub-specialize. My personal opinion is that if surgical residency was more focused on education and training instead of doing non-educational paperwork to make the attending happy and if advancement was based on skill not an arbitrary timeline, we could cut out an entire junior year of training and probably be well trained in 4 years... especially if going on to fellowship. That being said, I managed to get my PPL during residency by being efficient with my time and priorities. sometimes after working for 28 hours, sleeping 6 hours I get up to go for an evening lesson then come home refreshed to study surgery for a bit before going back to bed. The year I got my certificate my national exam scores actually went up by 22% compared to my peers because I was giving my brain a bit more time to recover and was more efficient with my time.

Anyways... this is way off topic! I found myself a really nice Mooney M20c with a full upgraded panel / GPS/ autopilot/ bladders in the tanks, no corrosion, good engine with 1000hours and current annual good for another year. We settled on a price and got a really extensive pre-buy from Byron at RPM aviation (thanks to this forum for the recommendation!) and that went well. Hoping my loan from one of the finance companies mentioned on this thread gets approved early next week and I can close soon after! Sounds like the monthly payment will only be 320$ a month for a 20 year term, so much cheeper than expected if it works out. Will post pictures when / if the deal is done!

Edited August 21, 2021 by rwabdu

[ilovecornfields]

I get it. Residency is hard. Back when I was a resident we had to walk uphill both ways to the hospital in the snow…and I trained in California.

I was actually there during the change. It’s a appealing narrative to say that residents are just more efficient now and we were a bunch of inefficient troglodytes, but that’s a little disingenuous. The work has changed. Things that residents used to do are now done by more residents, attendings and to a large extent mid-level providers. When I trained you would never see PAs or NPs in the hospital and now they’re all over the place doing the work that interns and residents used to do. I get the appeal of the “work smarter, not harder” philosophy but I think it’s worth noting that we thought we were pretty smart, hard-working and efficient too.

Medical education has definitely changed. Asynchronous learning, reverse classrooms, small groups, simulations, etc.. some of these advances are great and others not so much. I’m glad you and your attendings feel that your training is better than theirs was but I haven’t really appreciated that with the “finished product.” Confidence is definitely higher, but I haven’t seen that correlated with relevant clinical outcomes.

Maybe I’m just jealous. I took a very intentional break from flying during residency because I didn’t feel I was in a place where I could do it safely. I took a BFR and ICC every two years (yes, I know they’re not called that anymore) and then wouldn’t fly again until the next one was due. I guess I didn’t want to give up on calling myself a pilot but knew I wasn’t safe and proficient to fly on my own.

I’m glad you found a plane. I hope flying becomes a lifelong hobby for you and brings you all the joy and happiness it has brought me and others here. I also hope you realize your limitations and don’t become another statistic as has happened to many other intelligent, highly-educated, high-achieving individuals.