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- July 16, 2020
It’s not easy becoming a doctor or a dentist. Nor is it cheap. Yet, despite the many years involved and hundreds of thousands of dollars invested, many will tell you it’s worth it.
Others, of course, will disagree.
Although I spent nearly as much time in my post-secondary education and training as I did in my actual career as an anesthesiologist, I truly do not regret the path I’ve taken in life thus far. My father and his father were both dentists with fulfilling careers.
In this post, we’ll compare and contrast what it takes to become a medical doctor or dentist with a focus on both the time and costs involved.
Today’s guest post is from Nadine Evans at BeMo Academic Consulting. BeMo is one of the most sought-after academic consulting firms in the world famous for helping applicants with admissions to highly competitive programs and its staunch advocacy for fair admissions.
It’s no secret that embarking on the journey of becoming a doctor or a dentist costs an arm and a leg, regardless of what school you decide to attend.
One of the first things you should consider is how much debt you are willing to carry with you as you complete your education, head into residency, and begin your career.
Most importantly, you should consider the overall investment you’ll be making when analyzing the cost vs reward of becoming a doctor or dentist. If like many, you’re wondering if a doctor or dentist’s salary outweighs the costs of completing your education and residency, you’ll find the answers here.
Time
Costs don’t only come in the form of dollar bills. Becoming a doctor or dentist requires a serious time commitment: between 7-12 years for doctors and 4-12 years for dentists. This commitment begins after the completion of secondary school, as a Bachelor’s degree is required for prospective medical students to continue to medical school.
While not all dental programs have this requirement, most do. During undergraduate studies, students will have to ensure they complete common prerequisites for medical and dental school including the completion of biology, physics, math, English, inorganic chemistry, and organic chemistry.
Next, prospective medical and dental students need to begin acquiring the necessary experiences to be seen as competitive applicants. Both medical and dental applicants need to shadow a doctor or dentist as shadowing is expected, if not required, for admission to most schools.
In addition to shadowing experience, clinical experience, an excellent GPA and test scores, strong letters of recommendation, and fantastic extracurriculars are needed to get accepted.
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Applications and Interviews
Preparing applications, writing standardized tests, and attending interviews take a significant amount of time and effort. Prospective medical students must fill out the time-heavy American Medical College Application Service, (AMCAS) work and activities section and craft an excellent medical school personal statement to apply.
Similarly, dental school hopefuls must create a dental school personal statement which is one of their biggest projects to tackle while applying. Most students spend months writing, editing, and re-writing their application materials until they are strong enough to stand out among other applicants.
If you’re with me so far, all of this time invested only brings us to the application phase of these professional programs. Once students have submitted their applications, they’ll hopefully move to the interview phase of the admissions process.
To start with, some programs expect students to complete the CASPer test, a Computer-Based Assessment for Sampling Personal Characteristics, which asks students a series of questions to determine who should even be invited for interviews.
After that, students can expect to participate in traditional one-on-one interviews, panel interviews, or even the Multiple Mini Interview (MMI). Students spend hours preparing for their interviews by practicing with sample questions and taking part in mock simulations.
Completing the interview circuit can take weeks, depending on how many interview invitations students receive.
Residency and Fellowship
The real bulk of the time commitment occurs during the four years of training at both medical and dental school. But that’s not all, in addition to the four years of undergraduate education, physicians are required to complete residency training before they can practice, which takes between 2-7 years depending on their chosen specialty.
While many dentists also proceed to residency training, it’s not required to practice. If dentists choose to attend residency, most programs are completed in 1-3 years, aside from complex specialties which can take between 4-8 years.
Applying to residency is another timely endeavor as students will apply using the Electronic Residency Application Service (ERAS) which requires the completion of a residency personal statement. Applicants must follow the ERAS timeline carefully, ensuring they adhere to all requirements and deadlines.
Application Costs
The very first expense in becoming either a doctor or a dentist is the cost of applying to medical or dental school. For medical applicants, AMCAS charges $170 for a primary application and $40 for each additional application.
Secondary applications are common and can cost between $75-$150 on average. The MCAT will add on another $320. Plus, about one-quarter of students re-take the MCAT in order to improve their score which increases the cost significantly. Most medical school applicants apply to 16 medical schools on average, which means the overall cost to apply can be over $2500.
The application fee for dental students is $251, plus $108 for each additional school applied to thereafter. Dental schools then require a supplemental fee that goes to the schools themselves, and this costs between $50 – $90 on average. The DAT costs $475.
If a dental school applicant applies to only 10 schools, they will spend around $2500, roughly the same cost that medical school applicants spend, but medical applicants can apply to 16 schools at that price. Applying to dental school is, therefore, quite expensive compared with applying to medical school.
Tuition and Debt
The average annual cost of medical school tuition, fees, and health insurance for residents at public medical schools is roughly $37,000 and $62,000 at private medical schools. Non-residents can expect to spend significantly more, around $60,000 at either type of school.
Dental school is more expensive, with dental school tuition costing on average $53,000 for residents at public schools and $72,000 for residents at private schools.
As with medical school non-residents, dental school non-residents pay much more than residents, approximately $69,000. Overall, dental school residents pay approximately $16,000 more each year compared with medical school residents.
In terms of debt, medical school students that borrowed money come out with an average debt of $200,000. For dental school students that borrowed, the average debt is higher, at $292,000.
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Residency Application Costs
As with applying to medical school, applying to residency can also be costly. You’ll incur fees from both the ERAS and later on, the National Resident Matching Program (NRMP).
When applying through ERAS, for $99 you can apply to up to 10 residency programs within one specialty. If you want to apply to another specialty, you have to pay the $99 again. For each additional program you apply to, you’ll pay between $16-$26, depending on the number of programs you select.
For example, if you want to apply to 20 Emergency Medicine programs and 30 Family Medicine programs, you’ll spend $99 plus $160 for Emergency Medicine, and another $99 plus $360, making your entire cost over $700.
Plus, if you’re a DO vs MD student, you’ll have to spend $80 for your COMLEX-USA transcript and potentially another $80 for your USMLE transcripts. Next, you will need to register with the NRMP which costs $85 for up to 20 programs, with additional programs costing $30 thereafter.
Finally, you’ll have your residency interviews which come with their own set of accommodation, transportation, and food overheads.
Salary & Career Outlook
There is no doubt that the demand for both doctors and dentists are high. According to the AAMC, by 2032, there will be a shortage of up to 122,000 physicians in the US. Similarly, there are over 6000 dental care Health Professional Shortage Areas (HPSAs) where there are over 5000 patients for only one dentist.
This shortage continues to fuel demand. The US Bureau of Labor Statistics projects that employment growth for dentists is around 7.6%, creating an estimated 10,400 jobs between now and 2028. Physician employment growth is high, projected at 7%.
It’s quite clear that the costs associated with becoming a doctor or dentist are astronomical, but excellent salaries, in addition to scholarships, bursaries and grants can help soften the blow.
The median salary for dentists is $156,000 annually and $208,000 annually for doctors. These salaries are much higher than the average US salary of $957 weekly, or approximately $49,764.
Related: 4 Physicians Revisited: The Impact of Specialty Choice
Fulfillment
Let’s face it, if you’re only interested in becoming a doctor or dentist for the salary, there are much easier ways to make money in a much quicker turnaround. Truthfully speaking, salary is not going to be enough to keep you happy if you’re already unsure whether you want to pursue either field.
Both fields require a massive time, effort, and financial commitment, not to mention the high stakes environment, constant stress, and high pressure you’ll be under. The reason most people choose to become doctors or dentists is that it’s their life calling – they truly want to help others and make a positive impact in their community.
Many agree that the consequences of either career are far outweighed by the simple fact that it is extremely rewarding to help others. To be a successful and fulfilled doctor or dentist, you must truly enjoy it in order to accept both the highs and lows of a career in the healthcare field.
Most doctors and dentists love what they do and are willing to make the ultimate sacrifice; putting others before themselves, to serve their patients, no matter the costs.
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Are you a medical doctor or dentist? Were the costs and efforts to become one worth it to you?
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21 thoughts on “Cost vs. Reward of Becoming a Doctor or a Dentist”
Hey actually found some good information about the CASPer test & sample questions on this website – https://www.freesampletest.com/casper-practice-test
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In the Q of dentists VS medical doctors, I would like to say one of today’s experiences is that we seem to focussed on repair instead of prevention, in both medical or dental, because remedy / repair procedures are easier to bill. As an independent dental hygiene practitioner (IDHP) with freestanding clinic (Est. 2009) I am saddened to see the ongoing cry for doctors and nurses, and “dental” only acknowledged in terms of dentists, when this focus on end-stage heroic intervention drives costs up to the extent increasing numbers of people are goin g without dental care in Canada, maybe dental plus medical in the US. Apparently 30% of hospital emergencies in Canada have dental causes which will be neither addressed nor fixed through painkillers and antibiotics (or self-medication). The dramatic effect of oral disease on systemic health is chronically underestimated in practice.
I think we will improve population health when we get more IDHP taking on the dental maintenance directly to the public, lowering barriers without having to go through a dentist who’s job it is to look for things to repair, and to see client health that way. IDHP do much more than “cleaning”: we reduce and eliminate inflammation, highlight and remove true causes of caries, provide sealants to protect un-decayed teeth, and temporary restorations for pain relief and preservation of tooth structure. We create stability, increase awareness, self-care and then health. It is uncanny how many people we have kept out of the hospital. In Canada, IDHP exist in most provinces now. It would be great if the US followed suit. We are not the enemy, nor the competition: we are the preventive care experts, central to all other health care professionals, referring out to MDs, dentists, chiropractors, etc. for the issues we encounter while doing oral care. Smart dentists (and other health care professionals) will befriend IDHP, get to know us, and when we know what you like doing and are good at, chances are you’ll end up with a lot of free referrals of educated clients who know what they need, and are ready to pay for it.
I hope this helps. Thanks for letting me post.Reply
In the Q of dentists VS medical doctors, I would like to say one of today’s experiences is that we seem to focussed on repair instead of prevention, in both medical or dental, because remedy / repair procedures are easier to bill. As an independent dental hygiene practitioner (IDHP) with freestanding clinic (Est. 2009) I am saddened to see the ongoing cry for doctors and nurses, and “dental” only acknowledged in terms of dentists, when this focus on end-stage heroic intervention drives costs up to the extent increasing numbers of people are goin g without dental care in Canada, maybe dental plus medical in the US. Apparently 30% of hospital emergencies in Canada have dental causes which will be neither addressed nor fixed through painkillers and antibiotics (or self-medication). The dramatic effect of oral disease on systemic health is chronically underestimated in practice.
I think we will improve population health when we get more IDHP taking on the dental maintenance directly to the public, lowering barriers without having to go through a dentist who’s job it is to look for things to repair, and to see client health that way. IDHP do much more than “cleaning”: we reduce and eliminate inflammation, highlight and remove true causes of caries, provide sealants to protect un-decayed teeth, and temporary restorations for pain relief and preservation of tooth structure. We create stability, increase awareness, self-care and then health. It is uncanny how many people we have kept out of the hospital. In Canada, IDHP exist in most provinces now. It would be great if the US followed suit. We are not the enemy, nor the competition: we are the preventive care experts, central to all other health care professionals, referring out to MDs, dentists, chiropractors, etc. for the issues we encounter while doing oral care. Smart dentists (and other health care professionals) will befriend IDHP, get to know us, and when we know what you like doing and are good at, chances are you’ll end up with a lot of free referrals of educated clients who know what they need, and are ready to pay for it.
I hope this helps. Thanks for letting me post.Reply
When I was in HS, multiple decades ago, a friend’s father, a PCP, tried to dissuade me from going into medicine. He was fed up with having to hire several more “girls” (his description) for the office to deal with the hassles of Medicare. He was burned out. Fortunately, I didn’t listen and have had a fabulous career, although not without my share of insurance hassles, etc. I encourage young people to enter the field and cringe every time I hear one of my colleagues bad mouthing it. I believe in the rational optimistic approach. Do we have issues, sure, but who doesn’t? Every generation thinks things are changing = going down the tubes. The rational optimist looks at the big picture. Will Physicians care for the sick and scared in the future, of course they will. Will Physicians continue to be highly compensated compared to average? I believe that as well. Despite all complaining to the contrary, most American Physicians remain in the top 1-2% of wage earners in the wealthiest nation that ever existed on the face of the planet! I want the best a brightest caring for me as I age, so stop pushing your burnout fueled pessimism on our future caregivers. As Morgan Housel explained, unfortunately, optimism sounds like someone trying to sell you something. The seduction of pessimism is that it sounds like a friend trying to help you out.
Reply
Dinosaur —-
College and med school tuitions were negligible. Salaries during internship (I am old) and residencies were also negligible. Military service was required – two years shot. During all of that time, never had a conversation with anyone about money. Went into practice and got $15,000 first year. Worked hard, built a great practice (no vacation seven years) and did very well financially and medically. Loved what I was doing, saved enough money that am now considered “rich” and no money worries.
Medicine today is being changed from a profession to a job. From a loved occupation to
“work”. If you are not a top student – don’t do it. You will either do poor work and struggle or do good work, enjoy it, and work to pay off your debts.
Speak to a doctor in each decade age group and see what you will be getting into. Those
in my generation generally discourage their offspring from entering the field.Reply
I believe for many people, happiness is determined by how much control you have over your own life. Can you be independent or will you be forced to work for someone else? Medicine is increasingly being taken over by administrators- be they insurance companies, hospital networks, etc. Will the bean counters put you on a treadmill……who are you really working for? Insurance companies are only increasing in strength after passage of the ACA. Life was a lot easier before Medicare Advantage plans entered the picture (what is their advantage?)- this is a game of semantics. The more insurance companies and the more products they offer, the more confused patients get and the more we look like the bad guy.
The only way to change this trend is unionize (which I doubt will ever happen) or develop a concierge practice. I am envious of those docs able to work in such practices- where they charge what they feel is reasonable and do not have any interference in the doctor-patient relationship (which has been modified to put the insurance company right between the two of us). Being a private doctor dealing with insurance companies to make a living is a sure path to burnout…….and the insurance companies want it to be that way!
I used to think that Medicare was a PITA…….now I have MA plans requesting copies of records of all their patients OR access to my medical records program….or offering to do an onsite visit…….and if you contract with them, that will be part of the contract…..so you are basically working for the insurance company….NOT THE PATIENT…and patients no longer care….they cannot tell the difference between an MD, a PA, an NP……heck we all get paid the same, don’t we?
Dentists have much more opportunity (at least where I live in Florida) to be independent, work in basically a concierge situation and not have anything to do with those silly dental insurance plans, although I know that will change. There is big money in dental implants (like there used to be in eye implants) which is attracting PE companies whose goal is to make dentists employees of their company. Each year they can always hire a new one at the going rate so being a better more experienced provider is meaningless if the patient is just going to the Acme Dental Clinic.
Nobody has spoken about the cost of starting out…..after you have your license…before you see patient number 1. Thanks to technology, finishing your training and hanging out a shingle (like my father did) harkens back to the age of dinosaurs.
All I will conclude with is that having a medical or dental license will guarantee you an income. And in medicine, I suspect it will be a falling income. Patient gratitude will make up for some of it. Some doctors work for free….we have all seen patients for free at some time……but I do not know how to present that in a business plan.Reply
I would like to point out too, for college students reading these posts, that it’s not just a matter of figuring time in terms of specializing in high paying fields like plastic surgery(MD) or orthodontics(dentists).
A chunk of them make 7 figures, but realistically you are going to have to be at the top of your class or an under represented minority (or both) to win a spot.
It’s hard to know where in the class you will be until you get there. Everyone is in the top one percent of IQ by that point.
Reply
A few thoughts, the first is that dentists are doctors and physicians are doctors, so to refer to each group accurately it should be ‘physicians and dentists’ rather than ‘doctors and dentists’.
Semantics aside, second is that that those dentists do not have time commitments of 4-12 years after college as the article states. It would be more accurate to say 4-10 years, although for dentists, most will be on the lower end of that year range.
Dental school is four years and then a dentist may go right out into private practice after that. Most dentists will usually choose to do a one year residency if they do not specialize, so for most general dentists it will be 5 years. There are nine recognized specialties in dentistry: orthodontics (2 or 3 year residency); pediatric dentistry (6 year residency); periodontics (3 year residency); prosthodontics (3 year residency); oral and maxillofacial surgery (4 or 6 year residency); oral and maxillofacial pathology (3 or 4 year residency); endodontics (2 years); public health dentistry (about 1 year); and oral and maxillofacial radiology (2 year residency). So while it could take up to 10 years, for most it would not come close as roughly 80% of dentists do not specialize and would graduate after 5 years maximum.
While considering that a dentist usually graduates much sooner than a physician, from a purely financial standpoint, entering the job market so many years sooner has quite an impact on one’s projected ability to earn. This fact should be highlighted for further consideration. The article also states “The median salary for dentists is $156,000 annually and $208,000 annually for doctors.” What was the source of this data? The American Dental Association says for 2018 that “The average net income for dentists in private practice in 2018 was $190,440 for general dentists and $330,180 for specialists.” Regardless of the accuracy of annual salary, the article should discuss the average earning potential for dentists and physicians over a lifetime of practice with consideration to the age at which they would start practicing.
Also, much text was devoted to the application costs, but there was no discussion of the far more important consideration of residency salary of costs. Dentist may be able to be paid during their residency or they pay tuition. What about physicians and their residency costs, is this paid by them or to them? This significant factor was missed as well.
Perhaps these points could be clarified so that readers could have a better understanding.
Reply
You make some good points, AM, and although I didn’t write the article, I would like to respond to a few of them.
When you ask what someone does for a living, and they say “I’m a doctor,” to me that implies that they are a medical doctor. My father and grandfather were both dentists and they never told people they were doctors, but they did, of course, carry a “Dr.” in their formal names. So did my uncle, a Ph.D. forester, and he didn’t claim to be a doctor, either.
Many degrees are now often or always granted as doctoral degrees, including pharmacy, nurse anesthetist, audiologist, and physical therapist to name a few. Using the term “physician” doesn’t unmuddy the waters, either, as there are people calling themselves chiropractic physicians and naturopathic physicians.
For what it’s worth, in the introduction, I stated “In this post, we’ll compare and contrast what it takes to become a medical doctor or dentist with a focus on both the time and costs involved.”
It is definitely true that a short or non-existent residency gives dentists a leg up in the ability to earn and save early on in life. The tens of thousands or hundreds of thousands saved while the medical doctors are in residency and fellowship can be millions of dollars after a few decades of investment returns.
Regarding the pay for medical residents and fellows, they are paid positions, and the pay is in the range of a teacher’s salary. I earned $38,000 to $41,000 from 2002 to 2006, and I would say $55,000 to $60,000 is more typical today. In some programs, there might be the opportunity to earn additional money by moonlighting, but you’re already working a ton of hours in most cases, so it’s not like you’re going to make big money on the side.
Best,
-PoFReply
My wife and I graduated from Buenos Aires University(Argentina). After 37 years in practice in Chicago , we are now retired.
We passed all our US boards multiple times, trained residents and students for several years, and our overall performance was at least equal to that of any American graduate.
We took an entry examination to medical school, and if we had a passing grade , we went to school. No interview, recommendation letters, shadowing, extracurricular activity or other similar BS required.
This obstacle course only weeds out the economically disadvantaged, loosing in the process some very promising candidates.Reply
It wasn’t just the insurance companies constantly beating down the fees, but the actual “grateful” patients that just didn’t pay their part on the insurance lowered fee that finally made the decision to retire an easy decision.
Reply
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I can’t say I like this blog post. I hope you consider taking it down or changing the name.
I can’t think of a better career or profession. Serving others who are in pain, worried, or need a life saving intervention is just priceless.
We are rewarded more than fairly despite costs of getting our degree.
When I saved my first live, I decided that thousands of dollars spent to be there were worth every penny for that opportunity.
Please don’t consider entering the medical field in terms of dollars… you will just end up retiring early.
Sorry PoF… but I feel encouraging FI is most important…not RE
Reply
Why would I take down the post? These are practical considerations and I don’t think the author was discouraging toward either profession.
As I said in the intro, I have no regrets for having chosen to become a physician.
At least we can agree on your last point, even if you don’t think we do. FI is indeed emphasized over the RE around here.
Best,
-PoFReply
I agree FI is more important than RE, and it may help reduce burnout.
I’m able to work part-time, which probably extended my clinical career. I know several physicians who quit clinical practice, and not because they went into it for the money.
If my children show interest in health care, I would encourage them to look at options beyond medical/dental schools. How do the cost:benefit comparisons look for the many other health care careers?
Reply
Great post- totally agree that financial reasons cannot be the primary goal for a physician to include their specialty choice.
I have been really struggling with burnout like many and have been trying to pin down the reasons. I believe it is the increasing loss of the fulfillment mentioned above that has been diminishing due to increasing time pressures and loss of autonomy. I worry about the future generations if the non monetary payoff/fulfillment they too will be seeking will be even more lost by then. If so, why would one take on the debt and many years of training to get there? A couple of my children were initially interested in medicine but have lost interest as they have been observing what I have gone through. Something has to be done to turn things around, but what? How can physicians fight the endless pressure of administrators to generate more and more RVUs to beef up the bottom line? When you look at other industries a union seems to be a possible answer, but this would be obviously problematic for medicine.
Wondering if there are any other other burned out physicians out there concerned about the same things….
Reply
I had no idea that dental school tuition was MORE than medical school!
A lot has changed since I graduated from LSU Dental in 2000.After practicing for 15 years, I do feel that someone should pursue their calling no matter the cost, unless of course it may bankrupt them.
There are so many opportunities now for someone to obtain scholarships, grants and even work part time while in school. It’s going to take work to make it work.
Reply
The mixed emotions about becoming a doctor seems to come in waves. At times, when things go your way, you feel like it was really worth it. Other times, not so much. Healthcare professionals will always be needed, but I certainly am expecting a shift in qualifications and who actually decides to become a doctor in the next decade.
Hope that there will still be qualified doctors around when I will be needed their expertise!
Reply
great post! I gave into lifestyle inflation when I first became a doc, and my wife also after years of torture through med school and training we both let loose. But then after having financial difficulty we cut back, but boy was it awesome! We thought in our 20’s because we were able to suffer and be frugal we would have the same mentality when we got older, but was not true. I wish I had realized in our 20’s that we actually we would want more money. We love our careers, but didn’t realize in our youth that our older selves would have wanted more. We are sad that we have kids but can’t afford a swimming pool, have to limit vacations, all because we don’t make enough money as doctors 🙁 First world problems, but deep down inside we thought in our 20’s that these things would easily be bought because we worked so hard.
Reply
The biggest issue in the foreseeable future for a physician is the disturbing trend of rising tuition coupled with declining reimbursem*nts.
Lowering the cost of providing medicine has been a priority by the policy makers placing physicians reimbursem*nt in the crosshairs. Every year it seems there is a threat for cuts in Medicare payments for a service (and the private insurance companies often follow suit).
Coupled with the fact that hospital administration is now focusing on mid levels to cut costs and thus lowering the need for having as many physicians on staff could make the demand for physicians (and thus income potential) much lower.
And there is always the possibility that AI finally gets to a point where some specialties could be greatly impacted (Radiology might be on the front line of this).
It is tough to say what medicine will look like in 10 or 20 years from now. But the past few years have not shown much optimism for doctors and it is no wonder burnout is raging rampant.
Reply
When I started Orthopaedic practice in 1984 hospital administrators were making $120,000 a year and I was making $750,000- 1 million a year depending on how hard I worked. Now the administrators are making $750,000 a year and the doctors are barely able to pay their overhead. What happened!
Reply
Absolutely fulfillment is such an important part of the equation. Especially if you are talking about a speciality where the residency and/or fellowship time goes up to 7-8 years. There may be an increase in average salary for the specialty but its probably only worth it if you love it. I feel very lucky to love what I do and that came about by focusing on the fulfillment that I got from it. Paying attention to the financial aspect is important though as well, which I completely failed to do until recently.
I think another important point comes when people become “forever trainees” and keep adding on fellowship after fellowship. There is a huge opportunity cost for you and your family if you have one. It’s important to consider all angles when determining if you really need another year of training versus getting out and helping patients as an attending.
Reply
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