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How to Choose A Medical Specialty: A Pharmacist Perspective

You may be wondering, “why is this guy talking to me about choosing a specialty right

now? All I want to do is know how to get into medical school.” I completely understand where you are coming from, however it's also imperative to recognize that every medical specialty isn't ideal for a transitioning pharmacist. I also realize that you will have plenty of time throughout medical school to soul-search and find your true passion. I am only introducing this concept because having a general idea upfront can help motivate you throughout the application cycle. Additionally, having a set specialty can help you navigate difficult questions you may receive throughout the interview season. For instance, “I loved pharmacy school, and it helped me identify that I am extremely passionate about pursuing a career in anesthesiology.”

Medical Specialty

Another facet pharmacy graduates need to consider when choosing a specialty in medicine is the opportunity cost of lost income as a pharmacist. In other words, you need to factor in your lost pharmacy income to better match your future attending physician salary. I am not saying you should select your career based solely on the highest paying position, but it certainly needs to be part of the discussion.

A pharmacy graduate is starting medical school sometimes 2-4 years later than most matriculants. That’s 2-4 years of attending income you will never see, unless you plan on making up for it by working until you are 70. Pharmacy graduates have high debt burdens (approximately $160,000 upon graduation), and a higher paying specialty will help remove some of the financial pressure you may face. Lastly, the opportunity cost of attending medical school is much higher for pharmacy graduates than it is for traditional biology graduates.

According to the Bureau of Labor Statistics the median pharmacist pay in 2020 was $128,720. In comparison, graduates with a bachelor’s degree only made $48,400 on average. Based on these crude numbers you can extrapolate the forgone income based on your time in medical school and the time you spend completing residency training. Factoring in your future specialties income it will take a pharmacy graduate far longer to overcome the lost income than it will for a biology graduate. Therefore, pharmacy graduates should consider higher paying specialties to offset this financial imbalance.


Pharmacist Opportunity Cost For Medical School (Excluding Residency Training Years):

$128,720 x 4 years of Medical School = $514,880

Biology Major Opportunity Cost For Attending Medical School Instead of Working:

$48,400 x 4 years of Medical School = $193,600


Example 1: Family Physician

This is not to say you should avoid family medicine, but it will take you far longer to recover financially. For instance, the 2020 Medscape Family Medicine Physician Compensation Report found that the average compensation was $234,000 a year. When you decide to pursue your medical education, you are throwing away any potential pharmacy income. I shouldn't say all income is forgone, since you technically can work as a pharmacist during school. However the income generated is inconsequential in the model we are discussing.

Factoring in 4 years of medical school and 2 years of residency training you will have forgone 6 years of pharmacy income. That amounts to a total of $772,320 in lost income by going to medical school to become a family physician.

The average medical school debt is $215,900. Add this to your pre-existing pharmacy debt (~$163,496) and we are sitting at negative $379,396. I have included the pharmacy loans to this equation because most pharmacy students will not have the opportunity to start paying them down due to our education extension.

Now adding this all together (Realized Loan Debt, and Opportunity Cost of Lost High Paying Income) and the cost of going to medical school after pharmacy school is a whopping negative $1,151,716. That’s over a million dollars that a pharmacy student is behind and that’s just for the shortest residency training period. Review the chart below to emphasize how important choosing a specialty really is.

Keep in mind that Family Physician's on average make $234,000 annually.

Choosing a Medical Specialty

Example 2: Orthopedic Surgeon

Now let us use a higher paying specialty to see how the growth compares. The average income for an orthopedic surgeon is $498,080 a year. They must receive at least 5 years of residency training which extends the pharmacy income opportunity cost to a whopping deficit of $1,666,596.

Choosing a Medical Specialty


Are you still with me? Good, then check out the chart below to calculate the opportunity cost you may experience based on your specialty of Interest. This is meant to serve as a rough estimate so please do not solely base your decisions on this article.

When looking at the chart, add your anticipated cost of medical school tuition and current pharmacy school debt for an even more accurate prediction. Making more money leads to faster loan repayment but also remember that life isn’t just about money. I only hope that you take the opportunity cost a pharmacist experiences into consideration when making your decision.

Keep in mind that you will also generate income as a Medical Resident. This feature has been excluded from the models due to wide variation in pay based on region, years of experience, and choice of specialty.

Choosing a Medical Specialty

At this point you are probably wondering if I am even an advocate for pharmacy students going into medicine? Believe me when I say this, but going to Medical School was the best decision I ever made! Even when factoring the financials and extra years of schooling I have no regrets. Do not let the numbers discourage you! I want you to make sure you have an appreciation for the financials that are all to important to ignore. In the end you will need to Follow your passion, and if that means starting over with medicine, then jump in with both feet!


• Choose a medical specialty that you are passionate about.

• If you enjoy two different specialties equally, choose the one that pays more.

• Be aware of the pharmacy income opportunity costs and understand that these downside costs impact pharmacists more because of their forgone six-figure income


For more information consider signing up for a Membership with The Physician Pharmacist for complete access to our comprehensive guide. Additionally, check out "Pharm.D. to M.D." on Amazon.

Thank you for the support!

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