The following is a guest post by an MD/MBA who wishes to remain anonymous:
Historically, there has been a cohort of MD/MBA graduates who have planned to go right into the business world (and skip internship and residency completely). Some may spend 1-2 years working in business and may actually "return" to clinical medicine and complete a residency, but those are the exceptions. Others may start residency and drop out before finishing. These days, with the explosion of digital health and other entrepreneurial opportunities surrounding medical school graduates, the temptation to skip residency is probably greater than ever for those with an MD/MBA (and even for those who don't have an MBA).
When MD/MBA graduates seek advice about residency, they seem to get polarizing feedback: Some will strongly urge them to skip residency and get a jump start on their promising career in business. Others will insist that they will not gain the first-hand experience and knowledge of being a physician in a clinical environment. I believe they are both right (in some ways), so the decision must be tailored for each graduate. When an MD/MBA graduate asks me, "should I skip residency?" I always respond, "It depends." Do I sound like a lawyer or what?
There are medical students who have started their own companies and achieved business success before graduating. There are stories of students who were accepted into medical school, but deferred admission to pursue some ventures and found a successful path in business (never to go to medical school). There are medical school dropouts who have become successful business people. Are these examples the exception or the rule? If you happen to be someone with extreme talent, would you know if you're the exception or the rule? If you look in the mirror and see the next Steve Jobs or Mark Zuckerberg, then you're either delusional or extremely talented. Maybe you're both.
Residency can be hard. Grueling. Some people come out of residency feeling like they have been abused or hazed. Times have certainly gotten better with work hour limitations, but we still hear stories of physician residents committing suicide or experiencing major mental health problems.
If you're pursuing an MD/MBA and have no intention of practicing medicine, be sure to speak with a handful of other MD/MBAs who are in the business world. Advice may follow certain trends (geographic, generational, philosophical, etc.) and may vary based on the risk-tolerance of the individual offering the advice. Traditionally, most physicians tend to be quite risk-averse. But, the MD/MBA who has an entrepreneurial spirit (and who also has no student loans and happens to be married to an extremely wealthy spouse) may be quite willing to take major risks.
Skipping residency isn't simply about calculating risks. It's also about having a plan and a series of backup plans (along with supportive family who'll be there if none of your plans work out). Skipping residency is also about managing your perspective about time. You may never plan to practice medicine, but do you want to limit yourself from having the option to practice medicine someday?
So, instead of spending countless hours in an intellectual wrestling match to calculate whether you should pursue a residency, just go for it (and if you get to be that miserable, then just quit!)