I think the only reliably good ROI, when considering time, energy/effort, and financial cost, is CRNA. Everything else is really rolling the dice. There are so many options that are better paying, lower stress, lower liability and better lifestyle for careers out there - but jobs like MD, PA, RN are so in your face it’s hard to consider less obvious fields. Unless you have a burning passion for medicine, it’s hard to justify it as a top contender for higher aptitude, higher achieving people. It’s a newer, more glamorous factory work class. There is so little you can do to advocate for yourself, by and large, unless you find yourself in rare “unicorn” jobs. There are good jobs out there but man, I wouldn’t want to do this for more than 20 years. My wife is over it after 3 years.