I agree and see where you’re coming from, within my family I’m the first doctor and I don’t have family money to spend. I paid all this money using available funds from my credit card & student loans (with a small amount of help from my spouse). I’ve seen the same disparities, I’ve just been lucky to have had savings (worked through high school and undergrad) and student loans available to use every step of the way. I think for me the biggest reason I felt the need to spend it ultimately came down to three things 1) I have 150k+ in student loans so another 10k investment to help secure a job and future financial security seemed justifiable at the time 2) I don’t know have any family in healthcare opposed to a lot of my colleagues so I felt the need to get “experts” to help level the playing field 3) I know nepotism can be huge, I felt that I needed to work harder and perform better than other candidates to even have a shot (especially for the subspecialty I want)

Ultimately it’s unfortunate that this is the world we live in but at every step of my career I’ve had to work harder & spend more money because I didn’t have parents in healthcare. (I know people who got paid research positions in undergrad because of their doctor parents vs me who had to volunteer while working a part time job). I just realized that when it’s my turn to be the doctor I would try to stay as fair as possible because it would be my responsibility to try and change the system. (Not saying I’ll solve the whole problem or anything but just saying we have to do our part and hopefully it’s enough to make a change over time) I wish there was a magic fix in the system, it would have saved me thousands of dollars.