When you work out, stress on the muscle activates chemical pathways that increase the rate of synthesis, so now the net effect is to build muscle tissue. The muscle damage ('tearing') you mention is one signal for synthesis, but there are many more (metabolic, hormonal, dietary, etc)....
Although tuition varies greatly by year and has significantly increased over the last decade, medical school averages $34,592 per year and $138,368 per degree for in-state students at public schools and upwards of $50,000 per year or well over $200,000 for private institutions as of 2017.
Medical Degree. According to the Association of American Medical Colleges, the average cost for a first-year medical student at a public school in 2011-2012 was $28,947 a year for residents and $51,278 a year for non-residents.hile not yet at the level a psychiatrist can expect when licensed, the starting salaries for 2012 were $58,032 a year in San Mateo County, California, and $50,283 a year at UCLA; the University of Pennsylvania's School of Medicine pays $50,087 a year to start.