Family Med - salaries, sign-ons, loan payoffs, bonuses, etc

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It seems that many of us are interested in family med and primary care and would do it regardless of the pay scale. However, after reading this thread:

http://forums.studentdoctor.net/showthread.php?t=814385

...I became aware that some are making as much as $200k with loan payoffs, sign-on bonuses and more. I'm an older first year student who's considered the military route and loan forgiveness programs and also so-called "direct primary care" models. I'm looking forward to practicing medicine, but it would be nice to have a centralized thread for talking about who's making what and where. I'm interested in finding out which loan forgiveness programs are best and how to maximize my income as a primary care physician (without being a specialist outside primary care).

I've done a good deal of research on my own, but would love to hear from those with more experience and knowledge than myself.

Originally Posted by SpesMeaInDeoEst

It seems that many of us are interested in family med and primary care and would do it regardless of the pay scale. However, after reading this thread:

http://forums.studentdoctor.net/showthread.php?t=814385

...I became aware that some are making as much as $200k with loan payoffs, sign-on bonuses and more. I'm an older first year student who's considered the military route and loan forgiveness programs and also so-called "direct primary care" models. I'm looking forward to practicing medicine, but it would be nice to have a centralized thread for talking about who's making what and where. I'm interested in finding out which loan forgiveness programs are best and how to maximize my income as a primary care physician (without being a specialist outside primary care).

I've done a good deal of research on my own, but would love to hear from those with more experience and knowledge than myself.

Taking income is like picking your nose or fartin in the elevator. Everyone does it, but no one really talks about it.

As for the military route, this is pretty tough from what I hear. Ain't no such thing as a free lunch. But I do love the smell of napalm in the morning.

Originally Posted by ghost dog

Taking income is like picking your nose or fartin in the elevator. Everyone does it, but no one really talks about it.

As for the military route, this is pretty tough from what I hear. Ain't no such thing as a free lunch. But I do love the smell of napalm in the morning.

I wouldn't presume to ask others what they're making; I simply was looking for replies like the ones in the thread I linked (i.e. - info on what offers others had seen in ads or what they'd personally witnessed others being offered). Seemed like several were discussing it in that thread just fine. Thought it would be nice to have a thread dedicated to the question.

I've since steered away from military options. I was just listing it for sake of noting what I'd considered and researched.

Originally Posted by SpesMeaInDeoEst

It seems that many of us are interested in family med and primary care and would do it regardless of the pay scale. However, after reading this thread:

http://forums.studentdoctor.net/showthread.php?t=814385

...I became aware that some are making as much as $200k with loan payoffs, sign-on bonuses and more. I'm an older first year student who's considered the military route and loan forgiveness programs and also so-called "direct primary care" models. I'm looking forward to practicing medicine, but it would be nice to have a centralized thread for talking about who's making what and where. I'm interested in finding out which loan forgiveness programs are best and how to maximize my income as a primary care physician (without being a specialist outside primary care).

I've done a good deal of research on my own, but would love to hear from those with more experience and knowledge than myself.

Inquiring about potential income is a practical thing, and I commend you for it. Life after education is practical, and income plays a big part. While it is true most family medicine positions with large practices and hospitals pay a certain amount, private practitioners do tend to make a little more, but get swamped (and sometimes overwhelmed) by insurance company issues, the business of medicine, and government intervention. Direct Primary Care (DPC) physicians generate substantially more income - the concierge doctors cater to the well-heeled, but true DPC physicians lower the cost of care across the board. The family doctors at MedLion in California, for instance, can earn incomes close to, if not more, than a specialist surgeon's.

This is my own personal experience being on the job hunting front for the last 3 years. and what I have been offered salary wise.

Sign on bonus usually runs 10-15K pre tax
Moving allowance up to 10K

Denver: 140-160K
Rural Colorado 160-190K depending on location
Iowa 200+K
West Texas 220K
Central Texas 190K
Montana 180-200K
Northern Idaho 250-300K
Central Nevada 250+K
Oregon 140-180 depending on location
Southern WA 190K

These are base salaries that were offered as part of the job package. It doesn't include bonus or RVU, etc.

I applied for student loan help in MT - was denied by state
I applied for student loan help in CO (3 separate programs) -was denied by all three
In Colorado my employer had it in my contract would pay my monthly student loan payment - did not see any money for this. Was able to settle out of court for breach of contract.
In Oregon I was awarded the rural tax credit. No student loan help here
I applied NHSC right out of residency, waited 18 months and was eventually declined due to lack of funding in 2010


I have never seen a penny for student loan repayment help but I will tell you as family practice I don't have any problem making my payments as long as I make sure my base salary is 180K

Hope that helps.

I can tell you for certain, that my friend, who is a general hospitalist in Mpls/St. Paul area is making 220 (Salary) PLUS sign-on bonuses and some loan repayment (not sure how much loan repayment)... She works 7-11s and then has 7 off and still gets her ~4wks vacation... I have no fear about going into primary care. My mentor makes ~190-200 (his pay is incentivized) and is in a clinic... He has call like once every 2 weeks...

Everyone here is making a very good assumption but this is the link to medscape. It will give you hard data about how much each kind of physician makes. You are to copy and paste this link or click it. Look below for it. Carefully look through it wisely and read everything. The details are important.

http://www.medscape.com/features/sli...ensation/2011/

This is a great idea! I'm a 3rd year student considering going into FM and while salary isn't the most important factor, it is at least nice to not be going blind into a specialty for the rest of your life when there are so many other options out there.

I have heard that 140-160 is a decent starting range for physicians in the Southeast US, but that the 3-5 yr salary is a much more important indicator of what earning potential will be like. Can anyone comment on how physician pay changes over the first few years of practice as your patient base grows? Is it closer to a typical 2-4% increase, or more like 10+% increase for the first few years?

Thank you to those of you who take the time to offer up information from your personal experience.

Originally Posted by cabinbuilder

Sign on bonus usually runs 10-15K pre tax
Moving allowance up to 10K

Denver: 140-160K
Rural Colorado 160-190K depending on location
Iowa 200+K
West Texas 220K
Central Texas 190K
Montana 180-200K
Northern Idaho 250-300K
Central Nevada 250+K
Oregon 140-180 depending on location
Southern WA 190K

These are base salaries that were offered as part of the job package. It doesn't include bonus or RVU, etc.

In general, I agree with the above. I looked primarily in the midwest and found that in larger cities (ie- Chicago) numbers started in the $140k-160k range. As you move away from the bigger cities, salaries go up. In Wisconsin I found base salaries in the $165k-$185k range (again not counting bonus + productivity).

Other important things to look for when looking at numbers is 1) hours worked, 2) malpractice insurance coverage and cost, 3) weeks vacation, 4) possibility of making shareholder and how that affects income, 5) call / inpatient / outpatient / nursing home / etc coverage, 6) retirement account info. For the job I signed, I won't make shareholder but my salary for the hours/week is great and my occurrence-based malpractice insurance is completely covered (state employee). Also came with a nice signing bonus + retention bonus x 4 years on top of salary / productivity.

Another thing to remember is there ARE high salaries out there but it's not necessarily just a clinic job. You make more in a rural setting when you are at a small hospital and are the hospitalist as well as the clinic doc. Those places pay a lot but you are also on call a lot more and have more responsibility. You really have to look at what type of job is important to you.

I personally like the inpatient/clinic/and covering ER because I like to do it all myself and I am so sick of not having hospital priviliges in a lot of places I work and have to beg the hospitalist to direct admit someone for me. Just last week I had an infusion center pharmacist call me and chew me because he felt that IV vanco wasn't warranted in a patient he had never seen nor had ever viewed the chart notes. I was forced to go a different route and send the patient to the next town because she was afraid of being admitted to the local hospital since is fearful of being killed there. Lovin' the reality of rural medicine. Ugh.

Originally Posted by cabinbuilder

West Texas 220K
Central Texas 190K

Not surprised by the West Texas figure- but I am surprised that Central Texas remains on the higher end of the salaries you found- my understanding was it was becoming a more desirable practice location.


Where'd you work out in Texas again?


~Smiley

Since I'm sure all the attendings here have a crystal ball...
My husband and I would really like to be in a small town in a particular state. However, still shocked by the outcome of last year's match, we're wondering just how much of a write your own ticket family medicine is, and what it will be like in 2014 when I become BC/BE. Can you still live practically anywhere and find a job, or will it based upon what offers are available?

Originally Posted by rachmoninov3

Since I'm sure all the attendings here have a crystal ball...
My husband and I would really like to be in a small town in a particular state. However, still shocked by the outcome of last year's match, we're wondering just how much of a write your own ticket family medicine is, and what it will be like in 2014 when I become BC/BE. Can you still live practically anywhere and find a job, or will it based upon what offers are available?

Not an attending yet, but it feels like job offers from pretty much every state have come in. I don't know what it will be like in 2014, but I wouldn't anticipate you having a lot of trouble finding a job in the area that you want to be in, unless you really have to be specifically in a particular town in that state.

Originally Posted by AFSmiley

Not surprised by the West Texas figure- but I am surprised that Central Texas remains on the higher end of the salaries you found- my understanding was it was becoming a more desirable practice location.


Where'd you work out in Texas again?


~Smiley

Job offer Alpine
Job offer Glenrose
Locums Colorado City
Locums Livingston
Residency: Corpus Christi

Adding my 2cents:

This is my wife's experience being on the job hunting front for the last 3 years. Including what she has been offered salary wise.

Sign on bonus usually runs 10K pre-tax
Moving allowance up to 10K

Lancaster, PA: 137K, Hospital Employed
Dover, De 137K, Hospital Employed

Virginia:
Winchester 120K ,FQHC, w/ 140K NHSC student loan repayment(you can apply but no guarantee)
Harrisonburg 155K, Hospital Employed
Staunton 160K, Hospital Employed, 40K student loan
Fairfax, 120K, Partnership.

North Carolina:
Charlotte, 160K, Hospital Employed.

South Carolina:
Fort Mill, 160K, Hospital Employed.

These are base salaries that were offered as part of the job package. It doesn't include bonus or RVU, etc.

Originally Posted by newby02

Adding my 2cents:

This is my wife's experience being on the job hunting front for the last 3 years. Including what she has been offered salary wise.

Sign on bonus usually runs 10K pre-tax
Moving allowance up to 10K

Lancaster, PA: 137K, Hospital Employed
Dover, De 137K, Hospital Employed

Virginia:
Winchester 120K ,FQHC, w/ 140K NHSC student loan repayment(you can apply but no guarantee)
Harrisonburg 155K, Hospital Employed
Staunton 160K, Hospital Employed, 40K student loan
Fairfax, 120K, Partnership.

North Carolina:
Charlotte, 160K, Hospital Employed.

South Carolina:
Fort Mill, 160K, Hospital Employed.

These are base salaries that were offered as part of the job package. It doesn't include bonus or RVU, etc.

Yikes, how do you pay the bills with salaries that low? I cannot imagine.

Originally Posted by black star

Everyone here is making a very good assumption but this is the link to medscape. It will give you hard data about how much each kind of physician makes. You are to copy and paste this link or click it. Look below for it. Carefully look through it wisely and read everything. The details are important.

http://www.medscape.com/features/sli...ensation/2011/

NO assumption here. The numbers I gave are my reality. Hard data doesn't mean crap in the real world. Just like all those "evidence based medicine"folks who constantly quote journal articles but have no clue about what it really means to take care of a live patient. You have to be fluid in your decision making. My contracts are my hard data.

Originally Posted by cabinbuilder

Yikes, how do you pay the bills with salaries that low? I cannot imagine.

Sounds low even for a NP

Originally Posted by rachmoninov3

Since I'm sure all the attendings here have a crystal ball...
My husband and I would really like to be in a small town in a particular state. However, still shocked by the outcome of last year's match, we're wondering just how much of a write your own ticket family medicine is, and what it will be like in 2014 when I become BC/BE. Can you still live practically anywhere and find a job, or will it based upon what offers are available?

From my experience (with my job search + talking to recruiters at the AAFP Scientific Assembly Meeting this year), primary care is still and will likely continue to be sought after for the foreseeable future. Salaries vary, sure, but if your primary goal is to live in a certain town you should still be able to find a job to allow that.

If people are having trouble paying bills with a six-figure salary perhaps those people need a more realistic lifestyle.

By the way, everyone realizes that the salary they report is always the take-home salary before taxes, and after all overhead and expenses are paid, right?

When someone offers to hire you for, say, $150k, that means that you will be taking home a salary of $150k at the end of the year. You do not have to pay off malpractice, staff, overhead, etc. off of that salary.

As a family doc, I'm expected to make about $350,000+ in revenue, and after you deduct malpractice, staff salaries, overhead, then I will be taking home a salary in the range of $150,000-190,000 depending on productivity.

I get that people should be able to live on a 150k salary, but when you have 300k in debt @ 7%, that is 21k in annual debt service not including principal paydown.

So maybe you have to pay 25k annually to pay down debt, well, you need to make 45k to have 25k after tax.

so you are really making 105k, again not bad, but for the schooling and training, that isnt great either.

Cabinbuilder - can you talk more about your denial of loan repayment programs? What was the HPSA score in your area(s)? What was the reason that you think you were denied?

Any other bits of information that you can provide would be helpful.

I've got an idea. Why don't you that are making these way low salaries negotiate better contracts? I wouldn't sign anything under 250 bonus and salary.

Originally Posted by OneLeven

Cabinbuilder - can you talk more about your denial of loan repayment programs? What was the HPSA score in your area(s)? What was the reason that you think you were denied?

Any other bits of information that you can provide would be helpful.

I applied to NHSC when I knew I was moving to Montana. I can't find that actual HPSA score for the area but I think it was around 15. I waited 18 months for a decision before being denied and was told that the federal government was out of funds for the program. NICE!!! I never applied again. Don't have much faith there. I applied to the MT state program and never heard back before I left the state.

In Colorado, there are 3 separate state programs for rural practictioners. I applied to all three, I was not awarded and money for the time I was there.

In Oregon, I was awarded the rural tax credit, you can claim $5000 tax credit for your area. You have to submit the paperwork and the state government decides how much you qualify since Oregon has a state income tax that really gouges your pay.

As far a federal help, I have not received any. I don't ever expect too. I just make sure my minimum salary is 180K or above so I know I will have a cushion each month.

Besides CabinBuilder has anyone received any loan forgiveness or loan repayment help? With the shortages of primary care in some areas it would seem the red carpet would be rolled out, as it were, with regard to paying off an applicants loans.

Originally Posted by OneLeven

I get that people should be able to live on a 150k salary, but when you have 300k in debt @ 7%, that is 21k in annual debt service not including principal paydown.

A 300k debt after medical school/residency is not typical. I know it happens, and it stinks, but it's far from the norm. To make an umbrella statement that "you can't live on 150k" based on the fact that a minority of people have high student loan debt is not accurate (and that's what many people do on SDN).

Most employers with provide loan repayment assistance for family docs up to a certain max (usually 50-60k). My employer originally did not, and when I stated I would like loan repayment assistance they added it to my contract right away without any negotiation. It's almost a given that in order to attract family docs you have to offer some sort of loan assistance.

As far as loan repayments go, with a loan of $300,000, I did some rough calculations. It seems like one can live pretty nice, as long as they stay within a reasonable lifestyle, with about $5,000 a month. My math may be a little off so please pardon any miscalculations.

I figure that if someone were to take home, after taxes and fees/overhead, $120,000 a year they would bring home about $10,000 a month.

$120,000 yr / 12 mo = $10,000 mo

If half of that was put into paying back a $300,000 dollar debt that would be $5,000 a month being put into the payoff and leave $5,000 a month to live off of. Most survive pretty good with less than that, and this is just your income alone. The lone would be paid off in about 5 years.

$300,000 loan / $5,000 = 60 mo ~ I figure that would be 60 months

60 mo / 12 mo = 5 yrs ~ I figure that would be 5 years.

Not sure about anyone else but $5,000 a month would pay all my bills with money to spare.

For $150,000 yr take home. that would be:

$150,000 / 12 mo = $12,500 mo take home.

Live off of $5,000 and put the rest into the loan ($7,500 towards lone monthly)

$300,000 loan / $7,500 = 40 mo

40mo / 12 = 3.33 (figure about 3.5 years to pay off loan)

For $150,000 yr take home. that would be:

$150,000 / 12 mo = $12,500 mo take home.

Live off of $5,000 and put the rest into the loan ($7,500 towards lone monthly)

$300,000 loan / $7,500 = 40 mo

40mo / 12 = 3.33 (figure about 3.5 years to pay off loan)

Gosh, I'm not sure what part of the country you live in but 150K a year after taxes are taken out does not give you 12.5K a month take home. At 180K/yr after taxes only gives me 9,500/mo take home. My monthly bills average 7,000 (that included my student loan payment). That only gives me 1-2K/mo extra. I have been out for 3 years and I am no where near paying off my grad loans, let alone my under grad loans. If I was single, maybe I could do it, but with a family of 4, I travel so my husband stays home the math just doesn't work.

Originally Posted by cabinbuilder

For $150,000 yr take home. that would be:

$150,000 / 12 mo = $12,500 mo take home.

Live off of $5,000 and put the rest into the loan ($7,500 towards lone monthly)

$300,000 loan / $7,500 = 40 mo

40mo / 12 = 3.33 (figure about 3.5 years to pay off loan)

Gosh, I'm not sure what part of the country you live in but 150K a year after taxes are taken out does not give you 12.5K a month take home. At 180K/yr after taxes only gives me 9,500/mo take home. My monthly bills average 7,000 (that included my student loan payment). That only gives me 1-2K/mo extra. I have been out for 3 years and I am no where near paying off my grad loans, let alone my under grad loans. If I was single, maybe I could do it, but with a family of 4, I travel so my husband stays home the math just doesn't work.

Like I said, that was a rough calculation. Plug the numbers in on a calculator and that is what comes out (ie. rough calculation). besides I stated "I figure that if someone were to take home, after taxes and fees/overhead" using $120,000 and $150,000 take home as my examples.

I also have a family of 4 and my bills are not as much as yours are, I am sure everything is dependent on where someone lives and lifestyle. I'm in the Central East Coast area, cost of living is different here than say NY, CA, and even most parts of South FL where I grew up.

Plus, I am keeping in mind that what might not work for one does not mean it won't work for everyone.

Originally Posted by MedPsy82

As far as loan repayments go, with a loan of $300,000, I did some rough calculations. It seems like one can live pretty nice, as long as they stay within a reasonable lifestyle, with about $5,000 a month. My math may be a little off so please pardon any miscalculations.

I figure that if someone were to take home, after taxes and fees/overhead, $120,000 a year they would bring home about $10,000 a month.

$120,000 yr / 12 mo = $10,000 mo

If half of that was put into paying back a $300,000 dollar debt that would be $5,000 a month being put into the payoff and leave $5,000 a month to live off of. Most survive pretty good with less than that, and this is just your income alone. The lone would be paid off in about 5 years.

$300,000 loan / $5,000 = 60 mo ~ I figure that would be 60 months

60 mo / 12 mo = 5 yrs ~ I figure that would be 5 years.

Not sure about anyone else but $5,000 a month would pay all my bills with money to spare.

For $150,000 yr take home. that would be:

$150,000 / 12 mo = $12,500 mo take home.

Live off of $5,000 and put the rest into the loan ($7,500 towards lone monthly)

$300,000 loan / $7,500 = 40 mo

40mo / 12 = 3.33 (figure about 3.5 years to pay off loan)

I understand the meaning of your post, but as a 1st year student this is why primary care is typically a hard sell. Without any loan repayment or other options there isn't any way that I am going to sacrifice the next 7-8 years to "get by" on 5k a month...I could have forgone medical school and made more, with these numbers I would essentially start saving for retirement in my late 30's, not be able to afford a home or save for kids college etc.

Yes 300k is atypical, but I go to one of the cheapest DO schools in the country and will still have 220-250. If I had gone to my state MD school I would have been over 215-220, which is about average for medical students now.

Originally Posted by preDoGuy24

I understand the meaning of your post, but as a 1st year student this is why primary care is typically a hard sell. Without any loan repayment or other options there isn't any way that I am going to sacrifice the next 7-8 years to "get by" on 5k a month...I could have forgone medical school and made more, with these numbers I would essentially start saving for retirement in my late 30's, not be able to afford a home or save for kids college etc.

Yes 300k is atypical, but I go to one of the cheapest DO schools in the country and will still have 220-250. If I had gone to my state MD school I would have been over 215-220, which is about average for medical students now.

Which is understandable.

The whole point was to somewhat show that it is possible. It might not be easy for some, but still possible. There are a lot of factors that go into it and some are better able to do it than other, but it is not impossible and you can still have a decent lifestyle without living frugal.

According to some internet calculators take home pay for 150K is about 9K per month. 180K is 12500 per month. My loans will be low because I went to a state MD school...about 1500 to 2000/month if I can't get it repaid by my employer/government. That is still 7K per month. So don't buy a home greater than 240K, don't buy a new car--a new used car perhaps...but it's all very doable. You just have to be smart. Don't go thinking you can live like all the TV doctors.

Originally Posted by rachmoninov3

According to some internet calculators take home pay for 150K is about 9K per month. 180K is 12500 per month. My loans will be low because I went to a state MD school...about 1500 to 2000/month if I can't get it repaid by my employer/government. That is still 7K per month. So don't buy a home greater than 240K, don't buy a new car--a new used car perhaps...but it's all very doable. You just have to be smart. Don't go thinking you can live like all the TV doctors.

Man are you residents really in for a wake up call. My last 3 jobs were minimum pay of 180K and I AM TELLING YOU after taxes my take home was 9,800. You guys are TOTALLY delusional if you think you take home will be 12,500. It won't after taxes, retirement, and health insurance. Forget some theoretical internet calculator, I TOTALLY WISH. That's why I went back to locums. Tired of getting shafted every month by "the corporation". Real world can suck. I did better on resident's pay.

I am privy to information that says some rural docs (NE KS mind you) will make about 180 or so base...(85-95/hr) with quarterly bonuses.


It apparently is not uncommon to have a quarterly bonus of 30-40K. One recently got a quarterly nearing 80K.

I could deal with that.

Originally Posted by cabinbuilder

Man are you residents really in for a wake up call. My last 3 jobs were minimum pay of 180K and I AM TELLING YOU after taxes my take home was 9,800. You guys are TOTALLY delusional if you think you take home will be 12,500. It won't after taxes, retirement, and health insurance. Forget some theoretical internet calculator, I TOTALLY WISH. That's why I went back to locums. Tired of getting shafted every month by "the corporation". Real world can suck. I did better on resident's pay.

Having the least experience here, I have nothing to argue against your experience. However, I have survived on roughly 50K/year (before taxes) while paying tuition, and now in residency. During that time I have had a mortgage on a house, sold a house, and bought a house. I would wager that making 5K more a month would definately be better, even if it goes to loans and retirement, I would still have some left over. Then again, I could be completely wrong.

Would you please explain your rant against the "corporation" and how you did better on a resident's pay? I presume you take home more than $2600/month.

Well, during residency my student loans were in deferment so that was 2000/month I didn't have to pay. I moolighted "a lot" so my income to debt ratio was very nice. However, once I got out there and you get over 6 figures I was surprised as to how much were taken out for taxes and all those "extras". I, too, bought a house in residency and still have that house. My loan is "under water" so that house will never be able to be sold due to the area. That is ok, but that means I now have the equivalent of three house payments: student loans, house loan, and the house I live in now. My personal debt was outrageous due to divorce, kids, moving, life, etc. So I have worked hard to pay that off first.

Sorry, about the "corporation" rant. I have quit three jobs in the last 3 years due to the inability to be anyone's slave even though I thought I was being careful with job choices, lawyer going over contracts, etc. Been in some really nasty situations and it seems the worse the situation, they find a way to take the biggest chunk out of your bonus, each paycheck, etc. Just did my taxes and it seems they took more than I took home. Pretty close.

So my take home message is that just because the numbers will jump once you get out of residency, the taxes do too and you take home less than you think you will. I make a great income but I am certainly is not where I expected to be at this point, three years later.

I worked for the man doing locums my first year out of residency. My hourly rate was 60-90 dollars per hour, depending on location, call, etc. I'm now in my third year of private practice. It's difficult. I put in a ton of hours. I admit my own inpatients, see about 25 patients a day in the office, do lots of procedures, and approximately 6 shifts in the ED a month. I don't want to do this forever, but I've allready paid off all of my student loans and my home with a good bit left over in my retirement account. My pre tax income is over 300K, and I did not pay over half in taxes.

Just goes to show that everybody's situation is different as are priorities. It's a huge difference getting out of residency at 30 vs 40. Lot's more life baggage and debt to pay down besides the student loans. I finally can see the light but it's probably going to take me another 5 years before I feel like I'm on the plus side and have my loans paid off. Plus I have kids in high school and try to maximize how to pay for their college. Mine will just have to wait for a while and that's ok by me.

Medpsy82 - you are forgetting interest. And - to take home 120k - you need to make ~200k, possibly more.

Does anyone else have any experience using NHSC for loan repayment after residency? Their websites and the job posting make it sound "readily available", but from what cabinbuilder is saying that does not seem to be the case.

Can anyone else shed some light on this from their experience?

Never said it was perfect, just a rough calculation.

The end results will of course vary among individuals and is dependent on how much the debt one actually has, which will change the amount of interest. Either way the examples provided show that it is possible, and the amount one earns can vary on location, so it is hard to come up with an example that would work for everyone. Plus, some are bound to have more debt and higher expenses than others.

Originally Posted by newby02

Adding my 2cents:

This is my wife's experience being on the job hunting front for the last 3 years. Including what she has been offered salary wise.

Sign on bonus usually runs 10K pre-tax
Moving allowance up to 10K

Lancaster, PA: 137K, Hospital Employed
Dover, De 137K, Hospital Employed

Virginia:
Winchester 120K ,FQHC, w/ 140K NHSC student loan repayment(you can apply but no guarantee)
Harrisonburg 155K, Hospital Employed
Staunton 160K, Hospital Employed, 40K student loan
Fairfax, 120K, Partnership.

North Carolina:
Charlotte, 160K, Hospital Employed.

South Carolina:
Fort Mill, 160K, Hospital Employed.

These are base salaries that were offered as part of the job package. It doesn't include bonus or RVU, etc.

120k in Winchester? Wow... I'm pretty sure you can do better as a plumber. Not that these numbers are terribly low compared with the general public, but when you have other specialties pulling 3x as much, it's hard to swallow.

http://www.bls.gov/oes/current/oes291063.htm

http://www.bls.gov/oes/current/oes291062.htm

I would be pretty sad if people's salaries in these areas are that low, probably why those positions are unfilled, unless the area has an incredibly low cost of living.

Originally Posted by OneLeven

Medpsy82 - you are forgetting interest. And - to take home 120k - you need to make ~200k, possibly more.

Does anyone else have any experience using NHSC for loan repayment after residency? Their websites and the job posting make it sound "readily available", but from what cabinbuilder is saying that does not seem to be the case.

Can anyone else shed some light on this from their experience?

You really shouldn't be paying 40% of your income in taxes even with the most unfavorable tax profile:

http://whitecoatinvestor.com/doctors...come-in-taxes/

Originally Posted by bronx43

120k in Winchester? Wow... I'm pretty sure you can do better as a plumber. Not that these numbers are terribly low compared with the general public, but when you have other specialties pulling 3x as much, it's hard to swallow.

A lot of these salaries look to be for someone fairly fresh out of residency, which is one thing to consider. Even in the other specialties, you're probably not going to be pulling down $400K your first year out of residency/fellowship.

The $120K listed is for a FQHC (= no money), which is a slightly different beast, as well. Some FQHCs are very well run, with a good CEO with good business sense. Others are not. As an example, at the NHSC job recruitment fair last summer, I met a recruiter who told me that they had had FOUR healthcare providers (Physicians/PAs) quit over the past year. She said that she was "pretty sure" that the problem had been fixed, though.

I'm ok with making a bit less, in exchange for more job flexibility, location flexibility, and a shorter residency. Throw in having the NHSC pay my med school costs, and it's not a bad deal at all.

depends what else is being sucked out of your income.

state income tax
social security
federal taxes
401k?
medicare
your portion of health insurance?

it adds up.

Originally Posted by OneLeven

depends what else is being sucked out of your income.

state income tax
social security
federal taxes
401k?
medicare
your portion of health insurance?

it adds up.

Yeah even all those things added up shouldn't be 40% of your paycheck. Even if you're single, rent, contribute little to a 401k, and have no kids your tax burden should be closer to 30%. If you're married, have kids, own a home, and max out your 401k your effective tax rate should be much closer to 20% or lower on 180k.

[QUOTE=SnakeOil;12186151]Yeah even all those things added up shouldn't be 40% of your paycheck. Even if you're single, rent, contribute little to a 401k, and have no kids your tax burden should be closer to 30%. If you're married, have kids, own a home, and max out your 401k your effective tax rate should be much closer to 20% or lower on 180k.[/QUOTE]

Man I wish, my tax rate this year comes out to 34.5% and I have a husband, 2 kids, own a home and have a 401K on 180K base. The $$ aren't stretching for me. Will see what my tax return comes out to be and how much I will still have to pay this year

Tax Bracket Married Filing Jointly for 2011
10% Bracket $0 – $17,000
15% Bracket $17,001 – $69,000
25% Bracket $69,001 – $139,350
28% Bracket $139,351 – $212,300
33% Bracket $212,301 – $379,150
35% Bracket Over $379,150

that bracket is just federal tax - does not include state, medicare, social security, etc.

[QUOTE=cabinbuilder;12186362]

Originally Posted by SnakeOil

Yeah even all those things added up shouldn't be 40% of your paycheck. Even if you're single, rent, contribute little to a 401k, and have no kids your tax burden should be closer to 30%. If you're married, have kids, own a home, and max out your 401k your effective tax rate should be much closer to 20% or lower on 180k.[/QUOTE]

Man I wish, my tax rate this year comes out to 34.5% and I have a husband, 2 kids, own a home and have a 401K on 180K base. The $$ aren't stretching for me. Will see what my tax return comes out to be and how much I will still have to pay this year

Tax Bracket Married Filing Jointly for 2011
10% Bracket $0 – $17,000
15% Bracket $17,001 – $69,000
25% Bracket $69,001 – $139,350
28% Bracket $139,351 – $212,300
33% Bracket $212,301 – $379,150
35% Bracket Over $379,150

Just keep in mind what you posted above are marginal tax rates, not effective tax rates. If you're married and filing a joint return with 2 dependents your effective federal tax rate with a base salary of $180k should be in the neighborhood of 17% with the standard deduction. Assuming a payroll tax of roughly 4% and state income tax of 10% your effective tax rate shouldn't be more than 31% and that's assuming you contribute zero to a 401k, make no mortgage interest payments, make no student loan interest payments, etc.

Assuming you max out your 401k and deduct interest on mortgage and student loans I don't see why your effective tax rate wouldn't be closer to 25% unless I'm missing something here.

Well, I'm just crossing my fingers and awaiting what my accountant has to tell me this year.