Thinking about dropping out of medical school now....

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I won't be happy with anything less than $200k, MAYBE I could settle for $150k.

And the way I see it, by the time I'm through with residency, regardless of what field I go into (not interested in surgery) that I will be making less than $150k thanks to our glorious presidente. I'm over halfway done but at this point I think it makes the most sense for me to go ahead and quit.

notsureifsrs?

Originally Posted by auburnO5

I won't be happy with anything less than $200k, MAYBE I could settle for $150k.

And the way I see it, by the time I'm through with residency, regardless of what field I go into (not interested in surgery) that I will be making less than $150k thanks to our glorious presidente. I'm over halfway done but at this point I think it makes the most sense for me to go ahead and quit.

Well, at least you can know you're providing a valuable service to society.

Originally Posted by auburnO5

at this point I think it makes the most sense for me to go ahead and quit.

I would if I were you.

Dang ol Obamer. He's ruinin' health care, he's fixin to take 'er jerbs and he's a gonna take 'er guns! I ain't havin' it! Git Obamer outta office!

Originally Posted by MrBeauregard

I would if I were you.

I will.

How anyone could accurately predict how physician salaries are going to change due to pending legislation is beyond me. All of the 'sky is falling' people are really starting to annoy me.

If anything Obamacare is good for physician salaries, especially if you're not in the upper echelons of medicine. For the marginally competent and even incompetent it buys a little more time in the sun, and protection via the monopoly. If all you care about is money, and not patients or the welfare of your fellow man, you should be 100% for Obamacare. It favors the monopolist and the corporatist, and we are all monopolists and corporatists now, eh Comrades!?

Some salaries will go down, some salaries will go up. Bottom line, we need more PCPs now and they need to be compensated better, we need to stop spending SOOOOOO much money on specialists it's as easy as that. For what one dermatologist makes we could pay 3 happy family practice physicians...you see how this isn't quite sustainable? And yes, the dermatologist will still make much more than a pcp even in the future. And I know, people will say "well dermatologist's had to be at the top of their class yadayadayada" I understand that, and they do deserve more compensation but at some point it just gets ridiculous and disturbing

1300 posts and an incoming ban for trolling. Eck!

On a side note, PCP's in Canada make about 300k.

Originally Posted by auburnO5

I won't be happy with anything less than $200k, MAYBE I could settle for $150k.

And the way I see it, by the time I'm through with residency, regardless of what field I go into (not interested in surgery) that I will be making less than $150k thanks to our glorious presidente. I'm over halfway done but at this point I think it makes the most sense for me to go ahead and quit.

pic.jpg

Originally Posted by fahimaz7

1300 posts and an incoming ban for trolling. Eck!

On a side note, PCP's in Canada make about 300k.

Is this in pesos? That number is inaccurate...

Doctor salaries should go up, not down, with the ACA. For sure, PCPs are going to be reimbursed better starting 2014. On top of that, nearly every patient now should have some sort of insurance, meaning that the total number of reimbursements are going to be higher. With a higher workload, hospitals will need to offer better compensation for physicians in order to keep them on since we won't have a corresponding increase in physicians for quite some time while the number of patients is going increase fairly drastically in 2014.

Originally Posted by Marcus Brody

If anything Obamacare is good for physician salaries, especially if you're not in the upper echelons of medicine. For the marginally competent and even incompetent it buys a little more time in the sun, and protection via the monopoly. If all you care about is money, and not patients or the welfare of your fellow man, you should be 100% for Obamacare. It favors the monopolist and the corporatist, and we are all monopolists and corporatists now, eh Comrades!?

Give it a rest.

And OP, didn't you get 260+ on Step 1? Plastics/derm ftw.

Originally Posted by notbobtrustme

Doctor salaries should go up, not down, with the ACA. For sure, PCPs are going to be reimbursed better starting 2014. On top of that, nearly every patient now should have some sort of insurance, meaning that the total number of reimbursements are going to be higher. With a higher workload, hospitals will need to offer better compensation for physicians in order to keep them on since we won't have a corresponding increase in physicians for quite some time while the number of patients is going increase fairly drastically in 2014.

I challenge you think of alternatives to this hypothesis. There is no way anyone knows what will happen to physician salaries.

Originally Posted by auburnO5

I won't be happy with anything less than $200k, MAYBE I could settle for $150k.

And the way I see it, by the time I'm through with residency, regardless of what field I go into (not interested in surgery) that I will be making less than $150k thanks to our glorious presidente. I'm over halfway done but at this point I think it makes the most sense for me to go ahead and quit.

And not a single tear is shed. At this point in your training, you're still pretty much worthless to the entire field.

I'm surprised and disappointed by the rationality of the responses to the OP. I came here expecting better.

See ya............no sweat off my back

Originally Posted by circulus vitios

Dang ol Obamer. He's ruinin' health care, he's fixin to take 'er jerbs and he's a gonna take 'er guns! I ain't havin' it! Git Obamer outta office!

They tuk 'er jobs! Tuk 'er jubs!

Originally Posted by SpecterGT260

Is this in pesos? That number is inaccurate...

That's what the dean of Alberta's medical school told us a few weeks ago. He was our dean before now.

Originally Posted by fahimaz7

1300 posts and an incoming ban for trolling. Eck!

On a side note, PCP's in Canada make about 300k.

Pretty sure it's closer to 200k in Canadian dollars (read: bacon) in some provinces, which makes it like 190k in real money. Pretty far from 300k.

Originally Posted by dr zaius

Pretty sure it's closer to 200k in Canadian dollars (read: bacon) in some provinces, which makes it like 190k in real money. Pretty far from 300k.

And don't forget Canada's income taxes are higher so its more like $100k after taxes.

Originally Posted by auburnO5

I won't be happy with anything less than $200k, MAYBE I could settle for $150k.

And the way I see it, by the time I'm through with residency, regardless of what field I go into (not interested in surgery) that I will be making less than $150k thanks to our glorious presidente. I'm over halfway done but at this point I think it makes the most sense for me to go ahead and quit.

Moment of silence guys.... The profession just lost a shooting star....

Originally Posted by auburnO5

I won't be happy with anything less than $200k, MAYBE I could settle for $150k.

And the way I see it, by the time I'm through with residency, regardless of what field I go into (not interested in surgery) that I will be making less than $150k thanks to our glorious presidente. I'm over halfway done but at this point I think it makes the most sense for me to go ahead and quit.

Dude, give it a rest -- as one of your classmates, you sound like an ass. I understand needing to vent (I post plenty of questionable things on SDN), but you're not even attempting to be constructive. Salaries, especially at the top end, are likely to go down. That said, the odds are very against salaries dropping to the levels you claim. In general, the ACA should expand coverage while (likely) decreasing reimbursements, so while there will undoubtedly be some net decrease (realistically), it's not as bad as all that.

In general, I'd say if you really don't like medicine / if it's not something you're passionate about, it might be worth talking to friends/family/etc about dropping out. It's a hell of a lot of work and hours (even post-residency, for the most part) for something you don't really love. If you'd really like a good job and steady income, I think there are much easier ways. That said, that's a decision only you can make.

Originally Posted by Slack3r

Give it a rest.

And OP, didn't you get 260+ on Step 1? Plastics/derm ftw.

I'll let the OP answer that, but that doesn't jive with the school rumor mill -- but whether SDN or the school rumor mill is a more reliable source is anyone's guess.

Originally Posted by dr zaius

Pretty sure it's closer to 200k in Canadian dollars (read: bacon) in some provinces, which makes it like 190k in real money. Pretty far from 300k.

I was looking at jobs in my own field in Manitoba last year, and the starting salary was $293K Canadian. For someone fresh out of fellowship that's a solid 93K over what you will find in the US (private), and about 133K (academic).

In most of the provinces primary care does better in Canada than the US. There are drawbacks, to be sure, but it's not a bad deal.

Originally Posted by Shnurek

And don't forget Canada's income taxes are higher so its more like $100k after taxes.

Pics or it didn't happen.

There has been no comment or information on how much salaries will be expected to be affected?

Originally Posted by notbobtrustme

On top of that, nearly every patient now should have some sort of insurance, meaning that the total number of reimbursements are going to be higher. .

A majority of the newly insured will have Medicaid

Lulz.... All around

Originally Posted by auburnO5

I won't be happy with anything less than $200k, MAYBE I could settle for $150k.

And the way I see it, by the time I'm through with residency, regardless of what field I go into (not interested in surgery) that I will be making less than $150k thanks to our glorious presidente. I'm over halfway done but at this point I think it makes the most sense for me to go ahead and quit.

Don't let the door hit you on the way out.

Originally Posted by Gut Shot

I was looking at jobs in my own field in Manitoba last year, and the starting salary was $293K Canadian. For someone fresh out of fellowship that's a solid 93K over what you will find in the US (private), and about 133K (academic).

In most of the provinces primary care does better in Canada than the US. There are drawbacks, to be sure, but it's not a bad deal.

Absolutely. $190k for family practice is also an example of excellent pay.

Canada is just pretty sweet in general.

Originally Posted by dr zaius

Absolutely. $190k for family practice is also an example of excellent pay.

Canada is just pretty sweet in general.

It's bizarro world up there. Family med pays well and General & Orthopaedic surgeons can't find jobs. A poster on the surgery forum said the market is so bad in Canada that some surgery residents are switching into IM & family med.

Originally Posted by Gut Shot

Pics or it didn't happen.

Canada:
0–29% (federal)
4-24% (provincial)
4.95% Canada Pension Plan (CPP)
1.78% Employment Insurance (EI)

So at $190,000 you would be at the highest tax brackets.

There is really no one answer because it depends if you are single or not, what province you live in, what city you live in, etc. etc. but I just threw out $100,000 as a very rough estimate. It might be more like $110,000 though.

Originally Posted by Shnurek

Canada:
0–29% (federal)
4-24% (provincial)
4.95% Canada Pension Plan (CPP)
1.78% Employment Insurance (EI)

So at $190,000 you would be at the highest tax brackets.

There is really no one answer because it depends if you are single or not, what province you live in, what city you live in, etc. etc. but I just threw out $100,000 as a very rough estimate. It might be more like $110,000 though.

You are making my brain hurt as usual.

http://en.wikipedia.org/wiki/Progressive_tax

Remember just because the highest marginal rate has a value of X%, that doesn't mean all your money is taxed at X%.

http://en.wikipedia.org/wiki/List_of...centage_of_GDP

Tax as a % GDP 2012

Canada: 32.2%
USA: 26.9%

It's not really that big of a difference when you figure in all the extra benefits you get from your taxes in Canada, like health insurance (potentially 10's of thousands of money saved) and lower education costs (if you have kids/affects how much loan money you have to borrow).

BUT IT GETS MORE INTERESTING.

http://www.outsidethebeltway.com/taxes_per_person/

If you look at the average tax burden per person:

Canada: $12,789
USA: $13,097

Only a $308 difference.

BTW the guy proposing we look at tax comparisons this way is Professor Gregory Mankiw, a staunch conservative republican economist and chair of economics at Harvard.

Finally people histrionic about physician salaries are hilarious. There are no physicians in my family making under 500k/yr. Granted, they are not the rule, but no physicians I know are wallowing in poverty.

Salaries might come down slightly for specialists, but really it'll be fine. More insured patients = more $$$ no matter how you slice and dice it.

OP, please quit medicine. If your analytical skills are this weak when it comes to economics I'd hate to see you try and parse the medical literature.

Originally Posted by Whiskeypunch

You are making my brain hurt as usual.

I know how progressive taxes work and I never stated its not progressive but its good to show others. Now you really didn't calculate a figure.

Originally Posted by Shnurek

I know how progressive taxes work and I never stated its not progressive but its good to show others. Now you really didn't calculate a figure.

http://lsminsurance.ca/calculators/canada/income-tax

Have fun. That's without ANY deductions other than the basic personal tax credit. 190k would be 116-132k in take home pay before you factor in all the deductions that will significantly lower your tax burden.

That took 5 seconds of playing with google to find.

Originally Posted by fahimaz7

That's what the dean of Alberta's medical school told us a few weeks ago. He was our dean before now.

If you look at any of the bazillions of comparison charts covering physician salaries (usually in the articles claiming doctors are paid too much) you typically see the US sitting as a high outlier and canadia lumped towards the middle. Do a Google search. Its also a little strange for your dean of medicine to bring up PCP salary in front of the class but whatever. I doubt he has any sources on the matter that Google doesn't have

Originally Posted by Whiskeypunch

You are making my brain hurt as usual.

http://en.wikipedia.org/wiki/Progressive_tax

Remember just because the highest marginal rate has a value of X%, that doesn't mean all your money is taxed at X%.

http://en.wikipedia.org/wiki/List_of...centage_of_GDP

Tax as a % GDP 2012

Canada: 32.2%
USA: 26.9%

It's not really that big of a difference when you figure in all the extra benefits you get from your taxes in Canada, like health insurance (potentially 10's of thousands of money saved) and lower education costs (if you have kids/affects how much loan money you have to borrow).

BUT IT GETS MORE INTERESTING.

http://www.outsidethebeltway.com/taxes_per_person/

If you look at the average tax burden per person:

Canada: $12,789
USA: $13,097

Only a $308 difference.

BTW the guy proposing we look at tax comparisons this way is Professor Gregory Mankiw, a staunch conservative republican economist and chair of economics at Harvard.

Finally people histrionic about physician salaries are hilarious. There are no physicians in my family making under 500k/yr. Granted, they are not the rule, but no physicians I know are wallowing in poverty.

Salaries might come down slightly for specialists, but really it'll be fine. More insured patients = more $$$ no matter how you slice and dice it.

OP, please quit medicine. If your analytical skills are this weak when it comes to economics I'd hate to see you try and parse the medical literature.

lol, why are pre-DO students posting the allopathic forum now?

Originally Posted by JackShephard MD

lol, why are pre-DO students posting the allopathic forum now?

Because I'll be your boss some day I want to get to know you.

Originally Posted by Whiskeypunch

Because I'll be your boss some day I want to get to know you.

Dumb.

Originally Posted by auburnO5

I won't be happy with anything less than $200k, MAYBE I could settle for $150k.

And the way I see it, by the time I'm through with residency, regardless of what field I go into (not interested in surgery) that I will be making less than $150k thanks to our glorious presidente. I'm over halfway done but at this point I think it makes the most sense for me to go ahead and quit.

Do you like medicine? If so, don't quit. There are more options than just the US - US MDs are highly valued in many countries. In general docs make good money the world over, and besides what are your options at this point? Start college again to get a degree in economics?

If it's really about the money, medicine is your best bet. Assuming you're innovative enough to make it in business/finance/banking etc., you will figure out a way to make money in medicine. E.g. concierge practice.

Originally Posted by Shnurek

Canada:
0–29% (federal)
4-24% (provincial)
4.95% Canada Pension Plan (CPP)
1.78% Employment Insurance (EI)

So at $190,000 you would be at the highest tax brackets.

There is really no one answer because it depends if you are single or not, what province you live in, what city you live in, etc. etc. but I just threw out $100,000 as a very rough estimate. It might be more like $110,000 though.

You would be in the highest brackets, but those are still marginal rates. 190K gives and individual about 180K in taxable income, which works out to an effective federal rate of 21%.

Also consider that you don't have to pay health insurance premiums. It's expensive, to be sure, but I don't think it's quite as bad as you originally made it out to be.

Originally Posted by Whiskeypunch

http://lsminsurance.ca/calculators/canada/income-tax

Have fun. That's without ANY deductions other than the basic personal tax credit. 190k would be 116-132k in take home pay before you factor in all the deductions that will significantly lower your tax burden.

That took 5 seconds of playing with google to find.

That link does not include the 4.95% CPP and 1.78% EI but yes I also used that link. I just didn't post it because it wasn't sufficient enough.

So 4.95% + 1.78% = 6.73% and 6.73% of $190,000 is $12,787.

Therefore.... your final take home pay will be $116,000 - $12,787 = $103,213 in the worst case scenario. Hmmm that seems awfully like my original figure of $100,000 but thanks for your pompous tone.

Originally Posted by Dave89

Do you like medicine? If so, don't quit. There are more options than just the US - US MDs are highly valued in many countries. In general docs make good money the world over, and besides what are your options at this point? Start college again to get a degree in economics?

If it's really about the money, medicine is your best bet. Assuming you're innovative enough to make it in business/finance/banking etc., you will figure out a way to make money in medicine. E.g. concierge practice.

I don't think he truly wants to quit, just frustrated.

The thing we should all be infuriated about is that health care reform did not address tort reform or frivalous medical malpractice suits- perhaps this is due to the lobbying efforts of the American Trial Lawyers Association.

Originally Posted by nowanmd

The thing we should all be infuriated about is that health care reform did not address tort reform or frivalous medical malpractice suits- perhaps this is due to the lobbying efforts of the American Trial Lawyers Association.

Well tort reform is a moral issue - it doesn't save much money in terms of healthcare.


I support tort reform because it's the right thing to do.

Originally Posted by nowanmd

The thing we should all be infuriated about is that health care reform did not address tort reform or frivalous medical malpractice suits- perhaps this is due to the lobbying efforts of the American Trial Lawyers Association.

Hard to pass tort reform when lawyers are the most represented profession in Congress (I think - I may be wrong).

Originally Posted by Lokhtar

Well tort reform is a moral issue - it doesn't save much money in terms of healthcare.

This is debatable, though. The policy wonks say it won't lead to significant savings but this guy and a handful of EM physicians I've spoken with estimate that >50% of the tests they order are defensive medicine. The truth is probably somewhere in-between, but I'd bet that the wonks are underestimating.

I wouldn't worry. We're getting 30 mln + new paying customers, are facing an aging population with a lot of docs retiring, and students have an average debt load close to $200k. I only see physician salaries going up.

Really hoping that the massive influx of newly insured patients as part of the ACA will accelerate the push for greater funding/expansion of residency positions. On the flip side, I can easily imagine this huge increase in patients will cause a new push for greater autonomy by mid-level providers like NP's and PA's. Unfortunately, I'm guessing the latter option is more likely.