Amount of hours to make 100k

[Silent Cool]

$250-300 is high paying. It's common in more rural areas in the south but is rare for the coasts.

Gotcha. That's what I figured. I've heard that large cities on the coasts like LA, etc.., typically are paying 125-150/hr.

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[Pinner Doc]

Pinner,
Is that more of the norm? I always hear about these 250-300/hr ER jobs like they are everywhere.

I can only speak for my experience. I work in Seattle. Most jobs (and I'm looking at, like, an n=5 keep in mind) seem to be about $160/hr. You can definitely make more elsewhere.

 

[Silent Cool]

I can only speak for my experience. I work in Seattle. Most jobs (and I'm looking at, like, an n=5 keep in mind) seem to be about $160/hr. You can definitely make more elsewhere.

Pinner,

Thanks a lot for the info. Would you say this is the norm for most popular metro areas (LA, SF, Portland, SD, Chicago, Boston, Houston, Miami, etc...)? Also, are you at Harborview, Swedish, or Overlake by chance?

thanx

 

[EctopicFetus]

Miami is really not good. My mom is an ER nurse there and those guys make $120/hr. Llikely there are better jobs than that but I doubt the pay gets even remotely close to what people would consider good.

 

[anbuitachi]

120$ a hr at 40 hrs a week is still 250k for the yr (52 weeks) pretax. thats not too bad. 300 a hr for 40 hrs a week for 52 weeks is 620k......... ER docs can make that much on a 40 hr shift?? what?

 

[gutonc]

120$ a hr at 40 hrs a week is still 250k for the yr (52 weeks) pretax. thats not too bad. 300 a hr for 40 hrs a week for 52 weeks is 620k......... ER docs can make that much on a 40 hr shift?? what?

1. Only people who like to go insane early in their careers work 40h/wk in the ED on a regular basis.
2. Nobody works 52 weeks a year.
3. Yes, you can make a lot of money (if you're willing to work neurosurgery hours at places nobody else wants to work) in EM. This is not news.

 

[anbuitachi]

1. Only people who like to go insane early in their careers work 40h/wk in the ED on a regular basis.
2. Nobody works 52 weeks a year.
3. Yes, you can make a lot of money (if you're willing to work neurosurgery hours at places nobody else wants to work) in EM. This is not news.

seems like if you put in neurosurgery hours .. you'll make more than a neurosurgeon

 

[Janders]

Try putting 70/hr a week (10hr shifts every day) at a busy ED with high volume enough to pay you a solid hourly rate.

Then try doing that for 6 months straight.

As gets repeated here over-and-over-and-over, its just not feasible long term. You will burn out and die and be a miserable person to work with and your patients will suffer.

You certainly COULD pull 600k via straight hourly work in the ED, and I'm sure a few people do, but I'd be VERY careful thinking I could do it for any sustainable period of time.

 

[emergentmd]

By my calculations, I work about 26 hrs a week (clinical hours), 13 shifts a month, and about 30 if you include staying back to. I work in one of the big 4 texas citys and very desirable area. I did calculations and if you include my pay + retirement, I make about 325/hr. I am a partner so my income is inflated.

Maybe I am just naive b/c I have been Texas all of my life, but why would any ER Boarded doc work for 160/hr? Who is making all of the money? The management group? As a partner, I am privileged to all of our finances and our group doesn't do anything special to inflate our collections. I just have to assume that alot of states outside of texas just has poor reimbursement and collections.


Come to texas and make atleast 250/hr.

I know ER docs in Tx that makes more than many surgical subspecialities working less hours. A Partner of mine works 40 hrs a week and pulls in over 600k but he works 18 shifts a month. That is alot of hours and something that I could not do. But its funny that in residency, I did 22 shifts/mo and they were 12 hrs on top of nonclinical work. If i worked Residency hours I could pull in over 1 mil.

 

[alpinism]

Its friggin crazy the pay differences between places like TX and CA/WA.

And that's not even taking into account the cost of living and taxes...

 

[link2swim06]

Will those numbers exist in Texas or Louisiana for the next 5-10 years?

I have a boatload of loans to pay off...

 

[The White Coat Investor]

By my calculations, I work about 26 hrs a week (clinical hours), 13 shifts a month, and about 30 if you include staying back to. I work in one of the big 4 texas citys and very desirable area. I did calculations and if you include my pay + retirement, I make about 325/hr. I am a partner so my income is inflated.

Maybe I am just naive b/c I have been Texas all of my life, but why would any ER Boarded doc work for 160/hr? Who is making all of the money? The management group? As a partner, I am privileged to all of our finances and our group doesn't do anything special to inflate our collections. I just have to assume that alot of states outside of texas just has poor reimbursement and collections.


Come to texas and make atleast 250/hr.

I know ER docs in Tx that makes more than many surgical subspecialities working less hours. A Partner of mine works 40 hrs a week and pulls in over 600k but he works 18 shifts a month. That is alot of hours and something that I could not do. But its funny that in residency, I did 22 shifts/mo and they were 12 hrs on top of nonclinical work. If i worked Residency hours I could pull in over 1 mil.

I agree. If you're getting paid $160 an hour, you're either in a terrible reimbursement area (I know someone in Northern California who as a partner was only getting like $180 an hour) or someone is simply skimming a lot of money off the top (like a CMG or the hospital employing you.) We only see 1.3 an hour in a very lifestyle focused group and still do around 50% more than that on average. You don't have to go to Texas to make $250. You just need to own the business. If I were seeing a lot more patients per hour like most emergency docs, I'd expect to make a lot more money.

 

[Pinner Doc]

Pinner,

Thanks a lot for the info. Would you say this is the norm for most popular metro areas (LA, SF, Portland, SD, Chicago, Boston, Houston, Miami, etc...)? Also, are you at Harborview, Swedish, or Overlake by chance?

thanx

I can't speak for most metro areas. When I was looking out of residency, my husband and I focused on areas that were good for his line of work. We looked at Seattle, Fort Collins and Boston. I think they were roughly comparable.

Some folks here know who I am in real life, but I'm trying to keep a low profile otherwise.... sorry to be cagey!

 

[Pinner Doc]

Maybe I am just naive b/c I have been Texas all of my life, but why would any ER Boarded doc work for 160/hr? Who is making all of the money? The management group? As a partner, I am privileged to all of our finances and our group doesn't do anything special to inflate our collections. I just have to assume that alot of states outside of texas just has poor reimbursement and collections.

Your reimbursement sounds awesome, but neither my husband nor I could ever live in Texas. Not a knock on Texas, but it's far from family and far from the skiing. Shrug. To each their own.

$160/hour is about par for my area. I've made more at an RVU-based gig based under a management group, but about that much at a group where I'm paid hourly and we're somewhat private/democratic.

 

[Janders]

I agree. If you're getting paid $160 an hour, you're either in a terrible reimbursement area (I know someone in Northern California who as a partner was only getting like $180 an hour) or someone is simply skimming a lot of money off the top (like a CMG or the hospital employing you.) We only see 1.3 an hour in a very lifestyle focused group and still do around 50% more than that on average. You don't have to go to Texas to make $250. You just need to own the business. If I were seeing a lot more patients per hour like most emergency docs, I'd expect to make a lot more money.

Even in the Boston area, you can certainly pull 200/hr, approaching 250/hr if you count retirement and CME monies. And not at inflated 1099 no benefits rates, i mean as actually salary. It helps to own the group, and have open books... As previously mentioned.

 

[Cerberus]

I agree. If you're getting paid $160 an hour, you're either in a terrible reimbursement area (I know someone in Northern California who as a partner was only getting like $180 an hour) or someone is simply skimming a lot of money off the top (like a CMG or the hospital employing you.) We only see 1.3 an hour in a very lifestyle focused group and still do around 50% more than that on average. You don't have to go to Texas to make $250. You just need to own the business. If I were seeing a lot more patients per hour like most emergency docs, I'd expect to make a lot more money.

How long is working for a private group and not the hospital or a CMG going to be an option? The coasts are going towards one or the other and the middle of the country is sure to follow. I'm not a huge fan of either but I see the writing on the wall.

 

[The White Coat Investor]

How long is working for a private group and not the hospital or a CMG going to be an option? The coasts are going towards one or the other and the middle of the country is sure to follow. I'm not a huge fan of either but I see the writing on the wall.

Wish I had an answer. I think it's a terrible trend. For me, the answer is "as long as possible." Fight tooth and nail. The solution to fighting off CMGs is to become bigger, unfortunately. Bring in anesthesia, radiology, hospitalists, intensivists, cardiologists, more emergency groups etc. You have to make yourself impossible to replace. A single CMG is going to have a hard time covering 20 EDs along with the other services all at once. That assumes you can keep the members of your group from jumping ship to the CMG.

 

[Hercules]

How long is working for a private group and not the hospital or a CMG going to be an option? The coasts are going towards one or the other and the middle of the country is sure to follow. I'm not a huge fan of either but I see the writing on the wall.

That's a great question that I wish I had the answer to as well. I'm a partner in an awesome SDG. There are 4 major hospitals in my city and in the past two years, 2 of those ED groups lost their contract to CMGs. Granted they were run questionably in a non-democratic way by non-EM physicians, but seeing CMGs move into your town is never a good thing. I think there will be a niche for SDGs for quite some time but that niche is shrinking.

 

[Birdstrike]

How long is working for a private group and not the hospital or a CMG going to be an option? The coasts are going towards one or the other and the middle of the country is sure to follow. I'm not a huge fan of either but I see the writing on the wall.

The trend away from private practice is strong, not only in EM but in primary care and even for specialists now. How far the pendulum will swing and whether and when it will swing back, nobody knows. Right now insurers pay much, much greater for the identical services in hospitals than in the outpatient setting. How cost inflating and stupid that is is another issue, but for now and as long as it lasts, it's a huge incentive for hospitals to scoop up doctor practices of all specialties. Once doctors are employed, in the cage, fully attached to the puppet strings, there's nothing to prevent the suits from treating the docs like easily replaceable, easily discardable hourly help. "Order more tests, do more surgeries, do more procedures. Run up our hospital bill!" It used to be illegal in many states for hospitals to employ physicians for the blatantly obvious reasons of conflict of interest and incentives to drive unnecessary care. No longer. The almighty dollar rules the day.

How long can even large doctor owned single- or multi specialty groups last with the cards so stacked against them? Nobody knows.

But once you are an "employee" you can be told to jump, sit, stand, bow, shake, fetch and whatever else the rest of the hourly worker pool is told to do to keep food on the table. They view your job as to primarily generate as many dollars for the hospital as humanly possible. Fail to do that and fail to get a check. Money drives the entire system now.

"Termination without cause," means "You're fired. Nice knowin' ya. Clean outcha desk. No more dinero after 90 days el hombre." Reason? None. None is needed. If fact, it's safer legally for you to be let go for "no reason," or "without cause."

 

[ER BlueBlood]

Pretty soon all the docs will be Bangalore MDs. They're taking over...Indian gunnery- you heard it here first

 

[WilcoWorld]

The trend away from private practice is strong, not only in EM but in primary care and even for specialists now. How far the pendulum will swing and whether and when it will swing back, nobody knows. Right now insurers pay much, much greater for the identical services in hospitals than in the outpatient setting. How cost inflating and stupid that is is another issue, but for now and as long as it lasts, it's a huge incentive for hospitals to scoop up doctor practices of all specialties. Once doctors are employed, in the cage, fully attached to the puppet strings, there's nothing to prevent the suits from treating the docs like easily replaceable, easily discardable hourly help. "Order more tests, do more surgeries, do more procedures. Run up our hospital bill!" It used to be illegal in many states for hospitals to employ physicians for the blatantly obvious reasons of conflict of interest and incentives to drive unnecessary care. No longer. The almighty dollar rules the day.

How long can even large doctor owned single- or multi specialty groups last with the cards so stacked against them? Nobody knows.

But once you are an "employee" you can be told to jump, sit, stand, bow, shake, fetch and whatever else the rest of the hourly worker pool is told to do to keep food on the table. They view your job as to primarily generate as many dollars for the hospital as humanly possible. Fail to do that and fail to get a check. Money drives the entire system now.

"Termination without cause," means "You're fired. Nice knowin' ya. Clean outcha desk. No more dinero after 90 days el hombre." Reason? None. None is needed. If fact, it's safer legally for you to be let go for "no reason," or "without cause."

Didn't you change your job? I'll change mine if mine becomes intolerable. The last time I looked for a job I had to tell the potential employers to be patient while I got out of my last one.

I agree that employee status has the potential to open us up to abuse. I reject that we have no choice but to accept it.

 

[golghiapparatus]

Unionize!

 

[Mbekweni]

Why is it that nurses and all the other healthcare providers can unionize but doctors can't? It's not uncommon for nurses at our county hospital to be making more on an hourly basis than the per diem EPs, and I can't help but feel like it has a lot to do with the multiple strikes? I wouldn't strike for money all that much but a good call to action to kick the butt of the insurance agencies would sure be a good move in my opinion.

 

[anbuitachi]

Why is it that nurses and all the other healthcare providers can unionize but doctors can't? It's not uncommon for nurses at our county hospital to be making more on an hourly basis than the per diem EPs, and I can't help but feel like it has a lot to do with the multiple strikes? I wouldn't strike for money all that much but a good call to action to kick the butt of the insurance agencies would sure be a good move in my opinion.

Why wouldn't you strike for more money?

 

[emergentmd]

If you are making less than the nurses/hr, then you need to get out of there. Why would you stand for that

 

[Birdstrike]

Didn't you change your job? I'll change mine if mine becomes intolerable. The last time I looked for a job I had to tell the potential employers to be patient while I got out of my last one.

I agree that employee status has the potential to open us up to abuse. I reject that we have no choice but to accept it.

Yes, I "changed jobs" but not in the way you might think.

My previous post really has more to with Medicine as a profession, than EM in particular. You're right, no one must take an employee position, as long as a private practice option still exists. Doctors of all specialties are throwing in the towel in on that, in droves.

EM long ago, gave up any real option for "private practice" when EPs made EM a specialty and killed the Subspecialty option (other than urgent cares which by definition is "Emergency" medicine and free standing EDs which are banned in many states). That eliminate any option to move in and out of EM and back and forth movement to and from a "primary" specialty. With EM as your "specialty" and only specialty, that pigeonholed all EPs into EMTALA based, hospital based and de facto employed positions, for better or for worse. (I used to think this was a good thing, but now I think it was a big mistake, but that's a different thread). Yes, I know, many EPs are in "private groups," and that does offer some additional autonomy and control. You can do your own billing, hire your partners, etc. But you can hire/fire support staff, you cannot pick and choose insurance payers, you cannot set your own rules, and truly be autonomous without doing so at the pleasure of the hospital, which may have entirely different goals.

Well, who cares? "I just want a job. To punch in, punch out, be a good doc and get a check." Well that's fine. It really is, and that's the way it is for many. But it's a whole different mindset than bing a science based clinician. You become a tool to generate money for someone else primarily (and secondarily, yourself).

Now, general surgeons, orthopedists, neurologists, spine surgeons are signing up for what are employed jobs. Right now they are being offered lots of dinero and promises of "security" to attract them like bees to honey. Yet "employed positions" for doctors have always existed. It's called "Academics" and they pay has always been less with enough bitter tasting departmental politics to make most docs say, "No thanks." This trend will only exist as long as the hospitals can use doctors to generate lots and lots of bitcoins for themselves (which hasn't always been the case). If, and as soon as that ends by whatever change in the healthcare environment may come along, these "hospital owned" doctors and their practices will be shutdown and thrown to the street as quick as they can replace your favorite cheeseburger with a gluten-free organic vegi-burger at the doctors lounge in the name of "bettering the health of the community."

Will the money always be there?

Will they always be happy jumping when they hear "jump" and having to put "customer satisfaction" before good medicine and before science?

I don't know.

Will the hospitals say, a few years down the road, "Well Doctor SoSpecial, we just can't afford to pay you "x," feed you "y," and let you have "z" weeks of vacation, because "You know, with this Obamacare thing we've really got to tighten our belts," cut your pay, have you take more call, and put the screws to docs?

I don't know. You tell me.

Or will it be a marriage made in heaven, with Press-Ganey, specialists Ego-Gods, MBAs and fast-food service-with-a-smile all living in alternative-domestic money-making bliss?

I don't know, you tell me.

 

[Apollyon]

I strongly suspect that neuroguy is checking this thread, but I predict that he is long gone, and won't respond any more. However, on the other side of the same coin, he might come back, and continue with the same spiel, and tell us we don't understand. The very distant bronze medal is the guy to come back and say either "hey, it was just a thought, and doesn't look like a good one", or "just kidding!"

Maybe we can guilt him into standing up for himself a little bit.

Or maybe not.

Two weeks later, this guy is vapor.

Called it!

 

[TooMuchResearch]

Two weeks later, this guy is vapor.

Called it!

Didn't doubt you for a second.

 

[anbuitachi]

I see people here say stuff like you can work few shifts and earn xyz amt of money. How easy is it actually for someone to just change the # of hours you work like that?? And people also mention here that most docs work <40 hrs (idk if its b/c you guys are partners or have been in field for a long time or something), but on the AAMC website, it lists average EM doc weekly hours as ~46, which is a lot more than what people are saying here. Any reasons? Perhaps theres a bias in that only the successful ppl (or ppl who choose to work less) got enough time to post on SDN? lol

and Ppl say its stressful working in ER, that's why teh low # of hours. so how long is this sustainable for? Id imagine it'll be much harder doing this when you are in your 60s.. ? What do you do then? just take fewer shifts and be forced to take a paycut?

 

[Birdstrike]

And people also mention here that most docs work <40 hrs (idk if its b/c you guys are partners or have been in field for a long time or something), but on the AAMC website, it lists average EM doc weekly hours as ~46, which is a lot more than what people are saying here. Any reasons? ?

Because there is a shortage of BC/BE EM physicians and therefore there is pressure to routinely work more than desired to fill the gaps in coverage. Also, because many people believe what they want to hear despite people like me and others keeping it real. EM shift work is used as a selling point for recruiting when in reality 46 hours every week of rotating shift work in EM is equal to 69 hour per week of any other type of work (multiply EM hours by factor of 1.5, to account for circadian rhythm, acuity and frenetic pace). You're seeing something that's there, that some others chose not to see. The sunset is much easier on the eyes than the rain.

 

[Mad Jack]

1. Only people who like to go insane early in their careers work 40h/wk in the ED on a regular basis.
2. Nobody works 52 weeks a year.
3. Yes, you can make a lot of money (if you're willing to work neurosurgery hours at places nobody else wants to work) in EM. This is not news.

I've heard some of the smaller/more rural gigs can be kind of relaxed though. Couldn't you do something like that for 40 hours a week?

 

[Mad Jack]

I see people here say stuff like you can work few shifts and earn xyz amt of money. How easy is it actually for someone to just change the # of hours you work like that?? And people also mention here that most docs work <40 hrs (idk if its b/c you guys are partners or have been in field for a long time or something), but on the AAMC website, it lists average EM doc weekly hours as ~46, which is a lot more than what people are saying here. Any reasons? Perhaps theres a bias in that only the successful ppl (or ppl who choose to work less) got enough time to post on SDN? lol

and Ppl say its stressful working in ER, that's why teh low # of hours. so how long is this sustainable for? Id imagine it'll be much harder doing this when you are in your 60s.. ? What do you do then? just take fewer shifts and be forced to take a paycut?

>asking about a field with an average burnout time of 5-8 years
>"what will I be doing in my 60s?"

 

[TooMuchResearch]

>asking about a field with an average burnout time of 5-8 years
>"what will I be doing in my 60s?"

Are you suggesting many EM docs quit 5-8 years out of residency? I find this difficult to believe. In fact, I don't believe it.

 

[Mad Jack]

Are you suggesting many EM docs quit 5-8 years out of residency? I find this difficult to believe. In fact, I don't believe it.

They don't quit, they burn out. Big difference. Multiple studies show 65% burnout rates in the field, with one showing 5 year attrition at an expected 7.5% and 10 year attrition projected at roughly 25%. Despite their lower hours, ED physicians have equal attrition to, and greater burnout levels than, most other specialties. Burnout does not bode well for longevity in the very long term.

http://www.ncbi.nlm.nih.gov/pubmed/8959173

http://www.ncbi.nlm.nih.gov/pubmed/24118838

 

[The White Coat Investor]

They don't quit, they burn out. Big difference. Multiple studies show 65% burnout rates in the field, with one showing 5 year attrition at an expected 7.5% and 10 year attrition projected at roughly 25%. Despite their lower hours, ED physicians have equal attrition to, and greater burnout levels than, most other specialties. Burnout does not bode well for longevity in the very long term.

http://www.ncbi.nlm.nih.gov/pubmed/8959173

http://www.ncbi.nlm.nih.gov/pubmed/24118838

You have to be careful assuming people leave because they're somehow burned out because the job sucks. Sometimes people leave because they become financially independent and retire (I expect to hit that mark at 18-20 years out of residency), sometimes to pursue other avenues (one doc I graduated with is now doing some clinic work in functional medicine-whether that's "burnout" or just another interest, I'm not sure), and sometimes due to disability. I'd say 7.5% at 5 years and 25% at 10 is about right. 65%? I'm not seeing it. Do they mean that 65% of emergency docs leave emergency medicine before 65? I guess I'll buy that. I might leave at 50 if I don't like it. Not sure that counts as burnout though. At any rate, that's very different from an "average burnout time of 5-8 years."

From the articles: Most studies used the Maslach Burnout Inventory to quantify burnout, allowing for cross-study (and cross-country) comparisons. Emergency medicine has burnout levels in excess of 60% compared with physicians in general (38%). Despite this, most emergency medicine physicians (>60%) are satisfied with their jobs.

If >60% are satisfied with their jobs, they're not burned out.

I mean, one of the things on that survey is "intent to leave the practice within 10 years." Well that might include every doc who's over 45! That's more than half our workforce I bet.

Burnout is real, but it isn't as extreme as some like to point out. Certainly 65% of residency graduates aren't getting out in 5-8 years.

 

[Mad Jack]

You have to be careful assuming people leave because they're somehow burned out because the job sucks. Sometimes people leave because they become financially independent and retire (I expect to hit that mark at 18-20 years out of residency), sometimes to pursue other avenues (one doc I graduated with is now doing some clinic work in functional medicine-whether that's "burnout" or just another interest, I'm not sure), and sometimes due to disability. I'd say 7.5% at 5 years and 25% at 10 is about right. 65%? I'm not seeing it. Do they mean that 65% of emergency docs leave emergency medicine before 65? I guess I'll buy that. I might leave at 50 if I don't like it. Not sure that counts as burnout though. At any rate, that's very different from an "average burnout time of 5-8 years."

The 65% is just the number experiencing burnout, not expecting to leave the field. Many of these same people also report being satisfied with their career, so it is a complex issue, surely. The going thought on why burnout is bad for career longevity is that if a career is rewarding and you enjoy going to work every day, you probably will keep on working, even if you have the money to up and leave. If you're feeling burned out and have saved well for retirement or well enough to stay a business you would enjoy more, you are more likely to leave the field.

 

[Old_Mil]

I currently easily live off of around 44k a year pretax, while contributing around 8k to my 403b and setting aside at least 3k a year for vacations. Can't see why being a physician will suddenly make living off 2-3 times as much seem impossible. Don't live in an expensive city, don't send your kid to private school, don't buy a McMansion, don't get a luxury car, and don't buy **** you don't need. If you don't buy into the myth that acquiring stuff will make you happy and don't fall victim to lifestyle inflation, you will likely be not only much wealthier but much happier overall.

Well, bless your heart.

My student loan payments are $20,000-$27,000 a year of post tax money at 6.8% for $165,000 depending on how fast I pay it off (12-15 years). By the time you actually get into medical school, get done with medical school, and get done with residency I'd plan on tacking another 1%-2% onto that, and probably another $100,000.

I live in a $180,000 house. Not exactly a McMansion. Depending on where you're living you may not even be able to get a reasonable house for that. That's another $17,000 a year for P&I, Insurance, and Property Taxes.

So I've burned up your entire $44,000 salary and I haven't even turned on the lights, put gas in the tank, or put food on my table.

Might want to learn a little more about money - unless daddy's paying your way, in which case carry on.

 

[Mad Jack]

Well, bless your heart.

My student loan payments are $20,000-$27,000 a year of post tax money at 6.8% for $165,000 depending on how fast I pay it off (12-15 years).

I live in a $180,000 house. Not exactly a McMansion. Depending on where you're living you may not even be able to get a reasonable house for that. That's another $17,000 a year for P&I, Insurance, and Property Taxes.

So I've burned up your entire $44,000 salary and I haven't even turned on the lights or put food on my table.

By the time you actually get into medical school, get done with medical school, and get done with residency I'd plan on tacking another 1%-2% onto that, and probably another $100,000.

Unless daddy's paying your way, in which case carry on.

I will finish residency with nearly 300k in student loan debt, which amounts to a payment (without IBR) of $1,975.53 a month. The average salary of an emergency medicine physician is $237,000 pre-tax, which amounts to $11,850 a month post both federal and state taxes in my current state. Though most hospitals pay malpractice and CME allowance for the ED physicians in my area, so that isn't an issue. The average resident lives off of $3,157 a month after tax at the local hospital's salary. I can easily live off of this amount (currently live off way less!). So we subtract that from our $11,850 and end up with $8,693 extra per month to either invest or save. This all assumes I get into emergency medicine, my specialty of choice, but there's plenty of specialties that can net 237k a year pre-tax.

Of course, I don't like nice things and that's not why I decided I wanted to be a physician, so for me living on little is extremely easy. I've never been a consumer, was always more of a saver. To me it isn't even "delaying gratification," it's just doing something with the money I probably wouldn't be spending anyway.

 

[Birdstrike]

Of course, I don't like nice things

You will most definitely be at risk for acquiring a taste for those naughties you refer to as "nice things." The "mediocre" and it's cousin "the crappiest" of things certainly can lose their luster after too long on the plate or palate. They most certainly have for me.

Wagyu Filet, lightly charred on the outside, warm red center with a side of fresh oysters on the half shell and sparkling water I'll take, over frozen pizza rolls out of a box and "purple drink" any day, my most modest of friends.

 

[Mad Jack]

You will most definitely be at risk for acquiring a taste for those naughties you refer to as "nice things." The "mediocre" and it's cousin "the crappiest" of things certainly can lose their luster after too long on the plate or palate. They most certainly have for me.

Wagyu Filet, lightly charred on the outside, warm red center with a side of fresh oysters on the half shell and sparkling water I'll take, over frozen pizza rolls out of a box and "purple drink" any day, my most modest of friends.

I make better food than most restaurants can prepare, and I already drink some damn fine booze on my modest budget. Good food is cheap if you can cook, and good booze isn't that great of an expense unless you're clearing a half bottle of blue label a night. Plus I'm planning on living in a fairly rural area- there's not really a whole lot of places to spend money when you live in the sticks, and having nice things is sort of pointless when there's no one around that really appreciates them.

 

[anbuitachi]

I make better food than most restaurants can prepare, and I already drink some damn fine booze on my modest budget. Good food is cheap if you can cook, and good booze isn't that great of an expense unless you're clearing a half bottle of blue label a night. Plus I'm planning on living in a fairly rural area- there's not really a whole lot of places to spend money when you live in the sticks, and having nice things is sort of pointless when there's no one around that really appreciates them.

It's absolutely possible to survive on that much, its all about preference. I got neighbors that go afterhours to supermarket dumpsters to pick up 'decent' veggies. I know ppl that never turn on the heat or AC. Some ppl are ok with driving a 1985 toyota corolla despite earning 200k. And some are ok with taking 30 years to pay off a 300k student debt. It's all about how you live. it's just that most of us dont want to live like that after going through so many years of school. but if you are like me and want to live in NYC and also own a house, you better be making a lot cause 200k buys you like a 1 bedroom studio, not even in many places

 

[Mad Jack]

It's absolutely possible to survive on that much, its all about preference. I got neighbors that go afterhours to supermarket dumpsters to pick up 'decent' veggies. I know ppl that never turn on the heat or AC. Some ppl are ok with driving a 1985 toyota corolla despite earning 200k. And some are ok with taking 30 years to pay off a 300k student debt. It's all about how you live. it's just that most of us dont want to live like that after going through so many years of school. but if you are like me and want to live in NYC and also own a house, you better be making a lot cause 200k buys you like a 1 bedroom studio, not even in many places

You don't exactly need to eat garbage or never use the heat or electric to live off 50k a year lol. The vast majority of Americans do it- and this is completely neglecting the fact that many, if not most, of us will be in dual-income households by the end of residency. If you've got two physicians, well, damn, you could be living off of over 100k AND pay down your loans in 3 years. Or even if you partner works a regular job netting 50k a year, you've still got 100k to work with, which is more than enough to live off of anywhere outside of SF, NYC, or DC.

Think about it this way: if you do a 3 year ED residency, you don't have to do a fellowship, so you've just saved yourself 3 years of additional training. Use those three years you saved to complete a "fellowship" in financial independence- pay down your debt, then live well for the rest of your life, rather than dealing with the burden and stress of six figure debt hanging over your head.

You'd really have to be a fool to opt to live in NYC by the way. The way they tax high earners is akin to robbery, the cost of living is insane, and the downgrade in lifestyle that you will suffer versus living almost anywhere else in the country is simply insane. Unless you're a native New Yorker, in which case, there's no place like home, I guess.

 

[anbuitachi]

You don't exactly need to eat garbage or never use the heat or electric to live off 50k a year lol. The vast majority of Americans do it- and this is completely neglecting the fact that many, if not most, of us will be in dual-income households by the end of residency. If you've got two physicians, well, damn, you could be living off of over 100k AND pay down your loans in 3 years. Or even if you partner works a regular job netting 50k a year, you've still got 100k to work with, which is more than enough to live off of anywhere outside of SF, NYC, or DC.

Think about it this way: if you do a 3 year ED residency, you don't have to do a fellowship, so you've just saved yourself 3 years of additional training. Use those three years you saved to complete a "fellowship" in financial independence- pay down your debt, then live well for the rest of your life, rather than dealing with the burden and stress of six figure debt hanging over your head.

You'd really have to be a fool to opt to live in NYC by the way. The way they tax high earners is akin to robbery, the cost of living is insane, and the downgrade in lifestyle that you will suffer versus living almost anywhere else in the country is simply insane. Unless you're a native New Yorker, in which case, there's no place like home, I guess.

Yea NYC sucks...

 

[gutonc]

Yea NYC sucks...

Then why are you so obsessed with staying there, regardless of specialty?

 

[anbuitachi]

Then why are you so obsessed with staying there, regardless of specialty?

Currently there for med school but plan on moving to another state possibly or residency. In NYC most of my life b/c parents here and they are my only family members which is important to me

 

[EMhopeful69]

What can I do during residency to make myself attractive to the more desirable shops? I already know that chiefs tend to get better jobs, but is there anything else? If it helps I want to practice somewhere in California (will probably end up being close to wherever I do residency)

 

[Old_Mil]

I will finish residency with nearly 300k in student loan debt, which amounts to a payment (without IBR) of $1,975.53 a month.

Your numbers are incorrect. Your monthly student loan payment is going to be almost $2000 a month higher than you anticipate for $300k of debt at 8% in a non IBR repayment.

http://www.finaid.org/calculators/loanpayments.phtml







Monthly Loan Payment: $3,639.83

 

[TooMuchResearch]

Your numbers are incorrect. Your monthly student loan payment is going to be almost $2000 a month higher than you anticipate for $300k of debt at 8% in a non IBR repayment.

http://www.finaid.org/calculators/loanpayments.phtml







Monthly Loan Payment: $3,639.83

Yeah, the $2k/month figure looks closer to correct for a 30 year repayment term. *steps away to run calculator* I get $1955/month on a 30 year term at 6.8%. Would not recommend extended repayment terms.

 

[deleted109597]

What can I do during residency to make myself attractive to the more desirable shops? I already know that chiefs tend to get better jobs, but is there anything else? If it helps I want to practice somewhere in California (will probably end up being close to wherever I do residency)

Chiefs don't necessarily tend to get better jobs. It helps with academics, and certain places, but chief is a lot like high school class president at other shops.
To get competitive jobs you have to to know somebody. Real competitive jobs aren't going to to take a new grad. They don't have to.
You don't have to practice near where you did residency. I'm 1400 miles from mine.

 

[Birdstrike]

What can I do during residency to make myself attractive to the more desirable shops? I already know that chiefs tend to get better jobs, but is there anything else? If it helps I want to practice somewhere in California (will probably end up being close to wherever I do residency)

There's zero mystery at this point of training. Do the same exact thing you've done up to this point, to succeed. Work hard, get good test scores, get good letters of recommendation, interview well, work well with others. Where's the mystery? The only thing a little more specific to being a private practice attending in EM is have it shown somewhere you see lots of patients and that patients like you (grinding out volume in private practice and keeping complaints low and pat sat scores high for your director.)


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