do yoy put your head on the sand with regards to the cost of getting the MD ?

[lucin]

it is afterall quite $$$$$$$

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[Lost in Translation]

Thankfully my family's financial situation is good enough to support me through applications and interviews but I've told them to let me be on my own once I've gotten an acceptance.

 

[Law2Doc]

You will earn a salary adequate to service the debt over time. So if it's what you really want to do you just look at it as a longterm investment in yourself, with an enjoyable career being looked at as a big portion of the return on investment. If you are looking at it as $ in, $ out, you probably won't like it and that investment, used differently, would make you happier in other ways.

I know a potential career changer who decided against medicine, stuck to his old career and used his first years tuition money to buy a Porsche instead and couldn't be happier. So it's kind of a question of whether this is really what you want to be doing. Medicine needs to be your Porsche for this to make any sense.

 

[SOMBound13]

It's a low enough risk that banks and the feds are lending huge amounts, even tho we can't currently show income to support.

 

[Lucca]

You will earn a salary adequate to service the debt over time. So if it's what you really want to do you just look at it as a longterm investment in yourself, with an enjoyable career being looked at as a big portion of the return on investment. If you are looking at it as $ in, $ out, you probably won't like it and that investment, used differently, would make you happier in other ways.

I know a potential career changer who decided against medicine, stuck to his old career and used his first years tuition money to buy a Porsche instead and couldn't be happier. So it's kind of a question of whether this is really what you want to be doing. Medicine needs to be your Porsche for this to make any sense.

But like used Boxster or 911 GT3 with ceramic breaks?

 

[Law2Doc]

It's a low enough risk that banks and the feds are lending huge amounts, even tho we can't currently show income to support.

Right.. Because they've never made poor investments before...

 

[rilte4]

I know a potential career changer who decided against medicine, stuck to his old career and used his first years tuition money to buy a Porsche instead and couldn't be happier. So it's kind of a question of whether this is really what you want to be doing. Medicine needs to be your Porsche for this to make any sense.

I'm going in with blind faith that medicine, itself, will turn out to be my Porsche. I fully expect the first year of med school to be a Ford Pinto, though.

 

[SOMBound13]

It's a low enough risk that banks and the feds are lending huge amounts, even tho we can't currently show income to support.

Right.. Because they've never made poor investments before...

If lending to med students was a rather new thing and/or that the debt was dischargeable in bankruptcy, then I'd agree with you. But banks have been lending to med students for decades and school loans aren't dischargeable.

 

[Law2Doc]

If lending to med students was a rather new thing and/or that the debt was dischargeable in bankruptcy, then I'd agree with you. But banks have been lending to med students for decades and school loans aren't dischargeable.

A nondischargeseable debt is only a good investment if the debtor has assets. Students don't so it's a gamble on their ability to pay. Law students continued to get hefty student loans well after the law market tanked. There's quite a lot of uncollected student debt out there. So don't assume these bankers are always a good metric for what's a sound investment.

 

[SOMBound13]

Law students continued to get hefty student loans

I was aware that law students have still been able to get large fed loans, but have they still been able to easily get large bank loans (Discover, Wells Fargo, etc)?

 

[Law2Doc]

I was aware that law students have still been able to get large fed loans, but have they still been able to easily get large bank loans (Discover, Wells Fargo, etc)?

Last I heard (which was admittedly a while back, but well after things went south), yes.

 

[Planes2Doc]

Yes but it's also quite a bit of money to work a job with far lower earnings. I was making around $50k at my previous corporate job. This is the norm for people who go into finance from top schools but can't break into higher-paying Wall Street jobs. Even if you end up doing a primary care specialty like Family Medicine, you will still make over six figures. I met too many people in the business world who were close to retirement and still not breaking five figures. This is much worse than the tuition you'll pay. Think of it as an investment, and it's overall much better than something like law school or a lower tier business school.

 

[Conforth]

its just part of the process.. it sucks but there is no way around it

 

[Satire5Texul]

Yes.

 

[Law2Doc]

Yes but it's also quite a bit of money to work a job with far lower earnings. I was making around $50k at my previous corporate job. This is the norm for people who go into finance from top schools but can't break into higher-paying Wall Street jobs. Even if you end up doing a primary care specialty like Family Medicine, you will still make over six figures. I met too many people in the business world who were close to retirement and still not breaking five figures. This is much worse than the tuition you'll pay. Think of it as an investment, and it's overall much better than something like law school or a lower tier business school.

First, there are plenty of people in law and business who make six digits much earlier. A point made by the author Dr. Gawande, which I think is accurate, is that if people put the same kind of effort people must put into premed/med school/residency into another professional field, they tend to be well above average and so any comparisons to "average" or " lower tier" in those fields are flawed. Along this same reasoning $50k is not "the norm" for people who put the same effort into their studies and job as people going into medicine. It is certainly not an uncommon salary for people who are not of the med school study/work ethic Gawande was talking about, but a low salary for the type A workaholic. So that's kind of an apples oranges comparison.

Second, you have to bear in mind that a doctor won't earn six digits for 7-15 years after college (10 is a good round number to use). So the "time value of money" looms large. You basically have to apply a heavy discount rate to your doctors salary to see what they earn in "today's" dollars. The point is $100 earned today is worth a LOT more than $100 earned a decade from now. That's where a lot of premeds get suckered by the numbers. Many of us career changers will be very very late in our careers if at all before what we earn in medicine overtakes what we could have amassed staying put. I can tell you from experience, lots of Adcoms on the interview trail are going to stress this point to you if you are coming from a well paid profession. So the money really needs to be secondary. It needs to be worth it as a career enjoyment move or it's not worth it.

 

[ConfusedChemist]

Yep. But I also put my head in the sand to the fact that MDs make >100K per year, because its just too much to think about for one person. So I feel like it balances-I'll have a lot of debt (family has no money to speak of), but I will make at least 3times the income my entire family grew up with, so I can't see it being an issue

 

[Law2Doc]

Yep. But I also put my head in the sand to the fact that MDs make >100K per year, because its just too much to think about for one person. So I feel like it balances-I'll have a lot of debt (family has no money to speak of), but I will make at least 3times the income my entire family grew up with, so I can't see it being an issue

1. It's never as much as it sounds like from the outside looking in.
2.If you hate what you are doing, a nice income is often just the handcuff keeping you from having a happier life.
3. If you dread that alarm clock going off each morning, a few extra bucks in the bank isn't going to make the 70+ hours you spend working each week more fun or palatable. It won't get back all the time with friends and family, all the events and holidays and weekends you will miss.
4. Medicine is not for everybody. It's a not so fine line between people who love it versus those who are truly miserable, and salary has no bearing on this.
5. You aren't going to find a job more emotionally charged, where you are regularly dealing with death and disease and people at their lowest and saddest points in life. The stakes are high and your errors (everybody has some) may be life impacting. To a big extent the money is hazard pay for what you are asked to shoulder.

 

[Goro]

Moderators, please sticky!!

1. It's never as much as it sounds like from the outside looking in.
2.If you hate what you are doing, a nice income is often just the handcuff keeping you from having a happier life.
3. If you dread that alarm clock going off each morning, a few extra bucks in the bank isn't going to make the 70+ hours you spend working each week more fun or palatable. It won't get back all the time with friends and family, all the events and holidays and weekends you will miss.
4. Medicine is not for everybody. It's a not so fine line between people who love it versus those who are truly miserable, and salary has no bearing on this.
5. You aren't going to find a job more emotionally charged, where you are regularly dealing with death and disease and people at their lowest and saddest points in life. The stakes are high and your errors (everybody has some) may be life impacting. To a big extent the money is hazard pay for what you are asked to shoulder.

 

[ConfusedChemist]

1. It's never as much as it sounds like from the outside looking in.
2.If you hate what you are doing, a nice income is often just the handcuff keeping you from having a happier life.
3. If you dread that alarm clock going off each morning, a few extra bucks in the bank isn't going to make the 70+ hours you spend working each week more fun or palatable. It won't get back all the time with friends and family, all the events and holidays and weekends you will miss.
4. Medicine is not for everybody. It's a not so fine line between people who love it versus those who are truly miserable, and salary has no bearing on this.
5. You aren't going to find a job more emotionally charged, where you are regularly dealing with death and disease and people at their lowest and saddest points in life. The stakes are high and your errors (everybody has some) may be life impacting. To a big extent the money is hazard pay for what you are asked to shoulder.

I get this....but why on earth is this related to my post?? I fully agree with all those things....I literally said I don't give a crap about making money, I don't even know how much doctors make, but I'm assuming it's enough to pay off the massive loans I'll have because my family lives on social assisantance.
I get your point, but please don't direct this at me. I have struggled immensely because of growing up on a family income below the poverty line, trying to pay for school, the MCAT, etc, myself (Canada....no FAP program to help with application costs).

I worked 6-2am every night during high school being yelled at as a telemarketer at 16. Please don't preach to me about how you need to love what you do rather than make money. I know this all too well. I would be a doctor for 50K a year. Because thats more than 4 of us lived off and it was ok in the end.

I think you post was great, but misdirected.

 

[SOMBound13]

4. Medicine is not for everybody. It's a not so fine line between people who love it versus those who are truly miserable, and salary has no bearing on this.

Very true. I feel badly for those whose parents have essentially forced them to become doctors. If I didn't love medicine, I would be miserable. I have a sibling who is much smarter than I am. (He would have been a 40+ MCAT, I'm sure of it.) However, if he had gone this route, he would have been truly miserable.

Some people think: smart = become a doctor.

 

[Law2Doc]

I get this....but why on earth is this related to my post?? I fully agree with all those things....I literally said I don't give a crap about making money, I don't even know how much doctors make, but I'm assuming it's enough to pay off the massive loans I'll have because my family lives on social assisantance.
I get your point, but please don't direct this at me. I have struggled immensely because of growing up on a family income below the poverty line, trying to pay for school, the MCAT, etc, myself (Canada....no FAP program to help with application costs).

I worked 6-2am every night during high school being yelled at as a telemarketer at 16. Please don't preach to me about how you need to love what you do rather than make money. I know this all too well. I would be a doctor for 50K a year. Because thats more than 4 of us lived off and it was ok in the end.

I think you post was great, but misdirected.

My bad. Your prior post referenced earning over six digits, and being likely to earn 3x what your family earned, so it read as being written by someone more $ oriented than perhaps you intended. If I misconstrued I apologize.

 

[ConfusedChemist]

My bad. Your prior post referenced earning over six digits, and being likely to earn 3x what your family earned, so it read as being written by someone more $ oriented than perhaps you intended. If I misconstrued I apologize.

Thank you. I meant that I don't see how someone can care about making 100 vs 200K, because I don't see what on earth one person would do with that kind of salary, considering I've lived in a family of 4 making only a fraction of that

I fully agree with your post about too many people going into medicine for the money, despite that they aren't that happy. It makes me cringe to see as well. However I can assure you I am not one of those people

 

[hiphopcrates]

Worth it.

 

[Avicenna]

nah. when every doc i see is driving around in a sweet ass porsche or owns multiple $300k houses or has their own private island they sail to for family vacations (no, i'm not exaggerating, i had the pleasure to join them on one instance) i can pretty much guarantee i'll be making some decent bank when i become attending too.

 

[TooMuchPressure]

I get goose bumps when I think about being a physician. Not the 6 figures.

 

[Law2Doc]

nah. when every doc i see is driving around in a sweet ass porsche or owns multiple $300k houses or has their own private island they sail to for family vacations (no, i'm not exaggerating, i had the pleasure to join them on one instance) i can pretty much guarantee i'll be making some decent bank when i become attending too.

Not gonna happen. Those days ended. Nobody coming out of residency these days become filthy rich like that anymore. No private island and most likely you'll end up with just one middle class home and one domestic car, (barring an ugly divorce where someone takes even that from you.)

 

[gmbz]

Golden days are over. Now we have to be financially smart like everyone else to come out ahead. The potential is there for sure, but you cant just fall into the Porsche/Nice house category by simply going through the motions. You gotta be smart!

 

[DubVille]

I get goose bumps when I think about being a physician. Not the 6 figures.

Not trying to be mean but this suggests to me that you have a fantasized/idealistic view of medicine that is nowhere near reality. I like my job and being excited is great, but this is a job. If it was sarcasm then my apologies.

 

[DubVille]

Thank you. I meant that I don't see how someone can care about making 100 vs 200K, because I don't see what on earth one person would do with that kind of salary, considering I've lived in a family of 4 making only a fraction of that

I fully agree with your post about too many people going into medicine for the money, despite that they aren't that happy. It makes me cringe to see as well. However I can assure you I am not one of those people

Well if you have 300k debt (what you will have if you don't have help) and theoretically have a non working spouse with kids, you will have virtually no money left to save for retirement or anything else. To use your example of 100k (which is super low) - 20k for tax assuming you have kids and great deductions 80k (this doesn't include social security or Medicare)

On a 20 year payment for your 300k (which will increase in residency) let's say 2k a month or 24k a year = 56k

House? Let's give you a break and say you work inbtween the coasts and not in Chicago home 200k payment 1.3k a month is about 15k a year = 41k

Professional disability insurance/life insurance = 2k a year or so.

Food, gas, property tax, repairs, cars, college savings?, vacation savings?, utilities, retirement, emergency funds, clothes, any other debts like credit cards, etc. if you aren't an employed doc you need malpractice insurance, etc.

This is where the money goes. Please do not clamor to make a lower salary. If you go into medicine solely to make money it's a mistake but idealizing the field and espousing the evils/extravagance of making 200k is asinine and naive.

 

[Gurby]

I meant that I don't see how someone can care about making 100 vs 200K, because I don't see what on earth one person would do with that kind of salary, considering I've lived in a family of 4 making only a fraction of that

I think most people adjust their standard of living to their income. It doesn't make logical sense, and it's easy for us not in that position to say "just keeping living like a student and invest it all!" But I think this is just human nature.

Example from my own life: I've always been interested in homesteading, growing a lot of my own food, building a tiny house, doing the minimum amount of work at a job for the man. I used to DIY everything and be very cost-conscious with every purchase. Then I got a better paying job. Suddenly, I discover that hey it's pretty nice to bring my car to a mechanic instead of spending my free time fixing it, I discover that it's pretty nice to pay someone to plow the driveway instead of shoveling it, I start thinking that a bigger house might be nice, etc.

If something is out of your ability to afford, you don't really consider it. I never used to mind working on my car, mowing the lawn, etc. But once you can afford it, you realize that luxury is pretty nice actually. I imagine this probably happens at a much larger scale once one becomes an attending, especially after working so hard for so long for free - "I've worked hard, I deserve this".

 

[ConfusedChemist]

I think most people adjust their standard of living to their income. It doesn't make logical sense, and it's easy for us not in that position to say "just keeping living like a student and invest it all!" But I think this is just human nature.

Example from my own life: I've always been interested in homesteading, growing a lot of my own food, building a tiny house, doing the minimum amount of work at a job for the man. I used to DIY everything and be very cost-conscious with every purchase. Then I got a better paying job. Suddenly, I discover that hey it's pretty nice to bring my car to a mechanic instead of spending my free time fixing it, I discover that it's pretty nice to pay someone to plow the driveway instead of shoveling it, I start thinking that a bigger house might be nice, etc.

If something is out of your ability to afford, you don't really consider it. I never used to mind working on my car, mowing the lawn, etc. But once you can afford it, you realize that luxury is pretty nice actually. I imagine this probably happens at a much larger scale once one becomes an attending, especially after working so hard for so long for free - "I've worked hard, I deserve this".

I agree. Haha but tell that to the person above who called me 'asinine and naive' for saying I wasn't too concerned if I made 200K a year or not

 

[ConfusedChemist]

Well if you have 300k debt (what you will have if you don't have help) and theoretically have a non working spouse with kids, you will have virtually no money left to save for retirement or anything else. To use your example of 100k (which is super low) - 20k for tax assuming you have kids and great deductions 80k (this doesn't include social security or Medicare)

On a 20 year payment for your 300k (which will increase in residency) let's say 2k a month or 24k a year = 56k

House? Let's give you a break and say you work inbtween the coasts and not in Chicago home 200k payment 1.3k a month is about 15k a year = 41k

Professional disability insurance/life insurance = 2k a year or so.

Food, gas, property tax, repairs, cars, college savings?, vacation savings?, utilities, retirement, emergency funds, clothes, any other debts like credit cards, etc. if you aren't an employed doc you need malpractice insurance, etc.

This is where the money goes. Please do not clamor to make a lower salary. If you go into medicine solely to make money it's a mistake but idealizing the field and espousing the evils/extravagance of making 200k is asinine and naive.

Wow. I was not 'clamoring for a lower salary'. I am fully aware of how much it will require to pay off the debt. Further, I am in Canada, and will have ~30K debt from undergrad, and tuition is 20-25K at the schools I've interviews at. I was referring to the difference between 150K+ plus, which is more than enough.
We clearly have different standards of living. Contrary to what some people think, not everyone has the luxury of owning cars, going on vacation, etc. These things are actually often bonuses. So yeah, I hope I one day go on a trip, and buy my own car, but that's not the reason I'm going into medicine

 

[DubVille]

I think most people adjust their standard of living to their income. It doesn't make logical sense, and it's easy for us not in that position to say "just keeping living like a student and invest it all!" But I think this is just human nature.

Example from my own life: I've always been interested in homesteading, growing a lot of my own food, building a tiny house, doing the minimum amount of work at a job for the man. I used to DIY everything and be very cost-conscious with every purchase. Then I got a better paying job. Suddenly, I discover that hey it's pretty nice to bring my car to a mechanic instead of spending my free time fixing it, I discover that it's pretty nice to pay someone to plow the driveway instead of shoveling it, I start thinking that a bigger house might be nice, etc.

If something is out of your ability to afford, you don't really consider it. I never used to mind working on my car, mowing the lawn, etc. But once you can afford it, you realize that luxury is pretty nice actually. I imagine this probably happens at a much larger scale once one becomes an attending, especially after working so hard for so long for free - "I've worked hard, I deserve this".

This absolutely can happen. A lot of young attendings buy an upscale car right away (which is often not he wisest move) and get a keep up with the Jones' attitude. I'm not even arguing that fact. It's very common for premeds and starting med students (usually not senior med students) to talk about how they would be a doctor for "100k a year, since its 2x as much as the average american family makes." With a doctor's debt (assuming school wasn't funded by someone else) you will struggle to pay off debt and save for retirement all while living like or arguably more frugally than the family making 50k. Med school is stupid expensive. I went to a state med school. Worked enough through undergrad to have 20k debt (parents fell just below the above mentioned average family, no help). Paid some of that off during a gap year working full time. My wife was also in med school with me. My loans came out just north of 250k (hers slightly less). For me alone I would need to pay over 3k a month to cover my loans on a 10 year repayment plan. A docs financial situation is different than the "average family" and we have lost out on 10 years of compound interest.

Fortunately, we should both have a good doctor's salary and we don't have kids, but looking at our total debt makes my stomach flip. We will be fine, but I have classmates from school that are in primary care, borrowed for school (some for a masters/undergrad at private institutions beforehand) had a kid or two during med school and have non-working spouses. They could easily have 500k debt that then accrued during residency and will be making less than 200k. I'd imagine their loan payments are >50-60% of their post tax income.....that is scary! If they lived in an area with a high cost of living, I honestly think they'd be near paycheck to paycheck living Sure there is IBR etc, but it's not a guarantee yet and banking on that as a get out of jail card is risky.


If med school costs continue to rise it would be financially dumb to pursue it past a certain point. If you have a non-working spouse, kids during med school, etc the financial situation can get pretty tight. Again, I enjoy the field but if tuition continues to skyrocket it will not be a wise financial decision. My advice: Be frugal, hopefully have a working spouse to support living expenses during school, consider salary of your field (although this changes too), don't have kids unless spouse/partner/parents pay for stuff.

 

[DubVille]

Wow. I was not 'clamoring for a lower salary'. I am fully aware of how much it will require to pay off the debt. Further, I am in Canada, and will have ~30K debt from undergrad, and tuition is 20-25K at the schools I've interviews at. I was referring to the difference between 150K+ plus, which is more than enough.
We clearly have different standards of living. Contrary to what some people think, not everyone has the luxury of owning cars, going on vacation, etc. These things are actually often bonuses. So yeah, I hope I one day go on a trip, and buy my own car, but that's not the reason I'm going into medicine

If you are arguing that as a doctor we should consider ourselves lucky to own a vehicle, then yes we will never see eye to eye. I've seen your type rapidly switch somewhere closer to my viewpoint through training. I've also seen docs that spend their whole careers serving the poor/volunteering/doing medical missions for huge periods of time. If you get through it and keep your idealism, good on you and I appreciate the people that can do it. Sure, as a Canadian your financial situation will be different (and I don't have experience in Canada) but this thread is about American school tuition. Good Luck!

 

[Seth Joo]

it is afterall quite $$$$$$$

The cost of higher education across the board has skyrocketed.

 

[Gandyy]

Very true. I feel badly for those whose parents have essentially forced them to become doctors. If I didn't love medicine, I would be miserable. I have a sibling who is much smarter than I am. (He would have been a 40+ MCAT, I'm sure of it.) However, if he had gone this route, he would have been truly miserable.

Some people think: smart = become a doctor.

You know what. I find the smartest people are the ones that are at the top of their fields in the pure science fields, not medical doctors or anyone in the health care fields.

 

[Lord Humongus]

Not gonna happen. Those days ended. Nobody coming out of residency these days become filthy rich like that anymore. No private island and most likely you'll end up with just one middle class home and one domestic car, (barring an ugly divorce where someone takes even that from you.)

Isn't that a bit pessimistic? Unless you work as a pediatrician in NYC and owe 400k, I think it's reasonable to assume you can afford more than an average middle class house and one domestic car as a physician. Teachers have that, as do plumbers, truck drivers, and virtually everyone else with a "real" job. Do you really foresee medicine falling that low, that quick?

Sure, perhaps the days of specialists making 1m+ and owning islands (I lol'd at that tbh) are over, but do you really foresee a scarcity of 300-400k specialty salaries for those who are currently on the verge of entering med school? You can't buy a private island for 300k, but it's quite enough for a pretty nice house, a 36ft sail boat and a Maserati. Again, "average middle class" lifestyle consists of a less than 70k income and affords the average middle class family with 2 domestic cars and the tautological middle class house. I'd certainly hope a physician with a 300k income could afford a good bit more than someone making 4 times less.

With that said, if I take out 300k in loans, work my ass off to land a competitive residency, and still end up making what a NYC pediatrician makes today then I'm going to abscond back to the old country with a quickness and forget I ever took those loans. You can only push me so far, Obama, and don't say I didn't warn you!

 

[Law2Doc]

Isn't that a bit pessimistic? Unless you work as a pediatrician in NYC and owe 400k, I think it's reasonable to assume you can afford more than an average middle class house and one domestic car as a physician. Teachers have that, as do plumbers, truck drivers, and virtually everyone else with a "real" job. Do you really foresee medicine falling that low, that quick?

Sure, perhaps the days of specialists making 1m+ and owning islands (I lol'd at that tbh) are over, but do you really foresee a scarcity of 300-400k specialty salaries for those who are currently on the verge of entering med school? You can't buy a private island for 300k, but it's quite enough for a pretty nice house, a 36ft sail boat and a Maserati. Again, "average middle class" lifestyle consists of a less than 70k income and affords the average middle class family with 2 domestic cars and the tautological middle class house. I'd certainly hope a physician with a 300k income could afford a good bit more than someone making 4 times less.

With that said, if I take out 300k in loans, work my ass off to land a competitive residency, and still end up making what a NYC pediatrician makes today then I'm going to abscond back to the old country with a quickness and forget I ever took those loans. You can only push me so far, Obama, and don't say I didn't warn you!

In medicine you'll assume a big debt load and not start earning much for a decade. So if you are thinking multiple homes, islands and sports cars, you are kidding yourself. You'll earn enough to pay your bills, service your debt and have a nice quality of life. But not the kind of rich you guys are talking about.

Per the latest Medscape survey (which is a decent starting point), the average doctors salary is in the low $200k range. Some earn more, some less. Some specialties and regions pay more or less. But that's truly about the average. You do yourself and your peers a disservice talking about "$400k specialty salaries" because while some people certainly will get to that, most on this board will never approach anything close to that number.

 

[Lord Humongus]

In medicine you'll assume a big debt load and not start earning much for a decade. So if you are thinking multiple homes, islands and sports cars, you are kidding yourself. You'll earn enough to pay your bills, service your debt and have a nice quality of life. But not the kind of rich you are talking about.

I think you misread me. I certainly do not expect islands, and am not holding out much hope for "multiple" homes, either. But at a minimum, I would like 1 nice (<$600k) house, 1 nice (<$150k) car, and 1 nice (<$200k) sailing boat in addition to plenty of discretionary income for stuff like vacations and eating out. I think the above is extremely doable with a $300k-400k salary and no dependents. Today, making as much as $600k or more is quite normal in many specialties for those who are willing to be flexible with location and workload. Even if that $600k were to be cut in half within the space of the next 10 years it would still afford me the lifestyle I have described.

Edit: as for shorter career, that is true, but I am of the mindset that I would rather spend the tail end of my time on earth living on a shoestring than my prime. By the time you get so old that work becomes a chore you're unwilling to countenance and are ready to retire you're probably not that enthusiastic about the fun stuff either and just want to tend to your petunias. I'll live large in my 30s, 40s, 50s, and (god willing) 60s and if I hit 70 I'll worry about that then. By the time you get real old the salient fact is that you're old, not the amount of money in your bank account.

 

[Law2Doc]

I think you misread me. I certainly do not expect islands, and am not holding out much hope for "multiple" homes, either. But at a minimum, I would like 1 nice (<$600k) house, 1 nice (<$150k) car, and 1 nice (<$200k) sailing boat in addition to plenty of discretionary income for stuff like vacations and eating out. I think the above is extremely doable with a $300k-400k salary and no dependents. Today, making as much as $600k or more is quite normal in many specialties for those who are willing to be flexible with location and workload. Even if that $600k were to be cut in half within the space of the next 10 years it would still afford me the lifestyle I have described.

Edit: as for shorter career, that is true, but I am of the mindset that I would rather spend the tail end of my time on earth living on a shoestring than my prime. By the time you get so old that work becomes a chore you're unwilling to countenance and are ready to retire you're probably not that enthusiastic about the fun stuff either and just want to tend to your petunias. I'll live large in my 30s, 40s, 50s, and (god willing) 60s and if I hit 70 I'll worry about that then.

Again, you are more likely to be closer to the average in salary. Every premed on this board is. That's just life. No point focusing on lottery winners. So $400k is a garbage number to focus on and $600k is even more unrealistic --put that out of your mind, seriously. If it happens for you great, but until then it's a pipe dream. It's certainly not a "normal" salary for any specialty- it's an outlier. It happens just enough to sucker a few premeds to think that's realistic. Assume closer to $200k range. That's average in medicine. And again there are doctors out there not even getting this. Given that, with a hefty mortgage you can afford a slightly smaller house than you are listing, a US or Japanese made modest reliable newish car for about a fifth of what you are listing, and whatever used boat you can get with a trailer included for about $8k. And you'll maybe go on one or two not too extravagant week long vacation each year to "recharge". That's kind of where doctors are at these days. It's not a bad gig -- you'll service your debts, never worry about basic needs. But you won't be the kind of rich you or the other poster are talking about. My suggestion is marry another doctor if you want salaries to add up to the $400k + range.

 

[Lord Humongus]

Per the latest Medscape survey (which is a decent starting point), the average doctors salary is in the low $200k range. Some earn more, some less. Some specialties and regions pay more or less. But that's truly about the average. You do yourself and your peers a disservice talking about "$400k specialty salaries" because while some people certainly will get to that, most on this board will never approach anything close to that number.

(^^This was added after I wrote my initial response, hence the separate reply)
Fair enough. I am perfectly willing to accept that I am banking (heh) on matching into a competitive specialty. I accept that if all I can get is FM/peds and I'm hell bent on practicing in a large metro area, even the lifestyle I described, which I by no means consider extravagant, is out of reach. But the average low 200k salary for all physicians doesn't really scare me. Subtract academics, subtract large metro areas, subtract the coasts, subtract all the part timers and the docs willing to trade convenience for $$ and I'd bet your average climbs significantly, even keeping all the low paying specialties in the bucket. And I mentioned those factors specifically because they are things 100% under individual control.

Let's say I completely underperform on my Step 1 relative to my MCAT and can only land IM. Furthermore, I proceed to bomb my residency as well, precluding me from qualifying for any lucrative fellowships and damning me to a life of being a hospitalist. Well, average hospitalist salary across the nation is low 200s 1 week on 1 week off. Since I want my Maserati, I will move to an unpopular area and bump that to mid 200s. Since I have no kids and must make those Maserati payments, I spend at least some of that half a year I have off working additional shifts, pushing me up to 300k.

Is this so unreasonable? I didn't use the words ortho, derm, or GI even once yet I'm at 300k...

 

[DubVille]

(^^This was added after I wrote my initial response, hence the separate reply)
Fair enough. I am perfectly willing to accept that I am banking (heh) on matching into a competitive specialty. I accept that if all I can get is FM/peds and I'm hell bent on practicing in a large metro area, even the lifestyle I described, which I by no means consider extravagant, is out of reach. But the average low 200k salary for all physicians doesn't really scare me. Subtract academics, subtract large metro areas, subtract the coasts, subtract all the part timers and the docs willing to trade convenience for $$ and I'd bet your average climbs significantly, even keeping all the low paying specialties in the bucket. And I mentioned those factors specifically because they are things 100% under individual control.

Let's say I completely underperform on my Step 1 relative to my MCAT and can only land IM. Furthermore, I proceed to bomb my residency as well, precluding me from qualifying for any lucrative fellowships and damning me to a life of being a hospitalist. Well, average hospitalist salary across the nation is low 200s 1 week on 1 week off. Since I want my Maserati, I will move to an unpopular area and bump that to mid 200s. Since I have no kids and must make those Maserati payments, I spend at least some of that half a year I have off working additional shifts, pushing me up to 300k.

Is this so unreasonable? I didn't use the words ortho, derm, or GI even once yet I'm at 300k...

You could probably "afford/blow" your money on a 150k car after you've paid off your debts. You technically could do it beforehand, but it would be very unwise. Those hospitalist gigs aren't usually long term though, tend to burn folks out. With bundled payments, I think hospitalist should salaries may stagnate or drop. No more absolute cake orthopedic/uro admits.

 

[Law2Doc]

You could probably "afford/blow" your money on a 150k car after you've paid off your debts. You technically could do it beforehand, but it would be very unwise. Those hospitalist gigs aren't usually long term though, tend to burn folks out. With bundled payments, I think hospitalist should salaries may stagnate or drop. No more absolute cake orthopedic/uro admits.

Agree a lot a salaries are in peril with bundled care, not just Hospitalists. I would point out/echo that some of the salaries and cush schedules being offered for hospitalist jobs is because the burn out and retention rates are bad -- you won't be doubling up the overtime to work more of these shifts -- it's hard enough to get people to work any. A lot of these, and virtually all the moonlighting, are long hectic overnight shifts where you sleep during the day. Not a lot of time to play with a Maserati even if you could afford it. And if you have to move out to the boonies to get that sweet hospitalist gig, who are you even going to impress with your Maserati anyhow? The feed salesman down the pike? He'd be impressed with a shiny new Honda Fit.

 

[Law2Doc]

...
Let's say I completely underperform on my Step 1 relative to my MCAT and can only land IM. Furthermore, I proceed to bomb my residency as well, precluding me from qualifying for any lucrative fellowships and damning me to a life of being a hospitalist....

First, the people that end up at average salaries aren't getting there because they underperformed, tanked residencies or were damned to any sort of life. Mature people choose jobs they think they will enjoy, not just push forward to the most lucrative and competitive option even if it's not for them. So I reject your premise. So let's say that after being beaten down by surgery or ortho you say " F$&@ this -- I don't think this is really for me". And Let's further say you really had a great month on your peds rotation, or thought the patient contact on inpatient medicine was kind of fulfilling, or kind of liked neuro or whatever. That's another big way you end up at average.

Second, your attitude that other doctors career choices are equivalent to underachieving, or being damned, likely will create hurdles for you in medicine and practice. Lose this fast.

Third, the level of competition in medicine is intense. Everyone who gets accepted got their fair share of good grades in college. By definition, half the class is going to be below the median. Might be you. Most people didn't realize that a lot of doing well in college stemmed from weaker competition, not that they were all that. So yeah, odds are always quite good at being average, no matter how hard you work. You have to swim quite fast just to keep up in medicine.

 

[SOMBound13]

You know what. I find the smartest people are the ones that are at the top of their fields in the pure science fields, not medical doctors or anyone in the health care fields.

I can see that. I'm just saying that there is a large part of the population, ranging from high school students to older adults, who once they hear that a student is smart, will automatically say, "Oh, I bet you're going to become a doctor."

I think it's one reason why a gazillion freshmen are "premed."

 

[Lord Humongus]

First, the people that end up at average salaries aren't getting there because they underperformed, tanked residencies or were damned to any sort of life. Mature people choose jobs they think they will enjoy, not just push forward to the most lucrative and competitive option even if it's not for them. So I reject your premise. So let's say that after being beaten down by surgery or ortho you say " F$&@ this -- I don't think this is really for me". And Let's further say you really had a great month on your peds rotation, or thought the patient contact on inpatient medicine was kind of fulfilling, or kind of liked neuro or whatever. That's another big way you end up at average.

Second, your attitude that other doctors career choices are equivalent to underachieving, or being damned, likely will create hurdles for you in medicine and practice. Lose this fast.

C'mon man. I was replying to the construct you yourself set up with the following thought:

Again, you are more likely to be closer to the average in salary. Every premed on this board is. That's just life. No point focusing on lottery winners. So $400k is a garbage number to focus on and $600k is even more unrealistic --put that out of your mind, seriously. If it happens for you great, but until then it's a pipe dream. It's certainly not a "normal" salary for any specialty- it's an outlier.

You set up a construct under which making a $400k salary is equivalent to being a lottery winner and so unlikely that even the most competitive specialties seldomly achieve this "pipe dream" number (which btw is complete B.S. per MGMA). So when I wrote my response I purposely replied in the same spirit, where 400k is so unreachable that only lottery winners in ortho and derm can dream of touching such numbers. Under such a rhetorical construct, yes, matching "only" IM or peds is in fact falling short. But that is not the construct I live under, it is the one you created with your posts in this thread. The only reason I kept playing along with my "short coming" scenario of "only" matching IM is to show you that even under your own unrealistically pessimistic assessment, these numbers are far from being "lottery."

So please stop with the shaming language and at least read my posts thoroughly. You've already accused me of expecting private islands and multiple homes, both things that were brought up by other posters not me, and one of which (the islands) I in fact laughed at as ridiculously unrealistic prior to you insinuating I expect such things.

We will just have to agree to disagree on this. Today, a 500-600k salary is perfectly reasonable in some of the more competitive specialties. It's basically the median for private practice full time Ortho, Urology, many IM subspecialties, and anyone working more than 4 days a week in Derm. A 300k salary is perfectly reasonable to achieve for EM, IM, Anesthesiology, Rads, Psych, etc. Even family med can hit 300k in the right location and practice type. It's very possible the next 10 years will see major cuts, but I find it extremely difficult to believe a job which lets you make $600k median today is going to be reduced to looking at 400k as a "lottery" number 10 years from now. And if all "you" can afford with $400k is a middle class house and a Honda, well, "you" must have an expensive coke habit. I'm not writing this to be gratuitously combative, but I hate spending time to write cogent posts only for them to be blatantly misinterpreted.

 

[Doug Underhill]

It is important to note that for most Americans with postgraduate degrees, $100k is a distant, unachievable pipe dream. We are debating whether $300k is achievable. That puts you close to One Percenter territory.

 

[Lord Humongus]

It is important to note that for most Americans with postgraduate degrees, $100k is a distant, unachievable pipe dream. We are debating whether $300k is achievable. That puts you close to One Percenter territory.

And what of it? Most "one percenters" are in fact physicians, dentists, plumbers, small business owners, etc. The one percent is the most diverse percent. It includes a urologist handling people's junk for 10 hours a day to barely make it into this "hallowed" group and George Soros overthrowing democratically elected governments in Eastern Europe. In other words, it's an empty propaganda term. By definition, there are 3,200,000 people in the United States who fall into this category, and only a tiny tiny fraction of them have real wealth or power.

 

[baratheonfire]

1. It's never as much as it sounds like from the outside looking in.
2.If you hate what you are doing, a nice income is often just the handcuff keeping you from having a happier life.
3. If you dread that alarm clock going off each morning, a few extra bucks in the bank isn't going to make the 70+ hours you spend working each week more fun or palatable. It won't get back all the time with friends and family, all the events and holidays and weekends you will miss.
4. Medicine is not for everybody. It's a not so fine line between people who love it versus those who are truly miserable, and salary has no bearing on this.
5. You aren't going to find a job more emotionally charged, where you are regularly dealing with death and disease and people at their lowest and saddest points in life. The stakes are high and your errors (everybody has some) may be life impacting. To a big extent the money is hazard pay for what you are asked to shoulder.

But you could be a hospitalist, work 9-5 and make 200k.

 

[Law2Doc]

C'mon man. I was replying to the construct you yourself set up with the following thought:



You set up a construct under which making a $400k salary is equivalent to being a lottery winner and so unlikely that even the most competitive specialties seldomly achieve this "pipe dream" number (which btw is complete B.S. per MGMA). So when I wrote my response I purposely replied in the same spirit, where 400k is so unreachable that only lottery winners in ortho and derm can dream of touching such numbers. Under such a rhetorical construct, yes, matching "only" IM or peds is in fact falling short. But that is not the construct I live under, it is the one you created with your posts in this thread. The only reason I kept playing along with my "short coming" scenario of "only" matching IM is to show you that even under your own unrealistically pessimistic assessment, these numbers are far from being "lottery."

So please stop with the shaming language and at least read my posts thoroughly. You've already accused me of expecting private islands and multiple homes, both things that were brought up by other posters not me, and one of which (the islands) I in fact laughed at as ridiculously unrealistic prior to you insinuating I expect such things.

We will just have to agree to disagree on this. Today, a 500-600k salary is perfectly reasonable in some of the more competitive specialties. It's basically the median for private practice full time Ortho, Urology, many IM subspecialties, and anyone working more than 4 days a week in Derm. A 300k salary is perfectly reasonable to achieve for EM, IM, Anesthesiology, Rads, Psych, etc. Even family med can hit 300k in the right location and practice type. It's very possible the next 10 years will see major cuts, but I find it extremely difficult to believe a job which lets you make $600k median today is going to be reduced to looking at 400k as a "lottery" number 10 years from now. And if all "you" can afford with $400k is a middle class house and a Honda, well, "you" must have an expensive coke habit. I'm not writing this to be gratuitously combative, but I hate spending time to write cogent posts only for them to be blatantly misinterpreted.

$600k is not median in any specialty and you are either being obtuse or naive to keep going back to that. You likely won't be getting that. But even if you hit the lottery and do, you are doing a big disservice to other people on SDN who might get suckered into thinking this is even a realistic number.