Factoring Age While Choosing a Specialty

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bomba

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Recently I've been contemplating my path as a non-traditional premed. The fact that I will be between 45-47 years old when I become an attending has been gnawing at me (that's if all goes as planned). This has made me take a step back and contemplate what specialties are realistic when considering I will be in my 40s during residency. The common platitude is "age is just a number", but it just seems like a cold, hard fact of life that disruptions to one's circadian rhythm and long, arduous work conditions are less tolerable as we age. I've accepted that surgical specialties are likely out of the question--which is okay because that's not a strong interest for me anyways. However, I do think I'd be happy in a more procedural focused specialty such as anesthesia as opposed to something like FM or IM. What gives me pause is I'd probably be in my 50s before I hit my stride as a physician--It's a bit sobering to think that I'll become proficient at an age where most think about slowing down.

Have any of you confronted this? Did it affect your decision process when picking a specialty? Are there specialties that are more conducive to older trainees?

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A lot of it depends on you and what specialty clicks with you. I'm 48 y/o and a current surgery resident. I'll likely be 51 when I become an attending. Yes, it is tough and some days I feel my age. But I realized I love the OR and that I would more miserable being bored to death looking at images as a radiologist or managing diabetes in an outpatient clinic (nothing against these specialties but just not my interests). And even certain surgical specialties can be more conducive to a more comfortable lifestyle once you get through the training (though I will be going into trauma/acute care so will not have that luxury). My advice is to get to your clinical rotations and see what specialties makes you happy then start deciding on which to choose.
 
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A lot of it depends on you and what specialty clicks with you. I'm 48 y/o and a current surgery resident. I'll likely be 51 when I become an attending. Yes, it is tough and some days I feel my age. But I realized I love the OR and that I would more miserable being bored to death looking at images as a radiologist or managing diabetes in an outpatient clinic (nothing against these specialties but just not my interests). And even certain surgical specialties can be more conducive to a more comfortable lifestyle once you get through the training (though I will be going into trauma/acute care so will not have that luxury). My advice is to get to your clinical rotations and see what specialties makes you happy then start deciding on which to choose.
Thanks for the insight. Quick question--and if this is too personal, I understand--do you have kids? If so, how is it trying to juggle both being present for your family vs the demands of a surgical residency?
 
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Yes, I have one kid. It is definitely challenging juggling family and surgical residency. I try my best to leave work at the hospital and be present as much as I can when I can, but the schedule can be grueling. But we make it work as best we can.
 
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Yes, medicine is a job think about how the rest of your training effects the rest of your life
 
It certainly can weigh in on specialty choice as well as the venue you choose to work in. That said, there is no hard and fast rule that says you can't do a certain specialty. Age bias exists, but it varies greatly by specialty and program. I know of a few M4s that are older than you will be and that interviewed and matched at top programs this cycle (though the methodology of rankings is an entirely separate can of worms.)

And hitting your stride as a physician is one of those ill-defined metrics that's not worth even worrying about. On day one, many non-trad students will be better than their attendings in some aspects of patient care. That ranges from basic elements, such as patient rapport, to more specific pathologies, such as GSW's if, for example, you are a combat veteran. EMR proficiency is another example, but that also depends on your background.

I forget who says this all the time (maybe Goro), but you are going to be 55 someday one way or another, so the question is, why not be a 55-year-old physician if that's what fulfills you?
 
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I like everything everyone says here. There is a certain diminishing return to medical expertise. Are you really going to be exponentially better having done 1,000 gallbladder surgeries compared to 200? What about treating 10,000 diabetes cases versus 1,000?

There is certainly a great respect for a physician of 40 years but at the same time we benefit from having them as our mentors in an age of even-more-modern medicine.

Many people go to medical school to learn how to be professionals and develop confidence and social skills, whereas most non-trads have long mastered that. Many traditional students' first significant full-time job is residency, whereas most non-trads will have a laundry list of them.

Each person brings unique perspectives and values to the team, and yes many doctors will have "forgotten more than you've ever learned", but that doesn't always equate to them being twice as good of a doctor as their years would suggest (some certainly are though).


My take on it is that I've already had my retirement. I have lost out on the privilege of serving my youth in the field, so I'm going to do everything that I can to get the most out of what's left. This gives me a motivation and desire to learn that I think is hard-pressed to come by. And it also means I'm going to place my physical and mental wellbeing high so I can live longer, practice longer, and be a better person and physician.

We are a unique brand of non-trads that will reshape the face of the medicine in some way or another. We will be part of the force that ushers in a new age of healthcare standards. We are not behind the game, no, our skills are necessary and our ability to reach out with and identify with our younger peers will be invaluable, just as we can continue to be inspired by them, and have the luxury of having career-long mentors.

If you wake up every day physically, mentally, and emotionally ready for surgery, then that will give you the energy that is far greater than what you thought you could muster or would ever need.
 
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Recently I've been contemplating my path as a non-traditional premed. The fact that I will be between 45-47 years old when I become an attending has been gnawing at me (that's if all goes as planned). This has made me take a step back and contemplate what specialties are realistic when considering I will be in my 40s during residency. The common platitude is "age is just a number", but it just seems like a cold, hard fact of life that disruptions to one's circadian rhythm and long, arduous work conditions are less tolerable as we age. I've accepted that surgical specialties are likely out of the question--which is okay because that's not a strong interest for me anyways. However, I do think I'd be happy in a more procedural focused specialty such as anesthesia as opposed to something like FM or IM. What gives me pause is I'd probably be in my 50s before I hit my stride as a physician--It's a bit sobering to think that I'll become proficient at an age where most think about slowing down.

Have any of you confronted this? Did it affect your decision process when picking a specialty? Are there specialties that are more conducive to older trainees?
I started Med School when I was 38, married at 40, finished Family Medicine Residency at 45, (had daughter while in residency), paid off debt at 53. Family Medicine offers a wide array of procedures, and I'm absolutely loving my life. I'm working harder than I did in my first career (programmer) and have more stress, but I'm so glad I made the switch. If being a doctor is in your blood, do it. All those aphorisms about doing what you love and the rest will work itself out, are true.
 
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I finished residency at 40 and currently in EM. My advice is to find something where you aren't working nights to increase your longevity. They get much more difficult as you age. Debt was much easier to pay off than I ever expected (two years but I went to school in TX). Read The White Coat Investor book early in training. The key is to stay frugal. I still live like a resident and I have maximal flexibility after only a few years. Don't listen to any negativity from people saying it can't be done.
 
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A lot of it depends on you and what specialty clicks with you. I'm 48 y/o and a current surgery resident. I'll likely be 51 when I become an attending. Yes, it is tough and some days I feel my age. But I realized I love the OR and that I would more miserable being bored to death looking at images as a radiologist or managing diabetes in an outpatient clinic (nothing against these specialties but just not my interests). And even certain surgical specialties can be more conducive to a more comfortable lifestyle once you get through the training (though I will be going into trauma/acute care so will not have that luxury). My advice is to get to your clinical rotations and see what specialties makes you happy then start deciding on which to choose.
Doctor,

This is exactly the kind of post I am looking for. I am 40 years old and have wanted to be a physician for thirty years (since kindergarten - my now late father was the town general practitioner). My father did a general rotating internship followed by one in general surgery. I was inspired by how he was always serving as first assistant to other docs, and I was also fascinated by the artificial heart (Jarvik-7). However, starting my senior year in high school (2001-2002), I started getting interested in non-surgical specialties (pediatric oncology-hematology). Then from 2004-2010, I was interested in dentistry, but only OMFS. Later ophthalmology, PM&R, neurology, etc.

Finally, post-pandemic season where there was heavy emphasis on comorbidities - including the heart - my interests once again turn to the artificial heart.

I want to be realistic, though. If I finish medicsl school late 40s, how much of a career as a surgeon or even a physician in general can I expect?
 
Recently I've been contemplating my path as a non-traditional premed. The fact that I will be between 45-47 years old when I become an attending has been gnawing at me (that's if all goes as planned). This has made me take a step back and contemplate what specialties are realistic when considering I will be in my 40s during residency. The common platitude is "age is just a number", but it just seems like a cold, hard fact of life that disruptions to one's circadian rhythm and long, arduous work conditions are less tolerable as we age. I've accepted that surgical specialties are likely out of the question--which is okay because that's not a strong interest for me anyways. However, I do think I'd be happy in a more procedural focused specialty such as anesthesia as opposed to something like FM or IM. What gives me pause is I'd probably be in my 50s before I hit my stride as a physician--It's a bit sobering to think that I'll become proficient at an age where most think about slowing down.

Have any of you confronted this? Did it affect your decision process when picking a specialty? Are there specialties that are more conducive to older trainees?

I am a bit younger than you will be, but not all that much. I can't speak for other specialties, but I can speak to anesthesia. Residency is tough regardless of where you do it, but is definitely more doable than any surgical specialty. I think it takes me longer to recover from a rough 24-hour call shift than my younger colleagues, or than I would have 10-15 years ago.

Once residency is over, there is a wild variety of schedules available (especially if you aren't picky about where you live). From jobs that I've talked to or my co-residents have taken I've seen everything from 4 days a week no nights/no weekends, to call jobs with pre and post-call days off, to jobs working more hours and more call than residency. Obviously, the jobs with more hours/call pay more, but even those 4 days per week jobs pay more than I ever thought I would make.

As a fellow non-trad, I probably wouldn't do medicine again. If I did, I would still pick anesthesia again. If that's your goal your age shouldn't hold you back.
 
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I think it takes me longer to recover from a rough 24-hour call shift than my younger colleagues, or than I would have 10-15 years ago.

My colleagues talk about things they do on their post-call days, and I'm like, all I do post-24-hour call is....:sleep:
 
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I am a bit younger than you will be, but not all that much. I can't speak for other specialties, but I can speak to anesthesia. Residency is tough regardless of where you do it, but is definitely more doable than any surgical specialty. I think it takes me longer to recover from a rough 24-hour call shift than my younger colleagues, or than I would have 10-15 years ago.

Once residency is over, there is a wild variety of schedules available (especially if you aren't picky about where you live). From jobs that I've talked to or my co-residents have taken I've seen everything from 4 days a week no nights/no weekends, to call jobs with pre and post-call days off, to jobs working more hours and more call than residency. Obviously, the jobs with more hours/call pay more, but even those 4 days per week jobs pay more than I ever thought I would make.

As a fellow non-trad, I probably wouldn't do medicine again. If I did, I would still pick anesthesia again. If that's your goal your age shouldn't hold you back.
What a timely post. Thanks for sharing your experience. Early-40's here, just started 2nd semester of MS1, and tell people all the time that I would't do medicine again. It is rough on an older individual with a family. I am also interested in anesthesiology, among other specialties. I dream of surgery, but it slips away more and more as the days pass. I am always tired, and cannot imagine how intense surgical training must be (plus, it's lengthier).

I needed this post. Two minutes left of my Pomodoro break, so it's back to Anki I go. Thanks again.
 
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I will be starting MS1 in the fall. I'm in my late 30's and I am already 100% set on FM. I mean I do like FM but I also know that the residency is easier than IM. I also value quality of life going forward. I'm hoping I can arrange for a 4-day week in the future.

At my age, I wouldn't even consider a surgical specialty even if it was handed to me. Your body changes as you age and you feel it.
 
I am a bit younger than you will be, but not all that much. I can't speak for other specialties, but I can speak to anesthesia. Residency is tough regardless of where you do it, but is definitely more doable than any surgical specialty. I think it takes me longer to recover from a rough 24-hour call shift than my younger colleagues, or than I would have 10-15 years ago.

Once residency is over, there is a wild variety of schedules available (especially if you aren't picky about where you live). From jobs that I've talked to or my co-residents have taken I've seen everything from 4 days a week no nights/no weekends, to call jobs with pre and post-call days off, to jobs working more hours and more call than residency. Obviously, the jobs with more hours/call pay more, but even those 4 days per week jobs pay more than I ever thought I would make.

As a fellow non-trad, I probably wouldn't do medicine again. If I did, I would still pick anesthesia again. If that's your goal your age shouldn't hold you back.
Can I ask as a non-trad who's starting the premed process why you wouldn't do medicine again?
 
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Can I ask as a non-trad who's starting the premed process why you wouldn't do medicine again?

It’s a good question. It’s a bit more nuanced. On one hand, I am thankful for the opportunity to provide my kids with a lifestyle and opportunities that my parents could only dream of. Anesthesiology is a great career and the jobs I’m looking at offer good salary, generous vacation and benefits, etc.

So why wouldn’t I do it again? it cost more than I would have agreed to pay. I don’t mean financially. I mean time, relationships, stress, my health, and time with my kids. Looking back I probably would pick something else.

I’m hoping that once I’ve been out of training for a few years my answer to that may have changed.
 
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It’s a good question. It’s a bit more nuanced. On one hand, I am thankful for the opportunity to provide my kids with a lifestyle and opportunities that my parents could only dream of. Anesthesiology is a great career and the jobs I’m looking at offer good salary, generous vacation and benefits, etc.

So why wouldn’t I do it again? it cost more than I would have agreed to pay. I don’t mean financially. I mean time, relationships, stress, my health, and time with my kids. Looking back I probably would pick something else.

I’m hoping that once I’ve been out of training for a few years my answer to that may have changed.
I have heard a lot of people say this before but my question is what would the alternative be when you also say that this career provided "lifestyle?"

PA would not provide the same "lifestyle" even though I have heard other physicians say they wish they went that route.

Can I ask, did you pick medicine as a career based on lifestyle?
 
Mid 40s relatively new ent attending here. Started my first attending job at 41yo and have been loving it.

Surgical residency in late 30s/early 40s was doable but challenging. Took longer to recover after being awake for 36+ hours (ah the joys of “home call” where the 24+4 hour rule doesn’t apply). I went to a rather cushy program with a chill call schedule though; would have been tougher had I gone somewhere else.

I feel like I’ve already hit my stride as an attending. I went to some of the very best programs as far as surgical training and I feel very confident in my skills and so far have had exceptional outcomes. Im probably more conservative than I would have been starting at 32yo, and will often send things to other sub specialists even though I know I could probably manage it myself. I’m a lot more risk averse now and just don’t want the hassle of OR staff not knowing how I do a rarely done complex case, or dealing with the complications of something goes wrong. So I focus mostly on my fellowship area and a few other things and am booked out well into the summer so it’s keeping me busy! I also really love my job and don’t want to leave, so I’m very self conscious about my reputation and outcomes and want to become a well respected fixture here. I’ve already seen some young risk taking cowboy types get bad outcomes and get shown the door.

I’m looking to practice at least 20 years, maybe 25. I’m lucky that my field has a very well worn path to retirement where it’s easy to slow down the OR and just do clinic as you get older. ENT is also one of those fields where the OR is kind of a loss leader and you make most of your money in clinic anyhow. I’ll do more wRVUs in 1-2 hours of a busy clinic than a full OR day. I really love the work and the thinking so I can see myself sticking around a long time. It’s just so interesting and challenging and I’ve finally conquered the whole charting thing so now I’m usually out the door well before 3pm with everything done.

So for me, would 110% do it all again. Now just crossing my fingers my administration keeps leaving me alone and letting me do my thing!
 
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I have heard a lot of people say this before but my question is what would the alternative be when you also say that this career provided "lifestyle?"

PA would not provide the same "lifestyle" even though I have heard other physicians say they wish they went that route.

Can I ask, did you pick medicine as a career based on lifestyle?

I did not pick medicine based on lifestyle, so maybe that plays into my answer.

I doubt there is another career path in which I would ever have the earning potential that I'll have soon, but there's a lot more to life than income.
 
I did not pick medicine based on lifestyle, so maybe that plays into my answer.

I doubt there is another career path in which I would ever have the earning potential that I'll have soon, but there's a lot more to life than income.
I agree that medicine is unique with earning potential but what about all these people that say they make "doctor money" in business or tech with just their 4-year degree? I always said they were lying but then again I don't know how much these people make. Any insight?
 
I agree that medicine is unique with earning potential but what about all these people that say they make "doctor money" in business or tech with just their 4-year degree? I always said they were lying but then again I don't know how much these people make. Any insight?
I’m in a HENRY subreddit and the people that make the most are 100% in tech usually FAANG. They graduate in 4 years and then after about 10 are making 650k with stock options. Of course there is the business owner outlier but it’s usually the tech bros without a ton of school debt.
 
It’s a good question. It’s a bit more nuanced. On one hand, I am thankful for the opportunity to provide my kids with a lifestyle and opportunities that my parents could only dream of. Anesthesiology is a great career and the jobs I’m looking at offer good salary, generous vacation and benefits, etc.

So why wouldn’t I do it again? it cost more than I would have agreed to pay. I don’t mean financially. I mean time, relationships, stress, my health, and time with my kids. Looking back I probably would pick something else.

I’m hoping that once I’ve been out of training for a few years my answer to that may have changed.
Thank you for responding! I can totally see this being draining on a person in all ways, as well as their family. I’m married but we aren’t planning on kids and said we could revisit that after residency.

Thankfully, my husband has already been through this process as a traditional applicant and is completely supportive and knows how all consuming med school and residency can be.

I really value your input!
 
I’m in a HENRY subreddit and the people that make the most are 100% in tech usually FAANG. They graduate in 4 years and then after about 10 are making 650k with stock options. Of course there is the business owner outlier but it’s usually the tech bros without a ton of school debt.
I keep hearing that but I have a friend, who is a physician, and he said his sister is married to a tech guy and he's been unemployed for a year now. I personally don't believe that most tech people make anywhere near 650K with four year degrees. If that were the case, med school applications would drop off drastically.
 
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I keep hearing that but I have a friend, who is a physician, and he said his sister is married to a tech guy and he's been unemployed for a year now. I personally don't believe that most tech people make anywhere near 650K with four year degrees. If that were the case, med school applications would drop off drastically.
I don't think most do. I also think it depends on location and specialty. Cyber security is technically tech but they make 80K. It's usually software engineers that are making tons of money. They also include their comp and stocks into that number.
 
I don't think most do. I also think it depends on location and specialty. Cyber security is technically tech but they make 80K. It's usually software engineers that are making tons of money. They also include their comp and stocks into that number.
That's interesting because I know someone who is going around saying he is a millionaire because he has a million of bitcoin stock. He doesn't say how much he makes a year though and that's what I want to know.
 
What a timely post. Thanks for sharing your experience. Early-40's here, just started 2nd semester of MS1, and tell people all the time that I would't do medicine again. It is rough on an older individual with a family. I am also interested in anesthesiology, among other specialties. I dream of surgery, but it slips away more and more as the days pass. I am always tired, and cannot imagine how intense surgical training must be (plus, it's lengthier).

I needed this post. Two minutes left of my Pomodoro break, so it's back to Anki I go. Thanks again.

But you’re so early on in the process and if you are already saying you wouldn’t do it again, wouldn’t it make sense to cut your losses and move on to do something you actually like to do? I mean, at 40 something, we have lived enough to know there are options out there and going through six-seven years of misery is never really an answer? I suspect the “I would never do this again if I had the choice” may be a bit of an overreaction?
 
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I am a bit younger than you will be, but not all that much. I can't speak for other specialties, but I can speak to anesthesia. Residency is tough regardless of where you do it, but is definitely more doable than any surgical specialty. I think it takes me longer to recover from a rough 24-hour call shift than my younger colleagues, or than I would have 10-15 years ago.

Once residency is over, there is a wild variety of schedules available (especially if you aren't picky about where you live). From jobs that I've talked to or my co-residents have taken I've seen everything from 4 days a week no nights/no weekends, to call jobs with pre and post-call days off, to jobs working more hours and more call than residency. Obviously, the jobs with more hours/call pay more, but even those 4 days per week jobs pay more than I ever thought I would make.

As a fellow non-trad, I probably wouldn't do medicine again. If I did, I would still pick anesthesia again. If that's your goal your age shouldn't hold you back.
What did you do before medicine?
 
I’m in a HENRY subreddit and the people that make the most are 100% in tech usually FAANG. They graduate in 4 years and then after about 10 are making 650k with stock options. Of course there is the business owner outlier but it’s usually the tech bros without a ton of school debt.
I'll add a caveat as a former FAANG non-SDE/SWE that the attrition rate and bar to go to FAANG is very high. Stress and lifestyle for entry level is pretty bad too, worse than some residencies.
In my estimation, medicine trades time for stability. The ceiling is lower but the bottom is also much higher if you can tolerate the delayed gratification. Comparing the 1% of other professions against the 99% of medicine always felt inaccurate to me.
There's no job that allows for the same level of income without also requiring a similar level of grind. So if you're prepared to put in another 8-10 years of 60 hr/wks then medicine is the safest path to 250+k income.
 
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I'll add a caveat as a former FAANG non-SDE/SWE that the attrition rate and bar to go to FAANG is very high. Stress and lifestyle for entry level is pretty bad too, worse than some residencies.
In my estimation, medicine trades time for stability. The ceiling is lower but the bottom is also much higher if you can tolerate the delayed gratification. Comparing the 1% of other professions against the 99% of medicine always felt inaccurate to me.
There's no job that allows for the same level of income without also requiring a similar level of grind. So if you're prepared to put in another 8-10 years of 60 hr/wks then medicine is the safest path to 250+k income.
You have a point there. With a lot of other careers, the high earners are really the 1%. In medicine, even the bottom 1% is doing really well.
 
I'll add a caveat as a former FAANG non-SDE/SWE that the attrition rate and bar to go to FAANG is very high. Stress and lifestyle for entry level is pretty bad too, worse than some residencies.
In my estimation, medicine trades time for stability. The ceiling is lower but the bottom is also much higher if you can tolerate the delayed gratification. Comparing the 1% of other professions against the 99% of medicine always felt inaccurate to me.
There's no job that allows for the same level of income without also requiring a similar level of grind. So if you're prepared to put in another 8-10 years of 60 hr/wks then medicine is the safest path to 250+k income.
I totally agree. I don't think everyone in that industry is making an income that high, only that it was possible.
 
I totally agree. I don't think everyone in that industry is making an income that high, only that it was possible.
All those people drive Tesla's though. Do you think they are actually broke?
 
All those people drive Tesla's though. Do you think they are actually broke?
Tesla cost 35-40K, you don’t need to be earning 250k to buy a Tesla. And you won’t go broke if you buy a 35K Tesla on a 150 k income.
 
Tesla cost 35-40K, you don’t need to be earning 250k to buy a Tesla. And you won’t go broke if you buy a 35K Tesla on a 150 k income.
I'd like to know what those average tech salaries are though. I can never get a straight answer.
 
The point is that there is no straight answer. A million factors dramatically change the value to the point some simplistic stat is basically telling you the average height of men vs women: useless in the face of overwhelming individual variation.

FAANG has a large enough population you can dig up the average salary. Note they accept about 0.5% of job applicants, so this is already a very specific top 1%. And it still massively depends on:
  • Job level (duh)
  • Location (SFO/NYC vs podunk can be more than double)
  • Specialty skills, education, experience
  • Interview performance within level and negotiation skills (did you get a counteroffer? retention?)
  • The usual discriminatory stuff: gender, race, age, disability, "culture fit"
Your value on the job market depends on all these factors and then some.

FAANG in Silicon Valley will pay ~125-175k+0-50 signon fresh out of Ivy League undergrad CS. Many unverified stories claiming 250k+. That's if you can get in, which on a % basis is far harder than med school. Also notable is FAANG internship salaries, which annualize to about 120k last I checked.

Non-FAANG pay is significantly lower, and I don't know enough about those. Down to 60k is quite possible.
 
But you’re so early on in the process and if you are already saying you wouldn’t do it again, wouldn’t it make sense to cut your losses and move on to do something you actually like to do? I mean, at 40 something, we have lived enough to know there are options out there and going through six-seven years of misery is never really an answer? I suspect the “I would never do this again if I had the choice” may be a bit of an overreaction?

It isn't misery, it's just a lot of work for someone who has three children and a spouse he'd like to spend more time with. We're learning and adjusting, and thus figuring out how to manage our time so that we spend more with each other.

I'm early on in the process of medical school, but put a lot of time and effort into going back and getting the prerequisites, selling our home, moving out of state, etc. I'm not at all early in the process of getting to this point. I am a big believer in not falling for the sunk cost fallacy, but we've come way too far to just quit because it's hard. As Mayo said, though, it's the time away from family, stress, and impact on one's health that make you realize at a certain age, it may not have been the best move. At this point, though, it would likely be more stressful to leave school and look into another field. I'm not saying I hate medical school or find it unbearable, I am saying that knowing what I know now, I wouldn't have jumped into this at 37, with a family, and certainly wouldn't advise someone in the same situation to do so. But I love what I'm learning, have awesome classmates, attend a great school, and am doing very well.

If you don't mind me asking, where are you at in the process?
 
It isn't misery, it's just a lot of work for someone who has three children and a spouse he'd like to spend more time with. We're learning and adjusting, and thus figuring out how to manage our time so that we spend more with each other.

I'm early on in the process of medical school, but put a lot of time and effort into going back and getting the prerequisites, selling our home, moving out of state, etc. I'm not at all early in the process of getting to this point. I am a big believer in not falling for the sunk cost fallacy, but we've come way too far to just quit because it's hard. As Mayo said, though, it's the time away from family, stress, and impact on one's health that make you realize at a certain age, it may not have been the best move. At this point, though, it would likely be more stressful to leave school and look into another field. I'm not saying I hate medical school or find it unbearable, I am saying that knowing what I know now, I wouldn't have jumped into this at 37, with a family, and certainly wouldn't advise someone in the same situation to do so. But I love what I'm learning, have awesome classmates, attend a great school, and am doing very well.

If you don't mind me asking, where are you at in the process?
I actually feel the same way you do and I won't start until the fall. But at the same time, I look at this decision with the end in mind and I know that 15 years down the road, I will not regret it.

I agree that the current part of the journey is much harder when you are older though.
 
The point is that there is no straight answer. A million factors dramatically change the value to the point some simplistic stat is basically telling you the average height of men vs women: useless in the face of overwhelming individual variation.

FAANG has a large enough population you can dig up the average salary. Note they accept about 0.5% of job applicants, so this is already a very specific top 1%. And it still massively depends on:
  • Job level (duh)
  • Location (SFO/NYC vs podunk can be more than double)
  • Specialty skills, education, experience
  • Interview performance within level and negotiation skills (did you get a counteroffer? retention?)
  • The usual discriminatory stuff: gender, race, age, disability, "culture fit"
Your value on the job market depends on all these factors and then some.

FAANG in Silicon Valley will pay ~125-175k+0-50 signon fresh out of Ivy League undergrad CS. Many unverified stories claiming 250k+. That's if you can get in, which on a % basis is far harder than med school. Also notable is FAANG internship salaries, which annualize to about 120k last I checked.

Non-FAANG pay is significantly lower, and I don't know enough about those. Down to 60k is quite possible.
That's news to me. I have been under the impression that these software people, even in SF and NYC, are making 500k or more. People describe it as such but I had a feeling that is going to be impossible with just a 4 year degree otherwise everybody would go that route.
 
That's news to me. I have been under the impression that these software people, even in SF and NYC, are making 500k or more. People describe it as such but I had a feeling that is going to be impossible with just a 4 year degree otherwise everybody would go that route.
I know plenty of these software people, as in myself and a large chunk of my peers and above. I even know of 7-digit TCs in software well below VP. My stats were for fresh grads in the valley, which is one of the rare ways you can nail down a clean enough subpopulation to even give a usable range.

At senior engineer level, the range is approximately 300-600k, with a rough median around 450. At this point, more than half of your pay comes from stock grants, so it's effectively luck-based whether you joined the company at a good time, right before a stock price run-up (and that's exactly how the 500+s happen). Unless you count "predict which one of the FAANG will outperform as a stock analyst" as a relevant skill.

It is typical to get in with "only" a 4-year degree, and even with coding bootcamps and no degree. Graduate degrees are a minority, same as med. Similarly the selection filter is right at hire, with depressed success rates compared to med because it's so easy to apply. Ultimately, the total number of FAANG hires is roughly the same order as M1 seats, with far greater volatility on economics.

The career progression from new hire is about 0.5-1.5y to first promotion, and then 1-3y to promote to senior. Senior (and even midlevel these days) is considered a terminal level, so a majority of FAANG senior engineers will never promote to staff engineer, but their pay will move from 300 towards 450.

All these big name companies strongly devalue work experience outside their own circles - I've heard a half cut, so expect to have 5-10+YOE outside for them to even consider hiring you at senior level. It took me PhD+5 and serious results. It's common for 2-3YOE to be used to just qualify for the bottom rung.

This actually means joining as a new grad is the fastest way to get to FAANG senior. PhDs are generally valued at one promotion step, which means you spent 5 years inefficiently getting that promotion you could have gotten in 1. Fresh MScs aren't really hired at midlevel, more like extra doors to get in at the bottom for some roles. For an academic qualification that gets senior-on-hire, try tenured associate professor.

Also, expect a drop in title moving from smaller companies, usually one level. I've seen engineering directors at startups being hired as a mere senior (that's 3 rungs down), when they likely got a pay bump. Reverse holds; a FAANG senior is easily equivalent to a staff engineer or better at a less brand name company.

Tech is its own career path. The big problem with using it as a backup plan to med is that the success stories ala getting into FAANG are roughly comparable in difficulty to getting into med school outright. Plus, all your ECs, even your GPA, are worth exactly zip to a FAANG interviewer like me, as you live or die on your technical interview scores alone. Analogous hierarchical structure, completely different values.
 
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I know plenty of these software people, as in myself and a large chunk of my peers and above. I even know of 7-digit TCs in software well below VP. My stats were for fresh grads in the valley, which is one of the rare ways you can nail down a clean enough subpopulation to even give a usable range.

At senior engineer level, the range is approximately 300-600k, with a rough median around 450. At this point, more than half of your pay comes from stock grants, so it's effectively luck-based whether you joined the company at a good time, right before a stock price run-up (and that's exactly how the 500+s happen). Unless you count "predict which one of the FAANG will outperform as a stock analyst" as a relevant skill.

It is typical to get in with "only" a 4-year degree, and even with coding bootcamps and no degree. Graduate degrees are a minority, same as med. Similarly the selection filter is right at hire, with depressed success rates compared to med because it's so easy to apply. Ultimately, the total number of FAANG hires is roughly the same order as M1 seats, with far greater volatility on economics.

The career progression from new hire is about 0.5-1.5y to first promotion, and then 1-3y to promote to senior. Senior (and even midlevel these days) is considered a terminal level, so a majority of FAANG senior engineers will never promote to staff engineer, but their pay will move from 300 towards 450.

All these big name companies strongly devalue work experience outside their own circles - I've heard a half cut, so expect to have 5-10+YOE outside for them to even consider hiring you at senior level. It took me PhD+5 and serious results. It's common for 2-3YOE to be used to just qualify for the bottom rung.

This actually means joining as a new grad is the fastest way to get to FAANG senior. PhDs are generally valued at one promotion step, which means you spent 5 years inefficiently getting that promotion you could have gotten in 1. Fresh MScs aren't really hired at midlevel, more like extra doors to get in at the bottom for some roles. For an academic qualification that gets senior-on-hire, try tenured associate professor.

Also, expect a drop in title moving from smaller companies, usually one level. I've seen engineering directors at startups being hired as a mere senior (that's 3 rungs down), when they likely got a pay bump. Reverse holds; a FAANG senior is easily equivalent to a staff engineer or better at a less brand name company.

Tech is its own career path. The big problem with using it as a backup plan to med is that the success stories ala getting into FAANG are roughly comparable in difficulty to getting into med school outright. Plus, all your ECs, even your GPA, are worth exactly zip to a FAANG interviewer like me, as you live or die on your technical interview scores alone. Analogous hierarchical structure, completely different values.
How much do you think the average software engineer makes when comparing to what the "average" doctor makes? I don't think it's 500K or anywhere near that figure.

When comparing tech to medicine, at least you know that you will make 250K as some type of a doctor. I know tech people who have been unemployed for years after being laid off.
 
How much do you think the average software engineer makes when comparing to what the "average" doctor makes? I don't think it's 500K or anywhere near that figure.

When comparing tech to medicine, at least you know that you will make 250K as some type of a doctor. I know tech people who have been unemployed for years after being laid off.
My point is "average SWE" is not the same selectivity of population as "average physician".

To become an average physician, you have to pass through the pearly gates of med school admissions, which already marks you as top 1% in healthcare. That level of cutoff is roughly equivalent to "average FAANG hire" in tech-land.

Average SWE would be more comparable to "average healthcare professional", maybe RN and up (CRNA as lower class matched with non-SWE non-FAANG tech). Still no comparison which side gets more $$$.
 
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My point is "average SWE" is not the same selectivity of population as "average physician".

To become an average physician, you have to pass through the pearly gates of med school admissions, which already marks you as top 1% in healthcare. That level of cutoff is roughly equivalent to "average FAANG hire" in tech-land.

Average SWE would be more comparable to "average healthcare professional", maybe RN and up (CRNA as lower class matched with non-SWE non-FAANG tech). Still no comparison which side gets more $$$.
So what you're saying is "average tech person" means nothing then because the compensation can vary greatly?

Every tech person and their parents leads you to believe that they are making so much money. I never believed it.
 
So what you're saying is "average tech person" means nothing then because the compensation can vary greatly?
I have in fact written exactly that, multiple times. You can get whatever answer you want by changing the definitions of who counts in the average.

Having worked with both FAANG and physicians, the populations are roughly comparable in caliber, modulo the very different perspectives. Both are very homogenized top 1% slices of their professions, and make a$$loads of money, multiples of the lower prestige plebes in their fields. Both are simultaneously commonplace and utterly unrepresentative of their industries as a whole. Tech pays significantly more, but not multiples more, at corresponding percentile rank of comp.

Then you start seeing how capitalism works. I made orthopod money, 10x the population median, with psych lifestyle, writing software we kid ourselves is meaningful. Our beloved CEO gets 1000x my pay, with bounties per coworker fired. Our founder(s) makes 10x that twiddling his thumbs watching the animal spirits keep going. If you really want to optimize TC, go to Wall Street.
 
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I have in fact written exactly that, multiple times. You can get whatever answer you want by changing the definitions of who counts in the average.

Having worked with both FAANG and physicians, the populations are roughly comparable in caliber, modulo the very different perspectives. Both are very homogenized top 1% slices of their professions, and make a$$loads of money, multiples of the lower prestige plebes in their fields. Both are simultaneously commonplace and utterly unrepresentative of their industries as a whole. Tech pays significantly more, but not multiples more, at corresponding percentile rank of comp.

Then you start seeing how capitalism works. I made orthopod money, 10x the population median. Our beloved CEO gets 1000x my pay. Our founder(s) makes 10x that twiddling his thumbs watching the animal spirits keep going. If you really want to optimize TC, go to Wall Street.
But again, I'm just talking about the average person, not the outliers. Most tech people don't end up on wall street but every doc makes at least $250K for life into their 70's and even 80's sometimes.

When I say average tech person, I'm not talking about FAANG.
 
But again, I'm just talking about the average person, not the outliers. Most tech people don't end up on wall street but every doc makes at least $250K for life into their 70's and even 80's sometimes.

When I say average tech person, I'm not talking about FAANG.
The vast majority of tech people never make it into FAANG.

The vast majority of premeds never make it as a doc.

I'm done.
 
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The vast majority of tech people never make it into FAANG.

The vast majority of premeds never make it as a doc.

I'm done.
You answered my question though. I don't even know many FAANG people but I know a lot of people in tech and I think they inflate their earnings descriptions.

It's true most premeds don't make it to medicine but I don't care about that group since I'm not there anymore.
 
Well, glad you got your answer then, to whichever question that was...
 
As I said, glad you found the answer to a question that I had no interest, intent, nor information to answer.

If you're continually hanging out with tech bros anyone who keeps dickwaving their TC, I suggest you find better company.
 
As I said, glad you found the answer to a question that I had no interest, intent, nor information to answer.

If you're continually hanging out with tech bros anyone who keeps dickwaving their TC, I suggest you find better company.
Yeah, I don't trust those tech guys. My friends in med seem more down to earth.
 
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