Why would anyone go into primary care nowadays?

[Pattycake25]

You forgot this little thing called taxes.

Damn, that's true. However, it still adds only a few more years to the resident lifestyle phase. As a crude, oversimplified estimate, say your overall income tax on such a salary is 25% (http://taxes.about.com/od/Federal-Income-Taxes/fl/Federal-Income-Tax-Rates-for-the-Year-2014.htm). 25% of 138K becomes 34.5K. Deduct that from the 90K earlier, and you still have a respectable 55.5K. 300K/55.5K comes out to a little less than 6.

I admit I made a big mistake that you quickly caught (thanks), and that I may potentially still be missing something else. If I'm not, though, I think an extra 6 years of a resident lifestyle is a reasonable price to pay for the subsequent liberation from debt. I mean, I'm not exactly living it up now as a student, nor was I at any point prior to enrollment at med school...

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[PL198]

Damn, that's true. However, it still adds only a few more years to the resident lifestyle phase. As a crude, oversimplified estimate, say your overall income tax on such a salary is 25% (http://taxes.about.com/od/Federal-Income-Taxes/fl/Federal-Income-Tax-Rates-for-the-Year-2014.htm). 25% of 138K becomes 34.5K. Deduct that from the 90K earlier, and you still have a respectable 55.5K. 300K/55.5K comes out to a little less than 6.

I admit I made a big mistake that you quickly caught (thanks), and that I may potentially still be missing something else. If I'm not, though, I think an extra 6 years of a resident lifestyle is a reasonable price to pay for the subsequent liberation from debt. I mean, I'm not exactly living it up now as a student, nor was I at any point prior to enrollment at med school...

Ugh there are so many things you are neglecting to include. This calculation is pointless.
Here's a few: State income tax, insurance changes, etc etc etc etc etc etc

 

[DermViser]

Damn, that's true. However, it still adds only a few more years to the resident lifestyle phase. As a crude, oversimplified estimate, say your overall income tax on such a salary is 25% (http://taxes.about.com/od/Federal-Income-Taxes/fl/Federal-Income-Tax-Rates-for-the-Year-2014.htm). 25% of 138K becomes 34.5K. Deduct that from the 90K earlier, and you still have a respectable 55.5K. 300K/55.5K comes out to a little less than 6.

I admit I made a big mistake that you quickly caught (thanks), and that I may potentially still be missing something else. If I'm not, though, I think an extra 6 years of a resident lifestyle is a reasonable price to pay for the subsequent liberation from debt. I mean, I'm not exactly living it up now as a student, nor was I at any point prior to enrollment at med school...

You mean live as a resident for six years AFTER finishing residency? Wow. Good luck with that. Even surgeons can't do that.

 

[PL198]

Yeah so you're gonna live like a resident until you're well into your 30s? If you graduate at 27, residency at 30, then we're talking 8-10 years honestly if you're actually considering everything at play and still minimizing expense.

 

[sinombre]

Yeah so you're gonna live like a resident until you're well into your 30s?

Some of us are going to live like med students until our 30s.

 

[maxxor]

Well with the choices Gen IM/Gen Peds/FM, Hospitalist tends to be quite popular. We don't have midlevel hospitalists. Yet.

I hate to be the contrarian, but there are lots of Midlevel hospitalists in MA. I did my subi on a hospitalist service that used NPs to carry 5 patients each.

The VA up here uses hospitalist NPs.

And my current residency program uses hospitalist PAs.

 

[Promethean]

So, y'all talk like 48k a year is poverty, and that "living like a resident" means not being able to have a house, a spouse, and children.

I challenge your premise. A great many of your patients are going to be people that don't come close to making 48k a year, and they have all of those things. I have managed to have all those things (sub in impoverished extended family in place of children) on less than that, as the sole income in the household. If you have a spouse, if they manage a similar income, you are pushing 100k, which is wealth beyond the wildest dreams of MOST American families.

It is a question of paying sooner or later, and how much. If you pay the loans off earlier, you don't inflate your lifestyle at the first opportunity, and in return you get 20-25 years of making several thousand dollars more per month that you aren't spending on loan repayment. Or, you can rush to live the so-called good life and find yourself stuck in it, as you struggle to keep up with all the additional debt you take on through mortgages, car payments, etc.

If the latter were my plan, since I care about financial freedom, Family Medicine would be insane. Hands down. You win the argument, @DermViser.

But, my plan for my first two years out of residency is to stick with my current lifestyle, work 60+ hours a week doing locums or moonlighting or whatever it takes to earn 200k above what I need to live on, after taxes and other expenses. 400k will pay off my loans and my house. At that point, I could decide that I only wanted to do direct care for people who can mostly only afford to pay me in barter and pies, and it won't matter because I won't have huge monthly payments to fret about. More realistically, I could end up ONLY taking home $150k or so and still living a better lifestyle than someone who rushed out to get the nicest car they could finance the moment they became an attending. I would be keeping more of what I earned than someone who had to pay it all out to banks as quickly as it came in.

Because I know what I want out of life, Family Medicine makes sense to me.

 

[BobbyB]

So, y'all talk like 48k a year is poverty, and that "living like a resident" means not being able to have a house, a spouse, and children.

I challenge your premise. A great many of your patients are going to be people that don't come close to making 48k a year, and they have all of those things. I have managed to have all those things (sub in impoverished extended family in place of children) on less than that, as the sole income in the household. If you have a spouse, if they manage a similar income, you are pushing 100k, which is wealth beyond the wildest dreams of MOST American families.

It is a question of paying sooner or later, and how much. If you pay the loans off earlier, you don't inflate your lifestyle at the first opportunity, and in return you get 20-25 years of making several thousand dollars more per month that you aren't spending on loan repayment. Or, you can rush to live the so-called good life and find yourself stuck in it, as you struggle to keep up with all the additional debt you take on through mortgages, car payments, etc.

If the latter were my plan, since I care about financial freedom, Family Medicine would be insane. Hands down. You win the argument, @DermViser.

But, my plan for my first two years out of residency is to stick with my current lifestyle, work 60+ hours a week doing locums or moonlighting or whatever it takes to earn 200k above what I need to live on, after taxes and other expenses. 400k will pay off my loans and my house. At that point, I could decide that I only wanted to do direct care for people who can mostly only afford to pay me in barter and pies, and it won't matter because I won't have huge monthly payments to fret about. More realistically, I could end up ONLY taking home $150k or so and still living a better lifestyle than someone who rushed out to get the nicest car they could finance the moment they became an attending. I would be keeping more of what I earned than someone who had to pay it all out to banks as quickly as it came in.

Because I know what I want out of life, Family Medicine makes sense to me.

talk is cheap. wait until you actually do these things and then post.

 

[Fluffy Pomeranian]

So, y'all talk like 48k a year is poverty, and that "living like a resident" means not being able to have a house, a spouse, and children.

I challenge your premise. A great many of your patients are going to be people that don't come close to making 48k a year, and they have all of those things. I have managed to have all those things (sub in impoverished extended family in place of children) on less than that, as the sole income in the household. If you have a spouse, if they manage a similar income, you are pushing 100k, which is wealth beyond the wildest dreams of MOST American families.

I'm so sick of hearing this argument. Only about 34% of Americans even have a college degree. After spending 4 years in college, 4 years in med school, and 3-7 years in residency, often working more hours than most Americans could dream of, I don't think a physician needs to shut up and just be thankful because they make more than someone with a high school diploma working at the mall.

I went to med school primarily because I want to serve as someone patients place their trust in and give responsibility to over the most intimate aspects of their life. I want to form strong relationships with my patients and be a positive influence in their life. But I also believe that after all the work I have and will put in to get there, I do deserve to live a comfortable life and provide nice things for my family because there were a lot of other easier and faster ways I could serve patients and improve their lives without so much sacrifice.

 

[username456789]

My reasoning is as follows:

-Average resident's salary: 48K
-Median starting FM attending salary: 138K
-Difference between the two: 90K
-Average indebtedness: 300K
-300K/90K = 3.3 years ** - I don't know and didn't research where you got 300K from, but I'm treating it as the amount you owe upon getting your MD. If that's the amount you ultimately pay back over 20 years, however, obviously a major perk of my plan is to not have to pay nearly that much, thanks to avoiding most interest.

You and @DermViser : I am aware that of course, I have to spend money on more things than just loan repayment. However, that is true for residency as well. The way I see it, graduating residency into an attending position is roughly equivalent to a 90K/year raise, with no other immediate changes in lifestyle expenses (bolded because this is an assumption essential to my post, so if I'm wrong, please let me know). Instead of using that raise to drastically improve your SoL right away, save it for a few years to wipe out your loans, THEN start living the high life.

As others pointed out, you're completely neglecting those pesky "tax" and "compounding interest" things. It changes the ballgame completely.

Now, I expect the uniformed public to make that mistake. But you should try to educate yourself a bit more than the average joe. You're in for a rude awakening.

 

[username456789]

Damn, that's true. However, it still adds only a few more years to the resident lifestyle phase. As a crude, oversimplified estimate, say your overall income tax on such a salary is 25% (http://taxes.about.com/od/Federal-Income-Taxes/fl/Federal-Income-Tax-Rates-for-the-Year-2014.htm). 25% of 138K becomes 34.5K. Deduct that from the 90K earlier, and you still have a respectable 55.5K. 300K/55.5K comes out to a little less than 6.

I admit I made a big mistake that you quickly caught (thanks), and that I may potentially still be missing something else. If I'm not, though, I think an extra 6 years of a resident lifestyle is a reasonable price to pay for the subsequent liberation from debt. I mean, I'm not exactly living it up now as a student, nor was I at any point prior to enrollment at med school...

Remind me again which year the government allowed 0.0% financing on student loans.

 

[username456789]

So, y'all talk like 48k a year is poverty, and that "living like a resident" means not being able to have a house, a spouse, and children.

I challenge your premise. A great many of your patients are going to be people that don't come close to making 48k a year, and they have all of those things. I have managed to have all those things (sub in impoverished extended family in place of children) on less than that, as the sole income in the household. If you have a spouse, if they manage a similar income, you are pushing 100k, which is wealth beyond the wildest dreams of MOST American families.

It is a question of paying sooner or later, and how much. If you pay the loans off earlier, you don't inflate your lifestyle at the first opportunity, and in return you get 20-25 years of making several thousand dollars more per month that you aren't spending on loan repayment. Or, you can rush to live the so-called good life and find yourself stuck in it, as you struggle to keep up with all the additional debt you take on through mortgages, car payments, etc.

If the latter were my plan, since I care about financial freedom, Family Medicine would be insane. Hands down. You win the argument, @DermViser.

But, my plan for my first two years out of residency is to stick with my current lifestyle, work 60+ hours a week doing locums or moonlighting or whatever it takes to earn 200k above what I need to live on, after taxes and other expenses. 400k will pay off my loans and my house. At that point, I could decide that I only wanted to do direct care for people who can mostly only afford to pay me in barter and pies, and it won't matter because I won't have huge monthly payments to fret about. More realistically, I could end up ONLY taking home $150k or so and still living a better lifestyle than someone who rushed out to get the nicest car they could finance the moment they became an attending. I would be keeping more of what I earned than someone who had to pay it all out to banks as quickly as it came in.

Because I know what I want out of life, Family Medicine makes sense to me.

To be fair, I remember when I was this idiotically idealistic and naive as a premed. How embarrassing.

 

[Psai]

Premeds just go away. You guys and your silly holier than thou attitude are so obnoxious. You think you're the only ones who came into medical school looking to help people? You think you're going to be better than the doctors now and live like a resident forever because you were poor? No one's impressed and we aren't an admissions committee. I see right through your bs. All the kids who start the year yapping about international health and underserved populations are the ones who gun for derm ortho ophtho uro etc. I've met exactly one person who is still a resident and is still planning on international medicine. Even they are wavering because of the burden of student loans.

It's painfully obvious when someone has no real life experience. You never held a job, you never paid taxes, you never supported a family. You tell us about living at 50k a year and preach to us about living frugally. You make all these ridiculous calculations that are so poorly thought out that they aren't even worth responding to. You tell us about the average American family, just parroting crap from news articles with no supporting research written by pisspoor journalists. I've lived at 20k a year in a bad neighborhood so don't cry to me about your hard life as a 50k middle class family. It sucked hardcore and I'm here so I can make sure that my kids won't have to go through what I did.

Doctors don't have trouble paying off loans because they are buying cars. What a stupid myth and it's a useless strawman argument. You have no idea what is like to live as an attending or resident. It's not just rolling in the dough after seeing ten patients a day. There are so many other expenses that you've never even considered that don't go into your simplistic calculations. Licensing exams alone run into the thousands of dollars. Emrs are more expensive than you can imagine.

I'm going to be a doctor because I'm way into the top 1%. I've always excelled at everything I do because I'm smart and I work harder than almost anyone else. I don't need my own peers or wannabes telling me that I will be making too much money and don't deserve it. If you want to give away your money and live at 50k for the rest of your life, be my guest. But all of you will talk the talk. None of you will walk the walk and I challenge any of you to prove me wrong in ten years.

 

[hallowmann]

I gotta be honest, I know a good amount of primary care docs, and they are happy doing what they're doing. A hospitalist I know makes over $140k working 1 wk a month. Whenever he wants, he can turn it into $250k with 2wks on. If he really wanted to work 21 days, he'd easily be making $370k (he actually did this for a period of time). He likes the work, finds it easy and is doing just fine. Honestly, that seems like a pretty versatile situation.

There are a lot of medical fields where you're basically at the whim of your employer (cough..cough..pathology). If not, you better brush up on those business skills, because its no fun opening a practice surrounded by some of these giant Kaiser-UPMC-Case hospital/insurance juggerhemoths. Doing primary care means you're in demand almost anywhere, and you can get a solid paycheck with little searching.

Now its a bit too early for me to know whether I actually like the work, but if you do, there are plenty of reasons to choose primary care. Obviously, its not for everyone, but there are plenty of people that have no problem doing it.

And who cares if people want a high paying specialty. If I was coming out of med school with $300k+ (or even $250k+) of debt, it might shorten my residency list too. For all the pre-meds out there, go to one of the cheapest schools you get into. At least then you can have the luxury of not choosing derm for the paycheck .

I'm so sick of hearing this argument. Only about 34% of Americans even have a college degree. After spending 4 years in college, 4 years in med school, and 3-7 years in residency, often working more hours than most Americans could dream of, I don't think a physician needs to shut up and just be thankful because they make more than someone with a high school diploma working at the mall.

I went to med school primarily because I want to serve as someone patients place their trust in and give responsibility to over the most intimate aspects of their life. I want to form strong relationships with my patients and be a positive influence in their life. But I also believe that after all the work I have and will put in to get there, I do deserve to live a comfortable life and provide nice things for my family because there were a lot of other easier and faster ways I could serve patients and improve their lives without so much sacrifice.

In fairness, I know plenty of people that go to school for 8 years and barely hit 6 figures (after working for some time). And I think its also fair to say that most docs I know live pretty comfortably (not extravagantly mind you) even with their loan repayments and high tax brackets. No one is saying to shut up and be thankful, but don't act like we are a particularly impoverished group. There are plenty of people that live most of their lives in debt. We just happen to be one of the few populations that tends to get out of it before we retire.

 

[username456789]

In fairness, I know plenty of people that go to school for 8 years and barely hit 6 figures (after working for some time). And I think its also fair to say that most docs I know live pretty comfortably (not extravagantly mind you) even with their loan repayments and high tax brackets. No one is saying to shut up and be thankful, but don't act like we are a particularly impoverished group. There are plenty of people that live most of their lives in debt. We just happen to be one of the few populations that tends to get out of it before we retire.

Just so you're aware, unless you're talking about docs who are fresh out of residency, most physicians you know who have been in practice for more than just a couple of years have had the advantage of much lower tuition/debt and slightly higher salaries previously.

I remember as a premed talking with the FP attending I worked with. I voiced some concern about all the debt I'd be incurring. His response? "Yeah, I know what you mean, my medical school was ~$10,000/year tuition and I owed almost $50,000 after graduating medical school." He had graduated medical school ~15 years prior.

Physicians from less than a generation ago are from another planet when it comes to discussing their debt/salary woes. Try not to look into the past to predict your future.

 

[hallowmann]

Just so you're aware, unless you're talking about docs who are fresh out of residency, most physicians you know who have been in practice for more than just a couple of years have had the advantage of much lower tuition/debt and slightly higher salaries previously.

I remember as a premed talking with the FP attending I worked with. I voiced some concern about all the debt I'd be incurring. His response? "Yeah, I know what you mean, my medical school was ~$10,000/year tuition and I owed almost $50,000 after graduating medical school." He had graduated medical school ~15 years prior.

Physicians from less than a generation ago are from another planet when it comes to discussing their debt/salary woes. Try not to look into the past to predict your future.

Actually, the physician I was thinking about was my brother who graduated with more debt then I hopefully will. He went to one of the most expensive medical schools at the time. He's still paying off the $250k he accumulated at the end of med school (<$80k left of what I imagine will be close to $400k-$450k paid when its all said and done). He also had/has a pretty comfortable life outside of residency.

EDIT: He's also part of the reason why I go to a pretty inexpensive medical school...

 

[WhippleWhileWeWork]

Something that's even harder for people to factor in (besides taxes, compound formulas, insurances, etc) is their own self discipline. Most of the people talking real big about how they will continue to live like a student or resident well into their first decade of being an attending have never had disposable income and have never paid down loans before. I only did it for 2 years after my first Ugrad degree in my first career, with a debt to income ratio of 1:2. It was a sacrifice and it was painful. I can't imagine too many people post-residency who will want to feel more pain, seems like you're probably tapping out by that point.

 

[Mad Jack]

Damn, that's true. However, it still adds only a few more years to the resident lifestyle phase. As a crude, oversimplified estimate, say your overall income tax on such a salary is 25% (http://taxes.about.com/od/Federal-Income-Taxes/fl/Federal-Income-Tax-Rates-for-the-Year-2014.htm). 25% of 138K becomes 34.5K. Deduct that from the 90K earlier, and you still have a respectable 55.5K. 300K/55.5K comes out to a little less than 6.

I admit I made a big mistake that you quickly caught (thanks), and that I may potentially still be missing something else. If I'm not, though, I think an extra 6 years of a resident lifestyle is a reasonable price to pay for the subsequent liberation from debt. I mean, I'm not exactly living it up now as a student, nor was I at any point prior to enrollment at med school...

You realize there's this thing called "interest," right? And that, as of next year most grad loans will be averaging about 8% if you factor in the up front fees? So if you've got 300k in loans, you're paying 24k a year just to keep up with the interest. So your 55k only pays down 31k of principle. Realistically you're looking at living life a resident for a decade on that salary.

 

[Mad Jack]

Something that's even harder for people to factor in (besides taxes, compound formulas, insurances, etc) is their own self discipline. Most of the people talking real big about how they will continue to live like a student or resident well into their first decade of being an attending have never had disposable income and have never paid down loans before. I only did it for 2 years after my first Ugrad degree in my first career, with a debt to income ratio of 1:2. It was a sacrifice and it was painful. I can't imagine too many people post-residency who will want to feel more pain, seems like you're probably tapping out by that point.

It's only painful if you like stuff. I don't really have anything that costs much that I enjoy, so I just don't get how living off of 40-50k a year post tax is so unbearable. I need one car, one TV, one cell phone, a computer, food, gas, and an apartment. I can easily swing those on 4-5k a month without feeling destitute lol. What kind of budget does a person have that they feel like they are in abject poverty with that level of income? Once my loans are paid off, I'm hoping to keep living cheap and by up some rental properties- wasting that excess capital on consumerism rather than investment seems foolish to me.

Hell, I was moving out of my apartment a couple weeks ago and I found a couple pay stubs from before I finished college. I was surviving on 14k a year pretax for about 5 years. Let's just say it has had a permanent effect on my spending habits and 60k per year still feels like way too much money to me all these years later.

 

[WhippleWhileWeWork]

It's only painful if you like stuff. I don't really have anything that costs much that I enjoy, so I just don't get how living off of 40-50k a year post tax is so unbearable. I need one car, one TV, one cell phone, a computer, food, gas, and an apartment. I can easily swing those on 4-5k a month without feeling destitute lol. What kind of budget does a person have that they feel like they are in abject poverty with that level of income? Once my loans are paid off, I'm hoping to keep living cheap and by up some rental properties- wasting that excess capital on consumerism rather than investment seems foolish to me.

Hell, I was moving out of my apartment a couple weeks ago and I found a couple pay stubs from before I finished college. I was surviving on 14k a year pretax for about 5 years. Let's just say it has had a permanent effect on my spending habits and 60k per year still feels like way too much money to me all these years later.

In my opinion, if you still feel this way in 7-10 years (after training) and continue to do this for another 10 years after that (loan repayment time), you will absolutely be the exception.

 

[BobbyB]

It's only painful if you like stuff. I don't really have anything that costs much that I enjoy, so I just don't get how living off of 40-50k a year post tax is so unbearable. I need one car, one TV, one cell phone, a computer, food, gas, and an apartment. I can easily swing those on 4-5k a month without feeling destitute lol. What kind of budget does a person have that they feel like they are in abject poverty with that level of income? Once my loans are paid off, I'm hoping to keep living cheap and by up some rental properties- wasting that excess capital on consumerism rather than investment seems foolish to me.

Hell, I was moving out of my apartment a couple weeks ago and I found a couple pay stubs from before I finished college. I was surviving on 14k a year pretax for about 5 years. Let's just say it has had a permanent effect on my spending habits and 60k per year still feels like way too much money to me all these years later.

don't forget that by residency a lot of people are married and looking to start families.

 

[Mad Jack]

don't forget that by residency a lot of people are married and looking to start families.

Given that most spouses will have incomes of their own, why would that be a problem? Two people pooling 50k is a six figure salary, more than enough to "survive" and raise a couple kids.

 

[hallowmann]

In my opinion, if you still feel this way in 7-10 years (after training) and continue to do this for another 10 years after that (loan repayment time), you will absolutely be the exception.

This sadly is true. When attending docs start seeing that they need new suits to go to department functions, and all their colleagues are driving brand new whatevers, they tend to feel the hurt/shame of being the only one driving the same old Hyundai Accent, especially when you'd rather spend time at home with your SO than using your weekends to fix it/get it fixed. Throw in random costs like conferences for CMEs, maintaining medical licenses, etc. etc.

On top of that, since some of you young whippersnappers will be in your early 30s after residency, you might be wanting to settle down and start a family, send kids to that Montessori school around the corner, etc.

Also, unless your spouse makes good money, it might be more cost effective to have them stay home with the kids.

Still doable, just harder.

 

[Psai]

It's only painful if you like stuff. I don't really have anything that costs much that I enjoy, so I just don't get how living off of 40-50k a year post tax is so unbearable. I need one car, one TV, one cell phone, a computer, food, gas, and an apartment. I can easily swing those on 4-5k a month without feeling destitute lol. What kind of budget does a person have that they feel like they are in abject poverty with that level of income? Once my loans are paid off, I'm hoping to keep living cheap and by up some rental properties- wasting that excess capital on consumerism rather than investment seems foolish to me.

Hell, I was moving out of my apartment a couple weeks ago and I found a couple pay stubs from before I finished college. I was surviving on 14k a year pretax for about 5 years. Let's just say it has had a permanent effect on my spending habits and 60k per year still feels like way too much money to me all these years later.

Yeah who likes stuff? Those diapers, toilet paper, child seats, daycare, taxes, they'll all just pay for themselves. Living as a college student is probably the same thing as a resident/attending with a family to take care of because college kids have to deal with mortgages, random expenses like car breaking down or the boiler blowing up, etc.

TL;DR live it first before you start talking about it

 

[Mad Jack]

Yeah who likes stuff? Those diapers, toilet paper, child seats, daycare, taxes, they'll all just pay for themselves. Living as a college student is probably the same thing as a resident/attending with a family to take care of because college kids have to deal with mortgages, random expenses like car breaking down or the boiler blowing up, etc.

TL;DR live it first before you start talking about it

I did the marriage thing already, it ain't for me again, ever. But if you're implying two people with incomes, one of which is pulling in 50k a year and the other that is likely pulling in the same or more, cannot comfortably raise children, you either don't know how to handle money or have expensive taste, both of which are your problems.

 

[Promethean]

None of you will walk the walk and I challenge any of you to prove me wrong in ten years.

It's a date, my friend.

 

[Promethean]

I don't understand how a tactical decision to spend 2 to 3 years extra living on more than I earned for most of my life is an enormous sacrifice. Especially when it pays such an incredible dividend as debt freedom.

You accuse me of having no life experience, but I have been working and supporting myself for longer than most pre-meds around here have been alive. I have owned a profitable small business that I started and built from nothing. I also lived in a crap neighborhood, earning less than 20k a year. No, I haven't been a resident or an attending, but hell, neither have most of you.

If you are aiming at being in the 1%, go for it. No one is stopping you. But stop implying that people who want something else are either stupid, naive, or lying.

 

[Psai]

Yeah many of us haven't and that's why you don't see us judging other people without having walked in their shoes. That doesn't give your opinions any more credence. You are naive and unexperienced, I don't need to imply it. It's very apparent in your posts.

 

[Promethean]

Yeah many of us haven't and that's why you don't see us judging other people without having walked in their shoes. You are naive and unexperienced, don't need to imply it. It's very apparent in your posts.

LOL.

Seriously, I can't stop laughing at you.

 

[Psai]

I am very concerned about a premed's opinion of me.

 

[sazerac]

Ultra fast? Not really. Living like a resident isn't realistic when you are an attending.... Just because something is possible doesn't mean it's right or acceptable... No idea what you are trying to say. A doctor COULD live on 50k a year, yet it obviously wouldn't be worth it, unless you're one of those calling people, which would mean you're full of ****.

It is a revered SDN tenet (almost an SDN law, really), that when somebody has been living on $50,000 a year for four or five years, and suddenly gets an increase in salary 4x or 5x or more, they couldn't possibly live on $50,000 a year anymore. It just can't be done.

The reasons given are usually taxes (increase faster than income), weddings and children (because no resident, normal $50K earner, or med student has ever done this), and home ownership (again, disregard all SDN posts about purchasing a home during med school or residency, it could never happen with sub-$100K take home pay. Never has, never will).

As somebody who has not finished residency, you will never get it, so just stop arguing now. You think it would be possible as a resident to put wage income after tax witholdings and after loan payments into bank account A, and then draw a regular salary from that account into normal checking account B for living expenses. Then when you get an attending salary you just keep drawing a similar salary off of account A into account B, giving yourself a raise of 10% or 20% a year, so you can ease into your new lifestyle. The extra savings in account A could be put towards loans. But no, the law of SDN income prohibits this. Cannot be done.

 

[Mad Jack]

Yeah many of us haven't and that's why you don't see us judging other people without having walked in their shoes. That doesn't give your opinions any more credence. You are naive and unexperienced, I don't need to imply it. It's very apparent in your posts.

I really feel like the "I need to finally spend some cash and buy nice things and keep up with the Joneses" mentality applies more to people who haven't had a real income their entire life. Many new physicians are basically getting their first "real" job in their early 30s, so they have a burning desire to spend that money from 31+ years of fantasizing. For nontraditional students like myself, that desire just isn't there- we've gone out and earned cash and consumed, and we're taking a short 4 year break from our regular consumption pattern to go back to medical school. When I'm in residency, my pay will be within a few thousand of my old job's pay, which has always been plenty for me. Even during medical school my income won't drop all that much thanks to the substantial savings I set aside prior to matriculation. So I just don't get where this need to spend is suddenly going to spring from when I will be able to afford the exact same luxuries I've always had.

Sure, there'll be a few extra expenses- but CME and many other expenses are often included in hospital employment packages, as is malpractice insurance. Dear god, I'll have to buy perhaps three suits that will last me for years and a new Elantra! Those easily fit into any non physician's budget, so I hardly think I will have a problem. Nor have I ever compared myself to others- I'm not a competitive or envious person by nature, so the idea that some guy is driving a cooler looking car than myself just doesn't even compute to me. I just want a quaint 2 bedroom house in a rural area,- not exactly going to break the bank- a car with good gas mileage, and a decent internet connection. Not too hard to afford.

 

[Promethean]

For nontraditional students like myself, that desire just isn't there- we've gone out and earned cash and consumed, and we're taking a short 4 year break from our regular consumption pattern to go back to medical school. When I'm in residency, my pay will be within a few thousand of my old job's pay, which has always been plenty for me. Even during medical school my income won't drop all that much thanks to the substantial savings I set aside prior to matriculation. So I just don't get where this need to spend is suddenly going to spring from when I will be able to afford the exact same luxuries I've always had.

Oh, Jack. You know very well that you and I haven't ever experienced anything. Just ask medical students. They will tell you all about yourself.

 

[BestDoctorEver]

I really feel like the "I need to finally spend some cash and buy nice things and keep up with the Joneses" mentality applies more to people who haven't had a real income their entire life. Many new physicians are basically getting their first "real" job in their early 30s, so they have a burning desire to spend that money from 31+ years of fantasizing. For nontraditional students like myself, that desire just isn't there- we've gone out and earned cash and consumed, and we're taking a short 4 year break from our regular consumption pattern to go back to medical school. When I'm in residency, my pay will be within a few thousand of my old job's pay, which has always been plenty for me. Even during medical school my income won't drop all that much thanks to the substantial savings I set aside prior to matriculation. So I just don't get where this need to spend is suddenly going to spring from when I will be able to afford the exact same luxuries I've always had.

Sure, there'll be a few extra expenses- but CME and many other expenses are often included in hospital employment packages, as is malpractice insurance. Dear god, I'll have to buy perhaps three suits that will last me for years and a new Elantra! Those easily fit into any non physician's budget, so I hardly think I will have a problem. Nor have I ever compared myself to others- I'm not a competitive or envious person by nature, so the idea that some guy is driving a cooler looking car than myself just doesn't even compute to me. I just want a quaint 2 bedroom house in a rural area,- not exactly going to break the bank- a car with good gas mileage, and a decent internet connection. Not too hard to afford.

To be honest with you, I was kind of surprised when someone said in that thread it would be difficult for a physician with 220k salary to pay back a 200k student loan in 7 years...

 

[PL198]

I really feel like the "I need to finally spend some cash and buy nice things and keep up with the Joneses" mentality applies more to people who haven't had a real income their entire life. Many new physicians are basically getting their first "real" job in their early 30s, so they have a burning desire to spend that money from 31+ years of fantasizing. For nontraditional students like myself, that desire just isn't there- we've gone out and earned cash and consumed, and we're taking a short 4 year break from our regular consumption pattern to go back to medical school. When I'm in residency, my pay will be within a few thousand of my old job's pay, which has always been plenty for me. Even during medical school my income won't drop all that much thanks to the substantial savings I set aside prior to matriculation. So I just don't get where this need to spend is suddenly going to spring from when I will be able to afford the exact same luxuries I've always had.

Sure, there'll be a few extra expenses- but CME and many other expenses are often included in hospital employment packages, as is malpractice insurance. Dear god, I'll have to buy perhaps three suits that will last me for years and a new Elantra! Those easily fit into any non physician's budget, so I hardly think I will have a problem. Nor have I ever compared myself to others- I'm not a competitive or envious person by nature, so the idea that some guy is driving a cooler looking car than myself just doesn't even compute to me. I just want a quaint 2 bedroom house in a rural area,- not exactly going to break the bank- a car with good gas mileage, and a decent internet connection. Not too hard to afford.

It's not keeping up with the Joneses, it's called " I'm gonna buy a frickin sweet set of new golf clubs so I don't blow my brains out." You'd never understand this fact as you're stuck in fairy land. Medicine is hard and incredibly stressful. But hey whatever, you can live on 50k for the rest of your life, so you're gonna be on that baller financial status anyway.

Again, a 4-5x salary increase DOES NOT end up as an 4-5x increase is disposable income. Don't you think if it was that easy, everyone would do it? You have no understanding of taxes, nor of life expenses. These posts are hilarious. You know we're not saying " living frugally is stupid, everyone should spend uber **** tons of money," right? It's just that you have an extremely unrealistic handle on what living frugally is. Dig your own grave, be my guest.

 

[PL198]

woops see below

 

[PL198]

I don't understand how a tactical decision to spend 2 to 3 years extra living on more than I earned for most of my life is an enormous sacrifice. Especially when it pays such an incredible dividend as debt freedom.

You accuse me of having no life experience, but I have been working and supporting myself for longer than most pre-meds around here have been alive. I have owned a profitable small business that I started and built from nothing. I also lived in a crap neighborhood, earning less than 20k a year. No, I haven't been a resident or an attending, but hell, neither have most of you.

If you are aiming at being in the 1%, go for it. No one is stopping you. But stop implying that people who want something else are either stupid, naive, or lying.

Typical holier than thou, special snowflake. You're the only medical student with those experiences and all the people before you

To be honest with you, I was kind of surprised when someone said in that thread it would be difficult for a physician with 220k salary to pay back a 200k student loan in 7 years...

LOL you realize average salaries aren't the same thing as starting salaries, right?

 

[Psai]

It's not that it can't be done, it's that it goes against human nature and no one actually does it. I don't expect you to understand because you haven't lived it. Do you guys think that you're the first ones to think of the whole "oh I'm going to live like a resident any pay off all my loans in two years" schtick? I've talked to many doctors and only heard of one person who paid off their loans in a year doing locums work and he was single. These are people who had a much smaller loan burden than we will.

It's like when premeds come in and ask if they should prestudy and almost every med student says no, that's stupid. The premed goes "oh I know how to study" and disregards us and comes back later telling us that it was a waste of time. Surprise, surprise. Or when first years ask about studying for step 1 during their summer and everyone says no go have fun. The people who study realize that they don't remember anything when dedicated study time comes around and it was a total waste. But nah, I'm sure you guys know better than everyone else and you'll be different because no premed has ever thought like you before and made crappy calculations that don't take anything into account.

 

[BobbyB]

both sides have stated their views, all that is left is evidence.

anyone know attendings who continued to live like residents while paying off their loans? what is the percentage of total attendings who do that? how about attendings in family medicine specifically?

 

[Mad Jack]

It's not keeping up with the Joneses, it's called " I'm gonna buy a frickin sweet set of new golf clubs so I don't blow my brains out." You'd never understand this fact as you're stuck in fairy land. Medicine is hard and incredibly stressful. But hey whatever, you can live on 50k for the rest of your life, so you're gonna be on that baller financial status anyway.

Again, a 4-5x salary increase DOES NOT end up as an 4-5x increase is disposable income. Don't you think if it was that easy, everyone would do it? You have no understanding of taxes, nor of life expenses. These posts are hilarious. You know we're not saying " living frugally is stupid, everyone should spend uber **** tons of money," right? It's just that you have an extremely unrealistic handle on what living frugally is. Dig your own grave, be my guest.

The other place I spend a lot of time aside from here are a few forums related to extreme early retirement. There are plenty of physicians and engineers on the forums that live on exactly what I plan to live on, who have paid their debt down in exactly the manner I plan to. There's some that go even more extreme than I plan to- this guy sree managed to pay down all of his debt, save nearly 700k into his investment porfolio, completely pay off his house, and retire at the age of 38. There's plenty of examples like his around the web if you just look around. Not everyone's goals in life involve buying stuff, nor does consumerism make everyone happy. I was able to fit literally everything I own in my car trunk and a 5'x5'x8' storage unit- I just don't need stuff and I never have.

Totally not sure how a new set of golf clubs'll keep you from blowing your brains out though. Golf makes me want to blow my brains out lol. All of my hobbies except one are extremely cheap- camping, hiking, video games, fitness and the like don't cost me much at all. Travel is the only major expense I have, and even that I do on the cheap (two months of travel actually costs me less than two months of living at home, even with the plane ticket included, due to my travel primarily taking place in developing countries and my living arrangements being only slightly above local standards. Even my "expensive" trips, such as when I went to Europe in 2012, only cost me 3k/month, food, lodging, travel, drinks, and plane tickets included.).

I guess it just bothers me that you insist, "since I cannot imagine my life in the way you suggest, it is impossible and completely insane." It isn't that crazy nor is it that hard for someone with a completely different set of priorities than you. Just because living on the cheap isn't up your alley doesn't mean that it is impossible.

 

[Mad Jack]

both sides have stated their views, all that is left is evidence.

anyone know attendings who continued to live like residents while paying off their loans? what is the percentage of total attendings who do that? how about attendings in family medicine specifically?

Here's sree's pre-retirement budget for 3.5 years. He was in outpatient IM. Paid off his loans prior to starting this budget, so those aren't in there, but you can see how much he was saving until he retired.

https://docs.google.com/spreadsheet...ZlRmTnRnVTlmNTh1aXFNcWdmd2c&pli=1&hl=en#gid=0

 

[Promethean]

I've talked to many doctors and only heard of one person who paid off their loans in a year doing locums work and he was single.

Well, if we are going to trot out the anecdata, the guy who gave me the idea is an attending that I've known since he was a fellow who did it while raising two boys his wife had while he was in residency. He paid off his loans and his wife's, since she became a stay-at-home when their second son was born with special needs. So, when he bought his first "attending car" he did it with cash.

We can trade stories all day. All I know is what I plan to do. I know that life can throw curve balls, but I'd wager that I've dodged a few more of those than you have, given my age. What kills me about this place is that people tell you that you can't know the future, but they turn around and tell you that what you have personally experienced doesn't count for anything either. Just their dogma about what is and isn't possible.

 

[PL198]

Again(I've said this at least 3 times now) I'm not opposed to living frugally. I'm not a material person and I am extremely thrifty. That doesn't mean I'm in lala land about the costs of things, like you are. You seem to think that I'm disagreeing with your notion that living frugally to pay off loans is a good idea. I'm not, it's a tremendous one. You just have to be realistic about it. No one is openly saying "spend money just to spend money," it's just that, there are way more costs than you are including.

I'll repeat this again, living frugally to pay your loans off faster is a great idea financially. It's a way to save large chunks of money in interest, alleviate stress and open up many additional opportunities in the future. However you have to be realistic about it.

 

[Mad Jack]

Again(I've said this at least 3 times now) I'm not opposed to living frugally. I'm not a material person and I am extremely thrifty. That doesn't mean I'm in lala land about the costs of things, like you are. You seem to think that I'm disagreeing with your notion that living frugally to pay off loans is a good idea. I'm not, it's a tremendous one. You just have to be realistic about it. No one is openly saying "spend money just to spend money," it's just that, there are way more costs than you are including.

I'll repeat this again, living frugally to pay your loans off faster is a great idea financially. It's a way to save large chunks of money in interest, alleviate stress and open up many additional opportunities in the future. However you have to be realistic about it.

I showed you an actual physician's budget that covers multiple years that proves it is, in fact, possible and I'm not excluding anything. Guy is married too, so don't say that it's impossible unless you're single.

 

[username456789]

I showed you an actual physician's budget that covers multiple years that proves it is, in fact, possible and I'm not excluding anything. Guy is married too, so don't say that it's impossible unless you're single.

I don't think (although I may be wrong) that he or anyone has been saying it's impossible; rather, that it's extremely difficult and entirely unlikely for most people. The fact that the forum you frequent is dedicated to "extreme" early retirement should help drive that point home.

Kudos to you if you're able to swing it. Most will not, and it's not entirely due to lack of wanting to either.

I've found that a disturbingly high percentage of premedical and medical students have an alarmingly distorted idea about what happens with interest on debt, what actual physician compensation entails, and what expenses (planned and unplanned-for) lurk around the corner. Which is why you get those comments about paying down "$200k in medical school debt in two years post residency on a $200k salary" pretty frequently on here.

 

[Mad Jack]

I don't think (although I may be wrong) that he or anyone has been saying it's impossible; rather, that it's extremely difficult and entirely unlikely for most people. The fact that the forum you frequent is dedicated to "extreme" early retirement should help drive that point home.

Kudos to you if you're able to swing it. Most will not, and it's not entirely due to lack of wanting to either.

Fair enough. Many people in this discussion have used the word "can't," which I suppose is my problem. The truth is they "won't" and there is nothing wrong with that. When someone says, "it's totally possible to pay off your loans in 4 or 5 years" they are very quick to insist that it cannot be done, you will not be able to do it, etc. It's entirely feasible, but only if you truly want to do it. Most people don't, and that's fine. But they shouldn't be so quick to knock those of us that plan on it. Someday, when my debt is all payed off, I fully intend to upload my budget and show SDN how it is easy, so long as it fits your goals.

 

[PL198]

I showed you an actual physician's budget that covers multiple years that proves it is, in fact, possible and I'm not excluding anything. Guy is married too, so don't say that it's impossible unless you're single.

How much were his loans? Again, you're cherry picking some random person that was successful on the internet. The fact that you have to go to an internet forum to find this, shows how rare it actually is. Also that dude has no expense for housing, which either A) someone paid it for him b) he's not a freshly minted doc c) he's excluding it. Your example is becoming less and less valid.

 

[WhippleWhileWeWork]

This thread is useless for the next 10 years or so....
Let's reconvene in 2024 and see how everyone is doing on their loans and budgets.

 

[Mad Jack]

How much were his loans? Again, you're cherry picking some random person that was successful on the internet. The fact that you have to go to an internet forum to find this, shows how rare it actually is. Also that dude has no expense for housing, which either A) someone paid it for him b) he's not a freshly minted doc c) he's excluding it. Your example is becoming less and less valid.

This is the last four years of his budgeting, he didn't keep perfect track until he became a member of the ERE forums. He paid off his condo and student loan debt early on, so those aren't included. Guy was an outpatient IM doc that lived on the same budget for many, many years- finished residency at 29 and retired at 38 if I remember correctly. He bought a cheap condo and had just under 2ook in debt at the outset, which he paid off as quickly as possible, then saved for the next few years and just retired outright with around 700k in assets.

 

[PL198]

This is the last four years of his budgeting, he didn't keep perfect track until he became a member of the ERE forums. He paid off his condo and student loan debt early on, so those aren't included. Guy was an outpatient IM doc that lived on the same budget for many, many years- finished residency at 29 and retired at 38 if I remember correctly. He bought a cheap condo and had just under 2ook in debt at the outset, which he paid off as quickly as possible, then saved for the next few years and just retired outright with around 700k in assets.

And that's gonna be a high quality retirement I'm sure. But yeah he did it so great, my point is that he's 1/1000000 and you're acting like being that is so easy. Look if someone is going to retire at 38 with 700k in assets and are married, they're planning on living extremely frugally.