Working 2 jobs?

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Baller MD

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Hey everyone,

I'm interested in psychiatry but I'm concerned about the (relatively) low pay. I know money is not everything so hear me out.

I'm looking to be in significant debt by the time I'm done with residency which all stems from med school. I paid for my own undergrad and worked to pay it off as soon as I could. I'm probably going to be in a 400k+ hole by the time I'm done training. I go to a state school as an out of state resident so that's why tuition is so expensive for me and there's not much I could have done about it besides apply to DO schools which at the time I refused to do.

Anyway, is it possible/realistic to work a full time job with set hours (ie 40 hours) while working another 10-20 hours on the side to supplement my income? Obviously I will only be doing this for a few years until my loans are paid off. Is it realistic to make 300k+ this way?

I know about loan repayment programs but I don't have full faith in those things as policy makers can change its criteria at any time they want (as evidence by Obama changing the criteria for one of it recently). I also hear that the scholarships for under-served areas are going away next year so there's that as well. So it seems it's all up to me to pay back these crazy loans.

Can anyone chime in?

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Yes, you can definitely work 40 hours one place and moonlight at another place and approach $300,000. Pay varies by region and location.

If you want to pay off student loans quickly, you might look at the VA. They just raised the match limit of their Education Debt Load Reduction program for the upcoming fiscal year. Now they'll match up to $120,000 over a 5 year period (up to $24,000 per year). I don't see that program going anywhere with the need the VA has to recruit physicians after last summer's scandal and all the returning veterans.
 
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I worked 3 extra jobs in residency to buy a car and a downpayment on my first house. I was making almost as much as the attendings. I chose not to continue doing this after training as I knew it would burn me out, but it's easily doable for a few years and many docs get accustomed to the higher level income and never stop.
 
In psychiatry, you can work entire weekends and find time to sleep and get paid as much as 5k a "shift." I found moonlighting in residency that wasn't quite that lucrative, but it was super easy (which was preferred - I just wanted to coast), and I did it about 2 weekends a months. If you can do something like that starting halfway through training, you'll take out a huge part of your debt. I couldn't imagine continuing it after training, but if you did, your income goals are pretty realistic.
 
I don't know if it's fair to say psychiatry makes relatively low pay cause we in general work less in the jobs we accept. When you rate our field hour-per-hour we often times make just as much as the other fields. Of course this isn't true with us vs Dermatology, but compared to surgery? Yes.

In psychiatry you have more room to manipulate your practice to the way you want it. ER, consults, inpatient, outpatient, methadone clinic, suboxone clinic, court evaluations, and some of these pay a heck of a lot more than others. If you play the game right you could make a heck of a lot more money while other fields are more flat with their opportunities. IM doctors, for example, tell me it's hard to set up a practice and fill it up because there's nowhere near as much of a shortage for their field vs ours in most areas.

My salary right now is based on me working only 32 hours a week. I get paid for a 40 hour week but I'm only scheduled to do 32 hours. In a few weeks I'll only be working 24 hours a week but will still be making the same full-time salary.
 
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Bravo Whopper. I completely agree with you in terms of opportunities, still trying to figure out how to work my way to under 30 hours, but now Im under 40 so at least thats good.
 
I was making a heck of a lot more money a few years ago than I am now. What's happened is my wife now works full time now vs being a stay-home mom for about 2.5 years. So I'm more content with making less. While I am not working much at my full-time job, it's because the department has set aside time for me to do what I would've done ANYWAYS FOR FREE cause I love psychiatry. That is do research, build connections for the department, and be involved with teaching.

I would've done that anyway even if they made me work the full 40 hours!! (And I get free food in the doctor's lounge, free GOOD food lke home-made chocolate chip cookies and high quality coffee).

If I wanted to manipulate the situation for evil I could just sit and play video games during the free hours but I really do enjoy working in an academic environment. I already have quite a few years of amassing cash and working in that direction. Continuing in that direction only would've put more money in the bank but with no real enjoyment over the process itself. That and I've pretty much always done well in investments too further reinforcing that I don't need the money.

All debts are paid except our mortgage that I expect to pay way ahead of schedule. All those things people do that spend lots of cash I'm not into. Maybe if I was then I'd opt for a cash over academics.

When my kids get older I might push the department to work me harder. Just that right now those kids are a handful.
 
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Yes, you can definitely work 40 hours one place and moonlight at another place and approach $300,000. Pay varies by region and location.

If you want to pay off student loans quickly, you might look at the VA. They just raised the match limit of their Education Debt Load Reduction program for the upcoming fiscal year. Now they'll match up to $120,000 over a 5 year period (up to $24,000 per year). I don't see that program going anywhere with the need the VA has to recruit physicians after last summer's scandal and all the returning veterans.
Can one negotiate with VA to work days/wk (M-TH)?
 
I will say this about the VA, and this is true of most state systems. There usually is flexibility but that flexibility must be played within already existing rules.

Most state hospitals including the VA (as far as I know-and the VA really isn't the state in terms of the 50 states, but the state in terms of government) have existing rules that allow docs to work more or less and get credit or less incentives for going on way or another. The "negotiation" must be handled within those rules.

If one were to break the rule's it'd have to be a very strong exception to the rule. E.g. When I worked at and left, they offered me to come back at a salary that was higher than was offered on the pay table they offer docs. What happened was that the #2 doctor in the hospital showed administration in the state that my performance numbers were through the roof compared to other docs that worked there and that I offered services virtually most of the other docs did not (because I had a forensic fellowship). They offered me about 30K more than the maximum allowable salary.

The administration were people literally in the governor's cabinet and people directly below them. Do not expect this to happen unless you're something special to them.
 
Hey everyone,

I'm interested in psychiatry but I'm concerned about the (relatively) low pay. I know money is not everything so hear me out.

I'm looking to be in significant debt by the time I'm done with residency which all stems from med school. I paid for my own undergrad and worked to pay it off as soon as I could. I'm probably going to be in a 400k+ hole by the time I'm done training. I go to a state school as an out of state resident so that's why tuition is so expensive for me and there's not much I could have done about it besides apply to DO schools which at the time I refused to do.

Anyway, is it possible/realistic to work a full time job with set hours (ie 40 hours) while working another 10-20 hours on the side to supplement my income? Obviously I will only be doing this for a few years until my loans are paid off. Is it realistic to make 300k+ this way?

I know about loan repayment programs but I don't have full faith in those things as policy makers can change its criteria at any time they want (as evidence by Obama changing the criteria for one of it recently). I also hear that the scholarships for under-served areas are going away next year so there's that as well. So it seems it's all up to me to pay back these crazy loans.

Can anyone chime in?


all excellent questions.....

1) Of course it's possible to work a full time job for 40 hours and then work another 20 hours on the side. Many people do this. The only difficulty sometimes is balancing the hours...it's sometimes difficult to fit in the 20 hr/week other job because the hours they want you may overlap with your real job. The only question is do you want to work 60 hours per week? but sure if you work 60 hours per week you can make 300k....that would come out to only about 105-110/hr...which is definitely doable(even when calculated hourly in the salaried job)

2) It seems to me you see more psychs working an extra job because the normal pay in psych is so low. The ER doc who is making 400k to work 1700 clinical hours doesn't pick up extra work because....well because 400k is pretty decent already. but when you are a psychiatrist and your base salary is 200k, well.....you've got a ways to go. But in general, MOST fields can work extra jobs. This is especially common with hospitalists. it's becoming very common for hospitalists now to juggle multiple hospitalists jobs if they want to make good money(ie > 400k)

3) In reading your previous posts, it seems you are very concerned about the financial end of things. If that's a big factor, I don't think this field is for you. You can make good money in psychiatry relative to a lot of jobs, but it's income potential is so much less than other fields of medicine...even other fields that are procedure heavy. Can you make 300k in psychiatry? Sure....but you're going to have to either hustle or cobble another job together....whereas in many fields you could make more than that 300k only working one job. Look at it this way- if you're ok with working 60 hours week and taking a second job and money is a prime factor, why not pick a field where you could work those 60 hours a week at two jobs and make 650k instead of 300k?
 
Yes, you can definitely work 40 hours one place and moonlight at another place and approach $300,000. Pay varies by region and location.

If you want to pay off student loans quickly, you might look at the VA. They just raised the match limit of their Education Debt Load Reduction program for the upcoming fiscal year. Now they'll match up to $120,000 over a 5 year period (up to $24,000 per year). I don't see that program going anywhere with the need the VA has to recruit physicians after last summer's scandal and all the returning veterans.

is this student loan matching thing guaranteed though? I have a friend who took a job at the VA last year(and this was a very solid candidate with no red flags, some previous good work experience, etc) and when she tried to go for this money she didn't get it. Maybe it was because it was a position the VA wasn't going to have a super hard time filling...I dunno.

On a side note, many of the good locations(and yes I realize what is and isn't a good location is very person dependent) for the VA are either all filled or rarely open. Just a quick look on USA jobs website or contacting the individual area recruiters(and people can pm me for various names if they want) shows that the jobs that are always open tend to be in the same places.
 
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It can be done. The going rate for an independent contractor is $130/hr. Work 10 hour days 5 days a week and BAM! 300k. :)

this is true....but then again, working 10 hours per day every week as an IC sorta sucks.
 
Thank you everyone for your wonderful advice so far.

all excellent questions.....

1) Of course it's possible to work a full time job for 40 hours and then work another 20 hours on the side. Many people do this. The only difficulty sometimes is balancing the hours...it's sometimes difficult to fit in the 20 hr/week other job because the hours they want you may overlap with your real job. The only question is do you want to work 60 hours per week? but sure if you work 60 hours per week you can make 300k....that would come out to only about 105-110/hr...which is definitely doable(even when calculated hourly in the salaried job)

2) It seems to me you see more psychs working an extra job because the normal pay in psych is so low. The ER doc who is making 400k to work 1700 clinical hours doesn't pick up extra work because....well because 400k is pretty decent already. but when you are a psychiatrist and your base salary is 200k, well.....you've got a ways to go. But in general, MOST fields can work extra jobs. This is especially common with hospitalists. it's becoming very common for hospitalists now to juggle multiple hospitalists jobs if they want to make good money(ie > 400k)

3) In reading your previous posts, it seems you are very concerned about the financial end of things. If that's a big factor, I don't think this field is for you. You can make good money in psychiatry relative to a lot of jobs, but it's income potential is so much less than other fields of medicine...even other fields that are procedure heavy. Can you make 300k in psychiatry? Sure....but you're going to have to either hustle or cobble another job together....whereas in many fields you could make more than that 300k only working one job. Look at it this way- if you're ok with working 60 hours week and taking a second job and money is a prime factor, why not pick a field where you could work those 60 hours a week at two jobs and make 650k instead of 300k?

1) I'm only willing to work that many hours at the beginning of my career to quickly pay off my loans.
2) I didn't realize this. Thanks for pointing it out.
3) Yes, I tend to post things that may err towards the financial side of things. Again, my loans will be around 400k by the time I'm done with med school and can balloon to 500-600k if I'm careless about it. If someone thinks that isn't concerning, then I don't know what to say.
 
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is this student loan matching thing guaranteed though? I have a friend who took a job at the VA last year(and this was a very solid candidate with no red flags, some previous good work experience, etc) and when she tried to go for this money she didn't get it. Maybe it was because it was a position the VA wasn't going to have a super hard time filling...I dunno.

On a side note, many of the good locations(and yes I realize what is and isn't a good location is very person dependent) for the VA are either all filled or rarely open. Just a quick look on USA jobs website or contacting the individual area recruiters(and people can pm me for various names if they want) shows that the jobs that are always open tend to be in the same places.

I agree with this. I think the VA only gives out loan assistance if they have a hard time filling a position. I guess that would be less likely in so-called nice areas such as Cali and the coastal cities.
 
This is separate vs what was mentioned above. I've heard data that if you work for the federal government for a certain amount of years your student loans are automatically paid for by the government. My sister-in-law is in such a potential position and is factoring this in to her possible next job choice. I'll ask her more about this because this is different vs the loan repayment mentioned above.
 
I agree with this. I think the VA only gives out loan assistance if they have a hard time filling a position. I guess that would be less likely in so-called nice areas such as Cali and the coastal cities.
Getting the max amount of Education Debt Load Reduction factors is impacted by location, and by how hard it is to fill the job and retain staff. The VA also prioritizes the money toward the most needed staff applying for the money. Psychiatry is generally in high demand. As with any other job, competition will be stiffer in LA or NY. However, there are many good positions that are not in the two or three largest metro areas.
 
all excellent questions.....

1) Of course it's possible to work a full time job for 40 hours and then work another 20 hours on the side. Many people do this. The only difficulty sometimes is balancing the hours...it's sometimes difficult to fit in the 20 hr/week other job because the hours they want you may overlap with your real job. The only question is do you want to work 60 hours per week? but sure if you work 60 hours per week you can make 300k....that would come out to only about 105-110/hr...which is definitely doable(even when calculated hourly in the salaried job)

2) It seems to me you see more psychs working an extra job because the normal pay in psych is so low. The ER doc who is making 400k to work 1700 clinical hours doesn't pick up extra work because....well because 400k is pretty decent already. but when you are a psychiatrist and your base salary is 200k, well.....you've got a ways to go. But in general, MOST fields can work extra jobs. This is especially common with hospitalists. it's becoming very common for hospitalists now to juggle multiple hospitalists jobs if they want to make good money(ie > 400k)

3) In reading your previous posts, it seems you are very concerned about the financial end of things. If that's a big factor, I don't think this field is for you. You can make good money in psychiatry relative to a lot of jobs, but it's income potential is so much less than other fields of medicine...even other fields that are procedure heavy. Can you make 300k in psychiatry? Sure....but you're going to have to either hustle or cobble another job together....whereas in many fields you could make more than that 300k only working one job. Look at it this way- if you're ok with working 60 hours week and taking a second job and money is a prime factor, why not pick a field where you could work those 60 hours a week at two jobs and make 650k instead of 300k?

seems like a lot of those jobs are either working more hour or two jobs as well to hustle and make big bucks. Pyshc is only different in that many dont even work a full 40 and still pull in 200. Seems like no matter what to make decent money you are gonna be doing some hustle whether thats 50+ hours with one job or two jobs to accumulate that time and money
 
Getting the max amount of Education Debt Load Reduction factors is impacted by location, and by how hard it is to fill the job and retain staff. The VA also prioritizes the money toward the most needed staff applying for the money. Psychiatry is generally in high demand. As with any other job, competition will be stiffer in LA or NY. However, there are many good positions that are not in the two or three largest metro areas.

Do you work for the VA?
 
Basically to make a lot of money in psychiatry you have to
1) Know people
2) Hustle

A cash only analysis practice in a rich area is the best way to do this (and you don't even need to know anything about medicine or neuroscience), but I am not sure how easy it is to get into/establish a practice right after residency. The NYC market is over-saturated and blue blood.

Forensics has the reputation for high pay, but again, you need to be established... and I doubt there are any non academic forensic psychiatrists who don't practice clinical psychiatry as well. (think: you need to be able to respond when the lawyer asks, "so when was the last time you actually evaluated and treated a patient?")

If you are okay with not practicing medicine, you could work for the pharmaceuticals, but again, I think that they generally hire more established psychiatrists (not people straight out of residency).

BUT, if you know how to hustle, that supersedes everything...
 
Basically to make a lot of money in psychiatry you have to
1) Know people
2) Hustle

A cash only analysis practice in a rich area is the best way to do this (and you don't even need to know anything about medicine or neuroscience), but I am not sure how easy it is to get into/establish a practice right after residency. The NYC market is over-saturated and blue blood.

Forensics has the reputation for high pay, but again, you need to be established... and I doubt there are any non academic forensic psychiatrists who don't practice clinical psychiatry as well. (think: you need to be able to respond when the lawyer asks, "so when was the last time you actually evaluated and treated a patient?")

If you are okay with not practicing medicine, you could work for the pharmaceuticals, but again, I think that they generally hire more established psychiatrists (not people straight out of residency).

BUT, if you know how to hustle, that supersedes everything...
 
Getting the max amount of Education Debt Load Reduction factors is impacted by location, and by how hard it is to fill the job and retain staff. The VA also prioritizes the money toward the most needed staff applying for the money. Psychiatry is generally in high demand. As with any other job, competition will be stiffer in LA or NY. However, there are many good positions that are not in the two or three largest metro areas.

it's not just about size of metro area(there are some va jobs available in fairly large metro areas right now...not sure if they offer the educational money). Size is just one component that makes an area ideal for many.

if you look at all the VA jobs open right now(and I have a pretty good idea what most of them are...perhaps there are some jobs that the employed VA receruiters aren't pushing publically that I don't know about) they are not in areas a lot of people want to live for the most part.
 
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Do you work for the VA?
Yes.

I'm in a friendly department, fair pay and workload, in one of the smaller VA Medical Centers (not an outlying clinic), pretty happy so far, good support staff. I do outpatient and consults. It's not perfect, of course, but after 6 months it's a pretty good gig. Better variety than I anticipated in cases , with so many younger veterans coming home.
I get to teach students, too, which I like.
We do have an opening for another psychiatrist. I'm not a recruiter, I'm just genuinely happy at this point.
 
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