Attending vs MBB: Lucrative consulting exits/career paths?

[Dirk__Diggler]

Hello everyone,

I'm currently in my last year of ER residency. During residency, I completed a summer internship at an MBB firm and got a return offer for after residency. I have two questions for SDN:

First, what are everyone's thoughts on taking the consulting FTO vs ER attending? Primary motivators are impact and monetary.
ER attending would be fewer hours, better salary, and more time to travel and work on side hustles. Consulting upsides seem to be that the sky is the limit, and the opportunities to create impact at scale. The starting salary is lower for consulting (250k vs roughy 450k in the ER), and the hours will be considerably worse in consulting.

Second, within consulting, for someone with clinical experience, what are the most lucrative exits? Linkedin search shows a lot of people go into biopharm, payor/provider, VC, PE, and startups but the salary/lifestyle/impact in those roles is difficult to find good info on.

My current thought is to accept the MBB offer, push the start date to about 6 months after residency, work as an attending for those 6 months and then do 12 months of consulting and reassess based on how much I enjoy it.

Would love to hear the forums thoughts. Thanks!

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[confused_doc]

How on earth did you manage to complete a summer internship during residency?

 

[Medstart108]

I agree, always maximize optionality. I have not done consulting work but I have friends in it, very different from ER. My honest thinking is, you either like one or the other. One is powerpoints, hierarchy, desk work and the other is active, decision making etc. The fact that you've gotten this far means you clearly like consulting, and they clearly like you enough to hire you. So, the best path would probably be to secure an attending post in ER for yourself, go into MBB and figure out if this really is for you, the ceiling at MBB is definitely much higher, but afaik, the hours are long, responsibility is high and at the senior levels you are certainly going to be working more than you would as an emerg attending (and making more).

 

[voxveritatisetlucis]

You will be taking a pay cut in MBB consulting at least initially unless you make it to partner which could be in 6-10 years or never. I guess you could make more as an engagement manager in a productive group compared to an an ER physician in a big coastal city but for others it’s at partner when the pay becomes significantly more

McKinsey Salary

The average McKinsey salary is a widely discussed topic in the consulting world. It makes sense. McKinsey is considered by most to be the world’s premier

managementconsulted.com

Exit opportunities in consulting are good but they tend to be more corporate roles rather than buy side finance (where the real, houses in Aspen/Hamptons type of money is made). There are a few PE shops that recruit from MBB but banking is a more well defined trajectory to VC/PE

 

[deleted1153764]

You will be taking a pay cut in MBB consulting at least initially unless you make it to partner which could be in 6-10 years or never. I guess you could make more as an engagement manager in a productive group compared to an an ER physician in a big coastal city but for others it’s at partner when the pay becomes significantly more

McKinsey Salary

The average McKinsey salary is a widely discussed topic in the consulting world. It makes sense. McKinsey is considered by most to be the world’s premier

managementconsulted.com

Exit opportunities in consulting are good but they tend to be more corporate roles rather than buy side finance (where the real, houses in Aspen/Hamptons type of money is made). There are a few PE shops that recruit from MBB but banking is a more well defined trajectory to VC/PE

Are the exit options as high paying at the EM and higher levels? Are they stable?

Usually they cull consultants at those levels.

 

[voxveritatisetlucis]

Are the exit options as high paying at the EM and higher levels? Are they stable?

Usually they cull consultants at those levels.

Not with the stability of medicine

 

[Dusn]

Where do you want to live? Im assuming 450k starting EM jobs are in rural areas, while consulting jobs are in major cities (nyc, sf) with lots of travel involved.

 

[torshi]

It all depends on your long-term goal.

1. MBB consulting would be much more worth it in the long-term if you're career-oriented; nonetheless, the MBB partner track takes about 10-12 years, then you can essentially lateral to a senior VP role of a healthcare/life sciences company

2. Also, another option is to pursue MBB consulting for ~2 years, then exit to healthcare buy-side roles = VC or PE

In short, I'm a non-target, EM APP-turned-investment banker in NYC who practiced for ~3 years prior to obtaining an MBA who tried to break into MBB; however, it all worked out since I transitioned my career to IB instead and soon will lateral to a buy-side PE / HF role.

With that said, I quickly learned that as a clinician you are essentially downstream from innovation and I was always interested in being at the forefront of the economy by way of investing or being involved in transactions, along with having no barriers to long-term career growth.

DM me if you're interested in a networking call.

 

[deleted1153764]

It all depends on your long-term goal.

1. MBB consulting would be much more worth it in the long-term if you're career-oriented; nonetheless, the MBB partner track takes about 10-12 years, then you can essentially lateral to a senior VP role of a healthcare/life sciences company

2. Also, another option is to pursue MBB consulting for ~2 years, then exit to healthcare buy-side roles = VC or PE

In short, I'm a non-target, EM APP-turned-investment banker in NYC who practiced for ~3 years prior to obtaining an MBA who tried to break into MBB; however, it all worked out since I transitioned my career to IB instead and soon will lateral to a buy-side PE / HF role.

With that said, I quickly learned that as a clinician you are essentially downstream from innovation and I was always interested in being at the forefront of the economy by way of investing or being involved in transactions, along with having no barriers to long-term career growth.

DM me if you're interested in a networking call.

So basically if you go to a "target" MBA with the MD added on, would you recommend doing 2 years at MBB then moving off to another position?

This is relevant for a doctor who has been practicing for 10 years clinically with a AP or lower partner salary already and would take a "pay cut" to start as a consultant.

Or would you recommend riding out medicine until reimbursement is cut and then join MBB at that point with more clinical experience?

 

[Medstart108]

So basically if you go to a "target" MBA with the MD added on, would you recommend doing 2 years at MBB then moving off to another position?

This is relevant for a doctor who has been practicing for 10 years clinically with a AP or lower partner salary already and would take a "pay cut" to start as a consultant.

Or would you recommend riding out medicine until reimbursement is cut and then join MBB at that point with more clinical experience?

I think whats not mentioned here is how hard it is to stick it out at "MBB" and how hard it is to get into MBB in the first place. I did a very rough estimation of how "difficult" breaking into MBB is just by comparing the competition in the business and medical fields for these roles and I estimated landing MBB consulting at the junior levels is roughly equivalent to getting into a top 30 med school.

Not only is the competition tough to get in, but staying in and performing at that level is also not for everyone. Physicians are smart, but having a business acumen, networking, social skills, big-picture thinking are not core requirements of being a physician, not every physician is going to succeed in the consulting world.

I also think you might be underestimating the ease of which you can enter MBB at a later stage, medicine is a different skillset so its less likely that you would be able to break in at a later stage without something on your CV other than just medicine.

So all in all, I don't think these two fields are apples to apples. A lot of people who would make great physicians would not do well in consulting and a lot of physicians would also truly be happier and more successful in the business world. You just need to figure out if you think this is for you.

 

[DonFL]

How on earth did you manage to complete a summer internship during residency?

My thoughts exactly -

 

[Dirk__Diggler]

How on earth did you manage to complete a summer internship during residency?

I used an elective block + a years worth of vacation time
It isn't as bad as it sounds. The internship is a nice change of pace and it pays relatively well.

 

[Dirk__Diggler]

I think whats not mentioned here is how hard it is to stick it out at "MBB" and how hard it is to get into MBB in the first place. I did a very rough estimation of how "difficult" breaking into MBB is just by comparing the competition in the business and medical fields for these roles and I estimated landing MBB consulting at the junior levels is roughly equivalent to getting into a top 30 med school.

Not only is the competition tough to get in, but staying in and performing at that level is also not for everyone. Physicians are smart, but having a business acumen, networking, social skills, big-picture thinking are not core requirements of being a physician, not every physician is going to succeed in the consulting world.

I also think you might be underestimating the ease of which you can enter MBB at a later stage, medicine is a different skillset so its less likely that you would be able to break in at a later stage without something on your CV other than just medicine.

So all in all, I don't think these two fields are apples to apples. A lot of people who would make great physicians would not do well in consulting and a lot of physicians would also truly be happier and more successful in the business world. You just need to figure out if you think this is for you.

In my experience, if you possess the hard and soft skills to succeed in med school/residency, you're more than capable of performing above the average at an MBB. That is one reason why they like hiring MDs, they generally perform well.

 

[deleted1153764]

I think whats not mentioned here is how hard it is to stick it out at "MBB" and how hard it is to get into MBB in the first place. I did a very rough estimation of how "difficult" breaking into MBB is just by comparing the competition in the business and medical fields for these roles and I estimated landing MBB consulting at the junior levels is roughly equivalent to getting into a top 30 med school.

Not only is the competition tough to get in, but staying in and performing at that level is also not for everyone. Physicians are smart, but having a business acumen, networking, social skills, big-picture thinking are not core requirements of being a physician, not every physician is going to succeed in the consulting world.

I also think you might be underestimating the ease of which you can enter MBB at a later stage, medicine is a different skillset so its less likely that you would be able to break in at a later stage without something on your CV other than just medicine.

So all in all, I don't think these two fields are apples to apples. A lot of people who would make great physicians would not do well in consulting and a lot of physicians would also truly be happier and more successful in the business world. You just need to figure out if you think this is for you.

Other people from my MBA class were able to get into the big 3 consulting group (one was a physician).

I spoke with recruiters (plus partners, EM, etc) at a big 3 a few years back at a recruiting event who basically offered an interview etc. I know there's preparation for the interview, etc but I think it wouldn't be that hard to get into considering the other people who got in from my MBA.

The problem is the risk of a major pay cut initially as an "associate" whereby you'd need to get to at least AP to get back to current salary. The associate role requires 60-80 hours of work and alot of travel as well.

Also the risk of "exit" options. How well do they pay if you leave at the Engagement Manager stage? Many leave at this stage to make a lateral move.

I am unsure if I would want to start over and its been a few years since my MBA so who knows at this point if I'm getting too old. Probably once you hit 50+, its a no go.