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I think @aneftp is her tax advisor:Yoooooo š
I would love to see the look on your employers face when you submit that CME reimbursement

I think @aneftp is her tax advisor:Yoooooo š
I would love to see the look on your employers face when you submit that CME reimbursement
I actually have the killers vip tickets that same week in Vegas Jan 24. Good idea. May try to swing by the next day now that you mention it.Are you sure you arenāt talking about the AVN Awards?
I actually have the killers vip tickets that same week in Vegas Jan 24. Good idea. May try to swing by the next day now that you mention it.
A big issue in our country is that nowadays LCOL and good public education doesnāt go hand in hand. Thatās probably a debate for another thread
Are you sure you arenāt talking about the AVN Awards?
This is interesting.You could be surprised. I was talking to one of our nurses whose husband is an engineering professor and on the admissions committee at our local University of California campus. She has access to very granular data about undergraduate admissions. In terms of college admissions, the kids applying from the ābestā school districts are often at a disadvantage compared to kids applying from a decent (but non the best) school district. Thatās because they are competing against their own classmates many of whom are gunning for the same schools. The kids applying from what is widely acknowledged as the best public high school in one of the most expensive districts in the county had a 5% admission rate to our local UC in the last cycle. The kids who applied from the middling high school in a much cheaper school district that my daughter attended years ago had a 30% admission rate in the same cycle.
The schools do offer all the same AP classes but most of kids at the top school take them while a minority of kids at the middling school do. Guess itās a big fish-small pond issue.
You could be surprised. I was talking to one of our nurses whose husband is an engineering professor and on the admissions committee at our local University of California campus. She has access to very granular data about undergraduate admissions. In terms of college admissions, the kids applying from the ābestā school districts are often at a disadvantage compared to kids applying from a decent (but non the best) school district. Thatās because they are competing against their own classmates many of whom are gunning for the same schools. The kids applying from what is widely acknowledged as the best public high school in one of the most expensive districts in the county had a 5% admission rate to our local UC in the last cycle. The kids who applied from the middling high school in a much cheaper school district that my daughter attended years ago had a 30% admission rate in the same cycle.
The schools do offer all the same AP classes but most of kids at the top school take them while a minority of kids at the middling school do. Guess itās a big fish-small pond issue.
This is interesting.
Are they actively suppressing the admissions rates of those schools because they have a quota for taking a certain number of students from certain schools or regions? Or do they think the students from the āweakerā schools with good stats are more impressive?
Are they not accepting kids who they think may be applying there as a backup to more prestigious schools?
Maybe there are fewer applicants from the middling schools. Not every kid that goes to a great school in an affluent district is a great student, but their parents are probably more likely to push them to apply to more reach schools. The kids from the middling school may not bother if they know their chances are slim. That would also impact admissions rates.
Regardless, I wouldnāt take this as a reflection of the quality of schools. Strong students with supportive, resourceful parents can succeed in any setting. It doesnāt mean the school is good. On the other hand, a good school can make all the difference for some students.
Lucky in that sense. I live in a LCOL area with good school district A/A/A- rating in niche. Cookie cutter homes here (4BR/2BA) go for < 300k.A big issue in our country is that nowadays LCOL and good public education doesnāt go hand in hand. Thatās probably a debate for another thread
Despite all this, why is it still so expensive to hire a lawyer? Even for minor civil matters it's thousands for retainers and hundreds an hour. At least when I pay out the nose for a plumber, I know they are making around 6 figures.āJohn reduces three years of law school to three words: āI was median.ā Average grades meant employers wouldnāt look at him despite having a Tier 1 school on his resumĆ©. Six years later, John still finds this insane. āThe legal industry treats law graduates like your career is determined before itās even started!ā
John estimates applying to 500 jobs before and after graduation. Out of this, he got four interviews; two were just courtesies. The only ājobā John landed was a volunteer position for a government agency. He lived in a former tenement in the South Side of Chicago and went on Medicaid for health insurance. Unable to make payments, his student loans quickly ballooned from $205,000 to $260,000. He scrambled to find doc review gigs for $19 to $22 hour. This meant reading thousands of spam emails and clicking on the ones that were not relevant to the pending lawsuit. He felt like a trained chimpanzee.
Whenever he could, John shared his nightmarish story on TLS. He posted in the āValeā and began his own discussion threads styled as public service announcements:
Just a warning to all new applicants. This process takes a lot out of you mentally, puts you in a mountain of debt, and in the end, is nothing more than a giant pyramid scheme that allows silver-haired shysters running law schools to become millionaires with no accountability to what they are doing to students or to society [. . .] I've seen this scam wilt the life out of so many brilliant, young people, from the T6 on down. You should make sure you're not one of them.ā
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This is where all the unemployed lawyers go to cry
The āVale of Tearsā is an epic thread on the Top-Law-Schools forum that chronicles the lawyer unemployment crisis.theoutline.com
Yoooooo š
I would love to see the look on your employers face when you submit that CME reimbursement
Despite all this, why is it still so expensive to hire a lawyer? Even for minor civil matters it's thousands for retainers and hundreds an hour. At least when I pay out the nose for a plumber, I know they are making around 6 figures.
I believe the region absolutely matters, a lot.Are they actively suppressing the admissions rates of those schools because they have a quota for taking a certain number of students from certain schools or regions? Or do they think the students from the āweakerā schools with good stats are more impressive?
Because those thousands of dollars are going to JG Wentworth not the lawyer that works for JG WentworthDespite all this, why is it still so expensive to hire a lawyer? Even for minor civil matters it's thousands for retainers and hundreds an hour. At least when I pay out the nose for a plumber, I know they are making around 6 figures.
A friend of mine went to a large prestigious public high school. There were more than 30 people in her class that applied early decision to a particular top 20, non-Ivy college, and half of them had alumni parents. Good luck with those odds.You could be surprised. I was talking to one of our nurses whose husband is an engineering professor and on the admissions committee at our local University of California campus. She has access to very granular data about undergraduate admissions. In terms of college admissions, the kids applying from the ābestā school districts are often at a disadvantage compared to kids applying from a decent (but non the best) school district. Thatās because they are competing against their own classmates many of whom are gunning for the same schools. The kids applying from what is widely acknowledged as the best public high school in one of the most expensive districts in the county had a 5% admission rate to our local UC in the last cycle. The kids who applied from the middling high school in a much cheaper school district that my daughter attended years ago had a 30% admission rate in the same cycle.
The schools do offer all the same AP classes but most of kids at the top school take them while a minority of kids at the middling school do. Guess itās a big fish-small pond issue.
I didn't go into medicine purely for financial goals. I certainly didn't pick Anesthesia for the money, but at the time I was a little envious of my classmates matching into the six year integrated cardiothoracic / NSG / Ortho. As I progress through my 30s, I realize that at the end of the day, all of that doesn't matter. Physicians never have, and never will compete with the Finance Brahs or the tech folks (with the rare exception of those surgeons working day and night to pull 7 figures).
After getting outbid on house after house, I've come to realize that while Anesthesia can give you a comfortable salary in the $400-600k range with absolute gratification; tech and finance (the true upper class) will always beat us.
Google, NVIDIA, Amazon, Tesla, Microsoft, and especially Meta directors have been on a tear in the South Bay. I thought they also made similar to what I make, but my eyes were finally opened after the last two bidding wars (in a climate with increasing interest rates and largely over valued housing). These clowns make millions of dollars a year:
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Facebook Director Product Manager Salary | $860K-$2.08M+ | Levels.fyi
The median total compensation package for a Director at Facebook is $1,415,468. View more Product Manager salary ranges with breakdowns by base, stock, and bonus amounts.www.levels.fyi
I cannot compete with someone making $2 million a year; nor did I ever know such things existed when I was in college or medical school. I knew about banking and finance, but I also knew about 2008 and losing it all. These tech, Venture Capital, Private Equity folks don't, and they have never seen their salaries during a real recession. So they get the bank to actually think their salary is $2 million and they are driving up the costs of housing even more when it's counter intuitive. I truly make my compensation, but they truly make $300,000 plus some made up RSU amount. It's extremely aggravating what capitalism has allowed to happen.
Then you have the corrupt Private Equity and Venture Capitalists riding what's left of the Covid boost knowing that they are one recession away from being solidly in the red on their over-leveraged lifestyles. It's a borrow now and worry about tomorrow attitude.
I'm not jealous of these tech or finance people; I just know they are doing it the wrong way and it ruins it for those of us doing it the right way - getting a good job, working hard, vetting in total index funds, saving up for a down payment and buying a correctly priced home. All physicians I know are conservative and these clowns just aren't and they ruin everything for everyone.
TLDR: I love Anesthesia, I love my current job. I'm so absolutely disgruntled with the amount of over leveraged "made up" money in South Bay it isn't funny.
Because Law, like so much else has become a āwinner take allā field.Despite all this, why is it still so expensive to hire a lawyer? Even for minor civil matters it's thousands for retainers and hundreds an hour. At least when I pay out the nose for a plumber, I know they are making around 6 figures.
One of my nephews goes to Berkeley. First year. Thank god for my brother since heās paying a ton for Cornell for the kid. Itās the same education. Other kids is tennis bum so ended up at UC riverside. The state schools better deal. Another nephew 2nd year Stanford but they got 50% off.I believe the region absolutely matters, a lot.
Those schools value geographic diversity.
Every high achieving SF bay area kid applies to Stanford. Every single one of them. I did too. It's hard to stand out. I got in everywhere else I applied, but not there.
At the time I was disappointed because it was my first choice, but it was a blessing. Went to a UC instead, graduated without any debt, things turned out OK.
Ideally, you'll retire with at least a $10 million net worth or greater to live the Fat FIRE lifestyle. Once you've got investable assets greater than $10 million, you should have no problem generating between $200,000 ā $500,000 a year in passive investment income. Once you get about $500,000 in passive income, youāre earning almost a top 1% income, which is definitely Fat FIRE.
Fat FIRE Is The Best, But Hardest Way To Retire Early
When you are no longer working for money, it's best to have as much money as possible. There's no point retiring early if you're going to constantly stress about whether you have enough money to pay the bills.
With Fat FIRE, you are truly free to live like a boss. As a Fat FIRE, you can do whatever you want, wherever you want in the world. And if you choose to earn supplemental income because it makes you happy, by all means do so. Pad your net worth even more so you can Fat FIRE even bigger.
Financial Samurai is focused on Fat FIRE. We want to help readers build great wealth through not only aggressive savings, but smart investing. However, that doesnāt mean you canāt reach Lean FIRE, Batista FIRE, and Regular FIRE along the way. Just remember to follow the rules of FIRE and not try and trick or cheat your way to financial independence. If you do, you're just hurting yourself.
To provide for a Fat FIRE lifestyle in SF, we've estimated needing at least $285,000 in passive to semi-passive investment income. However, due to inflation, I'm shooting to consistently generate $350,000 in passive income.
Oh man.
Late to the party here, but wow.
I'm EM in the northeast, make about 400k, millionaire a few years out of training, bought a modest house in a good school district that's bigger than the one I grew up in. I work on avg 3.5 days/week.
I'm doing great.
Thanks for the perspective š¤£...Bay area šš¤£
For reals. I know 30 yo physicians who are already complaining of knee pain walking up and down a couple of stairs. Retiring to bed rest at that rate. At least theyāll be able to DoorDash to their heartās content.
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Mark Zuckerberg says AI could soon do the work of Meta's midlevel engineers
Mark Zuckerberg told Joe Rogan that Meta will eventually reach a point where all coding for its apps is done by AI.www.businessinsider.com
Seems like a lot of possible jobs will be at risk.
The trades don't seem like a bad deal now
How's the Metaverse going?
Because those thousands of dollars are going to JG Wentworth not the lawyer that works for JG Wentworth
Amazing advertising....
"I HAAAVE A STRUCTURED SETTLEMENT AND I NEED CASH NOWWWW!"
I have a law degree. I think I can explain what happened to the legal profession. Please don't permaban me for commenting.It's incredible what a wasteland law is. Not sure when it got so bad. At least since the 90s? One of my college friends ('96 grad) went to law school and really struggled to find good work. I can't imagine applying to 500 jobs.
Every one of us here probably got 500 cold calls and emails from recruiters begging us to work last year.
I have a law degree. I think I can explain what happened to the legal profession. Please don't permaban me for commenting.
Three basic things occurred. First, the need for legal services declined due to simplified probate, no fault divorce, no fault auto insurance, deregulation of transportation etc. The Stark law didn't offset these changes to the legal landscape
Second, the delivery of legal services became automated due to word processing and computerized legal research. A lawyer can spit out a custom will and trust in no time. Law firms have computerized motion banks that require very little customization and review. These are just examples.
Third, law firms can no longer train associates on the dime of large corporations. Big companies flyspeck their legal bills and will not pay for the time of young associates who are learning how to practice law.
If you want to see what a scam legal education has become see this article by Paul Campos, a double Michigan graduate on the faculty at Colorado. The Crisis of the American Law School
Well, it was getting terrible in 1982. I knew two guys that year who were admitted as nonresidents to the University of Michigan Law School in the 1970s. At that time, UM's admission standards for nonresidents were almost as high as the general admission standards at Harvard Law School. One of these guys, who was also a tremendously talented writer, couldn't get a legal job of any kind and the other guy was chasing down deadbeat dads for Washtenaw County.Good points. Going to read the paper you cited later, but one thing jumped out at me in the abstract:
"...resident tuition at public law schools has nearly quadrupled in real terms over just the past two decades. Meanwhile for more than 30 years now the percentage of the American economy devoted to legal services has been shrinking. In 1978 the legal sector accounted for 2.01% of the nationās GDP: by 2009 that figure had shrunk to 1.37% -- a 32% decrease. These two trends are not mutually sustainable."
Maybe he expands on it later in the paper but even if there is a 32% decrease in legal work as a percent of the economy, the economy has still grown dramatically over the past 30-50 years. I agree that there is an ongoing problem of decreasing wages for US attornies, I just think this particular stat is deceptive.
You can bet your boots that this mid tier law school has a website that speaks glowingly about the employment prospects of its graduates. You can also bet that the average faculty member at that school teaches five hours a week and only spends two weeks a year grading exams. It wouldn't be so awful if the graduates didn't go neck deep in debt. You can only imagine how many law school graduates have foregone parenthood because of the debts they accrued in law school.I have a family member who graduated a mid tier law school about 20 years ago in a smaller city. He saw one of his classmates waiting tables and another working in a Home Depot a few years after graduating to make extra $. They both passed the bar.
Wow I opened up that article to just read the intro but was hooked haha. Very well written and I ended up reading all of it. There are parallels you can draw with medical training as well, although probably not as bad as the law profession. Some parts I liked:If you want to see what a scam legal education has become see this article by Paul Campos, a double Michigan graduate on the faculty at Colorado. The Crisis of the American Law School
Based on the above definitions, here are estimates of what percentage of the graduating classes of 2011 at the nationās 20 highest-ranked law schools hadundesirable employment outcomes as of:
February 15, 2012:
NYU: 23.6%
UCLA: 47.0%
USC: 42.9%
Given this pattern, certain fairly reliable conclusions can be drawn about what salaries graduates of the class of 2011 were receiving nine months into their nascent legal careers. NALP reported a median salary of $60,000 for graduates of the class. This means that 20.95% of the class was reported to be making a salary of $60,000 or more. The true figure is probably higher, but how much higher?84 Because salary reporting rates are so much higher among graduates with well-paying jobs, it seems improbable that more than one quarter of the class of 2011 was making $60,000 or more nine months after graduation. This conclusion can also be extrapolated from the so-called bimodal salary distribution in salaries paid to recent law graduates. As Professor William
Hendersonās analysis of the data has made clear, there are actually very few entry-level legal jobs that pay more, but not much more, than the median reported salary.85 A very large number of entry-level legal jobs pay between $35,000 and $60,000 per year, while a smaller number pay the six-figure salaries that big firms offer to starting associates. We know the reporting rates for six-figure salaries are very high, and that there are comparatively few jobs that pay in the high five
figures. In short, it seems unlikely that many graduates are making more than the reported median, yet having their salaries go unreported.86
Roughly speaking, we can estimate that at present perhaps 15% of law graduates are securing high-paying entry-level legal jobs, and another 25% are getting legal jobs that pay in the mid five figures, while a solid majority of graduates are unable to secure full-time, genuinely long-term legal employment within a year of graduation. The consequences for recent graduates of this overall employment and salary situation, given the skyrocketing cost of obtaining a law degree, are dire.
First, contrary to claims that what appears to be the unsustainable cost structure of legal education is only a temporary anomaly, produced by the downturn in large firm entry-level hiring in the wake of the recession of 2007-2008, there is a great deal of evidence that, for more than two decades now, long-term structural changes in the market for the providers of legal services have been eroding the expected return on
law degrees.. As a percentage of gross domestic product, the legal services sector in America has contracted by nearly one-third since the late 1970s.110 These long-term changes were reflected in hiring statistics for new law graduates well before the recent recession.
Almost every long-term trend in the employment market for graduates of American law schools points toward the elimination of jobs, especially entry-level jobs for lawyers. Technology and outsourcing are the two most obvious structural factors that help explain a 33% functional
unemployment rate among graduates of ABA law schools, even prior to the recent downturn.113
Thus over the course of the last four decades, American law schools have moved from a system in which faculty at a few elite law schools taught four classes per year, while faculty at other schools generally taught five or six, to a system in which those numbers have been reduced by nearly 50% at elite schools, and by nearly as much at many non-elite schools, as well.33 As we are about to see, this change has played a considerable role in driving up the cost of legal education. But before turning to the specific financial consequences of this change, we should not overlook the fact that the enormous increase in spending on faculty compensation at law schools in recent years has been dedicated largely to goals other than improving the classroom experience of law students.
Legal aid clinics were, among other things, originally a response to those complaints. In this regard they have had some effect, but whether that effect has been to make law school graduates more practice-ready than they would have been otherwise is debatable. The clinical legal experience no doubt helps those students who participate in it to have a better sense of what some forms of legal practice involve. Most law students, however, complete their legal educations without having participated in a clinic.53 This fact raises a question: what effect does the availability of clinical legal education have on what goes on in the traditional, ādoctrinalā classroom? If the effect is to make doctrinal legal education even less practical than it would otherwise be -- because the
doctrinal faculty believes, either consciously or otherwise, that students learn the nuts and bolts of legal practice in clinical classes that in fact most law students never take ā then paradoxically clinical legal education may have a net effect of making legal education as a whole less practical
than ever for the average student.
In recent years dozens of law schools have built new main buildings, or expanded existing facilities, even when they already possessed impressive and even magnificent physical plants.59 Law school building campaigns are often classic examples of conspicuous consumption at the social-institutional, rather than the individual, level: School A
builds a fancy new building, and as a result School B discovers that it āneedsā a new building too, in order to keep up with the academic Jonesās.).60
Now it is true that building campaigns are generally funded via some combination of private money, the university's general fund, and, at public schools, tax dollars. But when such efforts fall short, part of the direct cost can end up being transferred to law students. Another complicating
factor is that to some extent money is, as law students learn to say, fungible: a dollar spent on the physical plant is to a degree a dollar that isn't going to be spent on something else, such as holding down tuition increases.61 62In addition it seems quite odd to be pumping ever-greater sums into bricks and mortar, given changes in information technology that should be making it much cheaper to deliver education outside of contexts that require hundreds of people to all gather together in a $100 million structure at the same time.63 This point applies with special force to law libraries, which grow ever-more pharaonic even as the practice of law becomes ever-less book-based, and law students find it less and less necessary or desirable to use these literary labyrinths,
even as opulent study spaces.
Underlying this financial arms race is the ever-present rationale that to refuse to spend yet more money on faculty, administration, physical plant, self-promotional efforts, and so forth is not an option in the constant struggle to rise, or at least not fall too far, in the U.S. News rankings.
(Indeed the rankings actually reward inefficiency quite directly, as expenditures per student are treated in the ranking formula as a proxy for educational quality.)67 This rationale has created a negative-sum positional game where one schoolās gain is always some other schoolās loss. It has also exacerbated the classic collective action problem: no school wants to pay the short-term price for bucking a system that in the long term is not sustainable for the enterprise as a whole.
Law school should really only be 2 years.
Even Obama agrees on this
But than again. Anesthesia the basics technical skills can be taught in less than one year
The basic knowledge of anesthesia with complexities can be taught in another year as well.
Thatās why anesthesia residency used to be 2 years long up to 1986 I think.
None of this integrated 4 years residency plus fellowship. Has information changed ? Yes. But the basics of anesthesia remain the same decades after decades.
Correct.You put the patient to sleep than wake them up. KISS.
The law market is just bad/weird. The Harvard grad I know became a career prosecutor, so if you went to Harvard to do peds you would still easily make more than 3x what he does. Decent chance you could catch him in residency, especially since he got kicked off his last two big cases with sanctions from the judges. I foresee a career change.Wow I opened up that article to just read the intro but was hooked haha. Very well written and I ended up reading all of it. There are parallels you can draw with medical training as well, although probably not as bad as the law profession. Some parts I liked:
Those who graduate from top tier schools can choose to go into less remunerative practices. They often come from money anyway, so thatās not always the main motivating factor.The law market is just bad/weird. The Harvard grad I know became a career prosecutor, so if you went to Harvard to do peds you would still easily make more than 3x what he does. Decent chance you could catch him in residency, especially since he got kicked off his last two big cases with sanctions from the judges. I foresee a career change.
The grads from the next 2 highest ranked schools do environmental and immigration law, so not exactly lucrative fields. One is married to a friend of mine and likes to joke how nice it is to be able to spend ādoctor moneyā.
The 2 who do the best went to middle tier schools, then moved back to their hometowns where they had parents in big firms, so go figure theyāre doing well. Connections go far. One of them did some easy contract stuff for me a while back and gave me a discounted rate of $375/hr.
Do you do anything with your legal training now or do you stick to doctoring?I have a law degree. I think I can explain what happened to the legal profession. Please don't permaban me for commenting.
I'm a CPA and specialize in tax. I use the legal training all the time. Law school grads are common in CPA firms. I did actually practice law for a while and despised it. The worst part of practicing law is that you are in the company of other lawyers all freaking day.Do you do anything with your legal training now or do you stick to doctoring?
Yep, this is a geography problem. I can get you a nice 2k sqft 3-4 BR in great neighborhoods in every real city Iāve lived for around $800k. None of them is a good market for buyers either.The OP is correct about their area of California San Jose etc
Itās crazy. My friend was involved in this transaction that just closed. All cash. Middle class 1.3 million dollar small home. Eastern Europeans. They had to scrounge up cash sell stocks just to close on this house. The sellers really didnāt want to extend closing. Thatās the completion middle class people are up again. 60k over asking. Multiple offers
Take a look at this home I found on Realtor.com
1232 Singletary Ave, San Jose
$1,350,000 Ā· 2beds Ā· 1baths
![]()
1232 Singletary Ave, San Jose, CA 95126 | realtor.comĀ®
See photos and price history of this 2 bed, 1 bath, 1,136 Sq. Ft. recently sold home located at 1232 Singletary Ave, San Jose, CA 95126 that was sold on 01/14/2025 for $1350000.apps.realtor.com
Whatās your timeline? Including for when radiology will be taken over? Iām thinking of doing rads but Iām very scared of AINot for much longer. Robotaxis/waymo/drones will be the food delivery of the future and no tip needed. Then the robots like rosie from the jetsons will be in your house. Having high level family in AI/robotics I guess I know slightly more on how close the fantasy to reality ratio on some of this is.
IM_to_ortho_to_rads_hopeful.Whatās your timeline? Including for when radiology will be taken over? Iām thinking of doing rads but Iām very scared of AI
Whatās your timeline? Including for when radiology will be taken over? Iām thinking of doing rads but Iām very scared of AI
every area has its price, some prices are not financial - like culture and schools.. usually inversely proportional to hourly salary in the area
OP Try going to Nebraska and making 750K with everything being dirt cheap and tell me your middle class!
Its quite the difference from an area like NYC or LA/SF making 450k and not having much savings after expenses each month
And now everyone from Nebraska chimes in about how their area has great culture and schools, but some of us know better!
In my semi-rural Midwest town, my kids go to private school. Itās just fine. Not paying a gazillion dollars for a house means lots of money is left over for things like private schooling.
(Btw, sometimes the public schools arenāt so great in expensive locales either.)
As for ācultureā - not discrediting it, but Iām not sure culture alone is worth the immense price you pay to live in a VHCOL area. Wife and I both lived in ātier 1ā, culture rich areas for training etc. Neither of us would go back to spending hours in traffic each day, paying $800k for a basic/no frills house, everything else costing ****loads of money, me getting paid 2/3 less than I make now, etc etc to get more of that. When we do want cultural amenities and cuisine, thereās a midsized midwestern city 90 min away and a massive metropolis 4 hours away (30 min to either if you fly) - and that works just fine for us.
Plus, I make so much more money that when I go to the city I can actually enjoy it. Thereās nothing more depressing imho than working hard as a doc amid all the amenities of a city, and basically feeling broke/living paycheck to paycheck.
To start, I agree with your take @dozitgetchahi and I am more on that side of this argument.
There are folks in those VHCOL areas (Boston, NY, LA, just to name a few) who are stuck in that "paycheck to paycheck lifestyle but will cite whatever combination of culture and amenities/schools/etc suits them to justify that type of daily grind.
At the same time, those in semi-rural to rural areas will tell you a 4 hour drive to a major metro or 90 minute trip to a midsized city is "OK."
Both sides should simply realize they are unequivocally giving up something and accept that for what it is. Saying "I have access to these great schools", "I can get more house for my money here", or "I can't believe you would be wiling to pay those taxes" are all just ways to justify to oneself that the choice you have made is correct and to put someone else down.
At the end of the day, you pay your money and you take your chances.
Or, rather, to quote Warren Buffet - āprice is what you pay, value is what you getā. Culture and city amenities certainly have value. I just am not convinced that the value is worth the huge price often charged. Also, note that Iām not really complaining about having to drive to get to a big city. For me, I donāt feel like Iām giving very much up at all. The rest of the situation suits me quite nicely. I think a lot of docs would realize that they donāt need the big expense, big tax, big city āla vida locaā lifestyle if they gave it a try. The people who live in VHCOL areas, however, are often complaining bitterly about how expensive it all is and how they feel āmiddle classā despite objectively making near 1% income. It all starts to sound a bit ridiculous.
If people make that VHCOL choice for the sake of ācultureā and saying they live in a hip/trendy area or whatever, then they should make that choice and deal with the compromises that come along with it. But they shouldnāt act like there arenāt alternatives. If people canāt stomach true āflyover countryā, then they can consider any of the other several dozen metro areas in the country that are more affordable. There are more than 3 US metro areas to live in.