Dissatisfaction with current career choice

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vaidyaga

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Hello...
I am wondering how many of you have had second thoughts about whether you made the right decision by going to medical school. I am 2nd year psych. resident and at times I feel really trapped. I find myself day dreaming about how life would have been if I had gone into a completely diff. field such as business. I have artistic hobbies and I absolutely love them. I am at my happiest when I am away from work and involved in my hobbies. It is so hard however to pursue our hobbies given our current rigid and demanding residency schedules. I know that I cannot make much money even if I took up one of my hobbies and pursued it professionally. Psychiatry on the other hand does give me the potential to make a lot of money. But I just can't seem to find much fulfillment in it. A lot of time medicine as a whole just bores me and I simply dislike patient contact. It is so tiring and I feel like I just don't want to be THAT responsible for another human being. Anyway at present I am trapped due to all the student loans I have. My family would kill me If I quit 🙂 Anyone else with such feelngs ?
 
I'm a 4th year med student and I have felt that way through most of med school. I haven't had much fun. I hated many blocks/rotations. Surgery was painful. OB/GYN made me sick. I didn't even like the first year. I've hated being pimped. I've hated pretending to care. I hated smiling when I wanted to spit.

I keep hoping that residency will be better and I hope that having money coming in will help my mood. But I hate medicine. ANd now I owe to much to do anything else but this.
 
There is nothing that says you can't go and start a business in a few years. I have had similar feelings throughout the process, but I tell myself I always can go back and do something else, but if I bail before I finish my training, it is much harder to go back. Stick it out, dot your I's and cross your T's for licensure, and then if you want to walk away....at least you have something to fall back on.

I know many professionals (in medicine and biz) who start real estate businesses on the side, others have active investment portfolios, and others carve out niche markets in business.

-t
 
Yes, i have very much disliked most of med. school too. residency is certainly better than med school. i find it more fun. but i definitely do not love it. i can say that at times i lke it and it is fun doing the work. i don't think i would ever quit residency....but i can't wait till i get to a point where i have more freedom in general (financial and schedule-wise)...'cause i don't want to work more than 2 days a week. there is just too much else in life that is sooo soo fun and medicine is just too mundane and boring. if i had to think through this whole process again, i would have definitely not gone to medical school and would also discourage most ppl. from doing so. i think most of the time we get into thing without thinking too much about them...and when we are in them..it's just too hard to turn back. i have always been an idealist and believed in the possiblity of having a job that you love...but now i am forced to seperate my job from my hobbies...one if an obligation while the other is a passion. i find myself getting through most of the day doing the things i have to do just so i can have a couple of hours to do the things i really want to do. that is when i question myself whether i am wasting my life...
 
Eventually you'll have more flexibility after you get out, but until then you pretty much need to make the best of it. About 4-5 years ago I was your mirror image (established in a biz career, and contemplating dropping everything for med school / clinical psych), and the grass isn't always greener on the other side, though sometimes it offers a different view.

If your goal is happiness, then you mold your career around that, not the other way around. I went the clinical route because it allowed me to shape my career around a particular lifestyle, and med school was a bit more rigid in that regard. Though you are on the back-end of everything....I'd probably ride it out and then make a decision from a position of security, instead of doing it while in flux.

-t
 
vaidyaga said:
Yes, i have very much disliked most of med. school too. residency is certainly better than med school. i find it more fun. but i definitely do not love it. i can say that at times i lke it and it is fun doing the work. i don't think i would ever quit residency....but i can't wait till i get to a point where i have more freedom in general (financial and schedule-wise)...'cause i don't want to work more than 2 days a week. there is just too much else in life that is sooo soo fun and medicine is just too mundane and boring. if i had to think through this whole process again, i would have definitely not gone to medical school and would also discourage most ppl. from doing so. i think most of the time we get into thing without thinking too much about them...and when we are in them..it's just too hard to turn back. i have always been an idealist and believed in the possiblity of having a job that you love...but now i am forced to seperate my job from my hobbies...one if an obligation while the other is a passion. i find myself getting through most of the day doing the things i have to do just so i can have a couple of hours to do the things i really want to do. that is when i question myself whether i am wasting my life...
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The nice thing about psych is that you could practice effectively for a "living wage" doing only 2-3 days a week--and do it relatively early in your career. Case in point, I work with 2 women in early career who have chosen part-time outpatient work for family reasons. You could very well make $70-80,000/year doing straight outpatient, and have 2 days a week to paint, write, design jewelry, fly model airplanes, or whatever... 🙂
 
i did an elective rotation with a psychiatrist who only saw patients tues, wed, and thurs, first appt at 8:30, last appt at 4pm, with an hour and a half for lunch/catching up on the mornings charts. she did an occassional monday evening or friday or saturday morning to accomodate a patient who had difficulty making appts during business hours. after overhead, she probably wasn't bringing in much more than 60k, but it was just her and her husband so its not like she had to feed a family of 6 or anything. her husband was a retired pediatrician i believe. they traveled out of town almost every weekend, spent time on their boat, and were big yoga people. so it is definitely possible to make a decent (in the scheme of life, not in the scheme of medicine of course) salary and still have plenty of time to do the things you love. i firmly believe there is a light at the end of the tunnel 🙂
 
this thread is funny to me because it seems that this whole idea is never discussed by many medical students and residents, although many think this at some point in their studies. medicine can make you sick. i've spoken with many people about it -- how sometimes you just want to scream in your attending's face, and curse the patient or the nurse every time your pager goes off. you hate reading papers and all the tests, etc. it's very disenchanting, because this is the thing that you're supposed to want to do more than anything, right? you've put so much time and energy in it...and now to think something like this. all the other things in your life seem so much better and this thing that you've worked so hard for is just keeping you from all of them. well, it's enough to make you at least mildly depressed, at least some point along the way.

i had to take some time off to deal with that. i'm in newfoundland right now doing a lichen survey. mycology is a hobby of mine and i just couldn't deal with medical school, not when i had this opportunity. i took a leave of absence; but, in that time i have come to think that although it will suck (and residency will suck,) i have to fini$h it. i don't have a choi$e. but you can have a varied life as a psychiatrist when you get out of residency; and maybe with that varied life, you'll be able to figure out why you went into it in the first place. because the reason is there, it just gets lost sometimes. this is how i've made sense of all i have heard from people who think similarly. i want to care. honestly, i do love psychiatry, i just want it to love me too, you know. i don't want it to beat me up.
 
I was a former junior analyst for 2 years at Morgan Stanley in their investment banking division in New York. Nothing irritates me more when I hear physicians say that they could have just went into business and made a lot more money. That's so far from the truth. Without providing names, I attended a prestigious university in the northeast. No, it's not easy to become an investment banker. Morgan Stanley only recruited from a select number of schools. And among their list of schools, those who attended public universities had a slim chance of getting hired since alumni networks gave the Ivy league candidates a leg up. Your GPA has to be strong too. We had nearly 500 students from just my class apply for my job and they were not looking at anyone with less than a 3.6 unless they had connections or an Olympic medal. To be competitive, they were really looking at candidates with a 3.8 unless you were an engineering or math major. And when you become an analyst, there is no guarantee that you will become an associate or a VP, which is where the money is. The famous investment banker profile seen on television refers to VP's who have been in the field for about 10 years. In other words, those were the guys who made it past the layoffs and other political backstabbing. During the financial crisis of the last 7 years, several banks including minde layed of several analysts and associates. There is no job security regardless if you attended Harvard or Yale. I knew several Harvard guys who got cut just like the rest of us.

It's extremely difficult and unlikely to make a lot of money in business despite what you think. There is no field like medicine in which you are guaranteed job security, a six figure salary, respect, geographic flexibility and the ability to truly make a difference in people's lives. Yes, maybe the VP at Stanley' will make a 1 million per year but the odds of you becoming a surgical subspecialist earning 500K is far greater than anyone making VP. And remember, VP's get fired too.

You only read about the successes in the business world like how some dotcomer built a business from scratch. But you never hear about the millions who were fired, lost their venture capital or had their job outsourced to India. Most of your friends who get great jobs out of college working in the computer industry either lost their job to outsourcing or moved around several times; most of these guys are probably earning around the same salary they started with 5-7 years ago. 95% of all new businesses fail and there is a reason for that. When I read these posts, I just want to yell at these spoiled doctors because they have no idea how great they have it. You will never have to worry about losing your job in your mid-40's with kids in college the way most business guys worry.

Even in psych, you could probably work 3-4 days a week and earn 150K if you practiced in the right location. There are several jobs that offer cushy incentives if you are willing to live outside NY, LA, SF, Boston and Chicago. I honestly don't know of any physicians in private practice that work a full 5 days. Most work 4 days and the others who work on Friday, work half a day. A lot of these people who are complaining about managed care are doing so from a relative standpoint. Physicians just used to make that much more money 20 years ago, however, those in some type of private practice setting who have been practicing for 3 years or more average 200K per year. Less than 1% of the U.S. population earns 200K or more. Quit whining!

The highest paying jobs in the U.S.A (psychiatry is 10th).
http://www.acinet.org/acinet/oview5.asp?Level=Overall

http://www.careerbuilder.com/JobSee...4e5a8bd83a4f3caae0a3081bcfc6fd-240348505-r9-4

http://www.forbes.com/2006/05/20/06work_bestpayjobs_slide_2.html?thisSpeed=6000
 
psychfriend said:
. There is no field like medicine in which you are guaranteed job security, a six figure salary, respect, geographic flexibility and the ability to truly make a difference in people's lives.
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👍

psychfriend said:
When I read these posts, I just want to yell at these spoiled doctors because they have no idea how great they have it. You will never have to worry about losing your job in your mid-40's with kids in college the way most business guys worry.

Even in psych, you could probably work 3-4 days a week and earn 150K if you practiced in the right location. There are several jobs that offer cushy incentives if you are willing to live outside NY, LA, SF, Boston and Chicago. I honestly don't know of any physicians in private practice that work a full 5 days. Most work 4 days and the others who work on Friday, work half a day. A lot of these people who are complaining about managed care are doing so from a relative standpoint. Physicians just used to make that much more money 20 years ago, however, those in some type of private practice setting who have been practicing for 3 years or more average 200K per year. Less than 1% of the U.S. population earns 200K or more. Quit whining!
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I know where you're coming from. I was out of school for 6 years often working two jobs that made absolutely no difference in anyone's life and making peanuts before going to medical school. I think it really changes your perspective when you've spent time in the "real world" trying to make ends meet. It helps you appreciate how awesome being in medicine is. No offense toward those who went the traditional route, but the ones that seemed to complain the most about medicine are those that went straight through school.

As a psych intern, there are days this year when I think "this really blows" and maybe I've made the wrong choice. But what I've found really helps is to just think about the reasons I went into medicine--to make a difference in someone's life (it doesn't hurt that it is a stable career, too!). And despite how corny that sounds and how that makes some people want to :barf:, it's straight up damn freaking true that you can!!!! In some ways it's so easy, too. There is not a single day that passes that I can't do something for one of my patients. And when you know that you've helped, even a little bit, it makes those crappy days worth it and makes you feel all warm and tingly inside. 😀
 
psychfriend,

Again, that was a nicely written post. I can also agree with maranatha.

When you are out in the workforce for a couple of years, away from school, you develop a new appreciation for what you have in medicine. I too spent a couple years working outside of school. It gave me an appreciation for the relative predictability of academia and hospital life.

We enjoy a level of security, income, and prestige that people can only dream about. Even when people knock our field and we don't earn as much as our surgical colleagues, we're still so far ahead of the general public.

Be thankful and answer that page!
 
of course all of what you say is true, and all of your points are well taken. but still...the disillusionment is definitely there for some of those people who did go the "traditional" route, and i suppose it always will be. it's pretty easy to get burnt out taking that route, and you just have to keep your head up, i guess. because the reasons are there for having gone into medicine – the security, the money, the fulfillment of knowing you helped someone – you just have to keep reminding yourself and that’s the hard part sometimes.

it's certainly acceptable to look back and say, "you don't know what the real world is like. i saw how crappy it is, and now that i'm in medicine, i can thank my lucky stars because i don't have to deal with all those problems again." but at the same time, not knowing what it's like to have taken the "traditional" route, perhaps you might be a little more understanding of a person's situation and not necessarily badger them for “whining.”
 
MacGFlow said:
of course all of what you say is true, and all of your points are well taken. but still...the disillusionment is definitely there for some of those people who did go the "traditional" route, and i suppose it always will be. it's pretty easy to get burnt out taking that route, and you just have to keep your head up, i guess. because the reasons are there for having gone into medicine – the security, the money, the fulfillment of knowing you helped someone – you just have to keep reminding yourself and that's the hard part sometimes.

it's certainly acceptable to look back and say, "you don't know what the real world is like. i saw how crappy it is, and now that i'm in medicine, i can thank my lucky stars because i don't have to deal with all those problems again." but at the same time, not knowing what it's like to have taken the "traditional" route, perhaps you might be a little more understanding of a person's situation and not necessarily badger them for "whining."
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The disillusionment is there because they are firmly convinced it's better on the other side. And this belief is due to a lack of research on their part. It is their responsibility to research other fields before making assumptions. Regardless if I failed to go the traditional route, I would take the time to research avenues of business and speak to those who are involved in business related careers before I assume it's so much better. It's easy to assume the grass is greener on the other side and pity yourself without making any effort to truly research the facts.

Medicine is truly a priviledge and an honor. Psychiatry is an amazing field and we would be lucky to be able to serve as psychiatrists. Physicians work incredibly hard and deserve their success; I'm not arguing otherwise. But there is a reason why admissions to medical school have gotten more competitive over the years. Even Caribbean schools like Ross have gotten more competitive to the point that they are requiring the MCAT now which they didn't take just a few years ago. It's truly an honor to be able to serve patients and help them improve their lives.

I apologize for my tough love approach but I hope my story would inspire others to appreciate psychiatry and medicine in general. I know people who are applying to medical school for their 3rd time.
 
well said psychfriend. i worked on the "outiside" in the business world for several years before deciding to give med school a try. most people have the "it's greener on the other side" view...especially when they haven't seen the other side.

To the OP: for me, the most difficult thing is feeling trapped by the debt. It's not that I really want a change, it's just that knowing that I can't (at least not easliy) makes me question the decision. Once we have back our autonomy we will be able to focus on the reason we came to med school in the first place- to make a difference in the lives of our patients.
 
masterofnone said:
well said psychfriend. i worked on the "outiside" in the business world for several years before deciding to give med school a try. most people have the "it's greener on the other side" view...especially when they haven't seen the other side.

To the OP: for me, the most difficult thing is feeling trapped by the debt. It's not that I really want a change, it's just that knowing that I can't (at least not easliy) makes me question the decision. Once we have back our autonomy we will be able to focus on the reason we came to med school in the first place- to make a difference in the lives of our patients.
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maranatha, psychmd2100 and masterofnone

Thanks and I want to give all of you props as well. Another point I wanted to emphasize was geographic flexibility. As an ibanker, I was limited to cities like NY, Chicago, Boston, SF, Houston and a few other cities. If I wanted to move to a quaint little town with a lower cost of living, I couldn't do so as an I-banker. I couldn't move to small rural town and actually earn more than I would in New York. When I was laid off, it was scary because there were no jobs. There were no rural or small towns to fall back on. The nice thing about medicine is that you can always move to an area that pays more and has a lower cost of living. If you are earning 90K as a pediatrician in SF, you can always move to a smaller city or town and earn 2 to 3 times that amount and have a lower cost of living. If you are unhappy practicing as a psychiatrist in Los Angelas, you can always move to New Mexico and be welcomed with open arms. It was so scary at times because those of us who were layed off had no choice but to go unemployed and rotate through interviews in NY and the limited number of other cities that hired I-bankers. I know a lot of my IT friends in San Jose went through the same experience. They had these 1700 square foot homes that were a half a million dollars. They had no job and they couldn't just sell their homes and move to a rural area because those types of jobs didn't exist in some small towns.
 
MacGFlow said:
of course all of what you say is true, and all of your points are well taken. but still...the disillusionment is definitely there for some of those people who did go the "traditional" route, and i suppose it always will be. it's pretty easy to get burnt out taking that route, and you just have to keep your head up, i guess. because the reasons are there for having gone into medicine – the security, the money, the fulfillment of knowing you helped someone – you just have to keep reminding yourself and that's the hard part sometimes.

it's certainly acceptable to look back and say, "you don't know what the real world is like. i saw how crappy it is, and now that i'm in medicine, i can thank my lucky stars because i don't have to deal with all those problems again." but at the same time, not knowing what it's like to have taken the "traditional" route, perhaps you might be a little more understanding of a person's situation and not necessarily badger them for "whining."
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I think disillusionment is a risk for all of us and understand on a personal level how easy it would be to burn out. But I think having struggled in the "outside" for a bit just makes it easier to take a step back and realize that there are aspects of most every job that sucks and this makes it easier to tolerate the frustrating parts of medicine. It is also difficult for anyone to keep their 'head up" and to remember why they went into medicine on those bad days that we all have.

Also, some of the most mature and compassionate medical students and residents I have worked with have never held a "real job" and went straight through school. I certainly don't think everyone must take time off before starting medicine so they can appreciate their field more.

Based on your posts, it sounds like you've done the necessary things for yourself to keep from burning out. I'm sure that is going to serve you well as a psychiatrist. After all, won't going through a little disillusionment every now and then help us empathize with our patients?
 
Good comments. You've also got to remember how much autonomy a psychiatrist has. It's one of the last places in the world where you can still be your own boss and write your own schedule.

In my prior line of work, I answered to multiple bosses, each of whom had the ability to veto the decisions that I made. We were always fearful of our next quarterly productivity eval. Some people who had been with the firm for over 10 years were simply fired at the whims of management.

Income wise, only the top executives with 15-20 years experience made six figures. Making over $200,000 was reserved only for the CEO. Psychiatrists can make that much with relative ease and, like psychfriend mentioned, they can work anywhere in the US.

MacGFlow, it's not that anyone's picking on you. It's that people would kill to be in the position you're in. I'm sure you're going to do fine and be a productive psychiatrist. It'll just make things so much easier if you keep perspective of where you are in life. You've probably already accomplished more at age 25 than most people will accomplish in their entire lifetime.
 
I personally enjoy the "working at Taco Bell" fantasy. Despite a full scholarship to undergrad, a full tuition scholarship to med school, and an NIH-grant to pay for a masters program, I'll still be graduating med school with 75k debt at age 27. My family would barely have been able to afford to send me to a cheap state college, so I've been pretty fortunate.

Had I started working full-time at taco bell at age 18, I would have probably made about 150k cumulatively. By the end of four years of residency, I'll be just lagging behind what what "theoretical Taco Bell self" would have made cumulatively, if we ignore debt. Two more years for c&a, and I'll probably break even with "theoretical Taco Bell self," including debt.

So, until I reach the age of 33 (the age, mind you, when the historical Jesus was crucified), I'll have finally done better than I would have had I just started working at Taco Bell. From that point on, obviously the curve goes insane. But until I'm 33, I'm nuts!

Despite the massive problems with the above logic, it's pretty justified for any of us to have occassional existential crises. Thus, there's an easy treatment for minor existential crises.

1) Go to taco bell.
2) Realize that at least one of the GorditaMakers is at least as miserable as you are on a call night.
3) Eat food.

And later, while writhing on the toilet, you'll forget most all your woes.
 
PsychMD2100 said:
Good comments. You've also got to remember how much autonomy a psychiatrist has. It's one of the last places in the world where you can still be your own boss and write your own schedule.

In my prior line of work, I answered to multiple bosses, each of whom had the ability to veto the decisions that I made. We were always fearful of our next quarterly productivity eval. Some people who had been with the firm for over 10 years were simply fired at the whims of management.

Income wise, only the top executives with 15-20 years experience made six figures. Making over $200,000 was reserved only for the CEO. Psychiatrists can make that much with relative ease and, like psychfriend mentioned, they can work anywhere in the US.

MacGFlow, it's not that anyone's picking on you. It's that people would kill to be in the position you're in. I'm sure you're going to do fine and be a productive psychiatrist. It'll just make things so much easier if you keep perspective of where you are in life. You've probably already accomplished more at age 25 than most people will accomplish in their entire lifetime.
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thanks for your comments and insight. and i know things will pick up. it's hard now; that's all i said. i never said anything about it being greener on any other side of the fence because i don't know that for sure. i know about my side and that's it; and i can say for myself, that i'm not so happy with medicine these days. of course i know i'll feel differently when i graduate from residency.

yeah, and for the record, i would never think a career in business is better than a career in medicine. i'd sooner work in taco bell than push numbers around in a banking firm, or give more than casual attention to market place on npr. i know i couldn't handle that. i made the right decision to enter medicine. just having to remember this is hard sometimes.
 
I would absolutely finish out your residency. If you quit now, you could still practice medicine, but only in an urgent care setting. I was at a similar place during my internship and during my anesthesia residency. I actually had my beeper in my hand 3 different times and was walking towards the Housestaff Office to let them know where they could put it. But, then I thought about my student loans and what I could do with my degreee in Classical Greek and Roman civilizations......needless to say, I put my beeper back on and kept up the fight.

Hopefully you can find some motivation from somewhere to stick it out. Once you are done, you have so many options. Psych is in big demand these days. Locums for it is wide open, I know psychiatrists who are getting $800 a day for 8 hours work. It will be much easier to pursue your outside interests when you can pay the bills. Real life is much different than residency. I remember being up at 3 a.m. doing heart/lung transplants and hating it. Now, I am out and I do mostly outpatient cases and rarely am at the hospital after 3 pm. I enjoy talking with my patients in preop and seeing them comfortable and ready to head home after surgery. I started a few internet sites on the side, which has been a fun adventure. I would highly encourage you to finish residency, you'll be happy you did.
 
MacGFlow said:
thanks for your comments and insight. and i know things will pick up. it's hard now; that's all i said. i never said anything about it being greener on any other side of the fence because i don't know that for sure. i know about my side and that's it; and i can say for myself, that i'm not so happy with medicine these days. of course i know i'll feel differently when i graduate from residency.

yeah, and for the record, i would never think a career in business is better than a career in medicine. i'd sooner work in taco bell than push numbers around in a banking firm, or give more than casual attention to market place on npr. i know i couldn't handle that. i made the right decision to enter medicine. just having to remember this is hard sometimes.
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The truth is a job is just a job after a while and there are negative aspects to every job. There is no perfect job. I've talked to pro athletes and even they say the excitement wears off after the first few years. If you speak to experienced physicians, they all seem to say the same thing: "Go Into Radiology or Dermatology" 🙂 I'm half joking but their message is clear; go into a field that can afford you a great lifestyle and low stress. Psych might be tough now but it will be a lot better when you are done.
 
Just a random quesion based on the salary surveys. They say the chief executives don't make alot more than physicians. I thought CEOs were like millionaires?

Who are these people living in mansions in Beverly Hills? Besides actors, athletes, and people with family money.

Just curious.
 
sikegeek said:
Just a random quesion based on the salary surveys. They say the chief executives don't make alot more than physicians. I thought CEOs were like millionaires?
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"Salary" is different than the complete compensation package. Many C-levels get generous stock options because if the company does well.....they do well. I believe Eisner had a $1/yr salary for a long time, and then raked in $100-$200+ mil a year through other compensations. They also have golden parachutes....so even if they tank the company, they still make bank.

For founding CEOs, they typically keep most/all of their wealth in stock, and when they go IPO they can get taxed at a different rate.....which can mean saving millions when they finally do cash in (risking the fact they get a good IPO, etc)

-t
 
You've also got to remember that the CEOs you hear about on TV represent the top 1% of all CEOs. It's kind of like saying that Beverly Hills Plastic Surgeons are indicative of all physicians.

The CEO of non-Fortune 500 companies will make in the 100-200K range after putting in 20 years with the company. For every guy that makes it to one of these spots, there were probably 100 people that never made it. Board certified doctors, on the other hand, are almost assured this level of compensation.

The Fortune 500 CEOs are a tiny portion of the corporate population. While the Fortune 500 CEOs do make millions and have golden parachutes, there are tens of thousands of non-Fortune 500 companies.
 
PsychMD2100 said:
You've also got to remember that the CEOs you hear about on TV represent the top 1% of all CEOs. It's kind of like saying that Beverly Hills Plastic Surgeons are indicative of all physicians.

The CEO of non-Fortune 500 companies will make in the 100-200K range after putting in 20 years with the company. For every guy that makes it to one of these spots, there were probably 100 people that never made it. Board certified doctors, on the other hand, are almost assured this level of compensation.

The Fortune 500 CEOs are a tiny portion of the corporate population. While the Fortune 500 CEOs do make millions and have golden parachutes, there are tens of thousands of non-Fortune 500 companies.
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EDITED: Sorry didnt mean to repeat many of the things Psychmd said.

Great post again PsychMD! I just want to add that becoming a Beverly Hills plastic surgeon or other fields of medicine has a direct and linear path. I'm not arguing that path is easier but at least you have a formula. There is no formula to becoming a CEO. You can acquire the highest degrees and experience and still not become a CEO because so much of becoming a CEO is dependent upon chance and politics. Granted, you must have a great work ethic, personality and education to even stand a chance at becoming a CEO but there is much more uncertainty involved with ascending to the positon. The same can't be said of medicine.
 
psychfriend said:
EDITED: Sorry didnt mean to repeat many of the things Psychmd said.

Great post again PsychMD! I just want to add that becoming a Beverly Hills plastic surgeon or other fields of medicine has a direct and linear path. I'm not arguing that path is easier but at least you have a formula. There is no formula to becoming a CEO. You can acquire the highest degrees and experience and still not become a CEO because so much of becoming a CEO is dependent upon chance and politics. Granted, you must have a great work ethic, personality and education to even stand a chance at becoming a CEO but there is much more uncertainty involved with ascending to the positon. The same can't be said of medicine.
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And the risk is rewarded too. Don't forget about all those people who try to take pre-med classes but realize they don't have what it takes. Don't forget about all those people who apply to med school and don't get in.

I'm not complaining, & personally I'm happy with my career choice, but I just wanted to point out that a CEO who makes it to the top 1% is also rewarded for the risk he takes. Some of those CEOs could literally support their entire family for the next 10 generations (no joke).
 
SpiritiualDuck said:
I keep hoping that residency will be better and I hope that having money coming in will help my mood. But I hate medicine. ANd now I owe to much to do anything else but this.
Click to expand...

i hate to break it to you.. residency is worse..
 
no, I think it's irritating that anyone makes as much as a psychiatrist :laugh:

Seriously, we don't set the market in others career's...we bearly infuence the market in our own career (thanks to insurance companies, our lack of unity, and most of our desires to treat patients regardless of how much money they make).

If you spend too much time comparing how much money you make with others you will struggle to find happiness in your professional career. There is always someone who makes more...just do what you love.
 
Good post masterofnone,

Enjoying what you do is the important factor. Even if CRNAs are comparably paid to us, I wouldn't want to do what they do.

Nonetheless, I agree with the sentiments that paying nurses more than some doctors is a problem.

At the end of the day, a psychiatrist still makes in the top 1% of the population, which is a feat in itself.
 
PsychMD2100 said:
At the end of the day, a psychiatrist still makes in the top 1% of the population, which is a feat in itself.
Click to expand...

That is the more logical way to look at it, but the comparison group isn't the general public, but a small sub-section of the public.

If you ever want a shock, take a look at the national average for household income, or average income in diff states, etc.

-t
 
Therapist4Chnge said:
If you ever want a shock, take a look at the national average for household income, or average income in diff states, etc.

-t
Click to expand...

While I'm just a naive freshman in college, I know that that is not a viable comparison.

While it might appear that you are 'rich' when the average American makes less than $40,000 a year, consider the fact that the average American did not go to school for 10+ years, does not have any educational debt, and does not pay thousands of dollars in malpractice insurance each year (or even month).
 
hye345 said:
While I'm just a naive freshman in college, I know that that is not a viable comparison.

While it might appear that you are 'rich' when the average American makes less than $40,000 a year, consider the fact that the average American did not go to school for 10+ years, does not have any educational debt, and does not pay thousands of dollars in malpractice insurance each year (or even month).
Click to expand...


The "average" American does, however, have very little savings, may or may not have affordable health insurance, and has several thousand $$$ in credit card debt that they have difficulty paying the minimum on each month.

The professional expenses you cite do not take an appreciable bite out of the standard of living of most physicians, especially compared to "average Americans". I'm really rather tired of hearing educational debt cited as a reason that our six-figure salaries are somehow inadequate--especially given that most of us not only chose to enter medicine, but probably would have run over our own grandmothers to get here (if we'd had to--and speaking figuratively of course, lest anyone accuse OPD of matricide...🙄).

Add to that that most of our patients in mental health are NOT "average Americans", living closer to poverty levels and frequently with basic food and shelter needs in doubt. Dammit--we've still got it really good. And don't you dare forget it!
 
At least it's not coal mining.

Or surgery. :laugh:
 
Oh I agree entirely about doing something you love. It's just weird to me. I work with a doctor who does colonoscopies and he said that anesthesia gets reimbursed 700$ and he gets reimbursed 160$. I'd be surprised if that's true though. I have a friend who is in CRNA school and I'm convinced she went into it because of the money and she's smart enough to get through.

How could anyone love something so boring😉 I'm mostly kidding, of course.

I rarely compare salaries because I think it's about doing what you love and not money. Just thought I'd comment on the irony. It seems to me that, if nothing else, lotsa healthcare money is being spent in an area that could be used somewhere else.




masterofnone said:
no, I think it's irritating that anyone makes as much as a psychiatrist :laugh:

Seriously, we don't set the market in others career's...we bearly infuence the market in our own career (thanks to insurance companies, our lack of unity, and most of our desires to treat patients regardless of how much money they make).

If you spend too much time comparing how much money you make with others you will struggle to find happiness in your professional career. There is always someone who makes more...just do what you love.
Click to expand...
 
hye345 said:
While I'm just a naive freshman in college, I know that that is not a viable comparison.

While it might appear that you are 'rich' when the average American makes less than $40,000 a year, consider the fact that the average American did not go to school for 10+ years, does not have any educational debt, and does not pay thousands of dollars in malpractice insurance each year (or even month).
Click to expand...

You have to remember that physicians are paid during residency. They are paid on average 40K per year which is on par with what the average American earns. So they are not going upaid for 7-9 years (4 yr school, 3-5 yr residency). Malpractice insurance varies with the field and location. A general surgeon practicing in Florida versus Texas can literally save himself close to a 100,000 in malpractice premiums. Malpractice premiums are adjusted based on risk not based on what the physician earns. Dermatologists earn a lot of money and have low malpractice premiums. Most physicians tend to increase their spending considerably after residency. Physicians have the option to live frugally and pay off their debt. However, they have sacraficed so much for themselves and their families that they tend to overspend upon graduating from residency by purchasing luxury cars and large homes which only adds to their total debt. If a physician lived in a apartment or small house, he or she could probably pay off their debt in 2-3 years. Also, there are many loan forgiveness programs if a physician is willing to live in an underserved area for 3 years.

There is a lot of hype concerning the angst that surrounds physicians. The media loves to publish stories about general surgeons in Florida who have been sued several times and are practicing "bare" without insurance. Those surgeons will complain about their high cost of living and their loans etc. Mind you, I hate the litigious nature of Florida as much as any physician but no one forced that physician to practice in West Palm Beach. There are plenty of areas in this country that have physician shortages and offer a low cost of living with low insurance premiums but you never hear of those opportunites because they don't make headlines. You only read about the most depressing situations and then uninformed people get the impression that all physicians are sufferring. For example, I have a friend who is rheumatologist that moved to San Diego. He is earning about 200K and will likely earn 400K as a partner. However, his 1900 sq ft home in a "safe" area of the city cost him a little over a million dollars. Now, he could have just as easily practiced in another city with a far lower cost of living while earning the same if not more but he "had" to live in San Diego. In 5 years, I wouldn't be suprised if he starts complaining to me about how medicine doesn't pay enough. 🙂

I personally feel sorry for those who receive their MBA's and Law degrees from programs outside the top 10 or 20. J.D.'s and MBA's are a dime a dozen and those less reputable programs still charge tuition on par with any top program. The sad thing is many of those graduates have a hard time getting jobs upon graduation yet are strapped with 100-150K in loans. Yes, it may not be as much as our 200-250K in loans but at least we are guaranteed a 6 figure salary upon completion of residency whereas those graduates are not guaranteed anything at all. And I personally don't know of many small towns that are willing to pay off a loan if a recent MBA or JD graduate moves to their town.
 
As usual, a strong post from psychfriend,

Doctors are still at the top of the economic ladder. Regardless of how much is said, doctors still have it pretty good. I wouldn't trade what I have for anything. Is it any surprise that the majority of the Top 10 highest earners are health care professionals?

You've got to remember how much respect is still granted to doctors. Even though it's not as much as it was years ago, it still carries weight in many parts of society.

Have you ever thought about how many people tried and failed, or tried and switched away from medicine? It's amazing. There are lots of people who I know and respect who tried to be premed but couldn't make it past Orgo, etc.

I'm lucky to be where I am and psychiatry is a great way to go.
 
PsychMD2100 said:
As usual, a strong post from psychfriend,

Doctors are still at the top of the economic ladder. Regardless of how much is said, doctors still have it pretty good. I wouldn't trade what I have for anything. Is it any surprise that the majority of the Top 10 highest earners are health care professionals?

You've got to remember how much respect is still granted to doctors. Even though it's not as much as it was years ago, it still carries weight in many parts of society.

Have you ever thought about how many people tried and failed, or tried and switched away from medicine? It's amazing. There are lots of people who I know and respect who tried to be premed but couldn't make it past Orgo, etc.

I'm lucky to be where I am and psychiatry is a great way to go.
Click to expand...

Ditto and thanks for the kind words. In regards to the respect factor, I think that has more to do with society's changed attitude toward authority figures in general. In the past, society placed more trust in people in power and didn't question them. As the media expanded and as technology improved to aid the media in covering events, authority figures were exposed for incidents that may not have been made aware public in the past. Society then began to question people in authority which includes physicians. However, this isn't limited to physians. Attorneys have less respect than they did in the past. I remember when becoming an attorney was rather prestigious but now it's considered a joke in many circles especially with the increased number of accident lawyer commericals and well publicized frivolous law suits. Politicians are increasingly questioned and viewed with caution. Police officers haven't been viewed the same after the Rodney King beating and Mark Furhman's racist statements in the O.J. Simpson case. When I was a kid, optometrists were clinicians that often practiced in the same buildings as many physicians. Now, many optometrists practice in Wal-Mart and several grocery stores offerring coupons and "free consultations." I think dentistry has lost a lot of respect. I think I received about 10 flyers in the mail yesterday offerring a free whitening tray with a cleaning and x-ray. There was a study published in Readers Digest that had one researcher going to several dentists accross the country. He received reccommendations that ranged from $250 worth of work to $30,000 worth of work for the same problem. Physicians may have lost respect in society but relative to these other positions of authority, physicians still receive more respect in my opinion.
 
PsychMD2100 said:
Doctors are still at the top of the economic ladder. Regardless of how much is said, doctors still have it pretty good. I wouldn't trade what I have for anything. Is it any surprise that the majority of the Top 10 highest earners are health care professionals?
Click to expand...

Agreed... but I still doubt that top 10 highest earners stuff. I'd say we have a position or 2 up there, but I don't think they count bonuses and the like for many occupations we're being compared to.
 
Valid point mgdsh,

I think the key with the Top 10 highest earning professions is that it's a mean. With that, there's going to be a lot of skew and outlying datapoints. Despite all that, the healthcare professions still represent something like 7 or 8 out of the Top 10.

There's no question that Fortune 500 CEOs, professional athletes, and Hollywood celebrities are going to be many standard deviations above the mean. However, if you look at the mean for entertainers, it's not going to approach that of a physician.
 
mgdsh said:
Agreed... but I still doubt that top 10 highest earners stuff. I'd say we have a position or 2 up there, but I don't think they count bonuses and the like for many occupations we're being compared to.
Click to expand...

But then our incomes are usually based on what's reported on W-2's and fail to account for physicians who self-incorporate, receive bonuses or underreport their income. Hospital employed physicians will receive bonuses exceeding 100K in many cases. You could make the same argument for physicians.

Those lists are accurate because there are much fewer physicians in this country when compared to other professionals. For example, there are so many CEO's outside the fortune 500 CEO's. There are tens of thousands of companies in this nation that employ less than 100 employees. Those CEO's earn between 90-200K thus the average CEO salary is driven down.
 
Yea, I agree the CEO numbers do get diluted a bit, and then there are also those CEOs who give themselves a salary of $1 (like @ Google). But even after everythings diluted: I still would say that maybe the average salary might be in our favor, but I believe that if it was done with total net worth by profession that the top 10 wouldn't be littered with physicians.

I also know for a fact that the average Goldman Sach's employee pulled in over $600k a year last year. I'm not saying they didn't work hard to get there, etc... but it is what it is.
 
check this out:
http://www.merritthawkins.com/pdf/2007_Review_of_Physician_and_CRNA_Recruiting_Incentives.pdf

it had good news, well except maybe for those making the most as psychiatrists. not sure if they include child psychiatrists.

the minimum for psych is now 160k and is up 30-40k. for ER the low is 150k. (of course their max is higher than ours.) the avg went up as well. however the max went down from 260k to 230k. Thus the gap between the highs and lows seem to be closing and is half of what it was 3-4 years ago. 😕 not sure why this is happening.

anyhow i see it as good news as i dont expect to be in the top bracket anytime soon.
 
sga430 said:
check this out:
http://www.merritthawkins.com/pdf/2007_Review_of_Physician_and_CRNA_Recruiting_Incentives.pdf

it had good news, well except maybe for those making the most as psychiatrists. not sure if they include child psychiatrists.

the minimum for psych is now 160k and is up 30-40k. for ER the low is 150k. (of course their max is higher than ours.) the avg went up as well. however the max went down from 260k to 230k. Thus the gap between the highs and lows seem to be closing and is half of what it was 3-4 years ago. 😕 not sure why this is happening.

anyhow i see it as good news as i dont expect to be in the top bracket anytime soon.
Click to expand...

I'm no statistician, but are their sample sizes even large enough?

Also, how much under-reporting is going on?

Personally, I stopped caring much for these types of physician salary surveys a while ago. Every situation will always be different and their min/max almost never correlates to what you see.

Excuse my superficial questions, but I didn't do much more than just glance at the report.
 
you are probably right. i don't think they are so accurate. maybe looking into the trends might give u an idea though.
 
Wow you guys completely owned the arguments that Panda Bear and Law2Doc are so found of giving.
 
mgdsh said:
I'm no statistician, but are their sample sizes even large enough?

Also, how much under-reporting is going on?

Personally, I stopped caring much for these types of physician salary surveys a while ago. Every situation will always be different and their min/max almost never correlates to what you see.

Excuse my superficial questions, but I didn't do much more than just glance at the report.
Click to expand...

You don't see a lot of multi-partner groups in psychiatry as you do with other fields of medicine. For example, you can join a 20 physician group as an associate in Internal Medcine. You will be salaried for your first 1-2 years and earn 110-210K. However, upon becoming partner, you will earn anywhere from 250-450K depending upon the groups reputation, patient base and partner's experience/patient load. There are many of these types of opportunities in IM which include both outpatient and hosptialist groups. There are not many of these private practice type of opportunities in psych. You are either in solo practice or working for a hospital. There are private psych groups but multipartner groups are not as common in psych as they are in other fields. I think a big reason is that you can keep your overhead relatively low in solo practice in psych whereas in IM, it's really tough to practice by yourself because you many more expenses. Nonethelss, most psych residents can't afford to start out on their own so they will usually join a hospital. Those hosptial related psych jobs tend to pay in the 150-250K range not including any bonuses. That drives the salary averages down in psych and provides the impression that you are limited to around 180K as a psychiatrists. I'm not suggesting there is anything wrong with that salary and for many individuals, they would be satisfied with that income. But for people who want to earn considerably more than that, they might avoid psych based on these averages. Psychiatrists who have established themselves in private practice can earn much more than this. The bottomline is no one should be concerned about income potential in psych based on a published average because you could earn more should you choose to go into private practice.
 
As a social work graduate student, this whole entire thread made me :cry:. I'll be making a difference in people's lives (maybe) but I'll be making far less than half of the "whiners" in here... Luckily, I won't be straddled with loans, but loans do eventually get paid off...

Psychfriend -- I used to be in business as well and definitely can see where your posts are coming from. I'm glad you appreciate your new situation.
 
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