Doctors' Life Hack?

[doctorDoctor.]

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tl;dr.....there is none. Please take the time to read through it, as you might find it an interesting scenario.

I know that going into medicine solely for money and respect is not a very good choice, as there are much better alternatives to making better money and doctors frequently mistreated by their patients.

That's not the point of this question. Please move on from it.

Now, I can understand that many doctors are burdened with medical school debt and won't be able to "live comfortably" per se until they are 40~50 years old. Others say that doctors never "live comfortably" (as in go on vacations, enjoy uninterrupted family time at home, live in lavish houses, pursue extracurriculars and other hobbies, etc.) due to their extreme work hours, etc.

But let's look at this scenario. A man gets accepted into medical school. He joins the HPSP program in the U.S. Army and has 100% of his debt paid for him in exchange for 4 years of service. In this case, he is actually paid a stipend of a couple thousand dollars a month during the 4 years in medical school. Afterwards, he goes to the military to complete his residency (which is known to have much better hours and higher pay than civilian residencies). Once he completes his military residency he is in absolutely no medical debt and actually has amounted 200,000~300,000 dollars that he was paid during residency. He now needs to complete 4 years of service as an army doctor. Military doctors are paid substantially less (in the case of surgeons, only about 50~60% of what they'll be making in a civilian hospital)...BUT, they also don't have to spend any money on insurance, malpractice/lawsuit fees, paying back student loans, etc. He basically gets to take home every cent of the 100K~130K that he'll be making in the military for four years. After finishing his required years, he leaves the military to go to a civilian hospital, in which he is paid the same as all the other doctors in his field (about 200K~250K).

In this scenario, many of this man's 35~40ish year old civilian counterparts will still have medical debt to pay off and will not be living comfortably. However, the man has earned about 200K~300K during his 4~6 year residency, 400K~600K during his time as a military doctor (without any subtractions to his salary due to no need to pay malpractice fees, etc.), and now he makes the exact same or maybe just a little less than his civilian counterparts because he has not been in that particular hospital for long. So in total the guy has earned about 600K~900K over the 15 years or so that he spent during medical school, residency, and as a military doctor to spend on "living comfortably" while also having evolved as a human being in the military. His civilian counterparts are still in debt or have only recently gone out of debt and is just starting to make some real money.

I'm quite ignorant about the medical field and physicians' jobs, so please don't bash me for it. Also, I'm already aware that military doctors get deployed and that can suck big time. I'm also aware that they are on call for another 4 years after the completion of their service (but they don't get called extremely often, just when the military occasionally needs them).

Anyways, can you refute this scenario or explain which parts of it are flawed?

 

[psychbender]

Your assumptions and math suck.

Is the stipend really "a couple thousand dollars a month" now? I didn't go through all that long ago, but in my time, it was just over $1000 a month.

Military residencies are known to have much better hours? That's news to me. I know that I worked more hours than the residents in the three nearby civilian programs. I know this, because we talked about it on shared out-rotations. While they were relieved between 1500 and 1600 most days, I was still doing cases until 1800 or 1900 (later, for a while, until the PD smacked down the department).

As for better pay, that's about $75k vs $45k (numbers vary a lot, based on BAH). This comes out to nowhere near you $200-300k during residency figure.

In case of surgeons and some subspecialists, the pay is actually more like <1/4 what their civilian counterparts make (as in, the civilians can make a hell of a lot more than you suggested). When you factor in the nontaxable portions of pay to figure out what an equivalent pre-tax total would be, I personally make slightly below 1/3 of the regional average for my specialty. Also, my association membership fees, CME, licensing fees, etc are all paid by me, rather than my group, as is the case for my med school friends that are in my specialty. I also have less vacation (substantially so, compared to some of my colleagues) than my civilian counterparts, but work about the same number of hours per week.

Also, the payback is not 4 years. The payback is four years, or the length of residency (minus internship), whichever is longer. There are some more caveats in there, as well, that can adjust your service obligation (GMO time, sponsored training, fellowships, etc). The point is, if you train as a general surgeon in the Army, you will owe more than four years. If you pick up a fellowship, you will owe even longer.

Bottom line, you only come out financially ahead if you attended a very expensive medical school and/or go into a primary care specialty. In every other situation, you will have lower lifetime earnings by going HPSP versus taking loans out as a civilian. This topic, and the actual numbers behind it has been addressed numerous times on the forum (I think it's one of the stickies), so I suggest you do some searching.

Final statement. As has been repeated here ad nauseum, if you join for the money, you will be very upset at the result. Only join because you actually want to serve, and are willing to make less in the long-run to do it.

 

[deleted480308]

Stipend is ~2100/month

 

[sonofva]

Why would I take my financial advice from a high schooler?

 

[doctorDoctor.]

Why would I take my financial advice from a high schooler?

I'm not asking you to take advice. I'm asking you to give me advice.

 

[doctorDoctor.]

Thanks for the input, psychbender. I did say that I was ignorant on the subject, so my assumptions and math can only suck.

Is the stipend really "a couple thousand dollars a month" now? I didn't go through all that long ago, but in my time, it was just over $1000 a month.

By "a couple thousand a month" I'm talking about 1000~2000 dollars; over 4 years, that's 48000~96000 dollars.

Military residencies are known to have much better hours? That's news to me. I know that I worked more hours than the residents in the three nearby civilian programs. I know this, because we talked about it on shared out-rotations. While they were relieved between 1500 and 1600 most days, I was still doing cases until 1800 or 1900 (later, for a while, until the PD smacked down the department).

From what I've heard, military residency has better hours. Of course, I may be wrong, but I consulted currently serving army physicians, etc. who claim that they have discussed their hours with their civilian doctor friends as well.

As for better pay, that's about $75k vs $45k (numbers vary a lot, based on BAH). This comes out to nowhere near you $200-300k during residency figure.

75k x 3 years = 225k, 75k x 4 years = 300k, 75k x 6 years (surgical residency) = 450k... so it's actually 225k~450k if I'm not wrong?

 

[doctorDoctor.]

.

 

[psychbender]

Thanks for the input, psychbender. I did say that I was ignorant on the subject, so my assumptions and math can only suck.

By "a couple thousand a month" I'm talking about 1000~2000 dollars; over 4 years, that's 48000~96000 dollars.

From what I've heard, military residency has better hours. Of course, I may be wrong, but I consulted currently serving army physicians, etc. who claim that they have discussed their hours with their civilian doctor friends as well.

75k x 3 years = 225k, 75k x 4 years = 300k, 75k x 6 years (surgical residency) = 450k... so it's actually 225k~450k if I'm not wrong?

Depending on where you are going to school, that $2000 a month for food, rent, etc from the stipend may not go very far. It is better than taking out more loans, like my friends all did, but you aren't going to be accumulating a lot of savings during school. This part, though, is often what gets people interested, and why a lot of med students are very happy with HPSP. Very little is required of them, and they actually make enough money to go out and buy some nice things every once in a while.

Maybe some others had better hours, but I know that in my specialty, and amongst the surgeons and OBs with whom I interacted, the hours were the same or worse compared to our civilian counterparts in the area. We looked forward to our out rotations, as we not only were exposed to cases that we didn't get enough of back home, but we could also leave at a reasonable time each day.

Your math shouldn't be $75k x X number of years. Rather, to find out how far ahead one would be compared to civilians, it should be $75k-45k x X number of years. Additionally, that $75k may vary, as my current BAH is just over half what my BAH was in residency, due to area. Thus, residents here make substantially less than I made as a resident, narrowing that gap. Anyway, using the approximately $75k that I made in residency, over four years, I earned about $120k more than my civilian counterparts. Again, it meant that I could buy a new car during residency, pay for my wedding and honeymoon, and put something away for retirement, BUT in the first year out of residency, most of my med school classmates that went into my specialty had earnings that exceeded mine by well over $120k.

Again, don't do it for the money. Only do it if you want to serve.

 

[Cooperd0g]

Discussed heavily and recently here:
http://forums.studentdoctor.net/threads/the-skyrocketing-value-of-the-hpsp-scholarship.1003915/