Does the residency you get matched into affect how much you will be compensated?

Spine surgeons make so much, I doubt it would significantly impact your compensation. In my internet-searching experience, I have found that potential fellowships, private practices, good business skills, and even location are MUCH more influential factors in your paycheck as a future doctor. As a resident, it seems everyone gets paid pretty much the same amount across the board, which hurts the high cost-of-living states!

Oh, and is it not possible to also go into spine surgery through neurosurgery?

And I totally love how everyone who even mentions the word "money" has at least a sentence-long explanation at the end. It's not a dirty word people.

 

.

 

Think of it this way, most doctors don't come from those training programs. If you're an ace surgeon it will be recognized no matter where you trained.

 

Right. It shocks me so many people choose to go through with this just for money. Asking about surviving debt I can understand! But come on seriously, stop fishing for potential million dollar specialties!

And now, we're back from our commercial break! Continue with the actual thread topic.

 

Although there may be some difference in compensation based on where you're at their salaries defintely aren't adjusted for cost of living. For instance a resident's salary in Buffalo, NY may be a couple thousand dollars less than one in NYC, NY - but that difference is eaten up in NYC in just a month, while the resident in Buffalo is probably able to pay all of his/her bills and have a decent rolle of $$ to spend in what little free time they have. Similarly the residents at Mayo clinic make more than those at the University of Minnesota, but the cost of living in Minneapolis is more than it is in Rochester.

 

No. How you will be compensated as an attending depends on the region in which you practice, how well you advertise your services, how many patients you have, how good you are, how often you have been sued for malpractice, and how smart you are in managing your money.

But now that I have answered your question....

The chances that you will be good enough just to get into medical school are small.

The chances that you will be good enough to even be considered for even the least competitive ortho residencies is EVEN SMALLER. Ortho is incredibly competitive, and tons of excellent candidates go unmatched EVERY SINGLE YEAR.

And then, on top of all that, you have to survive an ortho residency. Not an easy thing to do, by the way.

Why do you persistently place the cart before the horse? You need to get into college first. Then survive o. chem, biochem, physics. THEN you need to take the MCAT.

Then you have to prove that somehow, someway, you are good enough to get into an allopathic medical school located in the United States (because otherwise you severely decrease your chances for something as competitive as ortho) - which over 50% of applicants fail to do in any given year.

Then you have to survive first and second year, which always claim their share of drop-outs and casualties. I know of a number of people who have failed out of medical school during those years, and others who have failed courses (which practically guarantees that they will not match into ortho). You may be one of those people.

Then you have to take Step 1, and 8 hour marathon of a test that is the culmination of 5-6 weeks of pretty intense studying. Actually, in your case, if you want to do ortho, it's probably more like 6-7 weeks of REALLY intense studying.

Then you have to survive third year, and emerge with at least a handful of honors. You definitely have to get honors in surgery. Which, if your surgery residents get an inkling that you're so hyper-concerned about money, is not going to happen.

You THEN have to apply to 60-70 programs, and interview at as many as possible, all in the hopes that you will match. By the way, applying to that many programs, and flying all over the country to interview, will cost you a small fortune.

Then comes residency, which are some of the hardest years you will endure. Don't forget, to even be considered for a fellowship (especially one like spine), you have to be a SUPERSTAR resident. It's not enough to be a fantastic med student....you also have to be a stellar resident. You have to be good in the OR, impress your attendings, and publish research papers. Lots of research papers.

THEN comes the fun process of applying to fellowship!

So worry about those steps FIRST. Worry about the money LATER.

 

It's considered SO bad, that unless you do your residency at a world-class institution, you're not even allowed to BE a spine surgeon. The other residencies are simply there for show. The graduates from a non-world-class orthopedic residency are doomed to become x-ray techs.


Come on, man, think about it. Those residencies simply wouldn't exist if you couldn't get a job afterwards. And it's getting pretty obvious that for you, it IS all about the money. As far as I'm concerned, that's not the worst thing in the world, but you can stop pretending for us.

 

<shrug>

You'll have to wait and see, and gauge each step as it comes. Don't write it off yet, but realize that it IS a long road that requires a fair amount of sacrifice and hard work.

 

Didn't you just get a 136 or something on the PSAT? How can you come around and then say you are a good test taker?

 

Keep an open mind.

 

Well I had a really nice long post typed out, but internet explorer crashed and I lost it all.

So I'll make this short and pleasant.

Stop worrying about how much money you might be making in 15 years, with the least amount of effort.

Medicine is not an easy field. You can't half-ass your way to being a super surgeon that will make 1 mil + a year. You can't even half-ass your way to being a family medical doctor making 100k a year (but that's not enough, right)?

You can't half-ass much in life and get a result you'll be content with. Medicine is definitely not one of those things. When you half-ass something in medicine, people die. End of story.

Wake up and realize life isn't easy. Becoming a doctor sure as hell isn't easy. You don't just walk down a blissful road picking flowers and catching butterflies and boom, you're a doctor. Far from it.

It's a grueling road that only gets steeper and steeper the further you go. It will never get easy; medicine is a lifestyle that never just flat-lines. It takes extreme devotion. The sooner you see this, the better off you'll be. Stop deluding yourself about the ease of getting in, and what it's like once you get in.

Now that I've covered that, your present situation. You're a junior in high school making decent grades and you were disappointed about your PSAT score. You're already reconsidering medicine, and you're not even through high school yet. Stop worrying about medicine for a while.

Take the most rigorous curriculum you can and bust your ass on that. Get straight A's from here on out, and prepare hard for the ACT/SAT. Get a good score on that. This is all that matters for you right now. If you really want to be a doctor, well, this is what you can do right now to help make that goal a reality.

Get into college. Take Ochem etc. and any other courses that interest you. Do lots of volunteer work, community service, and extracurricular activities. Work hard and keep your options open. Towards the end of college, if you find yourself still wanting to be a doctor, then worry about med school.

You likely won't know what specialty you want to go into until your 3rd and 4th years of med school when you actually see what each field involves, firsthand. You sure as hell don't definitively know as a junior in high school.

Bottom line, stop worrying about being an orthopedic surgeon or whatever with as little effort as possible. Worry about your present situation, not the situation you probably won't be in 15 years down the road. And most of all, stop accepting mediocrity from yourself. Mediocrity is not a mantra to live by, especially so for those aspiring to be doctors.

I could talk about how you're going into medicine for the wrong reasons, but really, it's already been beaten to death in your other threads.

I'll just say, if you adopt mediocrity and go into medicine expecting an easy way to lots of money, you'll be sorely disappointed at some point.


For the topic at hand, I doubt it'll make too big of a difference unless you're trying to get into a really prestigious partnership. Then I'm sure getting into a super residency would help your case out a bit. Don't take my word for it though, I'm just a junior like you. But you'd figure it would have at least some potential to make a difference.

On compensation, all doctors are compensated fairly. Sure, some might be able to buy ferraris where others won't. But all doctors make enough to live happily without financial concern.

 

And you make that sound like a bad thing! Non-world-class orthopedic residency grads make for some of the best x-ray techs in the country.

 

Can someone tell me why money is a dirty word. I really love interning at the hospital. I thrive in the environment, and i look froward to going every chance i get, but i still think money is an important factor in picking a career in any profession. I mean half the physicians i talk to at the hospital recommend me not going into specific specialties, because of to long of a work week and you could make better money by having a different specialty with less work. Money definitely isn't my deciding factor, but it is up there.
Yes a lot of Jef's posts revolve around money, but he receives so much criticism for just asking questions. I have found myself googling different physician salaries, and i don't think it is a bad thing. I have looked at the amount of debt and work it will take to become a physician. Personally if physicians made around 20-60k a year i don't think i would do it. Yes i love the study of the human body, solving medical problems, and just helping people, but i wouldn't think it was worth it. This is becoming a long post, but i just dont understand why money is a dirty word when it is an important aspect to be considered.

 

It's dirty because if people did something for money instead of what they loved, we wouldn't have teachers. The starting salary for a high school teacher in my area is less than that of an auto tech and is more schooling. I would still do medicine if I only had 20k a year, but I would definatly have to chose a different med school to go to because of the debt. Don't think that everyone goes into a job because of the money, what we do on the way to get there may make of think of it, but it is not why people do what they do. If it is, then they should stop doing it.

 

There is a difference between being aware of salary/debt issues and having every post being about making big bucks. Medicine is much much more than a get rich scheme or even a get rich and be prestigious scheme. It is a long long road. Peeps I was in undergrad with are buying houses and popping out kiddies and talking about IRAs and I'm still sinking farther and farther into debt and have no personal life. You have to really be into the other aspects of medicine to make it worthwhile.

It is also bizarre from a medstudent/resident standpoint to watch a highschooler posture about ridiculously far off and ridiculously vague possibilities. Only a handful of those who go into undergrad as a premed will even go on to apply and that is only the first weeding out that would occur on the path to any of the big bucks/big lifestyle specialties. I'm a medstudent and I really can't even say with confidence which specialty I'm interested in until I can see how I can do on my boards. So a highschooler thinking about fellowships is rather humorous. Add to that that the only fellowships he/she seems to be interested in are those that will get you rich and you are going to ruffle a few feathers.

 

Oh PLEASE. You're worse than jefgreen. $20,000 per year??? You do realize that residents make over twice this amount and can BARELY sustain a family. At least jefgreen is open about shouting "SHOW ME THE MONEY!!!" The guy has integrity, I'll give him that.

There is absolutely nothing wrong with wanting a nice lifestyle. Medicine is a job, just like any other. It isn't charity work (well, for the most part, anyhow). You provide a service, and you get compensated based upon how valuable your service is. Supply and demand, its as simple as that. Every physician will talk to you about how they supplement their income in the course of their job.

But if you want anyone to consider your application seriously, you need to make at least make some attempt at showing interest in what the job entails.

 

Are you saying I lack integrity in the way I would rather me and my family be happy than have money? If so, you might want to check your definition of integrity.

 

Lots of people could live decently with 20k per year. A large portion of America does every day.

Granted with Med school debt etc. it's a bit exaggerated, but without the huge lump of debt, I think that some people that really wanted to be doctors would still travel the road and do it.

 

$20K a year is unsustainable for the vast majority of Americans and is under the poverty line for a family of 4.

Even if med school were free, it would be unrealistic for me to justify spending this much time on my education when I wouldn't be able to provide for a family.

It's not about money = happiness at that point, it's about not being able to put food on the table.

 

I can absolutely guarantee that you would not. If you currently believe that you would go into medicine - that is, get an additional 7-11 years of physically and psychologically crushing years of education after college - for that kind of pay, then you have an epiphany heading your way.

If you equate "living decently" with "barely scraping by," then yeah, sure. Take taxes out of that, and you're around $16k (15% federal tax and a rough estimate of state taxes). Take out another $5000 for rent/house payment for a cheap place to live, and that's $11k. You still need to pay utilities. Got a car? You'll need insurance and gas. You have to eat, too. How about health insurance? The list goes on. You'll be doing well to support yourself, let alone your family.

We'd only need one medical school if physicians made $20k a year, that much is certain.

 

It's impossible for you to absolutely guarantee anything. That is a fact, and even if it wasn't, you do not personally know my dreams, goals, ambitions, or hopes, so you have no room to judge. I do see what you are saying though, I just personally disagree. I believe that many people would not do medicine as many people do not like the process as it is. I look forward to the hardships I will have to go through.

 

No they don't. A "family" cannot live a physically/metally/etc healthy life on $20k unless they're subsistance farmers or they have people working for them for free... Its just unrealistic. Its under the poverty line and thats exaclty why theres a drive from the left to distribute the wealth a little more evenly.

In reference to an earlier post from someone... teachers should be compensated more for what they do.

In reference to all the Mother Theresas on this thread who think that money doesn't matter or should not be a deal-breaker when it comes to your career. First of all some of you haven't even finished college yet so you have no "real world experience." Wait until you have to at least support yourself before you conclude that a salary that is below the poverty line for a family of 3/4 in the US will sustain your famliy somehow. Also heres a hypothetical question (but feel free to answer if you want): If you have a brain tumor would you rather go see the world's best neurosurgeon who is only in it for the money or would you rather go see Joe Shmoe, M.D. whose got a less than good track record as far as post-surgical outcomes but who went into medicine solely due to his altruistic nature and has since been doing brain surgery 70 hours/week for $20k/yr? Personally, I think I'd probably go with the guy who is in it for the money because at the very least hes sane

 

You don't know what you're in for if that's your opinion. I guarantee it.

 

I would go into medicine if I make 50k a year. I simply decided to go into medicine because I'm interested, not how much I can make. That's very simple for me. Choosing a career I like instead of how much money I can get. It's like choose a burger I like instead of how much meat in it.

P.S Burger kings have better burgers than A & W and McDonalds.

 

I also agree that teachers should make more. It is ridiculous what they have to go through

I'm not saying money isn't a factor in a job. I do not believe it is a deal breaker though. Now, your situation compared apples and oranges. You used a track record to prove that the guy who is in it for the money was a better doctor because of it.

However, I have supported myself for a few years now, so I do a little real world experience. Luckily, I don't have to pay taxes yet.

Haha, that was totally a JA statement =-). Mental breakdowns, physical fatigue, and no personal life? What can be better than that!?

 

I said 20k was a bit exaggerated. I know it sucks; I live in a family that doesn't make too much more. 50k would be about my bottomline before I looked somewhere else.

Your hypothetical question is flawed. You automatically assume anyone in the medical field for altruistic reasons has poor surgical outcomes, whereas Mr. Prick that only wants to make money has immaculate surgical outcomes.

An altruistic person making 20k/yr could just as easily have the best surgical outcomes.

But based on your question, I would choose the person that was in it for the money. I think a better question would be: Would you rather have an altruistic person working on you or somebody that is only doing it for the money (assuming equal skill)?

 

In the country where I am originally from, the word "teacher" refers the word "doctor" in English. We call teachers from K-12, professors, lawyers, medical doctors as "teachers".

The doctors make less and teachers make more in my country.

 

EXACTLY.

 

My question is not flawed. I'm not generalizing that all altruistic ppl going into medicine are sub-par doctors, I just gave an example of two doctors who differ in their skill level. It was also meant to illustrate that anyone who would put themselves through 4 yrs of undergrad, 4 years of medical school and X years of residency would have to be insane to accept a salary that does not compensate them fairly for their investment of time and money. Doctors DESERVE to get paid a lot and I expect that when I'm done with my training. Does that make me some money-hungry person who doesn't care about my patients? No. That makes me a realistic person with realistic expectations based on sacrifices and investments that I've made so far. So many people on this website lie to themselves every day and its easy to see through

 

Back to the OP, there is no need to worry about this yet, especially if you are already unsure if you want to do medicine now. Money may have a factor, but it is not the entire reason to do medicine.

 

FWIW I'm not siding with the OP in my posts - I'm convinced hes either a long-term troll, he has no common sense, or he has terrible short-term memory. If you look at his post history (some of which I've commented on), he asks similar ridiculous questions day-after-day and even when he gets a decent number of responses he apparently doesn't take any of them into account.

 

I do understand where you are coming from. I think that doctors do deserve their pay, a few of us were just saying even if we weren't making 200k+ a year as someone mentioned, we would still be happy. 20k was an exaggeration, as the person who said it was, but I would accept less money if it meant continuing with medicine. 60k is more than most people need.

 

Agreed, I have also noticed this.

 

You feel you deserve to get paid a lot. Other people aspiring to be doctors don't feel that getting paid a lot is as big a reason to be a doctor.

So, what's your problem? That other people would still find solace in the medical field if they were paid just enough to get by?

I'm not saying, because money is one of your stronger reasons for going into medicine, that you will be a shotty doctor. I'm saying that somebody who is going into medicine strictly to make money is probably going to be disappointed (money =! happiness in most cases; comfort, yes, happiness, no). You should have some interest and passion in the field beyond the money and prestige, and some people seem to fail to realize this.

And somebody who is in it just for the money probably isn't going to be truly happy. I'd rather go to a happy, altruistic person who enjoys what they do for a living, than a bitter, greedy person who hates what they do for a living.

 

. Exactly.

 

For some reason I kinda assumed you were a college pre-med instead of a high schooler so I'll cut you some slack. $20,000 just isn't realistic for most adults to live on if you're paying for rent, food, gas... etc.

But yeah, its great that you want to be a doctor for the sake of being a doctor. Just realize that you need to think practically with regard to any job.

Oh and btw, I like your icon.

 

Haha, thank you bud. I agree, 20,000 is very hard to live on. My family actual had to do it for awhile, which is why I said it was possible. Currently we are making about 40,000 with my older brother graduating college this year. Problem is our company lost some of the business from CAT, so there may be some more money problems in the future.

Yes, with rent, gas, food, electricty, car, insurance, and taxes, 20,000 is VERY hard to live on. With more than two people, that amount of money is basically impossible to live off of. I was more just trying to make the point that if you are ONLY going into medicine for money, it will not be enjoyable. If money is only a minor perk to the job, then you should be a happier person.

My arguement was a bit fueled by the reading of the OP past posts, so I apologize. Thanks for the comment btw, I enjoy it.

 

Notice how I did not define what "a lot" of money means in my last post? I'm not saying that I'll ONLY be making half a million dollars (which would be unrealistic for me to expect), but I'm am expecting to be well-compensated for the debt I take I've taken on and will continue to add to for the next couple years, the nearly 10 years of my life post bachelor-degree that I will have sacrificed/committed to my training once I'm done, etc. I'm not saying that money is my only motivator, but it is definitely a motivator for me - and I'd have to say that someone is either lying to theirself or extremely naive if they haven't considered the financial aspects of their career decision. I've enjoyed medical school and my previous jobs in healthcare so far so I know that I'm most likely going to enjoy whatever I end up doing a few years from now. The fact that it pays well just adds that much more to my decision to become a doctor. All I'm saying is that I expect to be well-compensated and that is a realistic expectation.

My problem is not that people would find solace in the medical field if they were paid just enough to get by - its that people repeatedly post on these boards that they'd go into medicine for pennys on the dollar (and those people are either not rational or are lying to themselves). Obviously 20k is an extreme, even 40k - 60k is peanuts when you consider the means to getting your M.D. If I had a full-ride scholarship right now that would of course have an impact on how much weight I put on my future income, but thats not the case.

When you look at almost every other job/profession/etc, you must realize that people aren't doing what they're doing because they love it... They're doing it to survive. Many many many people don't "love" their job and you have to realize that medicine is just a job. There are going to be many current pre-meds and medical students who get out into the real world FINALLY after 8 years of post-HS education + residency and realize they don't love their job. I personally think its impossible at this point for any premed to say without a doubt at this point that they'd take $X for an annual salary as a doctor, whether that amount be very high or very low.

 

Yes, I wasn't trying to discredit you. I apologize if I came off that way.

I've lived in a pretty poor family my whole life, and I understand that it sucks. Yes, 20k is pretty extreme, particularly with the debts we accrue along the path. 50-70k would be about the minimum I could make and still go for it. I obviously don't want to go to school for 14 some odd years to live in a trailer again.

Of course only a fool would not consider the financial side of a career they are planning on spending their entire life in. Some people just place more weight on it than others. The only real issue is when a person puts all of the weight on that one aspect, or even most of the weight, to a point where naivity clouds their judgment and perception of what the field actually entails.

That's true, but in my opinion, medicine is a pretty unique field. You're dealing with people's lives on a daily basis, on the spot. There aren't many other fields that boast that kind of responsibility and passion.

You're right that it is impossible for any of us to say without a doubt that we'd take $X. We're naive, we haven't even started the process, and we haven't seen firsthand the difficulties that it entails. Some of us, most of us, will probably change as we near the end of the road. I suppose that's why it pays well, eh? We can say we'd accept X, but we'll get Y anyway, so what we say we'd accept doesn't really matter.

Probably not the answer you were looking for, since it pretty much makes our whole argument kind of a moot point. But we all know it's true, that our opinion on something like this is just about worthless, because we haven't endured the hardships yet. Anyone can say they'd do one thing at the end of one path, when they haven't even started that path yet.

One thing I think we can agree on though, is that high school students shouldn't be worried about their future fellowships in spinal surgery.

 

I will definitely agree with this haha

 

I am a high schooler and worrying about my retirement options as a spine surgeon now. I am so worried if I have done 30 years surgery then where should I do ?

 

20k was an exaggeration. I was just confused why being worried about your future income was a bad thing. Im a senior in highschool and make 9$ an hour. I would like to make a good bit more then this. I would like to have enough money to raise a family, live comfortly, and hey maybe even go on a vacation once a year. I cerntainly wont become a doctore soley for the finiacial aspect, but i think it would be foolish to commit such a huge portion of your life to going to school and not know how much you will be making afterward. I do think its a bit extreme to be looking into fellowships while in highschool. Im just trying to pick what UG to go to... Thanks for all the arguments-i mean comments regarding my question.

Btw i like it too

 

I'm not doing great in math either.

I can understand you Jeff. It does not feel good.

But I'm not going to give up ! ! ! ! ! ! ! ! ! !

 

Not doing the best either. But then again, our teacher equates calculators with the devil. It really hurts when you realize you're not that smart after all.

Jeff, you can't just assume you'll walk into college and suddenly be a superstar student, get into Harvard, work at Mayo, etc. If anything, college might make it more difficult to concentrate on studies as opposed to an expansive social life. Does that mean you should give up? Does that mean you don't have a chance in hell of getting into medical school because you aren't perfect? No, it doesn't.

It does mean you need to take life one step at a time! Pre-med courses weed out more than simply intellect-lacking students...they also weed out those who can't handle stress, give up easily, and lack motivation. Don't be one of those. But don't set your heart on Hopkins just yet either. Think less, act more.

 

Sounds like your making one to many excuses Jef, just step it up.

 

Blaming it on the teacher is no excuse - whenever I don't understand something because the teacher explains it different than the way that works best for me then I read the textbook or ask someone else for help. Theres always another way to figure it out.

Also saying that you're not doing good in something and that you "can alwayys do better when you get to college" is not a good way to look at things. I took two calculus classes in high school and they were nowhere near as difficult as the calculus classes that I took in college. I did just as well in both, but it required a lot more work in college than it did in HS.

Relative to the average human being, it is that hard to become a spinal surgeon. You have to do very well in college an on the MCAT, along with having some other impressive resume builders usually just to get into medical school. Once in medical school you have to do very well in yhour classes and on the boards because orthopedics or neurosurgery are two of the most competitive specialties (the two routes to spine surg). I don't know much about fellowship competitveness, but I kow that spine surgeons are the highest paid physians on average so I'm assuming the fellowship probably the easiest one to get a spot in. I'm not trying to discourage you, I'm just being realistic. Its very early in the game for you right now. Step it up and put in the work and you can do whatever you want really.

 

Yikes, now you're talking suspiciously like another SDN Lounger I know of.

jef, just focus on the present. Do well in school NOW. The better you do in school, the more doors that stay open for you. Its that simple.

After a certain point, I'm sure you'll find that you'll be able to practice whatever medicine you want and still make as much money as this guy.

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