EM: Room for growth?

[coconut lime]

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I am a 3rd year considering EM as a career, but a physician mentioned to me that I should keep in mind that there is no potential for growth or increase in salary in EM. He said that it's nice if you want to start at a high salary right out of residency, but that is pretty much the salary you will be at without any growth. Any ideas on this?

 

[dlung]

depends how much money makes you happy I suppose... $120k+ for a starting academic position and $200-300k for a regular job don't seem that shabby to me right now... but then again, I'm making something like negative $40k a year right now (not including interest), so even an In-N-Out salary sounds awesome...

like any other field, if you get a fellowship (eg tox, sports med), you can always do work on the side and increase your cash flow...

if want earning potential, radiology and pmr look pretty good for the next couple decades... 😴

 

[DrQuinn]

I am a 3rd year considering EM as a career, but a physician mentioned to me that I should keep in mind that there is no potential for growth or increase in salary in EM. He said that it's nice if you want to start at a high salary right out of residency, but that is pretty much the salary you will be at without any growth. Any ideas on this?

There is potential in EM, just like FP or IM or whatever you want. There are democratic EM groups where you can become "partner" in. I know hospitalists who worked for 20 years and are still employees and some that are partners in 2. Same in EM. Also in EM you can be a medical director on top of an EM attending and that can substantially boost your salary. Also don't forget being a part time EMS administrator, that can also buy you a BMW 5 Series per year.
Q

 

[Freeeedom!]

THink of it this way...


MANY EM groups add vacation or subtract monthly shifts as you increase in seniority (as little as 2-3 years).

THis means that while as a 10 year member of the group, you may be making 250k or so...but you either have >6weeks of vacation a year or perhaps you only work 10shifts per month.

Furthermore, bonuses are oftentimes NOT worked into salary calculations as they deal primarily with profitsharing when you are truly a partner and may be variable. (5k one period 30k another)

 

[iatrosB]

I am a 3rd year considering EM as a career, but a physician mentioned to me that I should keep in mind that there is no potential for growth or increase in salary in EM. He said that it's nice if you want to start at a high salary right out of residency, but that is pretty much the salary you will be at without any growth. Any ideas on this?

Only a physician could cry about $200,000 in easy money! 👎

 

[edinOH]

If you think it is "easy money", think again.

 

[iatrosB]

If you think it is "easy money", think again.

The phrase "easy money" is to broad and subjective to have a rational debate over. My criterion is based on hrs. worked for your gross salary. ~36-40 hours per week for 200K is not to shabby. Do you have to work you a** off to get there, yes. Do you work you a** off while you are on your shift, yes. In my case, I don't mind doing either and if I am to be rewarded with 200K, then by golly that's "easy money" (subjective determination for me). The point is, what other occupation would cry because they will cap at $200,000 (besides athletes and hollywood folk). You gotta be kidding me!

 

[phillyfornia]

EM has got to be one of the most flexible specialties in medicine. the number of days off would probably give you plenty of time to get involved in some lucrative investment opportunities on the side.

 

[Febrifuge]

The phrase "easy money" is to broad and subjective to have a rational debate over. My criterion is based on hrs. worked for your gross salary. ~36-40 hours per week for 200K is not to shabby. Do you have to work you a** off to get there, yes. Do you work you a** off while you are on your shift, yes. In my case, I don't mind doing either and if I am to be rewarded with 200K, then by golly that's "easy money" (subjective determination for me). The point is, what other occupation would cry because they will cap at $200,000 (besides athletes and hollywood folk). You gotta be kidding me!

Yeah, but you're forgetting that not only does a student doc have to work his/her ass off, but there's also the outlay for tuition and the opportunity cost of not earning the salary someone not in school/ residency would be earning.

For me, a non-trad leaving a career to go back and do med school, this issue is not trivial, and it's not sufficient to talk about hours worked per week vs money earned at the post-residency level. If I stay with my current tack, let's say I earn someplace between $35k and $45k a year, for the next 10 years. That's $350k to $450k, in income. If I go to school for 6 years (postbac 1 year + glide year; med school 4 years) and then do residency, that same 10-year period is one where I have to PAY about, what, $150K?

So I give up the income, I pay the tuition, and combined I "spend" about half a million to $600,000.00 over 6 years, in order to get to where I earn $42k a year as a resident. For those three years, maybe things even out, or maybe I'm still a little behind my hypothetical, didn't-go-to-school self (or a person just like me who was happily puttering along in the corporate world).

Only after residency do I get even a shot at that $200k a year. Right now my student loans are about equal to a year's pay. When I'm done with school, the loans will be about equal to 125% of a year's pay... at that big-ass doctor-money level. Then there's malpractice insurance, the house payment I'll just be able to take on for the first time even though all my friends will have built up 10 years worth of equity, etc, etc. There are a lot of costs that people forget, ignore, or gloss over. So it's a bit of a pet peeve of mine, when people talk about docs being overpaid or money-grubbing.

Okay, end of rant. 😀 Ask me again after I've been out of residency for 5 years, and the loan payments are budgeted and chugging along. I'll probably agree with you. But the above is something to consider, if the push-back you're seeing in this thread strikes you as odd. (It's also good for getting my family and friends to shut the hell up about all the big-time cash I'll allegedly have.)