Everyone says physician compensation is going down…. but medscape shows 29% increase since 2015?

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
Status
Not open for further replies.
D

deleted1139416



Is this as simple as self-selection bias regarding which doctors choose to participate?

Members don't see this ad.
 
Who is everyone? I haven't heard of physician compensation going down except maybe for an over saturated field like EM.
 
  • Like
Reactions: 5 users
When inflation is factored in physician compensation has decreased. With declining reimbursement rates physicians also have to work harder and see more patients to generate the same revenue
 
  • Like
  • Sad
Reactions: 8 users
Members don't see this ad :)
in radiology the overall trend in reimbursement rates is downward. however the volumes are higher than ever. If you did the same amount of work as 5 years ago, you'd be paid decently less. combined with inflation, it's a real decrease in purchasing power.

But if you factor in ever increasing volumes, the numbers might show an increase in compensation though its at the cost of more work.
 
  • Like
Reactions: 4 users
The ROI is still ok for docs. Almost all docs with student debt can pay it back in 3 yrs if they want to.

Inflation is eating away most people purchasing power. Just imagine how a young family of 4 who make 80k/yr is doing these days. I believe inflation is worse than 9%; it might be closer to 30% IMO.

Most physicians are doing ok... Cant even get a radiologist who would agree to work for 500k/yr at my shop. One GI doc who is doing locum here is getting paid 5k/day.
 
  • Like
  • Hmm
Reactions: 4 users
The ROI is still ok for docs. Almost all docs with student debt can pay it back in 3 yrs if they want to.

Inflation is eating away most people purchasing power. Just imagine how a young family of 4 who make 80k/yr is doing these days. I believe inflation is worse than 9%; it might be closer to 30% IMO.

Most physicians are doing ok... Cant even get a radiologist who would agree to work for 500k/yr at my shop. One GI doc who is doing locum here is getting paid 5k/day.
You're wrong about paying loans back in three years. Student loans are much more now with high interest rates.
 
1662426918448.png


Looks pretty stagnant to me.
 
  • Like
Reactions: 1 users
You're wrong about paying loans back in three years. Student loans are much more now with high interest rates.
Most physicians have 250-300k in student debt... Even FM/IM docs can make 300k/yr (200k post tax) w/o killing themselves. 110k/yr for 3 yrs. 330k should pay principal and interest.
 
  • Like
Reactions: 3 users
I think that a lot of people are upset that right tail compensation options (ie equity stakes, private practice) are not as prevalent as they once were.
 
  • Like
Reactions: 1 user
When inflation is factored in physician compensation has decreased. With declining reimbursement rates physicians also have to work harder and see more patients to generate the same revenue
Incorrect. Physician wages have far outpaced inflation in most fields for many years. What has not outpaced inflation is compensation per RVU with Medicare/Medicaid patients, so physicians are working harder to make more. Overall we have been able to keep working harder for that money without losing ground, however.
 
  • Like
  • Love
Reactions: 4 users
Incorrect. Physician wages have far outpaced inflation in most fields for many years. What has not outpaced inflation is compensation per RVU with Medicare/Medicaid patients, so physicians are working harder to make more. Overall we have been able to keep working harder for that money without losing ground, however.
I haven't seen physician wages outpace inflation. There's no yearly cola
 
Most physicians have 250-300k in student debt... Even FM/IM docs can make 300k/yr (200k post tax) w/o killing themselves. 110k/yr for 3 yrs. 330k should pay principal and interest.
So all expenses 90k for each of those years? Doubtful. And people have undergrad loans too.
 
So all expenses 90k for each of those years? Doubtful. And people have undergrad loans too.
Well, people live on 50-60k/yr during residency...

The median household income is 68k/yr (Lets say 55k after taxes are deducted). 90k/yr or 7.5k/month should be enough for a family of 4 to live on.
 
Last edited:
  • Like
Reactions: 1 users
Members don't see this ad :)
Comp per service rendered has definitely gone down, especially when compared against inflation. Salary has gone up but that masks a huge change in dynamics where many more docs are employed. This buffers the decreased reimbursement because hospitals can charge fees beyond the physician fees to recoup other costs, plus they have built in ancillary revenue streams.

There have also been lots of little rule changes over the years that make it harder to generate the same revenue.

For example, full endoscopic sinus surgery in the late 1990s would reimburse 20-30k. Now surgeon fees are 3k ish depending on payor. Same operation, a fraction of the pay. Little rule adjustments now prevent you from doing a nasal endoscopy and a flexible laryngoscopy on the same patient on the same day; it’s just lumped in the laryngoscopy. Oh and the laryngoscopy pays less than the nasal endo. This is because the frequency of that code being billed drives down reimbursement per that code. Nasopharyngoscopy actually pays a little more than the laryngoscopy simply because people do fewer of them (you can’t bill it with the lary or endo either).

So it’s a lot of little things like that - those are just examples from my field.
 
  • Like
  • Hmm
Reactions: 2 users
I haven't seen physician wages outpace inflation. There's no yearly cola
Salaries generally keep pace or above with inflation for the majority of physicians, though there are obvious winners and losers in the specialties. I was doing some math last night, and here we go with the facts instead of "muh COLA," because at the end of the day we're doctors and we manage to make money by increasing production even if COLAs don't happen basically ever:

2002 salaries, by specialty:
Anesthesia: $306,964
General Surgery: $255,438
OB/Gyn: $233,061
IM: $155,690
Peds: $152,690
Psych: $163,144
FM: $150,267

2022 salaries, by specialty (net difference when accounting for inflation):
Anesthesia: $469,283 (-$36,282)
General Surgery: $473,367 (+$52,689)
OB/Gyn: $379,769 (-$16,057)
IM: $287,179 (+$31,118)
Peds: $245,860 (-$5,604)
Psych: $306,059 (+$37,379)
FM: $270,334 (+22,861)

All salaries were calculated using most recent inflation numbers from 2002-2022, and salaries were sources from MGMA.
 
  • Like
Reactions: 3 users
Salaries generally keep pace or above with inflation for the majority of physicians, though there are obvious winners and losers in the specialties. I was doing some math last night, and here we go with the facts instead of "muh COLA," because at the end of the day we're doctors and we manage to make money by increasing production even if COLAs don't happen basically ever:

2002 salaries, by specialty:
Anesthesia: $306,964
General Surgery: $255,438
OB/Gyn: $233,061
IM: $155,690
Peds: $152,690
Psych: $163,144
FM: $150,267

2022 salaries, by specialty (net difference when accounting for inflation):
Anesthesia: $469,283 (-$36,282)
General Surgery: $473,367 (+$52,689)
OB/Gyn: $379,769 (-$16,057)
IM: $287,179 (+$31,118)
Peds: $245,860 (-$5,604)
Psych: $306,059 (+$37,379)
FM: $270,334 (+22,861)

All salaries were calculated using most recent inflation numbers from 2002-2022, and salaries were sources from MGMA.
yea, probably just the price of med school tuition and living expenses are what makes young doctors so antsy. Hope most of us get PSLF.
 
  • Like
  • Care
Reactions: 1 users
Salaries generally keep pace or above with inflation for the majority of physicians, though there are obvious winners and losers in the specialties. I was doing some math last night, and here we go with the facts instead of "muh COLA," because at the end of the day we're doctors and we manage to make money by increasing production even if COLAs don't happen basically ever:

2002 salaries, by specialty:
Anesthesia: $306,964
General Surgery: $255,438
OB/Gyn: $233,061
IM: $155,690
Peds: $152,690
Psych: $163,144
FM: $150,267

2022 salaries, by specialty (net difference when accounting for inflation):
Anesthesia: $469,283 (-$36,282)
General Surgery: $473,367 (+$52,689)
OB/Gyn: $379,769 (-$16,057)
IM: $287,179 (+$31,118)
Peds: $245,860 (-$5,604)
Psych: $306,059 (+$37,379)
FM: $270,334 (+22,861)

All salaries were calculated using most recent inflation numbers from 2002-2022, and salaries were sources from MGMA.
I am really having a hard time believing that just 20 years ago people were making less than 200K a year, and how the heck was Anesthesiology pulling so much more than general surgery?
 
I am really having a hard time believing that just 20 years ago people were making less than 200K a year, and how the heck was Anesthesiology pulling so much more than general surgery?
You can look at the MGMA tables yourselves. Anesthesiology was a beast of a field before AMCs hit.
 
  • Like
Reactions: 1 users
The ROI is still ok for docs. Almost all docs with student debt can pay it back in 3 yrs if they want to.

Inflation is eating away most people purchasing power. Just imagine how a young family of 4 who make 80k/yr is doing these days. I believe inflation is worse than 9%; it might be closer to 30% IMO.

Most physicians are doing ok... Cant even get a radiologist who would agree to work for 500k/yr at my shop. One GI doc who is doing locum here is getting paid 5k/day.
Inflation is 30% ? I realize that's your opinion, but I find that hard for anyone to conclude. I buy most of the typical American goods and while I'm seeing increases, I'm not seeing anything near 30% on an overall basis. The full year CPI for 2022 will probably end up around 7-8% by the time it's all said and done. You really think it's nearly 4 times as high as that ?
 
  • Okay...
  • Like
Reactions: 1 users
The ROI is still ok for docs. Almost all docs with student debt can pay it back in 3 yrs if they want to.

Inflation is eating away most people purchasing power. Just imagine how a young family of 4 who make 80k/yr is doing these days. I believe inflation is worse than 9%; it might be closer to 30% IMO.

Most physicians are doing ok... Cant even get a radiologist who would agree to work for 500k/yr at my shop. One GI doc who is doing locum here is getting paid 5k/day.
Yeah, we're hardly hurting. Even in psych I can get $2k/day without going too far out of my way, and much more than that if I'm willing to go for a bit of a hike.
 
  • Like
Reactions: 1 users
After taxes it would take me around 4 or 5 years, but at that point I could just get PSLF.
You are a psychiatrist, so 400-450k should not be difficult for you to make. Is your student debt > 400k?
 
Inflation is 30% ? I realize that's your opinion, but I find that hard for anyone to conclude. I buy most of the typical American goods and while I'm seeing increases, I'm not seeing anything near 30% on an overall basis. The full year CPI for 2022 will probably end up around 7-8% by the time it's all said and done. You really think it's nearly 4 times as high as that ?
It feels like it...
 
Yeah, we're hardly hurting. Even in psych I can get $2k/day without going too far out of my way, and much more than that if I'm willing to go for a bit of a hike.
You would think the sky is falling reading some of the posts in SDN... Of course making more $$$ is better, but we should not exaggerate things.
 
  • Like
Reactions: 1 user
You would think the sky is falling reading some of the posts in SDN... Of course making more $$$ is better, but we should not exaggerate things.
The sky is always falling on SDN. I'm surprised it's still above our heads at this point.
 
  • Like
  • Haha
Reactions: 4 users
Well, people live on 50-60k/yr during residency...

The median household income is 68k/yr (Lets say 55k after taxes are deducted). 90k/yr or 7.5k/month should be enough for a family of 4 to live on.
Last I checked the median household income was closer to $70-80k/year, depending on the methodology. I don't think median household income is a good comparative metric either way.

1) It over counts single people. I'm a "household" and I make $40K/year as an MSTP student. Meanwhile a family of 8 is also a household.

2) It uses taxable income, which is underreported.

3) You should compare to your geographical and household size peers.

If you're a physician in Massachusetts with a family of 4, the median household income is $140k. Even in Kansas, the median is $92k. If you live near a bigger city, add at least 20%, so probably $170k in Boston and $110k in Kansas City. Imagine working like a dog through med school and residency, continuing to work hard, long days as an attending, being 7-10 years behind on saving/investing, and only being able to provide a below-median lifestyle to your family while continuing to put nothing in your retirement accounts. When you consider the amount of work an attending has done compared to the median person in the US, it's really not a great deal. Physicians definitely underperform compared to their intellectual peers in other industries.
 
  • Like
Reactions: 5 users
Last I checked the median household income was closer to $70-80k/year, depending on the methodology. I don't think median household income is a good comparative metric either way.

1) It over counts single people. I'm a "household" and I make $40K/year as an MSTP student. Meanwhile a family of 8 is also a household.

2) It uses taxable income, which is underreported.

3) You should compare to your geographical and household size peers.

If you're a physician in Massachusetts with a family of 4, the median household income is $140k. Even in Kansas, the median is $92k. If you live near a bigger city, add at least 20%, so probably $170k in Boston and $110k in Kansas City. Imagine working like a dog through med school and residency, continuing to work hard, long days as an attending, being 7-10 years behind on saving/investing, and only being able to provide a below-median lifestyle to your family while continuing to put nothing in your retirement accounts. When you consider the amount of work an attending has done compared to the median person in the US, it's really not a great deal. Physicians definitely underperform compared to their intellectual peers in other industries.
I think there is a country's worth of PhDs who would like a word.
 
  • Like
  • Haha
Reactions: 5 users
I think there is a country's worth of PhDs who would like a word.
As an MSTP student... maybe.

That said, at top STEM programs where PhD students are comparable academically to MD students, the PhDs often make the same or more money as doctors over a lifetime if they manage their money well while young. Then if you compare wealth accumulated to hours worked, the PhDs win by a mile.

My PhD program is a T10 in the field and has great connections to industry. The most common pathway is PhD from 22-27, start at 27 with $115k base, $10k equity, and $30k bonus at a Big Pharma company. Rise to director or senior director level by 35 and pull in $250k+ TC with a much higher ceiling if you get to VP or SVP. Rarely work weekends. Never on call. No debt. 5+ extra years of compounding interest on however many hundreds of thousands you can stash away while making $150-200k while childless.

A lot of others take different paths that are even more lucrative. MBB and the Big 4 will start a PhD at $175k base and $50k bonus with a hefty signing bonus ($20-40k). At the principal level, very achievable, they are making $350-400k TC. Worse work-life balance than pharma, but easily doctor money and no call.

Then others go VC, which is risky and rarely results in partnership, but usually results in exiting to exec roles in small-to-medium sized pharma companies making physician pay as the floor and mega yacht money as the ceiling.

Very few PhDs go into academia these days, but even there if you are in engineering or are translation-focused (and you hustle a bit), total pay is higher than professor salaries would suggest via side gigs in industry. However, they do tend to make less and spend comparable time training.

Doctors and med students often sleep on how much money can be made outside of medicine because the comp is in equity and bonuses with a low base salary. You won't get these opportunities as a PhD from some random T50 university in the Midwest, of course, but I'm not sure those students are intellectual peers of most med students.
 
  • Like
Reactions: 1 user
"Death by thousand cuts" from CMS is not sustainability. For my field (radiology), reimbursement from CMS is down 50% from a decade or two when one considers inflation. Commercial insurers base their rates on CMS. Income has stayed the same or increased due to reading more RVUs...Interestingly hospitals have negotiated an automatic 2-3% increase/year...AMA (with contribution from many other specialty professional societies) is leading CMS payment reform
 

Attachments

  • CMS.png
    CMS.png
    571.4 KB · Views: 68
  • Like
Reactions: 1 users
As an MSTP student... maybe.

That said, at top STEM programs where PhD students are comparable academically to MD students, the PhDs often make the same or more money as doctors over a lifetime if they manage their money well while young. Then if you compare wealth accumulated to hours worked, the PhDs win by a mile.

My PhD program is a T10 in the field and has great connections to industry. The most common pathway is PhD from 22-27, start at 27 with $115k base, $10k equity, and $30k bonus at a Big Pharma company. Rise to director or senior director level by 35 and pull in $250k+ TC with a much higher ceiling if you get to VP or SVP. Rarely work weekends. Never on call. No debt. 5+ extra years of compounding interest on however many hundreds of thousands you can stash away while making $150-200k while childless.

A lot of others take different paths that are even more lucrative. MBB and the Big 4 will start a PhD at $175k base and $50k bonus with a hefty signing bonus ($20-40k). At the principal level, very achievable, they are making $350-400k TC. Worse work-life balance than pharma, but easily doctor money and no call.

Then others go VC, which is risky and rarely results in partnership, but usually results in exiting to exec roles in small-to-medium sized pharma companies making physician pay as the floor and mega yacht money as the ceiling.

Very few PhDs go into academia these days, but even there if you are in engineering or are translation-focused (and you hustle a bit), total pay is higher than professor salaries would suggest via side gigs in industry. However, they do tend to make less and spend comparable time training.

Doctors and med students often sleep on how much money can be made outside of medicine because the comp is in equity and bonuses with a low base salary. You won't get these opportunities as a PhD from some random T50 university in the Midwest, of course, but I'm not sure those students are intellectual peers of most med students.
I spoke to a PhD fraternity brother of my just last month. PhD chemist from University of Wisconsin. Works for LabCorp after several post docs and has been there for 5 years. Makes 120k. He was accepted to multiple medical schools that were much higher ranked than where I was accepted (I think UVA was his best, EVMS/University of SC were my acceptances).

I'm a lowly family doctor making a little over 3X what he is.

I have a cousin, PhD biocehmist from Duke working for Pharma. She does pretty well (not sure the actual number), but based on what little I know there's no way she's making what I am unless she's saving/investing 50% or more of her income.

Yes, PhDs can do very well. But on average they make a good bit less than MDs do. Unless you really try, you'll end up 300k+ as a physician. Most PhDs don't make that.
 
  • Like
Reactions: 3 users
Last I checked the median household income was closer to $70-80k/year, depending on the methodology. I don't think median household income is a good comparative metric either way.
 
Taxable income =/= wealth accumulation, which is all the matters. Missing out on the first 10 years of investment (gap years, med school, residency +/- fellowship) and severely hampering the next 10 with student loans has an enormous effect on wealth accumulation. The main reason doctors wind up wealthier is that other people live better lifestyles in their 20s and save less than they would living like a med student/resident. A chemical engineer would be quite wealthy at retirement age if they decided to live with roommates and pinch pennies like a med student and send all of the excess earnings into index funds in their 20s.

You can do a lot of fun exercises with this, but the takeaway is that most physicians have the wealth potential of someone making ~60% of their salary in a career with normal debt and normal training time.

So plenty of physicians earn top 1% taxable income. How many have top 1% income after loan payments? How many of them are earning top 1% wealth accumulation for the year? How many of them are in the top 1% most wealthy, which requires a net worth of ~$11M?
In this economy, data from FY2020 is outdated (and also particularly anomalous, given the COVID slump). We're easily across the $70k barrier in 2022 after everything that's happened the last few years. We just need to wait another two years for someone to calculate it officially. Estimates are in the $70-80K range. Another estimate. Another from HUD.
 
Last edited:
Taxable income =/= wealth accumulation, which is all the matters. Missing out on the first 10 years of investment (gap years, med school, residency +/- fellowship) and severely hampering the next 10 with student loans has an enormous effect on wealth accumulation. The main reason doctors wind up wealthier is that other people live better lifestyles in their 20s and save less than they would living like a med student/resident. A chemical engineer would be quite wealthy at retirement age if they decided to live with roommates and pinch pennies like a med student and send all of the excess earnings into index funds in their 20s.

You can do a lot of fun exercises with this, but the takeaway is that most physicians have the wealth potential of someone making ~60% of their salary in a career with normal debt and normal training time.

So plenty of physicians earn top 1% taxable income. How many have top 1% income after loan payments? How many of them are earning top 1% wealth accumulation for the year? How many of them are in the top 1% most wealthy, which requires a net worth of ~$11M?

In this economy, data from FY2020 is outdated (and also particularly anomalous, given the COVID slump). We're easily across the $70k barrier in 2022 after everything that's happened the last few years. We just need to wait another two years for someone to calculate it officially. Estimates are in the $70-80K range. Another estimate. Another from HUD.
Are we talking about lifestyle or are we talking about wealth here?

The fact of the matter is most engineers start making 60-75k after graduation... That kind of money give you no real purchasing power and very little room to save/invest.
 
Last I checked the median household income was closer to $70-80k/year, depending on the methodology. I don't think median household income is a good comparative metric either way.

1) It over counts single people. I'm a "household" and I make $40K/year as an MSTP student. Meanwhile a family of 8 is also a household.

2) It uses taxable income, which is underreported.

3) You should compare to your geographical and household size peers.

If you're a physician in Massachusetts with a family of 4, the median household income is $140k. Even in Kansas, the median is $92k. If you live near a bigger city, add at least 20%, so probably $170k in Boston and $110k in Kansas City. Imagine working like a dog through med school and residency, continuing to work hard, long days as an attending, being 7-10 years behind on saving/investing, and only being able to provide a below-median lifestyle to your family while continuing to put nothing in your retirement accounts. When you consider the amount of work an attending has done compared to the median person in the US, it's really not a great deal. Physicians definitely underperform compared to their intellectual peers in other industries.
True, but living in places like Boston is a choice. Physicians could easily have a much better life by moving 3 hours up to Portland or even Manchester. Again, not saying there’s anything wrong with wanting to living in cities but it’s not like they couldn’t have a much better life elsewhere
 
  • Like
Reactions: 1 users
I spoke to a PhD fraternity brother of my just last month. PhD chemist from University of Wisconsin. Works for LabCorp after several post docs and has been there for 5 years. Makes 120k. He was accepted to multiple medical schools that were much higher ranked than where I was accepted (I think UVA was his best, EVMS/University of SC were my acceptances).

I'm a lowly family doctor making a little over 3X what he is.

I have a cousin, PhD biocehmist from Duke working for Pharma. She does pretty well (not sure the actual number), but based on what little I know there's no way she's making what I am unless she's saving/investing 50% or more of her income.

Yes, PhDs can do very well. But on average they make a good bit less than MDs do. Unless you really try, you'll end up 300k+ as a physician. Most PhDs don't make that.
That all sounds about right. Chem/bio/biochem are all weak links in the STEM world. I also wouldn't put either Duke or UWis in the elite bucket in those fields, especially UWis. More importantly they are far from the real action in SF, SD, Boston, Seattle, etc... I'm thinking more along the lines of top 10 or maybe top 20 for fields like BME. I think almost any med student could reasonably have gained admission to these programs if they had redirected pre-med efforts to PhD. Duke's BME PhD (an elite program) averages a 3.6 and ~85%ile GRE. UVA med averages a 3.87 and 95-96%ile MCAT.

Your fraternity brother sounds like he made some odd career choices. Combine that with multiple post-docs and a job at LabCorp and something is off or he's just content with a low stress job. PhD is usually dramatically less competitive than MD except at the very, very top so the admissions there is not the norm.

Depending on where your cousin works she might be making/saving more than you think (especially if she's receiving significant compensation in equity, which people tend to save rather than spend). Pharma also is a bit more "choose your own destiny" than medicine. Lower floor. Higher ceiling.

But... you are right in that a lot of these people are very smart, work very hard, contribute very much to our society, and still get paid garbage. This is generally true of anyone who is dead set on actually practicing their craft rather than consulting or managing.
Are we talking about lifestyle or are we talking about wealth here?

The fact of the matter is most engineers start making 60-75k after graduation... That kind of money give you no real purchasing power and very little room to save/invest.
People exchange lifestyle for wealth. They're inseparable.

Much closer to $75K, and med students always forget there are bonuses and benefits (like retirement match) that boost TC. Senior BME undergrads from my lab are all talking about salaries in the $70K range and additional bonuses/benefits bringing compensation closer to $90-100K. I worked in engineering for 2 years before med school. If you apply a med student's work ethic to engineering you will soar through the bottom ranks and into the $125-140K range by 25 years old. From there you either transition to management, move to a much larger/flashier company for a raise, transition to another sector like consulting, or simply enjoy 40 hour weeks with a solid salary/bonus.
True, but living in places like Boston is a choice. Physicians could easily have a much better life by moving 3 hours up to Portland or even Manchester. Again, not saying there’s anything wrong with wanting to living in cities but it’s not like they couldn’t have a much better life elsewhere
This is true and a good point.

My partner is in biotech and it's looking like SF, SD, Boston, Seattle, or LA is an inevitability. Opportunities elsewhere are very mediocre in comparison from a career mobility/intellectual fulfilment perspective. However, my imaginary scenario doesn't apply because we'd have two incomes. Even if I could only contribute $90K, they'd be chipping in another $100-200K. If I were the sole earner, we'd be in Portland unless I were dead set on academic medicine at HMS or something, which is ultimately another choice.
 
True, but living in places like Boston is a choice. Physicians could easily have a much better life by moving 3 hours up to Portland or even Manchester. Again, not saying there’s anything wrong with wanting to living in cities but it’s not like they couldn’t have a much better life elsewhere

But you’re thinking from a doctors perspective, where you can have a job anywhere. Many people have non-physician spouses whose careers require them to be in a certain city (like law, finance, or tech).
 
That all sounds about right. Chem/bio/biochem are all weak links in the STEM world. I also wouldn't put either Duke or UWis in the elite bucket in those fields, especially UWis. More importantly they are far from the real action in SF, SD, Boston, Seattle, etc... I'm thinking more along the lines of top 10 or maybe top 20 for fields like BME. I think almost any med student could reasonably have gained admission to these programs if they had redirected pre-med efforts to PhD. Duke's BME PhD (an elite program) averages a 3.6 and ~85%ile GRE. UVA med averages a 3.87 and 95-96%ile MCAT.

Your fraternity brother sounds like he made some odd career choices. Combine that with multiple post-docs and a job at LabCorp and something is off or he's just content with a low stress job. PhD is usually dramatically less competitive than MD except at the very, very top so the admissions there is not the norm.

Depending on where your cousin works she might be making/saving more than you think (especially if she's receiving significant compensation in equity, which people tend to save rather than spend). Pharma also is a bit more "choose your own destiny" than medicine. Lower floor. Higher ceiling.

But... you are right in that a lot of these people are very smart, work very hard, contribute very much to our society, and still get paid garbage. This is generally true of anyone who is dead set on actually practicing their craft rather than consulting or managing.

People exchange lifestyle for wealth. They're inseparable.

Much closer to $75K, and med students always forget there are bonuses and benefits (like retirement match) that boost TC. Senior BME undergrads from my lab are all talking about salaries in the $70K range and additional bonuses/benefits bringing compensation closer to $90-100K. I worked in engineering for 2 years before med school. If you apply a med student's work ethic to engineering you will soar through the bottom ranks and into the $125-140K range by 25 years old. From there you either transition to management, move to a much larger/flashier company for a raise, transition to another sector like consulting, or simply enjoy 40 hour weeks with a solid salary/bonus.

This is true and a good point.

My partner is in biotech and it's looking like SF, SD, Boston, Seattle, or LA is an inevitability. Opportunities elsewhere are very mediocre in comparison from a career mobility/intellectual fulfilment perspective. However, my imaginary scenario doesn't apply because we'd have two incomes. Even if I could only contribute $90K, they'd be chipping in another $100-200K. If I were the sole earner, we'd be in Portland unless I were dead set on academic medicine at HMS or something, which is ultimately another choice.
You really know some top earning engineers. The 3 engineers that I am friends with make 95k (civil), 125k (computer engineer) and 175k (computer science) after 15 yrs. Two of them get very uneasy when there is a downturn in the economy.

I might be too risk averse here. I rather start making 300-350k/yr at 29 as a hospitalist and be able to find a job ANYWHERE in the country than starting out making 70k at 22 while worrying about job security.
 
  • Like
Reactions: 4 users
True, but living in places like Boston is a choice. Physicians could easily have a much better life by moving 3 hours up to Portland or even Manchester. Again, not saying there’s anything wrong with wanting to living in cities but it’s not like they couldn’t have a much better life elsewhere


Define “better”. There was no boba, no Hmart and no Korean BBQ the last time I was in Klamath, OR.
 
  • Haha
  • Like
Reactions: 1 users
You really know some top earning engineers. The 3 engineers that I am friends with make 95k (civil), 125k (computer engineer) and 175k (computer science) after 15 yrs. Two of them get very uneasy when there is a downturn in the economy.

I might be too risk averse here. I rather start making 300-350k/yr at 29 as a hospitalist and be able to find a job ANYWHERE in the country than starting out making 70k at 22 while worrying about job security.


Maybe it is location dependent. A good chunk of the guys that show up at our local weekly cars n coffee in their Ferraris and Lamborghinis are engineers. More so than doctors. And they actually have time to show up at cars n coffee.
 
Define “better”. There was no boba, no Hmart and no Korean BBQ the last time I was in Klamath, OR.
This is true. Maybe the ideal is
-Become hospitalist in middle of nowhere with 7 on 7 off
-Stay single (don’t think this would work if not)
-Travel the country/world every other week
 
I spoke to a PhD fraternity brother of my just last month. PhD chemist from University of Wisconsin. Works for LabCorp after several post docs and has been there for 5 years. Makes 120k. He was accepted to multiple medical schools that were much higher ranked than where I was accepted (I think UVA was his best, EVMS/University of SC were my acceptances).

I'm a lowly family doctor making a little over 3X what he is.

I have a cousin, PhD biocehmist from Duke working for Pharma. She does pretty well (not sure the actual number), but based on what little I know there's no way she's making what I am unless she's saving/investing 50% or more of her income.

Yes, PhDs can do very well. But on average they make a good bit less than MDs do. Unless you really try, you'll end up 300k+ as a physician. Most PhDs don't make that.
Many PhDs aren't nearly as difficult as the one you mention and also don't have to pay for school. Medical students start at least 300k in the hole.
 
You really know some top earning engineers. The 3 engineers that I am friends with make 95k (civil), 125k (computer engineer) and 175k (computer science) after 15 yrs. Two of them get very uneasy when there is a downturn in the economy.

I might be too risk averse here. I rather start making 300-350k/yr at 29 as a hospitalist and be able to find a job ANYWHERE in the country than starting out making 70k at 22 while worrying about job security.
There are many more engineers in this country than physicians. And they don't have seven plus years of post college education.
 
You really know some top earning engineers. The 3 engineers that I am friends with make 95k (civil), 125k (computer engineer) and 175k (computer science) after 15 yrs. Two of them get very uneasy when there is a downturn in the economy.

I might be too risk averse here. I rather start making 300-350k/yr at 29 as a hospitalist and be able to find a job ANYWHERE in the country than starting out making 70k at 22 while worrying about job security.
A few points, then I've hit my SDN limit for the month

1) You can't compare the average engineer to the average doctor. You have to look at outcomes of the top performing engineering students.

2) I find it weird that as soon as there's a point to be made, everyone knows their friends' exact income, MCAT scores, GPAs, phallic girth, etc...

3) Lots of engineers make a lot of money. $100K is sort of the floor for a mid-career professional, and for someone performing at "physician-level" in the engineering space, $200K+ or even $300K+ is pretty normal. It's just that they're not called engineers anymore. They're consultants. They're business owners. They're managers. A lot of people start at that $70K with an engineering degree, and the lowest earning among them just hum along in an employed engineer role (and there's nothing wrong with that). The more ambitious ones go back and get an MBA, start their own firm, or climb the ladder from within.

4) Hospitalist at 29 is an optimistic scenario. The average age of matriculation is closing in on 25 as adcoms start to value work experience more and more, so 32 with $400K in debt and 0 in retirement savings is more realistic. A realistic timeline for an ambitious engineer is $70K + $10K bonus at 22 up to $100K + $20K bonus at 26, then get an MBA part-time while working and either take a management role at a company for $140K + $30K bonus at 28 or leave for a consulting role at $200K TC (or as high as $250K TC on the high end), all with no or minimal debt and 6 years of substantial retirement savings and unlimited upside. Yes, the physician role is less risky, but there are plenty of reasonably sure pathways with an engineering degree, and you work harder for every dollar as a physician for sure.
 
  • Like
Reactions: 1 user
That all sounds about right. Chem/bio/biochem are all weak links in the STEM world. I also wouldn't put either Duke or UWis in the elite bucket in those fields, especially UWis. More importantly they are far from the real action in SF, SD, Boston, Seattle, etc... I'm thinking more along the lines of top 10 or maybe top 20 for fields like BME. I think almost any med student could reasonably have gained admission to these programs if they had redirected pre-med efforts to PhD. Duke's BME PhD (an elite program) averages a 3.6 and ~85%ile GRE. UVA med averages a 3.87 and 95-96%ile MCAT.

Your fraternity brother sounds like he made some odd career choices. Combine that with multiple post-docs and a job at LabCorp and something is off or he's just content with a low stress job. PhD is usually dramatically less competitive than MD except at the very, very top so the admissions there is not the norm.

Depending on where your cousin works she might be making/saving more than you think (especially if she's receiving significant compensation in equity, which people tend to save rather than spend). Pharma also is a bit more "choose your own destiny" than medicine. Lower floor. Higher ceiling.

But... you are right in that a lot of these people are very smart, work very hard, contribute very much to our society, and still get paid garbage. This is generally true of anyone who is dead set on actually practicing their craft rather than consulting or managing.

People exchange lifestyle for wealth. They're inseparable.

Much closer to $75K, and med students always forget there are bonuses and benefits (like retirement match) that boost TC. Senior BME undergrads from my lab are all talking about salaries in the $70K range and additional bonuses/benefits bringing compensation closer to $90-100K. I worked in engineering for 2 years before med school. If you apply a med student's work ethic to engineering you will soar through the bottom ranks and into the $125-140K range by 25 years old. From there you either transition to management, move to a much larger/flashier company for a raise, transition to another sector like consulting, or simply enjoy 40 hour weeks with a solid salary/bonus.

This is true and a good point.

My partner is in biotech and it's looking like SF, SD, Boston, Seattle, or LA is an inevitability. Opportunities elsewhere are very mediocre in comparison from a career mobility/intellectual fulfilment perspective. However, my imaginary scenario doesn't apply because we'd have two incomes. Even if I could only contribute $90K, they'd be chipping in another $100-200K. If I were the sole earner, we'd be in Portland unless I were dead set on academic medicine at HMS or something, which is ultimately another choice.
Wisconsin in the particular type of chemistry he does is #6 in the US.
 
Something I always see in these Physician vs (insert hot other career) discussions when talking about compensation is a comparison of the worst-case scenario (high debt, relatively lower-comp specialty) in medicine vs best case scenario in engineering, finance, tech, etc.

Here's a very similar thread developing over on the WCI forums where practicing physicians overall aren't as concerned with their overall compensation being "maybe the 2nd best path to becoming a millionaire by your 40s": Is there any financial advantage of going in medicine ? - The White Coat Investor Forum - Investing & Personal Finance for Doctors.

Not every medical student takes on crazy amounts of debt. I'll be graduating with $40k after my medical school's tuition scholarship and Biden's forgiveness as a college pell-grant recipient as a 2nd-generation immigrant.

Anyway, if we want to talk opportunities in medicine, there are a plethora. ROAD + surgical specialities are competitive because you can be offered $400-600k right off the bat in say PP Rads + breast fellowship (from direct conversations with a fellow at my institution) or $750k in PP Ortho after fellowship (numbers from my cousin's experiences back in 2014 when he started practice in a major TX metro). Or you can go big with say elective surgical fields (PP surgeon in my community who I've shadowed charges $30k per average surgery. with offers as high as $100k. cash. Does 7-10 per week).

I'm speaking up just to talk about opportunities because it's often hard to see at the medical student level. But it's always worth noting the best case scenarios for medicine do better than 99% of the country's population and no one is stopping you from becoming an ambitious business owner with multiple service locations or offering high-value healthcare products or investing in healthcare adjacent startups with large valuation multiples to compete with the 1% (if that's your goal).
 
  • Like
Reactions: 1 user
Status
Not open for further replies.
Top