countingdays

ASA Member
5+ Year Member
May 16, 2009
1,147
33
Status
Attending Physician
Anybody have plans for moving on when this profession goes sour?
Non-clinical work?
Pain?
Icu?
Re-train in another specialty?
Move abroad?
 

sevoflurane

Ride
15+ Year Member
Jul 16, 2003
4,936
1,748
Visit site
Status
Attending Physician
No plans. Even with a 50% pay cut. If that happens, I'll just work less than I do now or go 1/2 time.
Passive income in the form of rental properties can help offset the loss of income and provide another avenue of ongoing income when you retire. It can be a hassle though.
 

dr doze

To be able to forget means to sanity
Lifetime Donor
10+ Year Member
Dec 6, 2006
3,720
1,697
Status
Attending Physician
For the overwhelming majority of us, there is nothing that will compensate us more than our clinical work. Even with a significant cut.

Save as much as you can. Learn about personal finance and investing. Don't get hooked on the lifestyle that comes with our current paychecks.
 

digitox

5+ Year Member
Sep 18, 2013
34
31
Status
Medical Student
Very encouraging for us applying for residency right now. Awesome.
 

IkeBoy18

ASA Member
10+ Year Member
Jul 13, 2005
691
80
Status
Resident [Any Field]
Very encouraging for us applying for residency right now. Awesome.
exactly.. I guess Id better (as a third yr) start looking hard for an exit strategy to ditch loving anesthesia
 

aneftp

7+ Year Member
Mar 23, 2010
1,854
722
Status
Attending Physician
There's only so much one can cut skilled labor income.

Remember you got lots of federal folks with barley bachelors degrees making easy 100k money by age 28-30 years old.

Having lived in DC area half my life (along with friends in all higher income parts of the country (San Fran, New York, LA etc). I know many folks with psych degrees working as contractors making very good money.


It's very hard to imagine anesthesiologist income being lower than 200k and that's a straight 40 hour week job no call.

The market will dictate income.

Right now Sheridan can't find any suckers to worker at Winnie Palmer hospital in orlando for 260-280k. Even with working more hours they cannot find people to work for 350k at Winnie Palmer.
 
Last edited:
OP
C

countingdays

ASA Member
5+ Year Member
May 16, 2009
1,147
33
Status
Attending Physician
Right now Sheridan may seem terrible, but in the near future there will only be AMCs, VAs, and academics. When that happens, Winnie Palmer will have an easy time recruiting.
 

dhb

Member
Lifetime Donor
10+ Year Member
Jul 12, 2006
3,887
1,077
Status
Attending Physician
If Europe is any indication i can assure you that you will not make less the 200k in the future. Plus there will always be a demand for private practice medicine.
 

pgg

Laugh at me, will they?
Administrator
10+ Year Member
Dec 15, 2005
12,120
8,054
Home Again
Status
Attending Physician
Gloomerific threads like this strike me as odd, to say the least.

If you have a mountain of debt in the mid-six-figures range, a job that only pays $250K can result in a disappointing and decidedly median lifestyle. But to be talking about exit strategies from a $250K job?

A fellowship might make one more competitive in a slow job market, or open doors in a competitive market. Worthwhile? Probably.

Be geographically flexible, at least until your debt's paid off, and take a deep breath. If anesthesia pay crashes through $400K on its way to a realistic worst-case floor of $250K, take a deep breath and get on with living your life. If that happens, you're not going to step into something better than $250K. You might be able to take a pay cut to $60-70K/year for 4-5 years and do a 2nd residency, but the forces that pushed anesthesia pay down to $250K poverty levels aren't going to leave other specialties untouched.

The truth is that $400-500K+ salaries of the last decade were probably as much an anomoly as the sub-$200K salaries of the horrible 90s. The expectation bar is perhaps a little unreasonable for the long term.

Somehow the guys in primary care are getting by, and so will you. You couldn't pay me enough to be a surgeon or do primary care. Pick a specialty you like and fit your lifestyle into whatever it pays.
 

Mman

Senior Member
10+ Year Member
Mar 22, 2005
4,878
2,616
Status
Attending Physician
My exit strategy is to stockpile as much savings as I can while I can. If my income can remain unchanged for the next 5-10 years I will have enough stockpiled to be stable for life with only needing to work part time to pay the daily bills. Wouldn't be ideal, but my family could live comfortably. I'd probably look for part time work in an academic setting where I could do a lot less work for a little less pay and still have plenty of free time.
 
OP
C

countingdays

ASA Member
5+ Year Member
May 16, 2009
1,147
33
Status
Attending Physician
Gloomerific threads like this strike me as odd, to say the least.

If you have a mountain of debt in the mid-six-figures range, a job that only pays $250K can result in a disappointing and decidedly median lifestyle. But to be talking about exit strategies from a $250K job?

A fellowship might make one more competitive in a slow job market, or open doors in a competitive market. Worthwhile? Probably.

Be geographically flexible, at least until your debt's paid off, and take a deep breath. If anesthesia pay crashes through $400K on its way to a realistic worst-case floor of $250K, take a deep breath and get on with living your life. If that happens, you're not going to step into something better than $250K. You might be able to take a pay cut to $60-70K/year for 4-5 years and do a 2nd residency, but the forces that pushed anesthesia pay down to $250K poverty levels aren't going to leave other specialties untouched.

The truth is that $400-500K+ salaries of the last decade were probably as much an anomoly as the sub-$200K salaries of the horrible 90s. The expectation bar is perhaps a little unreasonable for the long term.

Somehow the guys in primary care are getting by, and so will you. You couldn't pay me enough to be a surgeon or do primary care. Pick a specialty you like and fit your lifestyle into whatever it pays.
For younger docs, partnership is becoming a thing of the past. If the 'partners' will be making 250k, where does that leave the newer guys?
Close to exit strategy time-that's where.

Don't just pick the specialty you like. Pick a specialty you like with negotiating power. That means a specialty where they are your patients, see you in your office, and will follow you to whatever hospital you recommend.
Pick a specialty where if the older generation tries to exploit you, you can start your own practice.

In anesthesia, you have a daily risk of losing your job, and that will weigh on you. A surgeon could talk **** every day and the hospital will bend over backwards to keep his business. An anesthesiologist can get fired for minimal incidents. It's not that hard to avoid confrontation, but it sucks to have your livelihood in jeopardy every day.
 
Last edited:
  • Like
Reactions: bcovert

leigh83

5+ Year Member
Aug 18, 2012
37
0
Status
Anybody have plans for moving on when this profession goes sour?
Non-clinical work?
Pain?
Icu?
Re-train in another specialty?
Move abroad?
What other specialties would be good bets financially and would also make sense for an anesthesiologist to leave their career to retrain in?
 

nimbus

Member
10+ Year Member
Jan 14, 2006
4,276
4,365
Status
What other specialties would be good bets financially and would also make sense for an anesthesiologist to leave their career to retrain in?

Ortho. I'm increasingly convinced that is the best specialty around. If only I was young again......
 
  • Like
Reactions: IlDestriero

pgg

Laugh at me, will they?
Administrator
10+ Year Member
Dec 15, 2005
12,120
8,054
Home Again
Status
Attending Physician
What other specialties would be good bets financially and would also make sense for an anesthesiologist to leave their career to retrain in?
To leave anesthesia and retrain? That's rough. You'd have to walk away from still-high pay for 4-5 years of resident pay (still have loans compounding in the background?) to start anew in another specialty, mid-late career with fewer earning years left. And still come out ahead? That's rough.

Starting as a med student? I'd have to say surgical subspecialties like ortho, ENT, urology are probably up there in terms of stability, autonomy, pay. Maybe ophtho. Procedural, high barrier to entry, minimal or no midlevel encroachment, the patients are yours. But you've got to like, or at least be able to tolerate, working in those specialties.

You could always open a cash botox clinic if you can tolerate dealing with the kind of people who spend cash in botox clinics.
 

dr doze

To be able to forget means to sanity
Lifetime Donor
10+ Year Member
Dec 6, 2006
3,720
1,697
Status
Attending Physician
Gloomerific threads like this strike me as odd, to say the least.
Past performance is supposed to be a guarantee of future success. Just like investing. :)
Young grads have invested more than older docs. Both time and money. Tuition is much higher than in the past. Till about 1990 anesthesia was 2 years after one year of internship. In addition to the three year residency plus one of internship, lots of fresh grads are doing fellowships just to get in the game. Their return on investment (money, prestige, security, autonomy) is going to be a helluva lot less. Hence the gloom and doom. The mindset is, "We expected to be rich and secure if we did what we were supposed to do and minded our Ps and Qs. Now we are just going to be upper middle class with minimal security. Not what we were promised.:(. We have been robbed:mad:"
 

aneftp

7+ Year Member
Mar 23, 2010
1,854
722
Status
Attending Physician
95% of MDs regardless of speciality are not "wealthy". Comfortable. Yes. Absolutely.

But there is a huge distinction between wealthy and EARNING a lot of money.

Docs for the most part have to work for their money. Even physician owners of surgery centers work. Of course there are a few of them who have done well and branched off and owned multiple centers and rarely practice. And there are those who own national practices.

But if you want to get wealthy. And the key word is get wealthy quick.

1. Attend Ivy League undergrad. (Doesn't matter what you major in). Trust me on this one.

2. Work as govt employee for the Fed (usually in treasury dept)

3. Attend MBA school at the usual top schools after working exactly 2 years at the fed. (this is where your Ivy League under grad degree will get you a leg up)

4. Once you get MBA. Join X firm as banker

That's how you get wealthy quickly (besides being super bright and doing your own thing early).

But the above 4 steps are routinely taken by many I bankers.
 

jwk

CAA, ASA-PAC Contributor
15+ Year Member
Apr 30, 2004
3,640
764
Atlanta, GA
For younger docs, partnership is becoming a thing of the past. If the 'partners' will be making 250k, where does that leave the newer guys?
Close to exit strategy time-that's where.

Don't just pick the specialty you like. Pick a specialty you like with negotiating power. That means a specialty where they are your patients, see you in your office, and will follow you to whatever hospital you recommend.
Pick a specialty where if the older generation tries to exploit you, you can start your own practice.

In anesthesia, you have a daily risk of losing your job, and that will weigh on you. A surgeon could talk **** every day and the hospital will bend over backwards to keep his business. An anesthesiologist can get fired for minimal incidents. It's not that hard to avoid confrontation, but it sucks to have your livelihood in jeopardy every day.
Good luck finding those types of specialties as well. Hospitals, especially in urban areas, are buying up practices right and left. We don't just have IM hospitalists - we have them in GI, general surgery, vascular surgery, cardiology, colorectal surgery...the list goes on.
 

norwood

ASA Member
10+ Year Member
Dec 3, 2007
343
97
Status
Attending Physician
If Europe is any indication i can assure you that you will not make less the 200k in the future. Plus there will always be a demand for private practice medicine.
I wish this were true, but ESA did a study about wages in Europe - PubMed link is http://www.ncbi.nlm.nih.gov/pubmed/17608964

Admittedly this was in 2007, and I'm sure things have changed to some extent. But the brain drain from the poorer EU lands in the east has kept a pretty sharp upper limit on wages.

Here's an SDN thread where a Danish doc posted. Anesthesia in Europe? He offered that he was normally making 80-100k USD per year, then paying high Danish taxes on it.

Don't get me wrong - I love Europe as a place to visit. But the taxes there are unbelievable. VAT in Denmark (their equivalent of our sales tax) is 25%. Tax on a new car there is 180%.
 

cognitus

5+ Year Member
Oct 17, 2013
380
63
Status
95% of MDs regardless of speciality are not "wealthy". Comfortable. Yes. Absolutely.

But there is a huge distinction between wealthy and EARNING a lot of money.

Docs for the most part have to work for their money. Even physician owners of surgery centers work. Of course there are a few of them who have done well and branched off and owned multiple centers and rarely practice. And there are those who own national practices.

But if you want to get wealthy. And the key word is get wealthy quick.

1. Attend Ivy League undergrad. (Doesn't matter what you major in). Trust me on this one.

2. Work as govt employee for the Fed (usually in treasury dept)

3. Attend MBA school at the usual top schools after working exactly 2 years at the fed. (this is where your Ivy League under grad degree will get you a leg up)

4. Once you get MBA. Join X firm as banker

That's how you get wealthy quickly (besides being super bright and doing your own thing early).

But the above 4 steps are routinely taken by many I bankers.
I guess this approach works if ONLY wealth is the goal. The work-life balance of i-banking is HORRIBLE. Worse than medicine. There is HIGH turnover rate in banking
 

BLADEMDA

ASA Member
10+ Year Member
Apr 22, 2007
17,063
3,313
Southeast
Status
Attending Physician
Good luck finding those types of specialties as well. Hospitals, especially in urban areas, are buying up practices right and left. We don't just have IM hospitalists - we have them in GI, general surgery, vascular surgery, cardiology, colorectal surgery...the list goes on.

Hospitals view the specialties you listed as "money generators" vs. Anesthesia which is viewed as an "expense" (necessary but an expense nonetheless). Hence, hospitals will shop for the lowest common denominator for anesthesia which means the lowest possible salaries with the highest possible work load. But, "Generators" of income are seen in a different light as productivity is as important as cost/salary. This is why many anesthesia Groups are selling in droves to AMCs.
Obamacare will be the nail in the coffin to an already sick private practice model.

The future is ACOs, direct employment, Multi specialty practice, etc. I do not see any long term future for small private practice groups in anesthesia. SIZE matters for surviving the ACA and even then these large groups are selling out to AMCs.

http://www.pehub.com/2012/12/17/u-s-anesthesia-to-buy-great-houston-anesthesiology-assets/


http://www.prnewswire.com/news-releases/teamhealth-acquires-wolverine-anesthesia-consultants-231478011.html

http://sanfrancisco.cityandpress.com/node/7085833
 
Last edited:

dr doze

To be able to forget means to sanity
Lifetime Donor
10+ Year Member
Dec 6, 2006
3,720
1,697
Status
Attending Physician
I went to school with some folks who became investment bankers or other finance careers who made it really big. They were all exceptionally bright, strong interpersonal and communication skills, and worked like dogs (as bad as residency). I also knew a few wannabes who fell just a little bit short for one reason or another who wound up with a fraction of financial success of what the highly successful ones attained. They were no less bright and also worked like dogs. There is a huge "winner take all" component to those careers which has certainly cropped up in medicine over the last twenty years.
 

saratoga733

10+ Year Member
7+ Year Member
Oct 31, 2007
142
14
Northeast
Status
Attending Physician
I wish this were true, but ESA did a study about wages in Europe - PubMed link is http://www.ncbi.nlm.nih.gov/pubmed/17608964

Admittedly this was in 2007, and I'm sure things have changed to some extent. But the brain drain from the poorer EU lands in the east has kept a pretty sharp upper limit on wages.

Here's an SDN thread where a Danish doc posted. Anesthesia in Europe? He offered that he was normally making 80-100k USD per year, then paying high Danish taxes on it.

Don't get me wrong - I love Europe as a place to visit. But the taxes there are unbelievable. VAT in Denmark (their equivalent of our sales tax) is 25%. Tax on a new car there is 180%.
hmmm, yet Denmark year after year is often cited as the 'happiest' nation on earth. i guess money really doesn't buy happiness...
 

BLADEMDA

ASA Member
10+ Year Member
Apr 22, 2007
17,063
3,313
Southeast
Status
Attending Physician
I went to school with some folks who became investment bankers or other finance careers who made it really big. They were all exceptionally bright, strong interpersonal and communication skills, and worked like dogs (as bad as residency). I also knew a few wannabes who fell just a little bit short for one reason or another who wound up with a fraction of financial success of what the highly successful ones attained. They were no less bright and also worked like dogs. There is a huge "winner take all" component to those careers which has certainly cropped up in medicine over the last twenty years.
Anesthesiology is simply the wrong choice for "winner take all" for a medical student today.
 

pgg

Laugh at me, will they?
Administrator
10+ Year Member
Dec 15, 2005
12,120
8,054
Home Again
Status
Attending Physician
LOL, didn't take long for the inevitable "I coulda been an ibanker" to rear its ugly head ... :)
 

jeffblue

Membership Revoked
Removed
Account on Hold
Oct 27, 2013
47
3
Anesthesiology has become a punch the clock, watch the clock, when am i going home, when is vacation specialty. We no longer have control of our specialty and we are being marginalized at every turn. Really exhausting dealing with it all. It can change but It is not looking good. We'll see what happens in the next few years when obama care is fully actualized.
 
OP
C

countingdays

ASA Member
5+ Year Member
May 16, 2009
1,147
33
Status
Attending Physician
LOL, didn't take long for the inevitable "I coulda been an ibanker" to rear its ugly head ... :)
These discussions tend to turn into talk about very high income careers, but they don't have to. I'm not wondering about making more. I'm thinking- if salaries drop to 200k and AMCs and 'partners' take 20% of that, you don't have to be an ibanker to have a better job than a young(ish) anesthesiologist.
Any government job with a pension would be better than anesthesia financially, in work schedule, and in job security. Accounting, engineering, etc. start to look really good, especially for college students who can skip the years of training and debt involved.
Or maybe staying in medicine but doing pain, a med specialty or surgery where having your 'colleagues' co-opt a significant portion of your income indefinitely would not be an issue. 200k that you actually get to keep would still be better than the vast majority of careers.
For most of us it's too late to change dramatically. It's hard to impossible to get by on a resident salary for 3-6 more years of retraining. Pain is an option because it's only 1 year. Night school mba can be done. Hopefully things don't get bad enough that a profession change is necessary for those of us who are fully trained and certified.
I really like anesthesia. I have a sweet job in a great location and good income, despite being excluded from partnership (so far) based on my hire date, but it sucks to be in a specialty where you can be replaced tomorrow and no one would care. Even though I enjoy this career, I wouldn't recommend it.
 

cognitus

5+ Year Member
Oct 17, 2013
380
63
Status
iBanking is not what it's cracked up to be. Yes, you can make an AWESOME living, but the schedule is AWFUL. Essentially, you'll have the schedule of an intern for the rest of your career. The grass is not always greener on the other side.
 

pgg

Laugh at me, will they?
Administrator
10+ Year Member
Dec 15, 2005
12,120
8,054
Home Again
Status
Attending Physician
Any government job with a pension would be better than anesthesia financially, in work schedule, and in job security.
That's the truth. And I suppose I should admit that one of the reasons I can be so easily philosophical about this subject is that I have a government job with a pension, doing anesthesia. And I'll exit that (with pension) soon enough and young enough that I'll still have about 15 years of full-time civilian practice ahead before I approach the "that guy's old why is he still working" mark, with the freedom of being able to work part time or not at all if I want. (Unless the US gov defaults and .mil pensions get wiped or recalibrated, but if that happens I figure I'll have bigger problems to worry about.)

I love anesthesia and even with my current pay, in line with worst-case predictions in this thread, I'm comfortable and happy. Money and toys and vacations are great, but those aren't the primary determinants of my happiness. I know, sappy sentiment for a thread that mentions ibankers. :)
 

TheWeeIceMan

And like that... *poof*... he's gone.
10+ Year Member
7+ Year Member
Apr 8, 2009
3,500
2,372
TBF, fed pensions aren't really that great since they switched from CSRS to FERS. Military still has a solid pension from what I understand, though.
 

sevoflurane

Ride
15+ Year Member
Jul 16, 2003
4,936
1,748
Visit site
Status
Attending Physician
I have called around to a few companies that do medical tourism, and all of them told me that they hire their anesthesia on site.
Goes back to revenue generator vs. necessary overhead
Also depends on who you know.

I know for a fact that US boarded anesthesia docs are being looked into and hired for medical tourism. This is def. an exit strategy if you like the caribbean. It is something we are looking into later on down the line.
 

ruralsurg4now

Membership Revoked
Removed
Sep 28, 2013
1,347
188
Status
There's only so much one can cut skilled labor income.

Remember you got lots of federal folks with barley bachelors degrees making easy 100k money by age 28-30 years old.
That's because the government doesn't care about qualifications or quality. You just enter the job and stay there and get regular raises that are timed. There was a story about some guy in New York who was involved in a scandal where they had women strip for work in the Parks Department and he makes over $100K. And I bet whether he retired or was fired, he got a sweet lifetime pension, courtesy of the taxpayers. I'd be surprised if he had more than a high-school education.

http://www.nydailynews.com/new-york/women-parks-dept-stripped-better-jobs-sources-article-1.1357067

If I recall correctly, the average government employee makes close to six-figures, if you include their benefits. It's why the richest counties in America are generally located in Washington, D.C. and nearby Virginia and why there was no impact on that area during the recession. Don't bother comparing your job to those guys, it'll just make you angry.
 

aneftp

7+ Year Member
Mar 23, 2010
1,854
722
Status
Attending Physician
That's because the government doesn't care about qualifications or quality. You just enter the job and stay there and get regular raises that are timed. There was a story about some guy in New York who was involved in a scandal where they had women strip for work in the Parks Department and he makes over $100K. And I bet whether he retired or was fired, he got a sweet lifetime pension, courtesy of the taxpayers. I'd be surprised if he had more than a high-school education.

http://www.nydailynews.com/new-york/women-parks-dept-stripped-better-jobs-sources-article-1.1357067

If I recall correctly, the average government employee makes close to six-figures, if you include their benefits. It's why the richest counties in America are generally located in Washington, D.C. and nearby Virginia and why there was no impact on that area during the recession. Don't bother comparing your job to those guys, it'll just make you angry.
I've lived in DC area for half my life.

Trust me. Many are on pins and needles if any cut backs in federal spending. Especially contractors.

Cut 5% of defense spending the housing market there can snowball very quickly like it did in the late 80s.

But getting back to medicine and income. People won't continue to go into medicine if salaries are considered not offsetting their debt load and time spent getting trained.
 

ruralsurg4now

Membership Revoked
Removed
Sep 28, 2013
1,347
188
Status
I've lived in DC area for half my life.

Trust me. Many are on pins and needles if any cut backs in federal spending. Especially contractors.

Cut 5% of defense spending the housing market there can snowball very quickly like it did in the late 80s.

But getting back to medicine and income. People won't continue to go into medicine if salaries are considered not offsetting their debt load and time spent getting trained.
If you've lived in DC for that long, then you know there are never any cuts. There are decreases in the rate of increase.
 

BLADEMDA

ASA Member
10+ Year Member
Apr 22, 2007
17,063
3,313
Southeast
Status
Attending Physician
I've lived in DC area for half my life.

Trust me. Many are on pins and needles if any cut backs in federal spending. Especially contractors.

Cut 5% of defense spending the housing market there can snowball very quickly like it did in the late 80s.

But getting back to medicine and income. People won't continue to go into medicine if salaries are considered not offsetting their debt load and time spent getting trained.

Med Students are, in general, ignorant of the economics of the field. Most have a poor grasp of the cost of the education vs. after tax take home pay of their chosen specialty. Many falsely believe that income doesn't matter as long as one is a Physician. Unfortunately idealism doesn't pay the bills or allow one to live an upper middle class lifestyle.

Hence, Med Schools will continue to be highly competitive for the foreseeable future regardless of Physician income.
 
  • Like
Reactions: bcovert

aneftp

7+ Year Member
Mar 23, 2010
1,854
722
Status
Attending Physician
Med Students are, in general, ignorant of the economics of the field. Most have a poor grasp of the cost of the education vs. after tax take home pay of their chosen specialty. Many falsely believe that income doesn't matter as long as one is a Physician. Unfortunately idealism doesn't pay the bills or allow one to live an upper middle class lifestyle.

Hence, Med Schools will continue to be highly competitive for the foreseeable future regardless of Physician income.
I'm not too sure about that blade.

Med students tend to be very bright about everything including economics.

As someone who entered med school at the absolute "peak" of competitiveness in 1996 entering class. There were something like 46000 applying for 15000-16000 slots. By comparison the low easier time slow to enter med school was 1989 when 29000 applications for similar 15000-16000 slots.

Guess what was happening in 1996? The Internet boom. Many of the brightest who would have pursued a career in medicine went into the tech business. If you look at the AAMC data closely. There was a drastic cutoff in number of med school applications from the peak of 46000 applications in 1996 entering class to around 32000-35000 applications in 2000 for around 15000-16000 slots.

That was a 30% drop off cause people went where the money was. ThAt was the tech boom. As 2000 rolled around. And the Internet bubble crashed. Than you started seeing applications raise again.

I follow history very closely.

It's a whole different generation these days. Sure some may still want to pursue medicine regardless of income. But there is high subset that will wonder about the cost/income/lifestyle package. Is if worth it?

We will find out.
 

aneftp

7+ Year Member
Mar 23, 2010
1,854
722
Status
Attending Physician
If you've lived in DC for that long, then you know there are never any cuts. There are decreases in the rate of increase.
There will be cuts. It's only a matter of time especially defense contractors. There is a ton of money and even a 5% cut will make a huge dent in that economy.

People know it in that area. Many are mortgage up to the max. 2 income couple making 200-250k combine owning 700-800k home.

They got hit with a "small decrease" in spending after Cold War. It hit the housing market very hard and most of rest of the country didn't feel it at all
 

pgg

Laugh at me, will they?
Administrator
10+ Year Member
Dec 15, 2005
12,120
8,054
Home Again
Status
Attending Physician
Cut 5% of defense spending the housing market there can snowball very quickly like it did in the late 80s.
Yeah. And god forbid you own a home near a military base that gets CLOSED. That's the sort of thing that'll wreck a housing market and local economy for a generation ...

But getting back to medicine and income. People won't continue to go into medicine if salaries are considered not offsetting their debt load and time spent getting trained.
I disagree. Every medical school will fill every class, forever.

Exhibit A

Exhibit B, look at what the lawyers have done to themselves. Ridiculous overproduction by law schools. Ridiculous tuition. Absolutely horrendous job market for 95% of graduating lawyers. And yet ... there's no shortage of people who think going to law school is a terrific idea.

And people hate lawyers.

Doctorin' is still a noble profession and doctors are still mostly respected.
 

CityLights

7+ Year Member
Jan 27, 2010
1,609
75
Status
But getting back to medicine and income. People won't continue to go into medicine if salaries are considered not offsetting their debt load and time spent getting trained.
I disagree. Every medical school will fill every class, forever.

Exhibit A

Exhibit B, look at what the lawyers have done to themselves. Ridiculous overproduction by law schools. Ridiculous tuition. Absolutely horrendous job market for 95% of graduating lawyers. And yet ... there's no shortage of people who think going to law school is a terrific idea.

And people hate lawyers.

Doctorin' is still a noble profession and doctors are still mostly respected.
And to further support this, look at veterinary medicine. MD-sized debt load with a high-five-figure salary when done, and it's still very competitive.
 

ruralsurg4now

Membership Revoked
Removed
Sep 28, 2013
1,347
188
Status
Exhibit B, look at what the lawyers have done to themselves. Ridiculous overproduction by law schools. Ridiculous tuition. Absolutely horrendous job market for 95% of graduating lawyers. And yet ... there's no shortage of people who think going to law school is a terrific idea.

And people hate lawyers.

Doctorin' is still a noble profession and doctors are still mostly respected.
Keep in mind that law school is a little different from med school, since you literally can be average and be guaranteed of being accepted into a law school somewhere. Not Harvard Law, but you'll be a lawyer if you want to be one, almost certainly. But you're right that med schools will always fill because, at worst, all they'll have to do is lower standards for admission and some sucker will want to be a physician, no matter how bad the job becomes.
 

ruralsurg4now

Membership Revoked
Removed
Sep 28, 2013
1,347
188
Status
There will be cuts. It's only a matter of time especially defense contractors. There is a ton of money and even a 5% cut will make a huge dent in that economy.

People know it in that area. Many are mortgage up to the max. 2 income couple making 200-250k combine owning 700-800k home.

They got hit with a "small decrease" in spending after Cold War. It hit the housing market very hard and most of rest of the country didn't feel it at all
I'll believe it when I see it. So, basically, I'll never believe it.
 

dr doze

To be able to forget means to sanity
Lifetime Donor
10+ Year Member
Dec 6, 2006
3,720
1,697
Status
Attending Physician
Agree with pgg that med schools will fill every slot for the foreseeable future. Whether they get the same share of the students with the most options ( twenty somethings with top grades from name brand colleges) will depend on how medicine looks compared to the rest of the options. Nothing looks promising. Right now for an ambitious young bright person.
 
  • Like
Reactions: bcovert

BLADEMDA

ASA Member
10+ Year Member
Apr 22, 2007
17,063
3,313
Southeast
Status
Attending Physician
Agree with pgg that med schools will fill every slot for the foreseeable future. Whether they get the same share of the students with the most options ( twenty somethings with top grades from name brand colleges) will depend on how medicine looks compared to the rest of the options. Nothing looks promising. Right now for an ambitious young bright person.

Medicine is NOT all equal. It used to be the "cut" was to get a position in a medical school. No longer. Now, the real "cut" is landing a premier specialty/residency which puts one in the position to be quite successful. The bar has shifted from premed to med school if one wants more than Family Practice type income.

Hence, I would advise those looking for high income to either match into a high paying specialty or consider leaving medicine for a career elsewhere (e.g. MBA then join a Wallstreet firm as a healthcare analyst).
 

pgg

Laugh at me, will they?
Administrator
10+ Year Member
Dec 15, 2005
12,120
8,054
Home Again
Status
Attending Physician
And to further support this, look at veterinary medicine. MD-sized debt load with a high-five-figure salary when done, and it's still very competitive.
I think there are only about 30 (?) vet schools in the United States. I don't know how many seats that works out to, but there's a pretty tight supply constraint there.


I'll believe it when I see it. So, basically, I'll never believe it.
I don't know what to make of this statement.

BRAC happened. It happened. It really did. Wikipedia says so. Why don't you think it won't happen again?

(Incidentally, we're a year into sequestration right now.)
 

ruralsurg4now

Membership Revoked
Removed
Sep 28, 2013
1,347
188
Status
BRAC happened. It happened. It really did. Wikipedia says so. Why don't you think it won't happen again?

(Incidentally, we're a year into sequestration right now.)
Oh, we definitely do things like close military bases. So let me ask you: did our government budget then drop as a result? Nope. Look all over Wikipedia for that and it didn't. In fact, it went up because it goes up every year.

As far as sequestration, it's a decrease in the rate of increase in the budget. It says so on Wikipedia, look it up. And look at how Democrats wailed about that, acting like it was the end of the world. Guess what? We spend the amount we "save" with sequestration in a week or so. And sequestration takes places over a decade. And it only happened after a huge battle.

So as I said, I'll believe it when I see it. So I'll never believe it.