Future anesthesia job market ?

[Jay K]

MBA from a "real" program costs you around $150k when you factor everything in. Only management consulting (iffy) and banking offer real return on your investment, and you are in NO way guaranteed a job in either of those industries - especially banking. Even if you do, I bet you'll hate your life 1000x more as an investment banker than you will as an anesthesiologist even if you were making half as the anesthesiologist. Most of my buddies were or are in high finance, and they get DESTROYED while doing meaningless work. You want to spend 100 hours a week coming up with pitch books that will never materialize into actual transactions? You want to sit in front of Microsoft Excel all day crunching numbers? And don't kid yourself thinking that you can make it to MD (that's managing director, not medical doctor for you business illiterate folks) and make 7 figures. About 1/50 make it to that position, and at that point you're a salesman. You either make rain or you get the boot. I am willing to bet not many people in medicine has those skills.
Management consulting isn't worth your time. I don't want to waste my time even discussing it, tbh.

No offense, but whenever I see someone talking about MBAs or bankers like it's some great career, it confirms that they don't actually know anyone who is a high financier.

Excellent depiction, 100% accurate.

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[MaximusD]

Perhaps the best route would be to take the ones less traveled -
1. primary care (IM, FM - I would not do pediatrics) - you can dictate care without taking insurance, you name your hours, etc. plus lots of financial incentives in terms of loan payback programs, contracts and bonuses, forgiveness, etc. Potential fellowship options too, if you desire.
2. psychiatry - dictate care and name your hours
3. PM&R - nice lifestyle with the potential for going into pain
4. OBGYN - then go into REI - cash based practice. People will still pay top dollar to have a child.
5. Occupational medicine?? - Head about this from a colleague. However, admittedly, I'm much less privy to this particular specialty.

LOL wut?

1. You are referring to "concierge medicine", but this is not common and would be VERY geographically and socioeconomically dependent on a certain demographic.

2. Psychiatry - I have never met a psychiatrist who names his or her hours. You are aware that the PP model is becoming monetarily de-incentivized under the ACA, correct?

3. PM&R - Agree, but your residency consists of trying to fix stroke patients who may or may not improve. Pain and sports med are interested avenues from this pathway.

4. OB/Gyn - Cash-based practice? How many people have 30k sitting around?

5. Occ Med - Yes, but it's awful and mind-numbing. I do a lot of occ-med as a flight physician, and I would sooner stab in the delicates than do occ med indefinitely. I mean it. Say goodbye to medical knowledge and the ability to facilitate a medical outcome of any kind...

Just sayin'...

 

[mja75]

Chemical engineering is often quoted as one of those fields worth trading for medicine. I had a job 4 months before I graduated making great mint as a 21 year old in a f500 Co. I will sum up my experience by saying that the corporate office environment is absolutely toxic. The lack of autonomy and catering to psychopaths that is discussed in here is not unique to anesthesiology; sounds like my old job description. We all suffer from grass is greener syndrome at one point or another. Also, a 40 hour work week is an illusion in engineering or biotech. While I can't say I crossed 60 hours I was routinely in the mid 50s consistently. Trust me, they get their moneys worth out of these young eager lads. Neither me or my friends at other companies had cush schedules.

 

[HollATme]

LOL wut?

1. You are referring to "concierge medicine", but this is not common and would be VERY geographically and socioeconomically dependent on a certain demographic.

2. Psychiatry - I have never met a psychiatrist who names his or her hours. You are aware that the PP model is becoming monetarily de-incentivized under the ACA, correct?

3. PM&R - Agree, but your residency consists of trying to fix stroke patients who may or may not improve. Pain and sports med are interested avenues from this pathway.

4. OB/Gyn - Cash-based practice? How many people have 30k sitting around?

5. Occ Med - Yes, but it's awful and mind-numbing. I do a lot of occ-med as a flight physician, and I would sooner stab in the delicates than do occ med indefinitely. I mean it. Say goodbye to medical knowledge and the ability to facilitate a medical outcome of any kind...

Just sayin'...

1. Not referring exclusively to "concierge medicine" - however, that is just one of several models one could pursue via the primary care route.
2. You've met every psychiatrist out there in practice? That's incredible. Primary care is being emphasized and given all these shootings and stabbings, it'd be surprising if mental health doesn't become emphasized as well.
3. So what? That's most of medicine anyways. Hell, anesthesiologists ain't fixing anything, we facilitate the surgeons and other proceduralists and keep patients alive in the OR, but we ain't fixing anything. I enjoy the critical thinking and use of medications, etc. but there's plenty wrong with anesthesia, and one could also say how it's quite boring too. Different strokes for different folks.
4. Not really OB-GYN -- do a fellowship in REI -- So, you're saying a lot of those professionals who put their careers first and children second aren't gonna fork out the money to have a child? Hm, it happens now and it'll continue to happen. We don't need anymore dumb****s reproducing anyways, yet ACA will support them just as much.
5. Like I said, I'm not too privy to occ med, just something a colleague of mine brought up and it seemed chill. I'm sure there's colleagues of yours that likely find joy and pride in taking care of the military folks and their families. I had classmates in med school who couldn't wait to purge themselves of medical knowledge, and hence went psychiatry. Again, different strokes for different folks.

If I had to do it all over again, I'd probably given PM&R or EM a closer look.

 

[bronx43]

4. OB/Gyn - Cash-based practice? How many people have 30k sitting around?



Just sayin'...

Enough to keep your business busy. Repro endocrine banks. Not that it matters, since I think most of us would rather be castrated with a dull, rusty knife than to grind out an OB/Gyn residency.

 

[HollATme]

Enough to keep your business busy. Repro endocrine banks. Not that it matters, since I think most of us would rather be castrated with a dull, rusty knife than to grind out an OB/Gyn residency.

Bingo.

 

[MaximusD]

1. Not referring exclusively to "concierge medicine" - however, that is just one of several models one could pursue via the primary care route.
2. You've met every psychiatrist out there in practice? That's incredible. Primary care is being emphasized and given all these shootings and stabbings, it'd be surprising if mental health doesn't become emphasized as well.
3. So what? That's most of medicine anyways. Hell, anesthesiologists ain't fixing anything, we facilitate the surgeons and other proceduralists and keep patients alive in the OR, but we ain't fixing anything. I enjoy the critical thinking and use of medications, etc. but there's plenty wrong with anesthesia, and one could also say how it's quite boring too. Different strokes for different folks.
4. Not really OB-GYN -- do a fellowship in REI -- So, you're saying a lot of those professionals who put their careers first and children second aren't gonna fork out the money to have a child? Hm, it happens now and it'll continue to happen. We don't need anymore dumb****s reproducing anyways, yet ACA will support them just as much.
5. Like I said, I'm not too privy to occ med, just something a colleague of mine brought up and it seemed chill. I'm sure there's colleagues of yours that likely find joy and pride in taking care of the military folks and their families. I had classmates in med school who couldn't wait to purge themselves of medical knowledge, and hence went psychiatry. Again, different strokes for different folks.

If I had to do it all over again, I'd probably given PM&R or EM a closer look.

#5. Tread carefully. No where did I say that I don't find joy and pride in taking care of military personnel. My comment was moreso referring to the onslaught of well exams and administrative paper/computerwork... This can be mind-numbing after a while.

 

[Jay K]

Enough to keep your business busy. Repro endocrine banks. Not that it matters, since I think most of us would rather be castrated with a dull, rusty knife than to grind out an OB/Gyn residency.

Amen. The fellowship's neither short nor a walk in the park either, regrettably...

 

[BuddhaCanooda]

$250K is military anesthesiologist pay. I can't see the civilian mean really dropping below that. Maybe for mommy track jobs or people who MUST live in a few saturated highly competitive cities.

That's ridiculously flawed. Only if you have been in past your initial ADSO and get a multi-year bonus can you hit 200-220k. If you are simply doing your initial ADSO you peak out less than $140k!

 

[@JackShephard]

1. Not referring exclusively to "concierge medicine" - however, that is just one of several models one could pursue via the primary care route.
2. You've met every psychiatrist out there in practice? That's incredible. Primary care is being emphasized and given all these shootings and stabbings, it'd be surprising if mental health doesn't become emphasized as well.
3. So what? That's most of medicine anyways. Hell, anesthesiologists ain't fixing anything, we facilitate the surgeons and other proceduralists and keep patients alive in the OR, but we ain't fixing anything. I enjoy the critical thinking and use of medications, etc. but there's plenty wrong with anesthesia, and one could also say how it's quite boring too. Different strokes for different folks.
4. Not really OB-GYN -- do a fellowship in REI -- So, you're saying a lot of those professionals who put their careers first and children second aren't gonna fork out the money to have a child? Hm, it happens now and it'll continue to happen. We don't need anymore dumb****s reproducing anyways, yet ACA will support them just as much.
5. Like I said, I'm not too privy to occ med, just something a colleague of mine brought up and it seemed chill. I'm sure there's colleagues of yours that likely find joy and pride in taking care of the military folks and their families. I had classmates in med school who couldn't wait to purge themselves of medical knowledge, and hence went psychiatry. Again, different strokes for different folks.

If I had to do it all over again, I'd probably given PM&R or EM a closer look.

On giving EM a closer look... many of the EM guys also struggle later in their careers with trouble with circadian rhythm changes and feeling jet lagged when off of work. They are #1 in burnout on nearly every survey released.

Psychiatrists are having competition with NPs in some states, with some preferring NP's over MD's due to cheaper labor. Psych has lower salaries too, so their bottom would be lower than anesthesia in 10-20 years.

OB/GYN isn't one of the specialties that are lifestyle friendly and malpractice is intense (let alone the nature of the work!).

PMR - actually seems pretty good. But it's far from the greatest specialty on the planet. Only 56% is filled by USMD, which is still much lower than anesthesia.

Almost every field that isn't ultra competitive has difficulties if you look closely enough.

 

[pgg]

That's ridiculously flawed. Only if you have been in past your initial ADSO and get a multi-year bonus can you hit 200-220k. If you are simply doing your initial ADSO you peak out less than $140k!

No. During your ADSO, you're "earning" the med school tuition, book allowance, and stipend (AD O1 paycheck if USUHS) that the government paid you years earlier, plus interest. The correct comparison to make when looking at military physician pay vs civilian physician pay is post-ADSO, with a 4-year MSP contract for the specialty.


For anesthesiology, that'll usually be around $250K at the ADSO+1day mark since at that time they're typically O4s with 8-10 years of creditable service, give or take. O5-O6 types closer to the 20 mark will be around $275K. For perspective MGMA tells us that 25th %ile for regions 9 and 10 (CA OR WA AZ NV ID) are around $270-280K. Military anesthesiologist pay is low but it's not outrageously low, especially when you look at the # of hours worked. (They ought to triple it when deployed but that's another discussion.)

Then, figure the average .mil pension has a cash value around $1.5 - 2 million (based off what a single premium immediate annuity would cost if you walked into Vanguard with your checkbook looking to duplicate the pension payout), and divide that $1.5 - 2 million by the number of years from end of ADSO to retirement eligibility (objectively, this is really the vesting period that counts, since you get zero if you leave early), and depending on the individual's details he's effectively getting another $150 - 250K of pretax cash put into a retirement account during the I-coulda-gotten-out years. Never mind the fact that this kind of tax sheltered saving just isn't an option for civilians.

You can't look at the paycheck a military anesthesiologist gets during the "payback" period in a vacuum. It's called "payback" for a reason. HPSP/USUHS/HSCP aren't "scholarships" ... they're loans, repaid with time.

All things considered, a 40-year-old military anesthesiologist who has finished the ADSO and decided to gut out another 8-10 years for the retirement cheese is effectively getting paid somewhere between $350-500K per year. Now we're looking at median MGMA pay, even outside regions 9 & 10 (west coast).


Could the .mil retirement package change? I'm sure it will. It's oddly generous, considering someone can enlist at 17, retire at 37, and start immediately collecting a check for life. Congress won't retroactively alter the deal, Darth Vader style, but it'll change for new joins, soonish. Could .mil physician pay decrease? Sure it could. Lots of us have been waiting for the MSP figures to adjust downward since 2008ish. My magic 8 ball is broken.

But I still maintain the position that if you're wondering what your pay will be like as a national-healthcare government-employed doctor at some point in the next 20 years, you could do worse than look at what military doctors (who are past their med school tuition repayment period) are getting paid right now, and call that a reasonable floor.

If you'd like to argue minutia of .mil pay compared to civilian pay, we probably ought to take it to the milmed forum, rather than totally derail this thread.

 

[BLADEMDA]

PGG,


I'd like to argue the point that post payback the military option is a better deal than the majority of private practice jobs. I know you pointed that fact out in your last post but it is worth repeating it.

The floor of "250k" is definitely correct but remember the benefit package of that salary matters a great deal.

 

[punkedoutriffs]

No. During your ADSO, you're "earning" the med school tuition, book allowance, and stipend (AD O1 paycheck if USUHS) that the government paid you years earlier, plus interest. The correct comparison to make when looking at military physician pay vs civilian physician pay is post-ADSO, with a 4-year MSP contract for the specialty.


For anesthesiology, that'll usually be around $250K at the ADSO+1day mark since at that time they're typically O4s with 8-10 years of creditable service, give or take. O5-O6 types closer to the 20 mark will be around $275K. For perspective MGMA tells us that 25th %ile for regions 9 and 10 (CA OR WA AZ NV ID) are around $270-280K. Military anesthesiologist pay is low but it's not outrageously low, especially when you look at the # of hours worked. (They ought to triple it when deployed but that's another discussion.)

Then, figure the average .mil pension has a cash value around $1.5 - 2 million (based off what a single premium immediate annuity would cost if you walked into Vanguard with your checkbook looking to duplicate the pension payout), and divide that $1.5 - 2 million by the number of years from end of ADSO to retirement eligibility (objectively, this is really the vesting period that counts, since you get zero if you leave early), and depending on the individual's details he's effectively getting another $150 - 250K of pretax cash put into a retirement account during the I-coulda-gotten-out years. Never mind the fact that this kind of tax sheltered saving just isn't an option for civilians.

You can't look at the paycheck a military anesthesiologist gets during the "payback" period in a vacuum. It's called "payback" for a reason. HPSP/USUHS/HSCP aren't "scholarships" ... they're loans, repaid with time.

All things considered, a 40-year-old military anesthesiologist who has finished the ADSO and decided to gut out another 8-10 years for the retirement cheese is effectively getting paid somewhere between $350-500K per year. Now we're looking at median MGMA pay, even outside regions 9 & 10 (west coast).


Could the .mil retirement package change? I'm sure it will. It's oddly generous, considering someone can enlist at 17, retire at 37, and start immediately collecting a check for life. Congress won't retroactively alter the deal, Darth Vader style, but it'll change for new joins, soonish. Could .mil physician pay decrease? Sure it could. Lots of us have been waiting for the MSP figures to adjust downward since 2008ish. My magic 8 ball is broken.

But I still maintain the position that if you're wondering what your pay will be like as a national-healthcare government-employed doctor at some point in the next 20 years, you could do worse than look at what military doctors (who are past their med school tuition repayment period) are getting paid right now, and call that a reasonable floor.

If you'd like to argue minutia of .mil pay compared to civilian pay, we probably ought to take it to the milmed forum, rather than totally derail this thread.

Wow. Is there a way, as a current M-1 w/ no ties to the military to get on this deal?

 

[pgg]

PGG,


I'd like to argue the point that post payback the military option is a better deal than the majority of private practice jobs. I know you pointed that fact out in your last post but it is worth repeating it.

The floor of "250k" is definitely correct but remember the benefit package of that salary matters a great deal.

Yes, the side benefits are substantial. W-2 pay with huge tax shelters, zero-deductable family health benefits, and there's no better malpractice coverage than the Fed Tort Claims Act. Deserving patients, all of whom have insurance and regularly enforced primary care visits.

We talked about my career choice in the private forum a couple years ago, when I had to decide to stay or get out. My "scholarship" payback was done at the 12 year mark. 8 more needed for pension eligibility. 8 years to vest in a $2 million cash-value pension ... effectively the Navy's putting $250K/year away for me pretax every year now, after my paycheck. That's a pretty good deal for a 50-55 hr/week job that leaves room for some moonlighting on the side ... so far I'm glad I stayed.

The payback years can be rough though. It wasn't fun making $125K/year as a board certified anesthesiologist, even though I knew the paycheck had 'loan repayment' built into it.


OTOH, even the evil MBA bosses at Somnia et al don't send their anesthesiologists to Afghanistan.

 

[BLADEMDA]

Physician deployment pay should be an extra $25K for every 90 days. That's an extra $100K per year for deployment (bonus so not counted toward your pension).
Even with that bonus, I bet not many civilians would sign up for deployment duty.

Please hang in there and finish your time with the Navy. I hope you get that Fellowship year out of them as well. I then recommend the VA so you can start a SECOND govt. pension (my understanding is ten years at the VA and you will get a decent second pension).

 

[pgg]

Wow. Is there a way, as a current M-1 w/ no ties to the military to get on this deal?

Well, I'm not here to recruit, and there's a military medicine forum where you can read more, but the short answer is that it's probably not a great option for you at this point. Way too many details and caveats to get into here.

Short version: You could, via a 3-year HPSP contract, get the last 3 years of your med school paid for, then come on active duty for internship and residency, then pay back 3 years of obligated service. (Assuming no required GMO tour, which is a whole 'nother topic.) At that point you'd have 7 years toward the 20, would be a junior O4, and could choose to get out, or stay in for $225-250K/y plus the sorta-hidden pension vesting ($1.5 million / 13 years = $115K/y) for a total package around $350K/y. That's not quite where the financial angles end though. If you're not an anesthesiologist, you're not establishing a practice, and when you get out you're waaaay behind the doctors who did. For some specialties, that opportunity cost is near incalculable, it's so high. The hit to lifetime anesthesia earnings is not so bad, but when you get out you won't be a profit-sharing partner in a group the next day.

But, you're in the military, and that isn't for everyone. People who join for the med school money tend to wind up a lot more unhappy than the ones who thought "hey I'd like to be in the military and this would be a good way to do it" ... to be honest, there can be a lot of **** to put up with. Mountains of it. Read the milmed forum a bit, plenty of hate and discontent there, and much of the griping is legit. Not to mention those trips to places like Afghanistan and Iraq. I've spent 21 months of my life over there, in 3 even chunks, and it was rewarding in its own way, but that's along time away from home and family.

I no longer recommend HPSP to pre-meds and MS1s who don't have prior military service already, for non-financial reasons. I have enough concerns about what inservice GME will look like in 10 years that I think it's a little irresponsible to advise pre-meds and MS1s to commit themselves to whatever inservice residency programs will be available to them, that far in advance.

I hope you get that Fellowship year out of them as well.

I'm fairly confident it'll happen ... likely in the 2016-17 range, give or take. I'm not going to lie, the prospect of getting full pay and retirement credit to be a fellow for a year (vs getting out and taking a pay cut to $80K/y) was a big motivator to stay in.

 

[MaximusD]

It ain't all rosy when the military isn't on board with your specialty choice. There is significant chance you'll spend time in GMO land... Replete with lovely trips to sandy paradise

That said, I still would recommend HPSP WITH reservations. FAP or direct accession is better.

 

[pgg]

It ain't all rosy when the military isn't on board with your specialty choice. There is significant chance you'll spend time in GMO land... Replete with lovely trips to sandy paradise

That said, I still would recommend HPSP WITH reservations. FAP or direct accession is better.

Agree on every point.

HPSP is a great program for the right person. In my mind, the "right person" usually has prior military service ... and therefore sorta knows what he's getting himself into, and has time toward the pension that dramatically improves the financial math in his favor.

FAP is nice, but it pays less than HPSP, and if the military doesn't need that specialty when you're in the window to apply, no luck. Direct accession in these post-war days probably isn't going to be a good deal for many people.

 

[HollATme]

On giving EM a closer look... many of the EM guys also struggle later in their careers with trouble with circadian rhythm changes and feeling jet lagged when off of work. They are #1 in burnout on nearly every survey released.

Psychiatrists are having competition with NPs in some states, with some preferring NP's over MD's due to cheaper labor. Psych has lower salaries too, so their bottom would be lower than anesthesia in 10-20 years.

OB/GYN isn't one of the specialties that are lifestyle friendly and malpractice is intense (let alone the nature of the work!).

PMR - actually seems pretty good. But it's far from the greatest specialty on the planet. Only 56% is filled by USMD, which is still much lower than anesthesia.

Almost every field that isn't ultra competitive has difficulties if you look closely enough.

Which is why I didn't list EM - I said I would have given it a closer look.

I don't think I said either of those specialties were rosy pink and filled with rainbows and a pot o'gold at the end of them, but perhaps could be better options from a financial and lifestyle standpoint than anesthesia if you tailored those specialties accordingly.

 

[@JackShephard]

Which is why I didn't list EM - I said I would have given it a closer look.

I don't think I said either of those specialties were rosy pink and filled with rainbows and a pot o'gold at the end of them, but perhaps could be better options from a financial and lifestyle standpoint than anesthesia if you tailored those specialties accordingly.

Ok. I agree.

 

[circulus vitios]

Crap. Now AMCs manage radiology too? Those bastards! Next thing ya know, they'll get into derm and ophtha for a complete R.O.A.D. takeover.

And to think that ROAD used to lead to happiness....

Start your own AMC and undercut the competitors. Crush your enemies, see them driven before you, hear the lamentations of their women, etc.

The best and brightest won't continue to go into medicine if the rewards aren't there. Maybe we are heading towards a downward trend soon. It's a lot of time and debt to take on when you can get a 9-5 job easily making $100K with 4 year REAL degree. And much more with other advanced degree.

Let's ignore the "9-5" part. Outside of engineering in a super high cost of living locale e.g. software engineering in Silicon Valley, what $100k/year job could I get with a 4 year "real degree?"

If you have an "A" average from a top 50 University and an Engineering degree the starting pay should be over $80K and over $100 by age 25. "Nerds" with A averages from good schools "make bank."

http://online.wsj.com/public/resources/documents/info-Degrees_that_Pay_you_Back-sort.html

These reported numbers are low for some of the fields.

It shows starting salaries of ~$60k/year for engineers. Where are you getting "over $80k" from? No one really cares about GPA in engineering: large and prestigious firms might have a 3.5 GPA floor, but they care far more about engineering internship experience. If you think engineering hiring managers are obsessing over GPA like an adcom or program director, then you are really out of your depth.

 

[BLADEMDA]

Well for Computer Engineering starting salaries can exceed $100K and GPA matters. Just pay a visit to Google, Apple, Microsoft, etc and see for yourself.

Some of these "kids" only have 4 year degrees and are making $120K by age 22.

 

[BLADEMDA]

Majors That Pay You Back
Your choice of major can have a big impact on your post-graduation earnings. See PayScale’s list of college majors by salary potential.
Top 10 Majors by Salary Potential

Methodology

 

[postbacpremed87]

If you are proficient at mathematics and you can pass all of the actuarial examinations, then you can make 150k by your mid to late 20s and 250k+ mid-career. You are also usually Vice President/President level for an insurance company which means you get bonuses. I thought about it for a while and actually passed the first one. Haha. It is definitely a career with ROI. The upper level exams are definitely harder than anything you do in medicine. It is high level mathematics.

Check this out: http://www.dwsimpson.com/salary.html

Majors That Pay You Back
Your choice of major can have a big impact on your post-graduation earnings. See PayScale’s list of college majors by salary potential.
Top 10 Majors by Salary Potential

Methodology

 

[IkeBoy18]

If you are proficient at mathematics and you can pass all of the actuarial examinations, then you can make 150k by your mid to late 20s and 250k+ mid-career. You are also usually Vice President/President level for an insurance company which means you get bonuses. I thought about it for a while and actually passed the first one. Haha. It is definitely a career with ROI. The upper level exams are definitely harder than anything you do in medicine. It is high level mathematics.

Check this out: http://www.dwsimpson.com/salary.html

I majored in applied mathematics, can I still do this is a 2nd career? or is it too late as I am too far in? lol

 

[postbacpremed87]

If you are still up to date on calculus based probability and advanced calc then try to take an actuarial exam. You will probably need to study for 1-2 months first however....the pass rate for some of these exams is as low as 30%. All you need to do is pass 1-2 exams to be brought on as an actuarial analyst making 55-60K and they allow you to study while at work until you get your ASA or FSA.

 

[IkeBoy18]

If you are still up to date on calculus based probability and advanced calc then try to take an actuarial exam. You will probably need to study for 1-2 months first however....the pass rate for some of these exams is as low as 30%. All you need to do is pass 1-2 exams to be brought on as an actuarial analyst making 55-60K and they allow you to study while at work until you get your ASA or FSA.

It might be interesting to take one of these exams, but I def will not have the time to actually work at all. Are there jobs out there that will allow me to do something online part time just for some extra money? Im guessing Im probably not going to quit med school lol.

 

[postbacpremed87]

It might be interesting to take one of these exams, but I def will not have the time to actually work at all. Are there jobs out there that will allow me to do something online part time just for some extra money? Im guessing Im probably not going to quit med school lol.

No. This is a full-time profession.

 

[IkeBoy18]

No. This is a full-time profession.

Is the stress level comparable to medicine +/-?

 

[@JackShephard]

If you are proficient at mathematics and you can pass all of the actuarial examinations, then you can make 150k by your mid to late 20s and 250k+ mid-career. You are also usually Vice President/President level for an insurance company which means you get bonuses. I thought about it for a while and actually passed the first one. Haha. It is definitely a career with ROI. The upper level exams are definitely harder than anything you do in medicine. It is high level mathematics.

Check this out: http://www.dwsimpson.com/salary.html

These fields are better than medicine now.

We have too much downward pressure. On the other hand, they are a free market and thriving. No malpractice and no overnight shifts either!

 

[gasdoc77]

This just in. A buddy's group just sold to an AMC. He's been there maybe 6 months. Partners get 1 mil+ and everyone else gets to keep their job (initially).

 

[Baller MD]

This just in. A buddy's group just sold to an AMC. He's been there maybe 6 months. Partners get 1 mil+ and everyone else gets to keep their job (initially).

WTF. That is disgusting...

 

[IanMcGalt]

Blood money for stabbing the backs of everyone who will have no choice but to work for the AMC.

 

[bronx43]

Blood money for stabbing the backs of everyone who will have no choice but to work for the AMC.

And yet everyone here would do the same thing if they were nearing retirement...

 

[Arch Guillotti]

WTF. That is disgusting...

Unfortunately that is the sad reality these days. Anyone who signs a contract with a group has to realize that a sell-out is a possibility.

 

[IanMcGalt]

And yet everyone here would do the same thing if they were nearing retirement...

That's been the excuse for bad behavior forever. Doesn't make it right.

 

[Arch Guillotti]

And yet everyone here would do the same thing if they were nearing retirement...

Maybe, maybe not. I know many would not turn down a golden parachute but there are a few holdouts out there.

 

[@JackShephard]

And yet everyone here would do the same thing if they were nearing retirement...

I understand both sides.

One side is that you're old and you're on a sinking ship, the other side is you're young and you just got sold out.

I guess one defense for the old guys is that it was going to happen regardless if they sold it out or someone else did.

 

[Laryngophed]

Unfortunately that is the sad reality these days. Anyone who signs a contract with a group has to realize that a sell-out is a possibility.

I would think that someone could (provided they had the leverage to do it) to build in some protection into the contract. If the group isn't will to agree to something reasonable, that should be a warning in and of itself.

 

[bronx43]

That's been the excuse for bad behavior forever. Doesn't make it right.

Wait, so these guys are supposed to walk away from a big payday which would ensure the financial security of them and their family just so the younger guys can get theirs? Lol, your idea of "right and wrong" is totally off target here. It's not their divine duty to do anything for new grads.

 

[IanMcGalt]

Wait, so these guys are supposed to walk away from a big payday which would ensure the financial security of them and their family just so the younger guys can get theirs? Lol, your idea of "right and wrong" is totally off target here. It's not their divine duty to do anything for new grads.

What do you think they are getting paid for? Do they have the right to sell it?

 

[@JackShephard]

What do you think they are getting paid for? Do they have the right to sell it?

I'm assuming they get paid for selling their money making business, so another set of people can make money off of the same business. Partners profits (and some) go to the new owners via lower cost labor. Much like any huge corporate takeover that involves slashing expenditures and maximizing profits.

 

[bronx43]

What do you think they are getting paid for? Do they have the right to sell it?

Of course they have the right to sell it. They have EQUITY in their practice, which they are selling. I don't see the point of contention here.

 

[IanMcGalt]

Think about it. Would you get a penny for your 'equity' if there wasn't an exclusive contract? Of course not. All they are buying is the exclusive contract and as a result control of the workers. If all the people whose labor you are selling could just go independent and continue to work at that hospital would your 'business' have any value?

Exclusive contracts are necessary, but the way they are used these days is immoral.

 

[Consigliere]

WTF. That is disgusting...

No my friend.......that's the future.

 

[Stank811]

No my friend.......that's the future.

just the short term future for some groups…not worried about the long term future

 

[bronx43]

Think about it. Would you get a penny for your 'equity' if there wasn't an exclusive contract? Of course not. All they are buying is the exclusive contract and as a result control of the workers. If all the people whose labor you are selling could just go independent and continue to work at that hospital would your 'business' have any value?

Exclusive contracts are necessary, but the way they are used these days is immoral.

Really dude...? You realize that you are bemoaning the essence of business ownership. The founding partners started up the practice and obtained their exclusive contract... you don't like the terms of your employment? You can start your own outfit and undercut the competition while providing better service. But until then, you are operating under their set up, contract, and business relations.

 

[IanMcGalt]

Really dude...? You realize that you are bemoaning the essence of business ownership. The founding partners started up the practice and obtained their exclusive contract... you don't like the terms of your employment? You can start your own outfit and undercut the competition while providing better service. But until then, you are operating under their set up, contract, and business relations.

If their 'practice' had intrinsic value, then they could cancel their exclusive contract and noncompete clauses and still sell out. Without those things it has almost NO VALUE.
If it were a real business there would be value other than access to other people's work. I can't think of any other business where the kitchen schedulers offer so little added value beyond the work of all the independently practicing employees.

 

[Consigliere]

just the short term future for some groups…not worried about the long term future

Then you've got your head in the sand, man. "The greatest trick the Devil ever pulled was convincing the world he didn't exist"

 

[DocFocker]

Well, I'm not here to recruit, and there's a military medicine forum where you can read more, but the short answer is that it's probably not a great option for you at this point. Way too many details and caveats to get into here.

Short version: You could, via a 3-year HPSP contract, get the last 3 years of your med school paid for, then come on active duty for internship and residency, then pay back 3 years of obligated service. (Assuming no required GMO tour, which is a whole 'nother topic.) At that point you'd have 7 years toward the 20, would be a junior O4, and could choose to get out, or stay in for $225-250K/y plus the sorta-hidden pension vesting ($1.5 million / 13 years = $115K/y) for a total package around $350K/y. That's not quite where the financial angles end though. If you're not an anesthesiologist, you're not establishing a practice, and when you get out you're waaaay behind the doctors who did. For some specialties, that opportunity cost is near incalculable, it's so high. The hit to lifetime anesthesia earnings is not so bad, but when you get out you won't be a profit-sharing partner in a group the next day.

But, you're in the military, and that isn't for everyone. People who join for the med school money tend to wind up a lot more unhappy than the ones who thought "hey I'd like to be in the military and this would be a good way to do it" ... to be honest, there can be a lot of **** to put up with. Mountains of it. Read the milmed forum a bit, plenty of hate and discontent there, and much of the griping is legit. Not to mention those trips to places like Afghanistan and Iraq. I've spent 21 months of my life over there, in 3 even chunks, and it was rewarding in its own way, but that's along time away from home and family.

I no longer recommend HPSP to pre-meds and MS1s who don't have prior military service already, for non-financial reasons. I have enough concerns about what inservice GME will look like in 10 years that I think it's a little irresponsible to advise pre-meds and MS1s to commit themselves to whatever inservice residency programs will be available to them, that far in advance.



I'm fairly confident it'll happen ... likely in the 2016-17 range, give or take. I'm not going to lie, the prospect of getting full pay and retirement credit to be a fellow for a year (vs getting out and taking a pay cut to $80K/y) was a big motivator to stay in.

I got out because of my concern with in service GME. Luckily, I was on a three year HPSP "scholarship" and was able to pay it back with a three year GMO tour. I may consider trying to get back in after I finish training. It will depend heavily on the retirement/pay landscape at that time.