Honest Assessment of Lifestyle

[njcaldwell]

Greetings Everyone,

This is my first time posting here, so any help would be appreciated. I will be a 4th year in a couple of months and have anesthesia as my leading choice for a speciality. I see two big questions left to honestly answer: 1) What is the lifestyle like? I have seen varying answers from night time call Q3 to once a month? I want to have a family, and am looking for a field with ample time off 2) How much will the financial reimbursement of the field be damaged as our country goes to universal health coverage?

Thank you for your honest input or direction to where I can obtain answers to them.

-NJC-

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[lane]

from the FAQ thread

5) What is the lifestyle of a practicing anesthesiologist?

Post by Jetproppilot regarding lifestyle, scope of practice, financial issues- one of the most informative posts I've seen from a private practice anesthesiologist:
http://forums.studentdoctor.net/show...0&postcount=19

Thead covering lifestyle issues specifically:
http://forums.studentdoctor.net/showthread.php?t=56048

This thread covers both lifestyle and what it's like to transition from residency to private practice:
http://forums.studentdoctor.net/showthread.php?t=82587

 

[Pilot Doc]

2) How much will the financial reimbursement of the field be damaged as our country goes to universal health coverage?

No one has any idea.

Here's the basics. Anesthesia care is generally billed in units. A typical anesthesiologist bills 10,000 units/yr. Private Insurance will generally pay $50 or so per unit. Medicare pays $21/unit. Practices vary widely in their payer mix - All private to all Medicare to (in most cases) something in between. $40 or so for a blended unit (total revenue/total units) is common.

In the Doomsday scenario, healthcare reform directly or indirectly moves most of the private pay $50 units to medicare $20 units. Gross Revenue falls by 50% and income (revenue - expenses) falls more leading to high five figure salaries for private practice anesthesiologists.

Whether that happens depends on two big questions
1) what actually happens, if anything, in health care reform - particularly how much any new plan leverages Medicare rates.
2) to what extent hospital subsidies increase. Many anesthesia groups are heavily subsidized by hospitals who want their highy profitable OR's to run well even if their patients don't have good anesthesia coverage.

It's easy to construct credible scenarios that range from not much change in income to major changes.

If you want/need high and predictable income, anesthesia has substantial risks. ER is the non-primary care specialty most likely to come out neutral or positive in the transition to a new reimbursement model.

 

[Pilot Doc]

What is the lifestyle like? I have seen varying answers from night time call Q3 to once a month? I want to have a family, and am looking for a field with ample time off

The lifestyle can be anything. It will depend on your income needs and where you are willing to live.

If you are happy with $200K/yr and will move to where the jobs are (both after resideny and when you have kids in 10th, 8th and 5th grades) you can have anything you want.

 

[maceo]

truthfully speaking

there are specialties with much much better lifestyles than anesthesia. The job of an anesthesiologist is STRESSFUL

HOSPITALIST
emergency medicine
radiologist
to name a few

if you are going into anesthesia for lifestyle it aint there. sure, when we go home.. we wont be called about a patient but when we are in the hospital we are working our arses off. even if it looks like we re not working we are working

 

[Bertelman]

truthfully speaking

there are specialties with much much better lifestyles than anesthesia. The job of an anesthesiologist is STRESSFUL

HOSPITALIST
emergency medicine
radiologist
to name a few

if you are going into anesthesia for lifestyle it aint there. sure, when we go home.. we wont be called about a patient but when we are in the hospital we are working our arses off. even if it looks like we re not working we are working

So remember, when you see the gaggle of anesthesia attendings at the front desk showing off the pics of their...
a) recent carribean vacay
b) new girlfriend
c) new Porsche

on their...
a) iPhone
b) Blackberry

while drinking...
a) coffee
b) tea
c) Martini

They are really working their arses off!

 

[DScully]

if you are going into anesthesia for lifestyle it aint there. sure, when we go home.. we wont be called about a patient but when we are in the hospital we are working our arses off. even if it looks like we re not working we are working

Although I am still a MS4 (hence limited experience), I have to totally agree with the above post. When people say they want to do anesthesia because of the lifestyle, I truly believe they should look elsewhere.

I hate people when I tell them I am going into anesthesia and then they say "oh you have a good life style!" People in anesthesia appear laid back, but their day is pretty stressful. They just don't react to stress as other people do.

If you just want an easy lifestyle, choose another field. You'll be too stressed out in anesthesia if you are not genuinely interested in the field.

 

[Pilot Doc]

Lifestyle means different things to different people. If you want controllable, predictable work hours, gas can be a very good choice.

 

[sevoflurane]

I can't see myself doing anything else. Looked at Radiology and Surgery. Not for me. At our hospital, Hospitalist are one week on, one week off. That is pretty cush, but that job to me would be very boring and I would get burned out quickly.

Anesthesia is an awesome specialty. The very definition of anesthesia is very interesting. No other specialty trains you to be able to walk into ANY situation and handle the issues at hand. A partner called me into his room last week. When i got there, the chest was opened and the surgeon was squeezing the heart to try and get a CO. Went onto bypass and fixed the patient. D/C'd three days later. Where else will you see that? My next case was a 2mo. old kiddy with a huge arse submandibular abscess. We had a little laryngospasm, but he did well and went home 48 hours later. As an anesthesiologist you make a difference acutely and long term- you are doing medicine that works right then and there... none of this let's put you on this medication and see how it goes for a couple of weeks.

I think you need to have some inherent qualities to really like it. It is stressful at times, but some people gravitate towards that lifestyle. I like to be challenged intellectually as well as challenged from a procedure point of view.

I enjoy going to work everyday. I start missing work after the 5-6th day of vacation. For me, it is a lifestyle choice. I will always be able to provide for my family and will never wonder if i would have been happier doing something else.

My 2cents.

 

[wmc24]

I can't see myself doing anything else. Looked at Radiology and Surgery. Not for me. At our hospital, Hospitalist are one week on, one week off. That is pretty cush, but that job to me would be very boring and I would get burned out quickly.

Anesthesia is an awesome specialty. The very definition of anesthesia is very interesting. No other specialty trains you to be able to walk into ANY situation and handle the issues at hand. A partner called me into his room last week. When i got there, the chest was opened and the surgeon was squeezing the heart to try and get a CO. Went onto bypass and fixed the patient. D/C'd three days later. Where else will you see that? My next case was a 2mo. old kiddy with a huge arse submandibular abscess. We had a little laryngospasm, but he did well and went home 48 hours later. As an anesthesiologist you make a difference acutely and long term- you are doing medicine that works right then and there... none of this let's put you on this medication and see how it goes for a couple of weeks.

I think you need to have some inherent qualities to really like it. It is stressful at times, but some people gravitate towards that lifestyle. I like to be challenged intellectually as well as challenged from a procedure point of view.

I enjoy going to work everyday. I start missing work after the 5-6th day of vacation. For me, it is a lifestyle choice. I will always be able to provide for my family and will never wonder if i would have been happier doing something else.

My 2cents.

very good post sevo.

 

[cfdavid]

Although I am still a MS4 (hence limited experience), I have to totally agree with the above post. When people say they want to do anesthesia because of the lifestyle, I truly believe they should look elsewhere.

I hate people when I tell them I am going into anesthesia and then they say "oh you have a good life style!" People in anesthesia appear laid back, but their day is pretty stressful. They just don't react to stress as other people do.

If you just want an easy lifestyle, choose another field. You'll be too stressed out in anesthesia if you are not genuinely interested in the field.

In my experience, the gig isn't so bad as long as you're an early bird (or CAN be, as some have more flexible circadian rythms) and don't mind some pressure. Many people thrive in an environment with a bit of pressure and stress.

cf

 

[jl lin]

I can't see myself doing anything else. Looked at Radiology and Surgery. Not for me. At our hospital, Hospitalist are one week on, one week off. That is pretty cush, but that job to me would be very boring and I would get burned out quickly.

Anesthesia is an awesome specialty. The very definition of anesthesia is very interesting. No other specialty trains you to be able to walk into ANY situation and handle the issues at hand. A partner called me into his room last week. When i got there, the chest was opened and the surgeon was squeezing the heart to try and get a CO. Went onto bypass and fixed the patient. D/C'd three days later. Where else will you see that? My next case was a 2mo. old kiddy with a huge arse submandibular abscess. We had a little laryngospasm, but he did well and went home 48 hours later. As an anesthesiologist you make a difference acutely and long term- you are doing medicine that works right then and there... none of this let's put you on this medication and see how it goes for a couple of weeks.

I think you need to have some inherent qualities to really like it. It is stressful at times, but some people gravitate towards that lifestyle. I like to be challenged intellectually as well as challenged from a procedure point of view.

I enjoy going to work everyday. I start missing work after the 5-6th day of vacation. For me, it is a lifestyle choice. I will always be able to provide for my family and will never wonder if i would have been happier doing something else.

My 2cents.

Nice response. One physician friend of mine moved through a couple of residency programs actually before he finally found what stirred his cocktail. It was anesthesiology. As a recovery nurse, I can say that most of my interactions with ologists have been positive. Have to say, at least when I'm working, they are often busting hump--regardless of how many CRNAs are on in support.

To me it presents as a highly demanding role which requires much knowledge and critical thinking and and. . .well. . .what sevo said. Interestingly enough, even most of those in residency or fellowship that I've worked with love it--even if they are busting hump. I can' really remember or think of working with many disgruntled ologists.

 

[ssmallz]

Its kinda funny that you asked those 2 questions as separate ones b/c really they are 2 sides to the same question. The first thing you need to do is figure out which is more important. Then you can figure out the other. There are people in my program who took a job working 5 days/week 7-5 no call no weekends no holidays who are making in the mid 200s, there are other people who are taking call every few nights and working holidays making 400s. There are still others who are semi retired working only 3-4 days/week and I'm sure they take a pay hit for that. The nice thing about anesthesia is that you can find just about any type of job to match the lifestyle you want. The downside is that they all come w/strings attached, I.E. more work for more pay. This may not be true for every location in america but if you truly want one type of job, anesthesia is right for you.

 

[22go]

Depending on your practice model, some of the stress can be the feeling I get of being middle management when trying to cover 4 rooms with 4 CRNAs doing your best to prevent problems and keep the machine running smoothly...

was a little easier to do my own cases as a resident...at least then there was only one sick person at a time to worry about.

but part of the job is to never let them see you sweat...

 

[jl lin]

Depending on your practice model, some of the stress can be the feeling I get of being middle management when trying to cover 4 rooms with 4 CRNAs doing your best to prevent problems and keep the machine running smoothly...

was a little easier to do my own cases as a resident...at least then there was only one sick person at a time to worry about.

but part of the job is to never let them see you sweat...

Yes. I see this and wonder how in the world people think ologists will be replaced by CRNAs. Even a wise CRNA has to admit this. They're foolish in my view if they don't. The accountability load on the ologist is enormous. And honestly, if I were a CRNA (which I've thought about a number of times), I wouldn't be apt to work where there is no direct supervision of an ologist. Yes, having your own license is one thing, but there are problems that get too large and out of control. An example of this:

I hated working in one Open Heart Unit where there was no house thoracic surgeon, surgical resident, or CT surgery fellow on the premises during off hours. It was a nightmare at times--a huge pain in the arse--and in my view too dangerous. I worked there for a year and said screw that. I'm not a surgeon. I can't take the pt back into the OR when he needs to go--and it's beyond my scope of practice and experience to crack his chest at the bedside. BS to that.

22, you might not let them see you sweat, but it's such a demanding field, I am thinking some of you ologists must have the antiperspirant caked on in inches underneat your scrubs.

 

[karizma098]

i can't speak too too much for the lifestyle as i'm still a medical student, but my dad is an anesthesiologist in northwest indiana about 30 miles outside of chicago, and has been running his group for about 10 years. it's an all MD group, everyone brings in between 300 and 450k
( the 2 pain guys make more ), and works about 50 hours a week. post call days are always off, 6 weeks of vacation to start , 8 for partners. call is 1 weekend a month, and 1:10 weekdays. other 3 weekends are off -

i've been working with him since high school - and the job isn't as cush as a radiologist's, but isn't as stressful as an ER or cardiologists.

it's a lot of work, but at the end of the day, most anesthesiologists i've seen are happy with their career. what the future holds, i can't say.

 

[pgg]

isn't as stressful as an ER or cardiologists

That's a bold statement.

 

[karizma098]

That's a bold statement.

once again, just a med student, so that's just based on my experience in the OR and on rounds. this is all relative based on patient load and where you work as well, i'd say.

 

[Dirtball]

Best lifestyle is outside of medicine. Lifestyle and Physician= Oxymoron to me...My Dad was in business. M-F 9-5 , one hour for lunch or more, Office lights out at 5pm. Never , N-E-V-E-R did my Dad work a holiday or weekend. I am >20 yrs out of school. I did 2 years of a FP residency where we ran the house, never saw the call room, worked 1:2 or 1:3. I switched to Anesth after a friend did and I did a 3 year old school residency, no time limits =24 hrs. straight, absent attendings after the first few months, NO teaching, NO board prep lectures etc. I am a solo full time ologist, who hasnt had 2 concurrent weeks off in 15 years (honeymoon), burnt out to a crisp, trying to fund retirement with dwindling cases and reimbursement . I do love what I do , most days at work, as long as I had a good nights sleep. Sorry to smack you down, but this is medicine, not teaching at the local college with tenure. Sorry you guys owe 200-300k to the bank for your education, real sorry. I went to cheap schools and paid off my loans before buying a house or sportscar. My insurance agents and stock broker have great lifestyles.

 

[Coastie]

Best lifestyle is outside of medicine. Lifestyle and Physician= Oxymoron to me...My Dad was in business. M-F 9-5 , one hour for lunch or more, Office lights out at 5pm. Never , N-E-V-E-R did my Dad work a holiday or weekend. I am >20 yrs out of school. I did 2 years of a FP residency where we ran the house, never saw the call room, worked 1:2 or 1:3. I switched to Anesth after a friend did and I did a 3 year old school residency, no time limits =24 hrs. straight, absent attendings after the first few months, NO teaching, NO board prep lectures etc. I am a solo full time ologist, who hasnt had 2 concurrent weeks off in 15 years (honeymoon), burnt out to a crisp, trying to fund retirement with dwindling cases and reimbursement . I do love what I do , most days at work, as long as I had a good nights sleep. Sorry to smack you down, but this is medicine, not teaching at the local college with tenure. Sorry you guys owe 200-300k to the bank for your education, real sorry. I went to cheap schools and paid off my loans before buying a house or sportscar. My insurance agents and stock broker have great lifestyles.

how can you have trouble funding your retirement if you're making 300k+?

Sorry, but sounds like you have made some bad lifestyle choices. No more than 2 weeks off at a time? Something smells off...

 

[karizma098]

Best lifestyle is outside of medicine. Lifestyle and Physician= Oxymoron to me...My Dad was in business. M-F 9-5 , one hour for lunch or more, Office lights out at 5pm. Never , N-E-V-E-R did my Dad work a holiday or weekend. I am >20 yrs out of school. I did 2 years of a FP residency where we ran the house, never saw the call room, worked 1:2 or 1:3. I switched to Anesth after a friend did and I did a 3 year old school residency, no time limits =24 hrs. straight, absent attendings after the first few months, NO teaching, NO board prep lectures etc. I am a solo full time ologist, who hasnt had 2 concurrent weeks off in 15 years (honeymoon), burnt out to a crisp, trying to fund retirement with dwindling cases and reimbursement . I do love what I do , most days at work, as long as I had a good nights sleep. Sorry to smack you down, but this is medicine, not teaching at the local college with tenure. Sorry you guys owe 200-300k to the bank for your education, real sorry. I went to cheap schools and paid off my loans before buying a house or sportscar. My insurance agents and stock broker have great lifestyles.

i have to disagree here. i appreciate your background and hard work - and can understand that's rough where you're coming from, but i'd say your situation is rare. there just isn't very much room in business to make it if you're not a superstar. yes, some lawyers, investment bankers, private business owners, consultants, insurance salesmen, and accountants do very well - but this percentage is overall very low. i have many many friends in these fields and none of them offer the job security medicine does. will we become millionaires and rake in 500k+ a year easily as some exec's and i-bankers do ? never. will we be making less than 200k a year ( like 90% of these other fields? ) , doubtful.

quality of life depends on how often you work - there are jobs out there offering 250k where you can work 9-5 or 7-5 and take minimal call in a variety of medical fields as well. these jobs aren't too easy to come by in business nowadays.

i can't speak for funding retirement, but i'd say thats just something to start day 1 out of residency, isn't it?

all physicians work very hard for their money - we aren't overpaid, but our compensation makes for a good lifestyle. you work as hard you want to. in how many other fields are you guaranteed a salary minimum of 150ishk, and realistically 200k? not too many.

 

[Sergio99]

Hello,

The statistics Pilot Doc and Karizma098 give about workload and income may be true in certain locations, but those locations are difficult to find. Of course anyone would love jobs like the ones they describe! Who wouldn't? But alas, in most desirable locations those jobs are already taken.

Maceo and Dream Machine said it very well:

that "even if it looks like we are not working we are working."

...Don't be fooled. It is a very stressful job...
...If you do not handle stress well, do not go into anesthesiology. You will be miserable...

Dream Machine is right also about the issue of job security, because as an anesthesiologist you don't have an office to the street, where patients can choose you and come to you. No matter how you put it, no matter how carefully crafted is your statement about "private practice," you are not in the same category as other independent practice doctors: you are at the mercy of the surgeons, hospital administrators and hospital politics. That is where Dream Machine's statement comes true. At any time some enterprising colleague may come to your hospital and offer the administration an exclusive contract with sweatshop anesthesiologists that work for pennies on the dollar, and leave you out in the street.

Coastie cannot understand it; he asks,

"how can you have trouble funding your retirement if you're making 300k+?
Sorry, but sounds like you have made some bad lifestyle choices. No more than 2 weeks off at a time? Something smells off..."

The truth of the matter is, very few people are making that kind of money, and "not being able to fund your retirement" describes more than just a few people in our specialty.

Be warned.

 

[karizma098]

Hello,

The statistics Pilot Doc and Karizma098 give about workload and income may be true in certain locations, but those locations are difficult to find. Of course anyone would love jobs like the ones they describe! Who wouldn't? But alas, in most desirable locations those jobs are already taken.

Maceo and Dream Machine said it very well:

Dream Machine is right also about the issue of job security, because as an anesthesiologist you don't have an office to the street, where patients can choose you and come to you. No matter how you put it, no matter how carefully crafted is your statement about "private practice," you are not in the same category as other independent practice doctors: you are at the mercy of the surgeons, hospital administrators and hospital politics. That is where Dream Machine's statement comes true. At any time some enterprising colleague may come to your hospital and offer the administration an exclusive contract with sweatshop anesthesiologists that work for pennies on the dollar, and leave you out in the street.

Coastie cannot understand it; he asks,
The truth of the matter is, very few people are making that kind of money, and "not being able to fund your retirement" describes more than just a few people in our specialty.

Be warned.

once again, i'm a medical student, so i may not be a insightful as others here, but i wholeheartedly disagree. yes, it may be tough to make 300k+ in chicago, new york city, los angeles, san fran, miami, etc, but there are still plenty of other moderately desirable localities where you CAN make this kind of money. as far as 'very few people' making that kind of money, i don't really see where youre coming from. academic attendings at loyola in chicago make 260k + bonus and benefits and stroger make the same - this is on the low end an in academics. you may have to work your tail off to get to 400 - but 300 isn't an absurd number, especially when some crna's pull in 200k.

my girlfriend is a pharmacist and pulls in close to 130k working 40 hours a week in chicago, working for walgreens. my best friend is a hospitalist at central dupage hospital and makes 210k for a 35 hour work week with no calls.

honestly, i know reimbursements are going down - but being able to fund retirement or make 300k/year shouldn't be an unattainable goal in this field.

 

[cfdavid]

i have to disagree here. i appreciate your background and hard work - and can understand that's rough where you're coming from, but i'd say your situation is rare. there just isn't very much room in business to make it if you're not a superstar. yes, some lawyers, investment bankers, private business owners, consultants, insurance salesmen, and accountants do very well - but this percentage is overall very low. i have many many friends in these fields and none of them offer the job security medicine does. will we become millionaires and rake in 500k+ a year easily as some exec's and i-bankers do ? never. will we be making less than 200k a year ( like 90% of these other fields? ) , doubtful.

quality of life depends on how often you work - there are jobs out there offering 250k where you can work 9-5 or 7-5 and take minimal call in a variety of medical fields as well. these jobs aren't too easy to come by in business nowadays.

i can't speak for funding retirement, but i'd say thats just something to start day 1 out of residency, isn't it?

all physicians work very hard for their money - we aren't overpaid, but our compensation makes for a good lifestyle. you work as hard you want to. in how many other fields are you guaranteed a salary minimum of 150ishk, and realistically 200k? not too many.

I agree with the bold. You can even live reasonably comfortably (if you live well within your means) as a non-superstar, but the pressures that everyday businesses are under are enormous. This is coming to us also, but from what I've witnessed, most doctors are clueless as to the real economic realities of the corporate (or small business) world. Again, this ruthless pursuit of the bottom line is going to come to medicine, one way or another.

Regarding hours, 9-5 is dead if you want to make anything greater than like 50k/yr..... Good luck with that one, unless you're already an established partner in a successful firm. But, otherwise.... Come on man.

I love it when everyone talks about "Investment Banking". Sure, they can make huge sums of cash. But, this is less than 1% of everyone that graduates with a business degree (preferably accounting, finance, or economics). Then, you better have LORs, very well respected internships at large firms (with LORs from them too), ace the GMAT, and cross your fingers that you get into a TOP business school. I'm sure there are exceptions, but this is what I see from my cousin and his pals. And they put in hours that FAR exceed 60-70/wk.

IMO, there are simply very few jobs (if any) that both pay well, and DON'T require a good bit of sacrifice. That's why you need to enjoy what you do. Because, you'll be doing a lot of it. The future will make this even more relevant.

cf

 

[Coastie]

Coastie cannot understand it; he asks,
The truth of the matter is, very few people are making that kind of money, and "not being able to fund your retirement" describes more than just a few people in our specialty.

Be warned.

Dude, are you kidding me? 300k jobs are definitely doable within our specialty. VA guys make 250k plus bennies to start for 1:1 CRNA coverage and 4 days a week of work, with full retirement. Perhaps you should find one of these jobs!

 

[Coastie]

1. good pay (300k+)
2. good location (major US city: e.g., sports teams, airport, etc.)
3. good lifestyle (<55 hrs/week or <1call/week)

You will inevitably sacrifice at least one for the other two.

While I would agree with this most of the time, there are definitely exceptions. I've seen it in graduating seniors from last year and this year at my program.

 

[amyl]

What city?

Where I live, graduating seniors can't find any jobs within city limits, let alone one with good pay and lifestyle.

seems like there are some isolated saturated markets... good old supply and demand... what city are you in dream?

 

[Coastie]

What city?

Where I live, graduating seniors can't find any jobs within city limits, let alone one with good pay and lifestyle.

Miami
NYC
Charlotte

 

[Coastie]

seems like there are some isolated saturated markets... good old supply and demand... what city are you in dream?

f-ville?

 

[Jeff05]

seems like there are some isolated saturated markets... good old supply and demand... what city are you in dream?

all desirable metropolitan markets are now saturated. NO ONE is retiring. there are very few credible partnership track positions in these markets - and if they exist they are LONG.

as far as business - i think that if one can do well in medical school and residency, one can CERTAINLY destroy the GMAT, which is mostly high school level stuff (i have GMAT books on my shelf from a different time) and (if you're not socially retarted) do well in the business environment (shmooze and drink).

i think people with the intellect and drive that is adequate to succeed in medicine (not JUST get by) would rise to the top percentiles of banking. the hours are certainly not 9-5, but they're not 30 hour ICU shifts either. or 24 hour in house calls.

 

[Narcotized]

.

 

[Coastie]

5-7 year partner tracks? sounds like hotlanta is the new long island, except snooki wears pearls and is an ex-sorority girl from auburn.

What state is f***ville in??

I think Atlanta has taken over the anesthesia title of f***ville as far as opportunities are concerned, unless of course you are into 5-7 year partner tracks with nothing guaranteed at the end of that slashed pay increased call journey.

 

[karizma098]

I agree with the bold. You can even live reasonably comfortably (if you live well within your means) as a non-superstar, but the pressures that everyday businesses are under are enormous. This is coming to us also, but from what I've witnessed, most doctors are clueless as to the real economic realities of the corporate (or small business) world. Again, this ruthless pursuit of the bottom line is going to come to medicine, one way or another.

Regarding hours, 9-5 is dead if you want to make anything greater than like 50k/yr..... Good luck with that one, unless you're already an established partner in a successful firm. But, otherwise.... Come on man.

I love it when everyone talks about "Investment Banking". Sure, they can make huge sums of cash. But, this is less than 1% of everyone that graduates with a business degree (preferably accounting, finance, or economics). Then, you better have LORs, very well respected internships at large firms (with LORs from them too), ace the GMAT, and cross your fingers that you get into a TOP business school. I'm sure there are exceptions, but this is what I see from my cousin and his pals. And they put in hours that FAR exceed 60-70/wk.

IMO, there are simply very few jobs (if any) that both pay well, and DON'T require a good bit of sacrifice. That's why you need to enjoy what you do. Because, you'll be doing a lot of it. The future will make this even more relevant.

cf

i agree with just about everything you've got to say - if someone does medicine just for the money ( and unfortunately, there are still plenty of people who do ), they will be miserable, because that low- call, low stress lifestyle with tons of money is gone -

however, i stand by my point that you can work a lot less hours in this field and still do fairly well financially. there are plenty of chicago hospitals that are willing to hire you on a 9-5 basis if you are willing to take a paycut down to the 175-200k price arena.....( but how many anesthesiologists should and would do that? )...you're right, there is no way you can get close to that on a 9-5 doing anything non-healthcare related, imho.

1. good pay (300k+)
2. good location (major US city: e.g., sports teams, airport, etc.)
3. good lifestyle (<55 hrs/week or <1call/week)

You will inevitably sacrifice at least one for the other two.

i wholeheartedly agree with this post - but what's your definition of a 'good location'. i know nyc and socal , boston and florida are completely off limits -i was at stroger earlier today and the attending was telling me they're having trouble getting senior residents to come back as attendings next year at a salary of 260k-280, normal call schedule and most days at 7-4.

my old man had to search for months to get a general anesthesiologist to sign into his MD only group for 325k for a very moderate workload ( about 35 miles from chicago ). a similar grup in our area is hiring CRNA's for ~180k (plus bonus).

i know a lot less people are retiring - the economy sucks and has sucked for a while now, and will probably continue to suck. salaries and jobs will be harder to get for a while, but eventually docs will have to retire.

one more thing - the money is SO relative. even if you do find a job in los angeles paying 350k - that's probably equivalent to making 400-450k in chicago with the cost of living out there. making 350 in nyc , you might as well be making 500 in chicago.

in the job market , i'm not saying our profession is winning big right now, but we sure as heck aren't losing.

 

[Dirtball]

DO you folks know what the starting salary was for us in 1996 ? Ask some elders..It may happen again... .............BTW , my retirement is pretty well funded , I own my farm , racecar, toys etc.. I just feel anyone assuming they can control their medical practice to give them a great "lifestyle" has alot to learn. Most of my generation is burnt to a Crisp.

 

[DScully]

DO you folks know what the starting salary was for us in 1996 ? Ask some elders..It may happen again...Most of my generation is burnt to a Crisp.

So if that's the case, do you have any recommendations / suggestions for us?

I know that I won't make much during residency, but I am just wondering if there are things I should avoid / pursue to make sure I don't have to struggle too much in the future...at least financially.

 

[cfdavid]

DO you folks know what the starting salary was for us in 1996 ? Ask some elders..It may happen again... .............BTW , my retirement is pretty well funded , I own my farm , racecar, toys etc.. I just feel anyone assuming they can control their medical practice to give them a great "lifestyle" has alot to learn. Most of my generation is burnt to a Crisp.

I appreciate the insight, but who isn't generally burnt out after a long, hard career?

My gf's father is a partner in a law firm. When I ask if he enjoys what he does, she states "yeah, but he's getting burnt out". My dad is a small business owner. Guess what?? He's pretty burnt out. I just don't think medicine has a monopoly on burn out the way many seem to suggest.

As an aside, I personally feel that andropause is a way underdiagnosed medical problem. I wonder how much of this burn out is due to markedly decreased testosterone in men over 45-50 (and beyond ofcourse)?? Less energy, stamina, drive...... Perhaps an out of whack T/E ratio??

I'm not saying this is the cause of burn out, but how many "mid-life" crises might be avoided if only the older dude DIDN'T blame his lack of desire or energy on his "old lady", thereby supplementing the old lady for someone 20 yrs his junior and a sports car???

Could there be something to this? I'm not sure, but it seems plausible.

cf

 

[Bertelman]

I appreciate the insight, but who isn't generally burnt out after a long, hard career?

My gf's father is a partner in a law firm. When I ask if he enjoys what he does, she states "yeah, but he's getting burnt out". My dad is a small business owner. Guess what?? He's pretty burnt out. I just don't think medicine has a monopoly on burn out the way many seem to suggest.

 

[karizma098]

I appreciate the insight, but who isn't generally burnt out after a long, hard career?

My gf's father is a partner in a law firm. When I ask if he enjoys what he does, she states "yeah, but he's getting burnt out". My dad is a small business owner. Guess what?? He's pretty burnt out. I just don't think medicine has a monopoly on burn out the way many seem to suggest.

As an aside, I personally feel that andropause is a way underdiagnosed medical problem. I wonder how much of this burn out is due to markedly decreased testosterone in men over 45-50 (and beyond ofcourse)?? Less energy, stamina, drive...... Perhaps an out of whack T/E ratio??

I'm not saying this is the cause of burn out, but how many "mid-life" crises might be avoided if only the older dude DIDN'T blame his lack of desire or energy on his "old lady", thereby supplementing the old lady for someone 20 yrs his junior and a sports car???

Could there be something to this? I'm not sure, but it seems plausible.

cf

give me 20 years of the anesthesia salary some of these guys have seen and i'd be happy to be 'burned out' like they are by the time i'm 50, haha.

 

[Narcotized]

As an aside, I personally feel that andropause is a way underdiagnosed medical problem. I wonder how much of this burn out is due to markedly decreased testosterone in men over 45-50 (and beyond ofcourse)?? Less energy, stamina, drive...... Perhaps an out of whack T/E ratio??

I'm not saying this is the cause of burn out, but how many "mid-life" crises might be avoided if only the older dude DIDN'T blame his lack of desire or energy on his "old lady", thereby supplementing the old lady for someone 20 yrs his junior and a sports car???

cf

Well, there is something to be said for someone 20 years younger sparking a little increased desire.

And I think the growing trend of male hormone replacement therapy will only increase this phenomenon and not decrease it.

 

[cfdavid]

Well, there is something to be said for someone 20 years younger sparking a little increased desire.

And I think the growing trend of male hormone replacement therapy will only increase this phenomenon and not decrease it.

Perhaps. Perhaps....

I'll post a separate link on HRT in a new thread. Found an interesting study.

cf

 

[DScully]

As an aside, I personally feel that andropause is a way underdiagnosed medical problem. I wonder how much of this burn out is due to markedly decreased testosterone in men over 45-50 (and beyond ofcourse)?? Less energy, stamina, drive...... Perhaps an out of whack T/E ratio??

Totally agreed with the above. I rotated through urology x 1 month during third year and you won't believe how much better people feel after being put on HRT.

 

[cfdavid]

Totally agreed with the above. I rotated through urology x 1 month during third year and you won't believe how much better people feel after being put on HRT.

I'm sure. What did you put them on? T-propionate?

The problem with HRT seems to be lack of real knowledge, even amongst professionals (whom only do that as part of a practice). What I mean is, how many are following estrogen (boost the T and some will get aromatized away, for sure), and even the T/E ration. How about SHBG? Afterall, it's the free-T that matters.

It just seems like putting some T-gel on a dudes obese belly is asking for aromatization. Aromatase tends to like adipose tissue.....

Not sure, but I'd want to follow all of the above, and if an aromatase inhibitor (small dose of Arimidex) is warranted, so be it. Just not sure how many practitioners are doing all that.

cf

 

[Camel]

Another problem that has been hypothesized is with some of the "extreme" statin therapy, the lack of cholesterol substrate has led to an increase in the incidence of testosterone deficiency. A few of the primary care physicians that I have worked with, and one of the cardiologists, cited this problem.

 

[bronx43]

all desirable metropolitan markets are now saturated. NO ONE is retiring. there are very few credible partnership track positions in these markets - and if they exist they are LONG.

as far as business - i think that if one can do well in medical school and residency, one can CERTAINLY destroy the GMAT, which is mostly high school level stuff (i have GMAT books on my shelf from a different time) and (if you're not socially retarted) do well in the business environment (shmooze and drink).

i think people with the intellect and drive that is adequate to succeed in medicine (not JUST get by) would rise to the top percentiles of banking. the hours are certainly not 9-5, but they're not 30 hour ICU shifts either. or 24 hour in house calls.

I absolutely hate it when physicians or medical students repeat this tripe. The idea that anyone who can keep a reasonable GPA, and squeek out a 30 on the MCAT can make 300k in the "business" world (quotation marks due to the general lack of understanding of the term by members of the medical community) is just laughable.
To start out, maybe only 10% of medical students would even have a chance at the lucrative paths in business - investment banking, hedges, PE shops, trading, or even consulting. I don't know if anyone has actually tried to apply to GS or Citi, but you don't just drop your resume off at a local branch and ask for a position in their leverage finance group. Their recruiting process is pretty exclusive, and unless you went to a top 20-30 university with a recognizably large BBA program, you're gonna have to pull some crazy shiz out of your ass to even get an interview.
Then for the actual work - I've never heard of a single investment banker under the principal position to work 50-60 hours a week. Analysts and associates are pulling 80-90 hr weeks, and 100-120 on a deadline. As much as medical professionals can bitch about their lifestyle, any banker, PE or HF guy would take your hours in a heartbeat.
The truth of the matter is that unless you went to a prestigious undergraduate institution or were incredibly smart or lucky, your best bet for making 300k is in medicine.

 

[cfdavid]

I absolutely hate it when physicians or medical students repeat this tripe. The idea that anyone who can keep a reasonable GPA, and squeek out a 30 on the MCAT can make 300k in the "business" world (quotation marks due to the general lack of understanding of the term by members of the medical community) is just laughable.
To start out, maybe only 10% of medical students would even have a chance at the lucrative paths in business - investment banking, hedges, PE shops, trading, or even consulting. I don't know if anyone has actually tried to apply to GS or Citi, but you don't just drop your resume off at a local branch and ask for a position in their leverage finance group. Their recruiting process is pretty exclusive, and unless you went to a top 20-30 university with a recognizably large BBA program, you're gonna have to pull some crazy shiz out of your ass to even get an interview.
Then for the actual work - I've never heard of a single investment banker under the principal position to work 50-60 hours a week. Analysts and associates are pulling 80-90 hr weeks, and 100-120 on a deadline. As much as medical professionals can bitch about their lifestyle, any banker, PE or HF guy would take your hours in a heartbeat.
The truth of the matter is that unless you went to a prestigious undergraduate institution or were incredibly smart or lucky, your best bet for making 300k is in medicine.

I agree.

Also, it's absolutely not uncommon for associate-level dudes to "sleep" at the office on said deadlines. So, medicine isn't the only field with 30 hour shifts etc.

 

[karizma098]

i absolutely agree with bronx.

to make it in the business world with the 300k+ figures you've got to be a genius, incredibly ambitious, or have rich, well connected parents.

you can be an average physician ( not saying average intelligence, but average for a physician ) and make 300k in medicine pretty easily, in most states.

if you're a go getter , a genius, or a trailblazer, you can make much more.

 

[Arch Guillotti]

i absolutely agree with bronx.

to make it in the business world with the 300k+ figures you've got to be a genius, incredibly ambitious, or have rich, well connected parents.

you can be an average physician ( not saying average intelligence, but average for a physician ) and make 300k in medicine pretty easily, in most states.

if you're a go getter , a genius, or a trailblazer, you can make much more.

Making 300K in medicine ain't that easy. It is sad but a number of primary care salaries (as well as other fields) don't make near this amount.

 

[DScully]

Making 300K in medicine ain't that easy.

After reading this thread and talking to other people, this is what I think. Nothing is easy if you want to make 300K. You have to sacrifice one thing or another and you cannot have everything in life. Pick the fight you want to fight and stop looking elsewhere.

"If we all threw our problems in a pile and saw everyone else's, we'd grab ours back." - Regina Brett

 

[Pilot Doc]

Making 300K in medicine ain't that easy. .

True. The difference I see b/w business and medicine is that if you want to make $300K, once you get your step I score back, many people have a clear, 99% success rate path to making that money for 30 years should they choose to take it. Very few other $10million opps like that for a 24 year old.

 

[bronx43]

Making 300K in medicine ain't that easy. It is sad but a number of primary care salaries (as well as other fields) don't make near this amount.

For any reasonably intelligent person, who didn't go to a top national university (a majority of medical students), medicine is the easiest (if not the only) option for making 300k. That was my point.