How long does it take the doctor to catch up to the janitor?

[UniBoy5]

Ever heard of the question "does the doctor ever catch up to the janitor?". It's been asked because a janitor, given he/she starts work right after HS (or even before if a dropout), can 8 or more years of income and never had to pay any money for tuition. Don't get me wrong... I am not going into medicine just for the money - I enjoy physiology, would like a challenge in life, and would feel honoured in healing people.

We all know the answer to this question. In the end, doctors are more well-off - they have better houses , cars, hotter wives , etc.. But a better question to ask is, how long would it generally take for a doctor, given their massive debt in tuition, to level with a janitor in income? 5 years? So would I need to wait until my 30s to start seeing real benefits from my income? Is life this unfair?

Would appreciate your input, even if you think I am a money-hungry slimeball and only want to use my resources to pimp.

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[DrYoda]

But a better question to ask is, how long would it generally take for a doctor, given their massive debt in tuition, to level with a janitor in income?

.
It's going to vary widely depending on debt, time in residency/fellowship and attending-level income.

So would I need to wait until my 30s to start seeing real benefits from my income?

Yes, even if you go HS->college->med school with no gap years you won't be making much until your 30's.

 

[gmreed2]

Average physician first year salary is $125,000 (primary care) with an average medical debt of $154,600. The median janitor salary is $24,350 which accumulates to be $194,800 over 8 years (while the doc is in college and med school).

Now we obviously can't do exact math because of income taxes, insurance, mortgage, and other costs. But it appears that they should level out at around the 3 year mark after the physician starts actually making money.

 

[UniBoy5]

Average physician first year salary is $125,000 (primary care) with an average medical debt of $154,600. The median janitor salary is $24,350 which accumulates to be $194,800 over 8 years (while the doc is in college and med school).

Now we obviously can't do exact math because of income taxes, insurance, mortgage, and other costs. But it appears that they should level out at around the 3 year mark after the physician starts actually making money.

This is why I asked the question... too lazy to do the math. Thanks for doing it for me.

 

[Law2Doc]

Average physician first year salary is $125,000 (primary care) with an average medical debt of $154,600. The median janitor salary is $24,350 which accumulates to be $194,800 over 8 years (while the doc is in college and med school).

Now we obviously can't do exact math because of income taxes, insurance, mortgage, and other costs. But it appears that they should level out at around the 3 year mark after the physician starts actually making money.

First, the janitor's salary accumulates to more than your suggested $195k because money received earlier is worth more in any financial calculation -- the "time value of money" concept has to be worked into any such calculation, you cannot merely add up 8 years. $1 received today is worth a lot more than $1 received 10 years from now -- it's a basic finance concept, something they teach folks the fist day of business school, and is something anyone who graduates college really should know. Second, the physician will not earn six digits for another 3-7 years after med school -- you need to complete a residency for virtually any medical field in order to practice (which is paid more than the janitor's salary, but not absurdly more (something in the $40k range). Third, you skipped the most important part -- the physician is going to acumulate perhaps $300k in debt during college and med school, on which interest is going to grow over the years. So I'd say that the physician overtakes the janitor well into his 30s, (assuming starts med school at 21, graduates at 25, completes a 4 year residency at 29, and only then starts earning 6 digits and starts paying on his rapidly growing debt), which is what the OP postulated.

 

[randombetch]

First, the janitor's salary accumulates to more than your suggested $195k because money received earlier is worth more in any financial calculation -- the "time value of money" concept has to be worked into any such calculation, you cannot merely add up 8 years. $1 received today is worth a lot more than $1 received 10 years from now -- it's a basic finance concept, something they teach folks the fist day of business school, and is something anyone who graduates college really should know. Second, the physician will not earn six digits for another 3-7 years after med school -- you need to complete a residency for virtually any medical field in order to practice (which is paid more than the janitor's salary, but not absurdly more (something in the $40k range). Third, you skipped the most important part -- the physician is going to acumulate perhaps $300k in debt during college and med school, on which interest is going to grow over the years. So I'd say that the physician overtakes the janitor well into his 30s, (assuming starts med school at 21, graduates at 25, completes a 4 year residency at 29, and only then starts earning 6 digits and starts paying on his rapidly growing debt), which is what the OP postulated.

There we go 👍

 

[Sjs1234]

Ever heard of the question "does the doctor ever catch up to the janitor?". It's been asked because a janitor, given he/she starts work right after HS (or even before if a dropout), can 8 or more years of income and never had to pay any money for tuition. Don't get me wrong... I am not going into medicine just for the money - I enjoy physiology, would like a challenge in life, and would feel honoured in healing people.

We all know the answer to this question. In the end, doctors are more well-off - they have better houses , cars, hotter wives , etc.. But a better question to ask is, how long would it generally take for a doctor, given their massive debt in tuition, to level with a janitor in income? 5 years? So would I need to wait until my 30s to start seeing real benefits from my income? Is life this unfair?

Would appreciate your input, even if you think I am a money-hungry slimeball and only want to use my resources to pimp.

How can you call this unfair? Anyone, with no skills can be a janitor and do a very mundane and boring job and make little money. It makes sense that to make alot of money you need to put in alot of time and money for the training. You are acquiring a set of skills from medical school which you will use. Its not like the janitor sweeping floors making $100k...THAT would be unfair

 

[JJMrK]

Average physician first year salary is $125,000 (primary care) with an average medical debt of $154,600. The median janitor salary is $24,350 which accumulates to be $194,800 over 8 years (while the doc is in college and med school).

Now we obviously can't do exact math because of income taxes, insurance, mortgage, and other costs. But it appears that they should level out at around the 3 year mark after the physician starts actually making money.

Add another 3-5 years in there for a residency.

 

[searun]

There is a flaw in your thinking. Doctors' wives, or for that matter, doctors' spouses, male or female, are not that hot. I have seen them up close and personal. Most of them are pretty dumpy, definitely no supermodels. If you think that going to med school will guarantee you a sexual superstar, as a partner, buddy, you might just a well go to law school. It is alot cheaper and alot faster.

 

[jvesco22]

in b4

"become a plumber...they make bank"

 

[teenmachinery1]

http://www.er-doctor.com/doctor_income.html

 

[DrBowtie]

There is a flaw in your thinking. Doctors' wives, or for that matter, doctors' spouses, male or female, are not that hot. I have seen them up close and personal. Most of them are pretty dumpy, definitely no supermodels. If you think that going to med school will guarantee you a sexual superstar, as a partner, buddy, you might just a well go to law school. It is alot cheaper and alot faster.

That is usually the 1st wife. The one who was with them during school and residency.
The 2nd wife is always a looker.

 

[Bernoull]

That is usually the 1st wife. The one who was with them during school and residency.
The 2nd wife is always a looker.

Excellent point!!!😀😀😀 There's a strong correlation between number of 0s in the bank and hotness of wife... Therefore marry only after residency!!

 

[circulus vitios]

That UPS graph is bull**** just fyi.

 

[Bernoull]

http://www.er-doctor.com/doctor_income.html

😱😱😱 Is UPS hiring??

 

[Iso4ane]

http://www.er-doctor.com/doctor_income.html

So doctors catch up when they're 45. Look at the slope of that red line by the time doctors are ready for retirement they got a lot more money than and UPS driver. More than 3million more if your extrapolate the lines.

 

[teenmachinery1]

That UPS graph is bull**** just fyi.

is this just a feeling or would you like to make a useful post?

 

[randombetch]

http://www.er-doctor.com/doctor_income.html

Most (80%) of doctors do not work 60 hours a week. The ones that do make much, much more than $180k a year. Also, what undergrad works 80 hours a week? What med student works 80 hours a week?

 

[armybound]

imo the point when physicians get "ahead" is when they have more purchasing power, which is as soon as residency is over, or possibly even in residency.

sure they owe a lot of money, but the loan payment is relatively low in terms of their income

 

[apumic]

Most (80%) of doctors do not work 60 hours a week. The ones that do make much, much more than $180k a year.

Where do you come up w that? I'd argue most physicians do work at least ~60 hrs/wk. Sure, FPs often don't but to make $180k+ is likely to require a specialty that works that (in most cases). Remember that you don't stop working when you go home as a physician. 😉

 

[Narmerguy]

That UPS graph is bull**** just fyi.

Yah. Firstly, the debt doesn't go lower than around $100,000.

 

[teenmachinery1]

Yah. Firstly, the debt doesn't go lower than around $100,000.

true 👍

 

[randombetch]

Where do you come up w that? I'd argue most physicians do work at least ~60 hrs/wk. Sure, FPs often don't but to make $180k+ is likely to require a specialty that works that (in most cases). Remember that you don't stop working when you go home as a physician. 😉

http://www.biomedcentral.com/1472-6963/9/166
Table 2, p<0.0001

 

[apumic]

http://www.biomedcentral.com/1472-6963/9/166
Table 2, p<0.0001

Fair enough. It might be revealing to see a bit of a breakdown as to what is contained in each category. The fact that 27% of physicians are working <40 hrs is probably inflated by the number of women who enter medicine and then stop cut down their practices to <30 hrs/wk. Those women generally make <$100k (I recall seeing a figure around $60-70k). I would also wonder who that 41-50 hrs (28%) is.

My previous statement of 60 hrs being typical was a bit high, but the following list of specialties shows that one would expect the average physician to work >50 hrs:

 

[randombetch]

Fair enough. It might be revealing to see a bit of a breakdown as to what is contained in each category. The fact that 27% of physicians are working <40 hrs is probably inflated by the number of women who enter medicine and then stop cut down their practices to <30 hrs/wk. Those women generally make <$100k (I recall seeing a figure around $60-70k). I would also wonder who that 41-50 hrs (28%) is.

My previous statement of 60 hrs being typical was a bit high, but the following list of specialties shows that one would expect the average physician to work >50 hrs:

Haha, yeah I saw that too. I was wondering - if anesthesiologists have such a controllable lifestyle, why do they work 61 hours a week?! Do they really want to make that much money or what?

 

[circulus vitios]

is this just a feeling or would you like to make a useful post?

You don't just "start off" as a UPS driver. You start off loading package or picking orders in a sorting room for like 5-10 years. The pay definitely doesn't start at $60,000 a year because it's a union job. There's a lot of training and other bureaucracy to cut through before you can drive a truck because everyone wants to drive a truck. You can't simply work "MD like hours." What the hell kind of job is going to give you 20+ hours of overtime a week, every week for 20+ years?

 

[sustentacular]

That is usually the 1st wife. The one who was with them during school and residency.
The 2nd wife is always a looker.

Don't forget that by the time you're on to that second wife you're giving half your salary to wife #1. 😉

 

[Eggs n Coffee]

Don't forget that by the time you're on to that second wife you're giving half your salary to wife #1. 😉

and your weiner might not work anymore..

and your kids will hate you.

🙁

 

[bigal40]

First, the janitor's salary accumulates to more than your suggested $195k because money received earlier is worth more in any financial calculation -- the "time value of money" concept has to be worked into any such calculation, you cannot merely add up 8 years. $1 received today is worth a lot more than $1 received 10 years from now -- it's a basic finance concept, something they teach folks the fist day of business school, and is something anyone who graduates college really should know. Second, the physician will not earn six digits for another 3-7 years after med school -- you need to complete a residency for virtually any medical field in order to practice (which is paid more than the janitor's salary, but not absurdly more (something in the $40k range). Third, you skipped the most important part -- the physician is going to acumulate perhaps $300k in debt during college and med school, on which interest is going to grow over the years. So I'd say that the physician overtakes the janitor well into his 30s, (assuming starts med school at 21, graduates at 25, completes a 4 year residency at 29, and only then starts earning 6 digits and starts paying on his rapidly growing debt), which is what the OP postulated.

Your time value of money argument is only valid if the janitor is able to save the money he makes. Since he is making $25k/year he will probably be spending everything he makes.

You're right about the residency time thing - but his calculation isn't too far off.

Third where did you come up with the avg doctor having $300k in debt, the actual number is about $150k.

Like other people have said - although the total income might not overtake the janitor for several years, the doctor has about the same purchasing power as the janitor right after med school (in residency) and 4 years later has many times more purchasing power.

 

[randombetch]

Your time value of money argument is only valid if the janitor is able to save the money he makes. Since he is making $25k/year he will probably be spending everything he makes.

You're right about the residency time thing - but his calculation isn't too far off.

Third where did you come up with the avg doctor having $300k in debt, the actual number is about $150k.

Like other people have said - although the total income might not overtake the janitor for several years, the doctor has about the same purchasing power as the janitor right after med school (in residency) and 4 years later has many times more purchasing power.

Present value of money is valid regardless of whether he saves or not. $25k in 1990 is always going to be worth more than $25k in 2010 with any non-zero interest rate.

And no, the doctor does not have the same purchasing power as the janitor right after med school. If they're in the same time period, they have the same purchasing power. (http://en.wikipedia.org/wiki/Purchasing_power)

Maybe you meant to say that the doctor will be able to take out greater loans to pay for things? I suppose that's true. The average doctor also has had family members contribute to his/her education though.

 

[lrkoehle]

Third where did you come up with the avg doctor having $300k in debt, the actual number is about $150k.

Interest. Where are you getting your interest free loans? Also, L2D specifically added in undergrad loans as well, which many (most?) of us have. Oh, this is also probably assuming you don't start paying off loans until after residency during which interest is certainly accruing.

 

[scapermoya]

Haha, yeah I saw that too. I was wondering - if anesthesiologists have such a controllable lifestyle, why do they work 61 hours a week?! Do they really want to make that much money or what?

i don't think controllable is referring to the number of hours. it refers to the flexibility of schedules, vacation, call, etc.

 

[RevMD]

Haha, yeah I saw that too. I was wondering - if anesthesiologists have such a controllable lifestyle, why do they work 61 hours a week?! Do they really want to make that much money or what?

Blame the shortage of anesthesiologists. If someone has to work more hours to keep their job while making a lot of money, it usually is because they are the among the only few in their hospital that is qualified to administer anesthetics.

Your time value of money argument is only valid if the janitor is able to save the money he makes. Since he is making $25k/year he will probably be spending everything he makes.

You're right about the residency time thing - but his calculation isn't too far off.

Third where did you come up with the avg doctor having $300k in debt, the actual number is about $150k.

Like other people have said - although the total income might not overtake the janitor for several years, the doctor has about the same purchasing power as the janitor right after med school (in residency) and 4 years later has many times more purchasing power.

Spot on analysis. There are just too many spending vs saving variables that need to be accounted for. But, no matter how you look at the number, all physicians or specialists will beat the janitor within 5 years of licensed practice after residency/fellowship.

Interest. Where are you getting your interest free loans? Also, L2D specifically added in undergrad loans as well, which many (most?) of us have. Oh, this is also probably assuming you don't start paying off loans until after residency during which interest is certainly accruing.

$154,607 to be exact [AMA]. This figure is pretty realistic for the following logic. First, most families who can afford to send their students to med schools are usually middle class and the parents make sufficient income to have been saving money for their kids college for years. This college savings money ends up getting splurged by the end of undergrad. I am willing to bet most med school students end up who foresee taking loans eventually usually go to a instate public school to reduce costs and make their savings last. Even if you went to a private top school, chances are you got at least some aid from the school and parents were still capable of supporting your expenses at least until the end of undergrad. So once the savings are gone, most parents are willing to support for maybe the first or second year of med school. After that, the student is left to pick up the tab the rest of the way until they start earning around $50k during residency years. Coincidently, this is the exact situation I will be in.

But I will also point out the figure above is based on the amount of debt at the time of graduating from med school. You still need to account for the interest that will be tacked on during the typical 3-4 year residency. So the figure will be closer to $200K by the end of residency assuming you don't start paying off the loan at all. I would like to know whether you would use your residency income to keep the interest in check, or pay bare minimum until you start earning six figures as a full time physician?

 

[bigal40]

I would like to know whether you would use your residency income to keep the interest in check, or pay bare minimum until you start earning six figures as a full time physician?

For me - I'll probably be paying off as much of my loans as I can. I don't think you have much free time during residency to spend alot of money anyway.

 

[link2swim06]

This graph does not make sense, you normally must work at UPS for many years before you can apply to become a driver.

Second, UPS drivers are paid very very well, you might as well be comparing an accountant with a physician.

 

[Narmerguy]

Spot on analysis. There are just too many spending vs saving variables that need to be accounted for. But, no matter how you look at the number, all physicians or specialists will beat the janitor within 5 years of licensed practice after residency/fellowship.
?

Actually no it's not. Money has a time value. To illustrate this, if I offered most people $20,000 today or $100,000 in 10 years (with the reasonable expectation that they will be paid), most people would agree to accept the $20,000 now. In finance (or economics or whatever have you) money now is usually worth a lot more than money later even before concepts like interests and savings are taken into consideration.

 

[Iso4ane]

Actually no it's not. Money has a time value. To illustrate this, if I offered most people $20,000 today or $100,000 in 10 years (with the reasonable expectation that they will be paid), most people would agree to accept the $20,000 now. In finance (or economics or whatever have you) money now is usually worth a lot more than money later even before concepts like interests and savings are taken into consideration.

Those people are probably the same people who if you offer 5 million dollars toady or a penny today and doubling it everyday (2,4,8,16...)thereafter for a month, would be the ones who would still take the 5 million dollars.

Btw if you did the penny deal, if there were 30 days in that month you would make over 20 millon dollars, if 31 days over 40 million dollars, and if you were unlucky and got this in Feb with only 28 days you would still get a bit over 5 millon dollars.

 

[Law2Doc]

Those people are probably the same people who if you offer 5 million dollars toady or a penny today and doubling it everyday (2,4,8,16...)thereafter for a month, would be the ones who would still take the 5 million dollars.

Btw if you did the penny deal, if there were 30 days in that month you would make over 20 millon dollars, if 31 days over 40 million dollars, and if you were unlucky and got this in Feb with only 28 days you would still get a bit over 5 millon dollars.

Totally different concept. The time value of money is what lets lotteries pay a lump sum vs an annuity over time. Because there is a time value to money received earlier, the lottery knows it is paying out the EXACT same amount financially either way, be it the $200k lump sum or the $1,000,000 paid over X years. They are the same value -- it doesn't really matter which one you pick, at least not to the company offering it. Meaning they either give you $200k or they dump that same $200k into an annuity instrument that pays off the million to you over time. Still is the same because differing amounts of money paid at different points in a time line can actually be equivalent when adjusted for present value. It's a basic finance concept, and one that if you don't know probably can result in shrewd people taking advantage of you.
So no, we aren't talking about people not understanding exponential growth. We are talking about people not understanding the time value of money -- totally unrelated concepts, although you can probably take advantage of the naive with either.

 

[ChiDO]

Those people are probably the same people who if you offer 5 million dollars toady or a penny today and doubling it everyday (2,4,8,16...)thereafter for a month, would be the ones who would still take the 5 million dollars.

Btw if you did the penny deal, if there were 30 days in that month you would make over 20 millon dollars, if 31 days over 40 million dollars, and if you were unlucky and got this in Feb with only 28 days you would still get a bit over 5 millon dollars.

I think you did your math wrong, unless I messed it up, but, if you double the penny on day one, after 30 days you will have 5 million.

 

[Law2Doc]

Haha, yeah I saw that too. I was wondering - if anesthesiologists have such a controllable lifestyle, why do they work 61 hours a week?! Do they really want to make that much money or what?

As mentioned, controllable is a murky term in this table. Anesthesiologists tend to average in the 60 hour range, as to quite a few other specialties. I'd actually suggest that the majority of specialties are going to average between 55 and 65 hours/week, probably a bit more for the median since those number may include folks who have reduced schedules due to parenting needs and all the "semi-retired" older docs.

Also bear in mind that the table is not very current, and since reimbursements tend to have decreased in all of these fields, the hours generally have increased to keep the annual incomes in the same ballpark. It's pretty common for folks to be working 70-90 hours/week at the early attending stage, even in the nonsurgical fields. This is a profession where folks work very hard.

 

[ijn]

First, the janitor's salary accumulates to more than your suggested $195k because money received earlier is worth more in any financial calculation -- the "time value of money" concept has to be worked into any such calculation, you cannot merely add up 8 years. $1 received today is worth a lot more than $1 received 10 years from now -- it's a basic finance concept, something they teach folks the fist day of business school, and is something anyone who graduates college really should know. Second, the physician will not earn six digits for another 3-7 years after med school -- you need to complete a residency for virtually any medical field in order to practice (which is paid more than the janitor's salary, but not absurdly more (something in the $40k range). Third, you skipped the most important part -- the physician is going to acumulate perhaps $300k in debt during college and med school, on which interest is going to grow over the years. So I'd say that the physician overtakes the janitor well into his 30s, (assuming starts med school at 21, graduates at 25, completes a 4 year residency at 29, and only then starts earning 6 digits and starts paying on his rapidly growing debt), which is what the OP postulated.

Except that janitor is just as likely to be deep in debt, have children, and is more likely to get laid off or be forced into part time, etc.
😉

 

[DrYoda]

Except that janitor is just as likely to be deep in debt, have children, and is more likely to get laid off or be forced into part time, etc.
😉

Any debt the janitor has is probably secured by some kind of asset which, makes it much easier to get rid of if you fall on hard times. And I doubt someone with a sub 50k income is going to be 300k in the hole (especially unsecured), unless it's a resident.😉

 

[redsquareblack]

Actually no it's not. Money has a time value. To illustrate this, if I offered most people $20,000 today or $100,000 in 10 years (with the reasonable expectation that they will be paid), most people would agree to accept the $20,000 now. In finance (or economics or whatever have you) money now is usually worth a lot more than money later even before concepts like interests and savings are taken into consideration.

Narmer, first of all, I think you misunderstand the concept of the time value of money. The "time value", as I understand it, is the value of a given amount of money some time in the future, if that money is saved at a given interest rate. "A bird in the hand is worth two in the bush" seems to be more what you're getting at, but they're not the same thing.

But that aside, considering how long it takes for a physician to "catch up" to a janitor isn't particularly useful except for SDN posts about physician compensation. It's just not a very meaningful measure, because even though, on average, a physician won't "catch up" to the janitor until his/her mid-30's in terms of lifetime earnings (to use an earlier calculation), he or she will have roughly the same or better purchasing power right out of med school, and be able to start shopping for lakefront property pretty much right out of residency, something the janitor may never, ever be able to do.

 

[jvesco22]

This thread is a joke and it's amazing how some of you guys are actually spending so much time on your responses.

You want to be a janitor? Go be a janitor
You want to be a UPS Driver? Go be a UPS Driver

If not, then give it a rest and get a life...

 

[45408]

Gotta read this thread later...

 

[UniBoy5]

Gotta read this thread later...

Most useless post EVER.

 

[Narmerguy]

Narmer, first of all, I think you misunderstand the concept of the time value of money. The "time value", as I understand it, is the value of a given amount of money some time in the future, if that money is saved at a given interest rate. "A bird in the hand is worth two in the bush" seems to be more what you're getting at, but they're not the same thing.

Ok, forgive me if I am using the wrong terminology. I don't so much care if we call this "time value" or any other name. It is the concept I'm getting at. My mistake.

 

[RevMD]

Actually no it's not. Money has a time value. To illustrate this, if I offered most people $20,000 today or $100,000 in 10 years (with the reasonable expectation that they will be paid), most people would agree to accept the $20,000 now. In finance (or economics or whatever have you) money now is usually worth a lot more than money later even before concepts like interests and savings are taken into consideration.

Really? If I had a choice between getting $20K now or $100K in 10 years, I would pick the 100K. Here's why. Unless you know are an investing wiz, you need to make at least 18% annual ROI by reinvesting the $20K for 10 years straight in proper financial instruments just to get past the 100K mark. Realistically, this feat is nearly impossible even for the top investors on wall street and the amount of effort/time put into achieving this is costly.

The whole point of time value is to determine what you could make from the money by getting it upfront as opposed to getting paid later. So, the way I see it, a physician still wins out in the long run.

 

[johncalvin]

How about someone just do a series of NPV calculations for both salaries for years 5-25. Somewhere in the middle, the NPVs will equal each other...

In fact, if someone wants to give me a theoretical salary (year after year) for both the janitor and the physician, I will do this myself.

 

[RevMD]

How about someone just do a series of NPV calculations for both salaries for years 5-25. Somewhere in the middle, the NPVs will equal each other...

In fact, if someone wants to give me a theoretical salary (year after year) for both the janitor and the physician, I will do this myself.

Just go to salary.com and look up the average pay for both professions. If you really want to make it accurate, take into account typical 3% inflation-based pay raise each year and figure out proper income tax brackets. This will at least represent how much money actually makes into pocket before other expenses. Use $150K as average debt for a med school graduate and assume the janitor does not have any.